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Biomedical subjects

D E Tolman

Publications and source records attributed to D E Tolman.

At least 19 recordsLinked to original sources
PubMed1992

Tissue-integrated prosthesis complications.

Over a 78-month period from 1983 to 1990 at the Mayo Clinic, 353 patients involving 407 jaws were restored with 1,778 Brånemark system implants supporting prostheses. Complications involved loss of implant anchorage, soft tissue problems, or mechanical problems. The most predominant complication involved soft tissues. There were 152 patients with loaded prostheses who had no complications and 37 with only one occurrence. Those seen in 160 patients with more than one occurrence were all conservatively managed, so that prosthesis use was only permanently discontinued in 4 patients, who returned to the use of a maxillary complete denture.

Adolescent↗
PubMed1992

Mandibular ridge augmentation with simultaneous onlay iliac bone graft and endosseous implants: a preliminary report.

Mandibular onlay composite grafts (autogenous iliac bone and titanium cylindrical threaded endosseous dental implants) were placed in seven patients with advanced bone resorption. All seven patients have experienced uncomplicated healing and continuous, uninterrupted prosthesis use without soft tissue or mechanical complications for 1 to 4 years. This preliminary report includes a discussion of the indications for the procedure, potential alternative management of the severely resorbed mandible, and details of the surgical procedure illustrated by two patients who received this treatment modality.

Alveolar Bone Loss↗
PubMed1991

Extraoral application of osseointegrated implants.

The use of osseointegrated implants to provide support for craniofacial prostheses has provided the clinician with another approach to the treatment of complex craniofacial reconstructive problems. The surgical technique is reviewed and the Mayo Clinic experience is presented.

Adhesives↗
PubMed1991

Management of mandibular fractures in patients with endosseous implants.

Seven patients who had previously received mandibular endosseous implants sustained mandibular fractures and were treated. Three patients had advanced bone resorption and developed stress fractures through previous endosseous implant sites. Two patients sustained fractures through implant sites via trauma. Two patients sustained fractures anatomically separated from the implants, which caused an alteration in the dental occlusion. This report describes the treatment approach for these seven patients and reviews the treatment philosophy and procedures involved. A conservative treatment approach is advised when the fracture transverses through a stable or a recently failed implant site.

Accidental Falls↗
PubMed1991

Endosseous implant placement immediately following dental extraction and alveoloplasty: preliminary report with 6-year follow-up.

The philosophy of retaining natural teeth as long as possible for the preservation of alveolar bone has been a fundamental concept of dental treatment. With the introduction of predictable osseointegrated implant-supported prostheses, placement of an implant immediately after dental extraction can be considered. This paper discusses the technique of implant placement immediately following dental extraction. Clinical experience including 61 patients with follow-up of 1 to 6 years is reported.

Alveolar Bone Loss↗
PubMed1986

Dental implants: tissue-integrated prosthesis utilizing the osseointegration concept.

As an alternative to conventional removable dentures, osseointegrated dental implants can now be used in carefully selected edentulous or partially edentulous patients. The implant consists of a dental prosthesis and an anchorage unit made up of screw-connected components. The implantation procedure is performed in two phases: fixture installation and fixture uncovering and abutment connection. After completion of these surgical procedures, the dental prosthesis is fabricated and inserted. Follow-up examinations are scheduled at 1, 3, and 6 months and then annually thereafter. During a 2-year period at the Mayo Clinic, 358 osseointegrated dental fixtures were implanted in 70 patients. The overall success rate in this consecutive series of patients was 98%, and the associated complications were minimal and easily resolved.

Aged↗
PubMed1986

A new method for fixation of external prostheses.

As more extensive craniofacial resections for recurrent orbital and nasoethmoidal carcinoma are performed, the need for complex external prostheses increases. A new method of stabilization for large prostheses using osseointegrated implants is presented. This is illustrated in a typical patient who underwent a large naso-orbital maxillary resection for recurrent basal cell carcinoma.

Basal Cell Carcinoma↗
PubMed1978

Keratocysts of the jaw. Clinicopathologic study of 79 patients.

A study of 79 patients with keratocysts of the jaws revealed that 72% of the cysts were in the mandible, predominantly in the ramus. The most common symptom was a painful swelling in the jaw. Enucleation was used in 69.2% of the cases. The recurrence rate was 39%. Total removal of the lining of the keratocyst is essential to prevent recurrence.

Adolescent↗
PubMed1976

The use of methylmethacrylate in the fixation of mandibular fractures in dogs. Experimental results.

The efficacy of self-curing acrylic resin in the fixation of fractured mandibles was studied in eight adult mongrel dogs. Three dogs were killed at 1 month, two at 3 months, and three at 6 months after insertion of the resin. Roentgenograms taken after operation and after the dogs had been put to death demonstrated satisfactory fracture reduction and bony healing. The retentive grooves appeared larger on the postmortem roentgenograms, apparently from fibrous tissue that formed between the acrylic resin and the bone. Sections through the groove and fracture site did not show any fibrocartilage formation between the bone and the resin. Active osteoblastic activity was present at the fibrous capsule-bone interface as well as in the fracture calluses. Most sections showed acute inflammation, with a few giant cells. Whether the inflammatory component resulted from tissue breakdown over the acrylic resin or from the polymethylmethacrylate itself was not determined. There was no evidence of abnormal healing or nonunion along the fracture line and no evidence of necrotic bone. The undecalcified tetracycline-labeled sections confirmed active bone formation at the fibrous capsule-bone interface and in the fracture calluses at 1, 3, and 6 months. No mobility could be detected across the fracture site at any time after the insertion of the acrylic resin. Two of the three dogs that were killed at 1 month had incomplete bony union, as demonstrated by mobility along the fracture line seen in the resected specimens. Mucosal dehiscence over the superior acrylic fixation bar was a consistent finding. Once the resin had been either exfoliated or removed, the mucosa healed uneventfully. The insertion of methylmethacrylate did not result in blood pressure change in the dogs. The dogs maintained their preoperative weight, appetite, and jaw mobility. Although satisfactory bony healing resulted from the intraoral open reduction and fixation with self-curing acrylic resin in dogs, several factors need additional investigation before this technique can be considered for use in human subjects. The following findings in this study may contribute to healing complications in man: (1) loosening of the acrylic resin due to fibrous tissue formation between it and the bone, (2) mucosal dehiscence, (3) inflammation in and around the fibrous tissue adjacent to the acrylic resin, and (4) the necessity of bone removal to facilitate the insertion of the resin.

Animals↗
PubMed1975

An experimental study of autoclaved autogenous mandible in combination with cancellous bone and marrow.

Results of a study in eight dogs indicate that a combination of cancellous bone and marrow contained within autoclaved bone can produce a successful graft. Four implants failed because of breakdown of the oral mucosa and exposure of the graft; rejection may have been the cause of the breakdown in one instance. Although most of the factors that caused exposure of the grafts probably could be controlled in a clinical situation, the technique cannot be recommended without reservation.

Animals↗
PubMed1973

Case 1, Part 1.

Explore the source record for details and available documents.

Child↗