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Biomedical subjects

George K B Sàndor

Publications and source records attributed to George K B Sàndor.

14 recordsLinked to original sources
PubMed2006

Performance of six bone collectors designed for dental implant surgery.

OBJECTIVES: The aim of this study was to perform an in vitro comparison of six bone collectors for harvesting of particulate bone. MATERIAL AND METHODS: Four commercially available bone collectors (Frios, Osseous Coagulum Trap, ACE Autografter, Bone Trap) and two custom-designed models were tested. Three different in vitro tests were performed to determine the harvesting capabilities of the collectors. In test I, a bovine mandible was drilled and the bone collectors were used to collect bone chips. The harvested bone volumes and dry weights were measured after harvesting. In test II, three dental implant sites were prepared in a bovine mandible. The bones from the implant osteotomies were collected, and bone volumes and dry weights were measured. In test III, 1 ml of bone chips was mixed with water, and suctioned through the bone collectors. The volumes of the bone chips retained were measured to determine the efficiency of each collector. RESULTS: The Osseous Coagulum Trap and the custom-made collectors were the most effective instruments in test I. The mean volumes ranged from 0.17 to 0.38 ml. In test II, the difference between the collectors was small and the bone volume ranged from 0.28 to 0.37 ml. In test III, the Bone Trap became blocked before the other collectors, and its bone procurement was therefore limited. CONCLUSION: Comparison of six different bone collectors in this in vitro study showed that all collectors are usable in clinical situations but their effectiveness varies.

Animals↗
PubMed2004

Self-reinforced bioresorbable poly-L/DL-lactide [SR-P(L/DL)LA] 70/30 miniplates and miniscrews are reliable for fixation of anterior mandibular fractures: a pilot study.

OBJECTIVE: Bioresorbable osteofixation devices are being increasingly used in orthognathic surgery and in cases of trauma to avoid problems associated with conventional metal osteofixation devices. The aim of this clinical study was to assess the reliability and efficacy of bioresorbable self-reinforced poly-L/DL-lactide (SR-P(L/DL)LA 70/30) plates and screws in the fixation of mandibular fractures in adults. STUDY DESIGN: Ten patients (20 to 49 years old) with isolated anterior mandibular parasymphyseal fractures were treated by means of open reduction and internal fixation using SR-P(L/DL)LA 70/30 bioresorbable plates and screws. RESULTS: During the minimum of 6 months of follow-up, no problems were encountered except for 1 case where a plate became exposed intraorally and infected. This required debridement and later excision of the exposed part of the plate. Despite this setback the fractured bone healed well. CONCLUSIONS: SR-P(L/DL)LA 70/30 plates and screws are reliable for internal fixation of anterior mandibular fractures in adults. Proper soft tissue coverage should be ensured to avoid plate exposure. Should implant exposure occur, it might be necessary to excise the exposed part after fracture healing (6-8 weeks postoperatively).

Absorbable Implants↗
PubMed2003

Augmentation of the narrow traumatized anterior alveolar ridge to facilitate dental implant placement.

Traumatic tooth loss leads to alveolar resorption especially in sagittal direction. This can be due to avulsion of bone substance during the accident itself or due to resorption of the alveolar crest that takes place afterwards. Shortage of bone can prevent proper positioning of dental implants unless the volume of bone is increased before implantation. In the maxillary anterior area, this is also an esthetic problem. Several treatment modalities have been presented to augment the bone. This report reviews the latest literature on bone grafting, bone substitutes, guided bone regeneration, osteocompression and distraction which are potentially useful in the anterior maxilla. A special emphasis is paid to the versatility of using a crestal split osteotomy, by means of chisels and osteotomes to widen the narrow ridge. Three examples are illustrated showing onlay grafting, preservation of alveolar width with alloplastic coral material and lateral widening of a narrow maxillary alveolar ridge, using the crestal splitting technique.

Adult↗
PubMed2003

Preservation of ridge dimensions following grafting with coral granules of 48 post-traumatic and post-extraction dento-alveolar defects.

This prospective clinical analysis reports on the use of coral granules in alveolar ridge preservation procedures in a population of young, growing patients. The sample consisted of 21 patients, 12 females and 9 males, with a mean age of 13.6 years. These 21 patients had 48 dento-alveolar defects suitable for augmentation with coral granules, and were followed clinically and radiographically for 3-7 years after augmentation. There were two areas of augmentation: 17 defects in the anterior maxilla resulted from traumatic tooth loss, and 31 defects in the posterior maxilla and mandible resulted from the extraction of ankylosed retained primary molars with no permanent succedaneous teeth. Between 1-2 ml of coral granules were implanted into the alveolar bone defects left by the extraction of teeth in both the areas. This was in order to preserve the remaining edentulous ridge from further alveolar ridge resorption. The goal of the procedure was to preserve the alveolus so that in the future, a dental implant could be placed to replace the missing tooth, after jaw growth had stopped, without the need for a bone graft. The coral granules appeared to be totally replaced by the host bone on follow-up clinical and radiographic examinations. The two areas of the jaws behaved quite differently. In the anterior maxilla, where tooth loss was secondary to trauma, the coral granules restored the alveolar ridges temporarily. However, over the years of follow-up in this study, the coral granules failed to provide sufficient bone to support the placement of a dental implant without using a bone graft in 14 of the 17 defects or 82.4% of sites. In the posterior maxilla and mandible, where tooth loss was due to the elective removal of ankylosed primary molars, 29 of the 31 defects or 93.5% of sites were successful as they were able to support the placement of an osseo-integrated dental implant without the use of a bone graft. The alveolar sparing technique was more successful in maintaining an alveolar ridge sufficient for the placement of a dental implant without bone grafting in the posterior maxilla and mandible, where tooth loss was secondary to the elective removal of ankylosed deciduous molars than in the anterior maxilla, where tooth loss was secondary to trauma. Coral granules seem to be more suitable in the posterior maxilla and mandible where there were ankylosed deciduous teeth and congenitally absent permanent teeth than in the traumatized anterior maxilla. In successful sites, coral granules can spare the alveolus from residual ridge atrophy or resorption, obviating the need for a bone graft. This reduces patient morbidity, as a second surgical donor site is avoided because bone graft harvesting is made unnecessary.

Adolescent↗
PubMed2003

Clinical success in harvesting autogenous bone using a minimally invasive trephine.

PURPOSE: Autogenous bone grafting is well established for use in the maxillofacial skeleton. We present our experience with minimally invasive bone harvesting using a power-driven trephine, with favorable patient and clinical results. MATERIALS AND METHODS: This retrospective study evaluation patients requiring autogenous bone harvested using a trephine, treated consecutively over a 3-year period. Mean patient age was 27.2 years (range, 8 to 77 years). Only those patients requiring elective surgery and admission on the same day were included in the study. Intraoperative assessment included the description of complications and the quantity and volume of the bone cores harvested. The complications monitored included bleeding, nerve injury, and perforation of the medial or lateral walls of the ilium. Postoperatively, patients were assessed for ambulation, pain, bleeding, and suitability for discharge. The patients were evaluated 1 week after surgery and were examined for wound complications (incision breakdown, infection, paresthesia, pain) and ambulatory deficits. All patients were then surveyed using a questionnaire outlining short-term (1 to 14 days), and long-term (>6 months postoperative) deficits, pain, and general remarks about the procedure. RESULTS: A total of 84 patients underwent bone harvesting using a power-driven trephine. Bone was harvested from a total of 86 anterior iliac crest sites, for a total of 333 cores (3.96 cores per patient). Forty-one patients were discharged on the day of surgery. Intraoperatively, the volume of bone obtained ranged from 3 to 21 mL per harvest site (1 to 7 cores, 4 mm x 30 to 38 mm). The bone volume obtained was dependent on the size of the defect to be filled. Intraoperatively, 1 complication occurred (1 of 333 cores; 0.3%)-a broken instrument-and there were no perforations of the medial or lateral walls of the ilium or excessive bleeding. The complications totaled 3 (3.6%); none of these produced long term effects. Patients surveyed up to 6 months postoperatively noted positive results. CONCLUSIONS: The harvesting of bone from the anterior iliac crest using a power driven trephine appears to be safe and results in minimal morbidity and ample bone volume for many maxillofacial procedures, without delaying discharge from hospital.

Adolescent↗
PubMed2003

Comparison of conventional surgery with motorized trephine in bone harvest from the anterior iliac crest.

OBJECTIVE: A prospective study was performed to compare morbidity associated with the harvest of corticocancellous block grafts (CCBG) by conventional surgery and procurement of cancellous cores (CC) by means of a motorized trephine from the anterior ilium. STUDY DESIGN: Seventy-six patients requiring 30 mL or less of cancellous bone for maxillofacial reconstruction were placed into 2 treatment groups. One group underwent harvest of CCBGs in the traditional open medial approach to the anterior ilium. The second group had CCs harvested through a 0.5- to 1.0-cm incision with a motor-driven trephine. The following parameters were used to evaluate patient morbidity: number of days to unassisted ambulation, length of hospital stay, and pain scores for both the recipient and the donor sites. RESULTS: The mean time to patients' unassisted ambulation following a CCBG was significantly longer (2.8 days) than following CC (0.8 days). The mean length of hospital stay following a CCBG was significantly longer (4.1 days) than following a CC (2.2 days). The mean contemporaneous maxillofacial pain scores following procurement of CCs (day 1: 5.6; day 3: 4.2) and procurement of CCBGs (day 1: 5.8; day 3: 4.5) were not significantly different, whereas the mean hip pain was significantly greater (P <.05) on day 1 in patients having undergone a CCBG (pain score: 6.2) than in patients having undergone a CC graft (pain score: 3.0). Gait disturbance was identified in 15 of 22 patients (68%) who underwent a CCBG. Only 1 of the 54 patients (1.9%) who underwent a CC graft exhibited an abnormal gait. No other complications were noted. The results demonstrated a significant difference in morbidity between the 2 techniques in all variables. CONCLUSION: Where modest amounts of cancellous bone are required for maxillofacial grafting, trephining of cancellous cores results in significantly less morbidity than traditional open methods.

Adolescent↗
PubMed2003

Dental erosion in gastroesophageal reflux disease.

Dentists are often the first health care professionals to diagnose dental erosion in patients with gastroesophageal reflux disease (GERD). Gastroesophageal reflux (GER) is the passage of gastric contents into the esophagus, and GERD is defined as symptoms or complications of GER. Twenty-four-hour monitoring of esophageal pH is helpful in diagnosing GERD. Treatment of dental erosion resulting from GERD involves a multidisciplinary approach among family physician, dentist, prosthodontist, orthodontist and gastroenterologist. When possible, dental erosion should be treated with minimal intervention, and such treatment should include control of microflora, remineralization, adhesive restorations and use of biomimetic materials.

Dental Restoration, Permanent↗
PubMed2002

Nitrous oxide-oxygen or oral midazolam for pediatric outpatient sedation.

OBJECTIVE: A total of 1112 pediatric outpatient sedations, by either nitrous oxide-oxygen inhalation (N2O) or oral midazolam, administered over a 10-year period were reviewed. Patient responses and outcomes were evaluated to ascertain the safety of these sedation techniques. STUDY DESIGN: A total of 819 patients were included in this study. Patient health status, age, weight, behavior, treatment rendered, and length of treatment were recorded. Vital signs (heart rate, blood pressure, oxygen saturation) were recorded for the N2O group. Complications and successful completion of treatment were also noted. RESULTS: Both the N2O and midazolam groups demonstrated a low complication rate with a high rate of successful completion of treatment. Patients receiving N2O were somewhat older on average and underwent a greater number of surgical procedures than patients in the midazolam group. Vital signs recorded in the N2O group were observed to remain stable throughout treatment. CONCLUSIONS: The use of either oral midazolam or nitrous oxide-oxygen as single agents provides safe and effective conscious sedation in the pediatric outpatient population.

Administration, Oral↗
PubMed2002

Management of traumatic dislocation of the mandibular condyle into the middle cranial fossa.

Dislocation of the mandibular condyle into the middle cranial fossa is a rare complication of facial trauma that can have neurological and life-threatening implications. This article discusses the anatomic features that predispose patients to this type of injury, as well as the clinical features and mechanism of injury for this rare type of condylar deformity, to help practitioners recognize this easily overlooked injury and avoid disastrous complications. The article summarizes previously published case reports of this rare complication of condylar trauma and presents a case for which initial diagnosis and a management protocol are described.

Bicycling↗
PubMedDate not supplied

Differences in the location and multiplicity of mandibular fractures in Kuwait, Canada and Finland during the 1990s.

OBJECTIVE: To compare the location and multiplicity of mandibular fractures in Kuwait, Canada and Finland during the 1990s. SUBJECTS AND METHODS: Data were collected from several hospitals in Kuwait (1991-2000), Toronto General Hospital in Canada (1995-2000) and Oulu University Hospital in Finland (1990-1999). The data were analyzed statistically using chi-square test, ANOVA, t test and logistic regression. RESULTS: Condylar fractures were more common in Finnish patients (41%) than Canadian (35%) or Kuwaiti patients (21%). Condylar fractures caused by falls were about 3.4 times more common in Kuwait and Finland compared to Canada. In Finland the risk of road traffic accidents caused by condylar fracture was about 4 times higher than those caused by other etiologies. In Canada male gender was about 2 times higher for the condylar fracture than female gender. Female patients often had more multiple injuries than men in all three countries and multiple fractures were observed especially in traumas caused by falling. CONCLUSION: Differences in location and multiplicity of mandibular fractures are due to differences in etiologies and demographic patterns.

Accidental Falls↗
PubMedDate not supplied

Zygomatic bone: an additional donor site for alveolar bone reconstruction. Technical note.

This article describes a procedure to harvest bone from the zygoma for alveolar bone reconstruction. A detailed description of the bone harvesting procedure and a preliminary report of 3 patients undergoing alveolar bone reconstruction and simultaneous dental implant placement in the maxillary anterior area is presented. The technique is indicated when a modest amount of bone is needed, for example, to cover exposed implant threads and expand a narrow alveolar ridge. It also could be used as an additional source of bone with other intraoral donor sites. Surgical access to the zygoma is simple and can be performed using local anesthesia. Postoperative complications after zygomatic bone harvest are minimal.

Adult↗
PubMedDate not supplied

Safety of zygomatic bone harvesting: a prospective study of 32 consecutive patients with simultaneous zygomatic bone grafting and 1-stage implant placement.

PURPOSE: The purpose of this prospective study was to evaluate the safety of zygomatic bone harvesting and to determine whether a particulated zygomatic bone graft can be used simultaneously with 1-stage dental implants to reconstruct resorbed edentulous alveolar ridges. MATERIALS AND METHODS: Altogether, 82 dental implants were placed in 32 patients. Particulated bone grafts harvested from the zygomatic process were used in 72 of the implant sites. The volume of bone harvested, intraoperative complications, morbidity, and complications on follow-up visits were recorded. Implant survival was examined prospectively. RESULTS: As a harvest site, the zygoma yielded enough bone to complete the reconstructions in each case. The average zygomatic bone graft volume was 0.90 mL (SD 0.30). Perforation of the maxillary sinus occurred at 11 zygomatic sites. None of these perforations led to postoperative problems. No paresthesias or other complications were noted during follow-up examinations. Mean duration of postoperative swelling was 4.5 days, and patients used pain medication for a mean duration of 4 days. After the mean follow-up period of 26.9 months postplacement, 80 of 82 implants were osseointegrated (survival rate 97.6%). DISCUSSION: [corrected] Zygomatic bone is an alternative donor site for bone harvesting with low morbidity. The bone graft yielded is sufficient for use in 2 to 3 implant sites. CONCLUSIONS: The zygoma was a safe intraoral bone harvesting donor site in this patient population. Further, the use of simultaneous particulated zygomatic bone grafts and 1-stage implant placement appears to be an effective procedure.

Adolescent↗