Biomedical subjects
Publications and source records attributed to E P Shaber.
Recent advances in the field of biomatrix porous implant technology has stirred the interest of the oral and maxillofacial surgical community. One such material (Medpor), is a biocompatible, large-pore, high-density polyethylene implant which has proven both experimentally and clinically to fulfil the criterion for maxillofacial reconstructive and aesthetic surgical grafting.
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Clinical disease states encountered in the acquired immunodeficiency syndrome (AIDS) have been reviewed with an emphasis on oral Kaposi's sarcoma. The disease is reaching epidemic proportions among homosexual males and is characterized by onset of fever, malaise, diarrhea, and lymphadenopathy. Subsequent to these initial nonspecific signs and symptoms, patients develop a variety of opportunistic infections or Kaposi's sarcoma (or both). The oral lesions of Kaposi's sarcoma are characterized by red, blue, or purple plaques or nodules encountered primarily, yet not exclusively on the palate. Other oral manifestations of AIDS include candidiasis and herpetic stomatitis. Epidemiologic studies suggest the probability of a transmissible agent, perhaps a virus. It is recommended that dental care should be rendered to these patients, using mask and gloves with autoclave sterilization of all instruments.
Many questions remain to be answered. The intention here is to attempt to place in perspective a portion of what is known and understood scientifically, to make working sense of the pathophysiologic process so that we as clinicians can "in our mind's eye" understand what it is that we are trying to treat with what now seems to be a multitude of therapies. When a patient presents to your office with acute or chronic, or both, myofascial pain dysfunction syndrome, some basic questions must be addressed. Is the disease process genetic (intrinsic) or acquired (extrinsic), or both? It is the purpose of diagnosis to unearth the underlying predispositions that patients may exhibit. Often the predispositions are quite obvious (gross postural discrepancies and skeletal and dental malrelationships( or they may be consummately subtle (endocrinopathies and behavioral patterns). It seems that the main job to be completed is diagnosis followed by the utilization of well-known physical medicine (conservative) techniques that treat the source of the disorder: the myofascial trigger zone.
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A concept for the treatment of trigeminal neuralgia is presented. On the basis of distinctive pain patterns, localized areas of pathosis within the jawbones are detected and obilterated. To date, we have treated eight patients with idiopathic trigeminal neuralgia. All patients have experienced total or near total abatement of pain.
The indications for an anterior approach are lesions located predominantly in the body of the vertebra or intervertebral disks. Among these are spondylolisthesis, tuberculosis of the spine, prolapsed intervertebral disks, neoplasms, spinal biopsies, correction of fixed spinal curves, fractures, and fracture dislocations of the spine. Despite many indications, this approach is rarely used, primarily because of unfamiliarity with the surgical field, instrumentation, and oral microbiota. Use of appropriate disciplines and consultations enabled this patient to receive comprehensive treatment from a community of health care specialists.