Biomedical subjects
Publications and source records attributed to H D Edmondson.
A case is reported of acute facial swelling following tooth extraction that failed to respond in a normal manner. The patient developed systemic signs and symptoms ultimately revealing the diagnosis of lupus erythematosus. The possibility of soft tissue lesions arising in some forms of lupus is emphasised by this report.
A procedure is described for reconstructing the body, angle and ascending ramus of the mandible using split autogenous bone grafts from the iliac crest. These compound grafts have been monitored using clinical, radiological and radio-isotope scanning techniques which demonstrated early revascularisation and consolidation. The healing pattern is similar to that of one-piece cortico-cancellous grafts. Good functional and aesthetic results have been obtained, and two patients are presented to illustrate the procedure and the features of remodelling of the bone grafts.
Button wiring has been used as an alternative to eyelet wiring in the Department of Oral and Dental Surgery of Birmingham General Hospital since 1977. This clinical update reviews 65 patients with mandibular fractures in which button wires were utilised in their treatment.
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Radionucleotide scanning is now accepted as a reliable method of visualising the metabolic activity of the skeletal system. Its application to the maxillo-facial region is reviewed, and its possible role in monitoring the healing of bone grafts is discussed. The radio-isotope 99m technetium-methylene diphosphonate was used to study the revascularisation and healing of large autogenous bone grafts to the mandible in eight patients. The scans demonstrated the dynamic activity in the grafts and showed varying patterns in different types of grafts.
A study is presented which was designed to compare Solpadeine (paracetamol 500 mg, codeine phosphate 8 mg and caffeine 30 mg) and soluble DNP (dextropropoxyphene napsylate, equivalent to 32.5 mg hydrochloride and paracetamol 325 mg) in the control of pain following wisdom teeth extraction. A higher percentage of patients found Solpadeine more effective and significantly more Solpadeine patients considered their treatment easier to take.
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Urinary metabolites before dental treatment were compared in a group of patients with dental phobia and in a matched control group. Plasma adrenaline, noradrenaline, and free fatty acids were estimated before treatment, immediately after sedation with diazapam 0.2 mg/kg body weight in the phobic patients, during induction of oral anaesthesia, and during and after surgery. Patients with dental phobia had significantly higher levels of adrenaline, which were only temporarily lowered by sedation, and which during treatment remained consistently higher than those of control patients.
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In response to interest from readers the authors provide an update of their 1986 papers on coping with medical emergencies in dental practice. In particular they review drug regimes and the technique of cricothyroidostomy.