[Results of operative treatment of squamous cell cancers of the mouth and oropharynx with and without additional postoperative therapy].
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Biomedical subjects
Publications and source records attributed to E Fischer-Brandies.
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30 pre- and postoperative lateral cephalograms of patients with mandibular prognathism are used to evaluate the soft tissue profile prognosis given by the "dentofacial planner". As a result, the horizontal displacement of SLS (sulcus labrale superius) and Pg' (soft tissue pogion) in patients with a normal vertical dimension and additional LMF (labiomental fold) in persons with a marked overbite are calculated well. The horizontal changes of the other points analyzed as well as all vertical changes are not predicted satisfactorily in the momentary version 4.22 A (febr. 1989), which will be improved by the company.
Due to its mechanical properties circonia is an interesting implantation material. However, it may contain a certain amount of radioactive isotopes. The measurement of alpha-emission reveals varying amounts of radiation. As a result, a declaration of radioactivity should be required for circonia implants and only circonia with low emission levels should be used for implantation purposes.
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The importance of preoperative digital subtraction angiography (DSA) in revascularized tissue transfer in the maxillofacial area is demonstrated on the basis of 53 flaps: In 7 cases DSA revealed results which influenced the therapeutic procedure. Compared to conventional methods of vascular diagnosis, DSA has considerable advantages.
For the prediction of profile changes following orthodontic treatment the computer program "Dentofacial Planner" (DFP) which bases on cephalometric measurements is available. The object of this study is to analyse the precision of the DFP version 4.22 A (release Feb. 89). The material of the study consists of the lateral cephalograms of 33 patients treated for maxillary incisor protrusion. In order to evaluate the ensuing profile changes certain cephalometric parameters are measured pre- and post-therapeutically. They are compared to the values predicted by the DFP. Statistical analysis yields the following results: 1. Clinically acceptable precision was found for seven of the 20 cephalometric parameters. 2. In two of the six parameters stated to be stationary by the DFP notable changes were found in reality. 3. The most accurate prognosis was made for the upper lip profile; the least precision was found for the lower lip. According to the manufacturer the results of this study will be included in alternations of the DFP program so as to achieve improvements in the criticized areas.
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After 4 years of routine application of hydroxylapatite ridge augmentation 109 patients underwent a posttreatment examination. The quality of the alveolar ridge and the denture as well as the functional status of the craniomandibular system were evaluated in detail. For the maxilla good results were obtained in 80-90%, for the mandible in 70-80%. Further improvements seem more probable by the avoidance of prosthodontic faults and the elimination of functional disturbances than by additional surgical procedures such as vestibuloplasty.
Research work using easily resorbable HA- und TCP-ceramics does not give any proof for pathologic deposition in different organs. Based on current information, there is no objection against the clinical use of HA-ceramics.
The already known surgical interventions for absolute induction of extensive mandibular atrophy, cannot be suggested as routine standardized methods. Use of Hydroxylapatite-ceramic for restoration of the atrophic alveolar process, shows several advantages; among those, simplicity of the operation use of local anesthesia, as well as very low percentage of unsuccessful interventions are taken into consideration. The clinical results of 102 cases are shown and discussed. Through the addition of H.A. ceramic in the field of preprosthetic surgery, there is a broadening of the spectrum of the therapeutic possibilities of patients with prosthetic problems to be expected.
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Evaluation of the clinical charts of 86 patients with polytrauma, accompanied by fractures of the facial skull, and reexamination of 48 of these patients showed that with adequate therapy the concomitant lacerations do not influence the results of orofacial treatment. The complexity of the anatomical structures and of their functions necessitates early, differentiated, and interdisciplinary treatment. The special aspects and problems are presented and discussed.
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In spite of advances in radiation therapy of malignant tumours, osteoradionecrosis cannot always be prevented. This form of therapy causes problems particularly in reconstruction of the mandible. Seven cases are presented, and the advantages of microsurgically revascularized tissue transfer (over other methods of treatment) are pointed out and discussed.
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