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Biomedical subjects

H F Sailer

Publications and source records attributed to H F Sailer.

At least 19 recordsLinked to original sources
PubMed1995

Mandibular resorption due to systemic sclerosis. Case report of surgical correction of a secondary open bite deformity.

Systemic sclerosis (SSc) is a connective-tissue disorder of unknown origin causing a multisystem disease. While erosions of the distal phalanges are commonly described, resorption of the mandible has been considered an unusual finding. However, systematic radiographic screening of different groups of patients suffering from SSc revealed a resorption incidence of 20-33% of the examined mandibles. Women especially seem to be affected, and the male/female ratio is 1/7. Bilateral condylysis due to SSc has been described in seven cases, or 13.7% of the reported cases. To the best of our knowledge, this is the fourth report of surgical correction of secondary dysgnathia due to systemic sclerosis and the first with a 2-year follow-up period.

Adult↗
PubMed1995

Loose bodies in the temporomandibular joint. The advantages of arthroscopy.

Loose bodies are a rare cause of temporomandibular joint symptoms. Their main source is synovial chondromatosis. We report on clinical findings, diagnostic methods, treatment choices and outcome following the removal of loose bodies in 10 patients. Seven patients were evaluated and treated by means of arthroscopy, while in three patients open arthrotomy was performed. In five patients, no diagnostic imaging technique had demonstrated the presence of loose bodies prior to arthroscopy. In six patients, histology revealed synovial chondromatosis. In four patients, osteochondral fragments alone were found. Until now, the recommended treatment of choice for the removal of all loose bodies and of affected synovial tissue required open arthrotomy. We conclude that the advantages of arthroscopy consist in locating loose bodies that are not detectable radiologically and in reducing operative trauma.

Adolescent↗
PubMed1994

The unilateral hockey-stick incision for neck dissection in oral carcinoma. Technical note.

In 42 patients, a hockey-stick incision was used as standard approach in unilateral neck dissection. This approach permits a good overview of all structures in the neck and allows en bloc resection with intraoral tumor removal. The incision does not interfere with simultaneous reconstruction by pedicled or free flaps, and results in a scar which is barely visible and easily covered.

Adult↗
PubMed1994

A prospective study on changes in the sensibility of the oral mucosa and the mucosa of the upper lip after Le Fort I osteotomy.

A prospective study on 21 patients was performed in order to investigate the changes in the sensibility of the oral mucosa and the mucosa of the upper lip after a Le Fort I osteotomy. Patients were followed-up 1 month, 3 months and 6 months postoperatively. The sensibility of the mucosa was tested using electrical sensimetry (Laitinen, 1987). The teeth were tested with carbon dioxide snow (Obwegeser and Steinhäuser, 1963). A picture of the marked hypoaesthetic area was performed and magnified 1:1 if a hypoaesthesia of the cutaneous distribution of the infraorbital nerve was found. The area was measured using a Macintosh II CX computer. It was demonstrated, that after 3 months the infraorbital nerve regained its function completely. The greater palatine nerve and the posterior superior alveolar nerve demonstrated an incomplete recovery of sensory function after 6 months. After 6 months 92.8% of the teeth reacted to carbon dioxide snow. Within the first 6 months postoperatively, no pulpe necrosis was observed. No correlation could be found between the amount of anterior maxillary movement and the degree of hypoaesthesia of the infraorbital nerve. Dentate Le Fort I osteotomies showed a better sensory regeneration of the greater palatine nerve than edentulous Le Fort I osteotomies. After Le Fort I osteotomies in 2 parts, more hypoaesthesia of the greater palatine nerve was observed than after Le Fort I osteotomies in 1 part. After miniplate osteosynthesis, more hypoaesthesia of the posterior superior alveolar nerve was observed than after wire osteosynthesis. The results are discussed and compared with the results found in the literature.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1994

Application of purified bone morphogenetic protein (BMP) in cranio-maxillo-facial surgery. BMP in compromised surgical reconstructions using titanium implants.

After a review of the clinically relevant literature on early modified whole bone products (demineralized bone; AAA bone (Urist et al., 1975))--predecessors of purified bone morphogenetic protein (BMP)--and a summary of the only published clinical experience with purified human BMP (in orthopedic surgery; from the group of Urist; Johnson et al., 1988-1992), an introductory overview of our experience with our own preparations of BMP from bovine bone in 271 procedures on the face and cranium in 145 patients is presented. In this first article of a series of three, major preprosthetic reconstructions using iliac bone grafts and titanium screw implants are described. All patients are examples of compromised bone and/or soft tissue conditions and cannot be considered routine indications for the operations performed. The most endangered implants became osseointegrated after 6 to 8 1/2 months as judged from clinical examination and CT imaging. These results demonstrate the efficacy of purified, concentrated BMP preparations, able unequivocally to induce bone even in areas with seemingly lost implants.

Adult↗
PubMed1994

Application of purified bone morphogenetic protein (BMP) preparations in cranio-maxillo-facial surgery. Reconstruction in craniofacial malformations and post-traumatic or operative defects of the skull with lyophilized cartilage and BMP.

New ways of craniofacial reconstruction in old post-traumatic or fresh donor site craniectomy defects and in congenital malformations (Apert's and Crouzon's syndromes) are described. In all instances a stacked composite of lyophilized cartilage strips interspersed with BMP layers was applied to fill the defects and indentations or used in combination with autologous bone struts to rebuild the cranium completely in synostotic malformations. The stratified implants interlaced with BMP induced early bone formation, and in addition were rigid enough from the beginning to serve as bridging elements over and between autologous bone struts in the cage-like forehead reconstructions. The reconstructed areas became clinically solid after a few months. CT images taken in 4 cases showed progressive calcification starting in the BMP layers, sometimes already visible after a few weeks. These results indicate that the usual slow process of calcification/ossification of lyocartilage alone is considerably accelerated by the combination with BMP. From intermediate term observations (more than one year) we conclude that complete consolidation of the whole implants, so far without signs of resorption, will consistently be the final outcome of this type of reconstruction.

Acrocephalosyndactylia↗
PubMed1994

Histological evidence of osseointegration 4 years after implantation. A case report.

Histological examinations of clinically successful dental implants are very rare in the literature. This article presents a clinical case where an ITI hollow-cylinder titanium implant type F (red mark, 16 mm) had to be removed simultaneously with the resection of a squamous cell carcinoma of the lower jaw. The duration of functional loading of the implant was 49 months. The fixture was situated at the margin of the tissue to be resected during tumor surgery and could therefore be prepared as a histological specimen independent of the tumorous tissue. In the sections obtained, close contact of alveolar bone to the implant surface was clearly visible. Together with the clinical success of the implant, criteria of osseointegration seems to have been matched. This observation represents the longest histological survey of a clinically successful fixture of this implant system.

Carcinoma, Squamous Cell↗
PubMed1994

Inherited Treacher-Collins syndrome in twins after artificial insemination.

We present two cases of the Treacher-Collins syndrome and one case of plagiocephalus in a trigeminus childbirth resulting from artificial insemination. The mother, although affected with the Treacher-Collins syndrome, was not diagnosed before the birth of her children. Genetic counseling did not occur. Medical and forensic problems resulting from modern techniques of reproduction are briefly discussed.

Adult↗
PubMed1994

Value of three-dimensional computed tomography in craniomaxillofacial surgery.

Three-dimensional (3-D) computed tomographic (CT) scans of 72 adult patients were evaluated by two observers in a blinded fashion by comparing the 3-D images with the two-dimensional (axial and coronal) CT scans. With 3-D CT, the observers found improved visualization of facial anatomy in certain patients (i.e., asymmetries of the whole face and skull, large defects of the midface and skull vault, and fractures with major dislocation). In these defects, the information can be assimilated more rapidly. The documentation of effects of cranial surgery on craniofacial growth and resorption after reconstruction with autologous material can also be evaluated more accurately. Because higher levels of radiation are used, 3-D CT protocols are less indicated in patients with minor dislocation of fractures, tumors, and inflammations. Three-dimensional CT images in these patients are of little help and can mislead the surgeon. Further improvements in hardware and software will allow more accurate surgical planning by performing interactive surgery or by producing precise models.

Adolescent↗
PubMed1994

[The surgical removal of the lower wisdom teeth. Is open follow-up care still up-to-date?].

The removal of lower wisdom teeth is one of the most common procedures in oral surgery. Postoperative complications have been reported in over 10% of the cases, of those being 8.5% due to infection. In our Department, the open wound healing method has been used routinely for more than 50 years. In this article we present a retrospective and a prospective study comparing the open and closed wound healing techniques after lower third molar removal. The retrospective study dealt with 908 consecutive cases of the year 1991 in which all postoperative complications were analysed. The prospective controlled randomized study dealt with 300 cases in which the open and the half closed wound treatment was compared. Preoperative data including the papillary bleeding index and the postoperative incidence of infections were analysed. In the open wound healing group, a complication rate of 3%, with less than 1% being infectious, was observed. In the group where a semi-closed procedure was performed, a complication rate of more than 13% with 6% infections was found. It could be demonstrated that poor oral hygiene influences the postoperative infection rate, especially in cases where the semi-closed wound healing was used, whereas open wound healing is less affected by the status of oral hygiene. In both methods approximately three postoperative consultations were necessary. Based on these results, the open wound healing method after surgical removal of lower wisdom teeth is advocated.

Adolescent↗
PubMed1994

[Orbital volumetry as a planning principle for reconstruction of the orbital wall].

Before reconstruction of the orbital walls and other surgical procedures concerning the orbits leading to a modification of pathologically altered orbital volumes, it is useful to measure these volumes in order to allow preciser correction. Orbital volumetric studies on 22 patients and 6 dry skulls were performed using high resolution computer tomography. 14 patients presented enophthalmos of various origin, 3 patients fibrous dysplasia involving the orbits and 5 patients showed no orbital pathology. In 10 patients with unilateral posttraumatic enophthalmos an increase of the bony orbital volume of 20.1% in the average was found corresponding to an enophthalmos of 3.5 mm in the average. Correlation between the severity of the enophthalmos and the increase in orbital volume was found. Enophthalmos could not be correlated to the intraorbital fat volume, especially no atrophy of orbital fat could be demonstrated in these patients. Normal orbital volume measurements of patients and dry skulls were compared to those found in the literature. Planning of the surgery was therefore facilitated before correction of enophthalmos, reconstruction of bony orbital contour after tumor resection and in patients with fibrous dysplasia. Results suggest that the bony orbital enlargement, followed by a change in soft-tissue shape and position is the usual cause for posttraumatic enophthalmos. Changes in volume of soft-tissues themselves are less significant.

Cephalometry↗
PubMed1994

[Mandibular reconstruction with calvarial bone and temporalis flap].

Eleven patients with reconstruction of a massive mandibular defect with a vascularized full-thickness calvarian bone flap or a free full-thickness calvarian bone flap together with a temporalis muscle flap are reported. In six cases the resection was done because of squamous cell carcinoma, in four cases because of radioosteomyelitis and in one case because of gun shot trauma. In one case we lost the whole calvarian bone because of necrosis and in another case a permanent palsy of the frontal branch of the facial nerve remains. An advantage of using full-thickness calvarian bone flaps is that the donor area is in the same operation field and that the thickness of bone allows insertion of titanium osseointegration posts, which was done in five patients. The transplantation of full-thickness calvarian bone and temporalis muscle is a real alternative to an osseomyocutaneous microvascularized free flap for reconstruction of the mandible in cases where the neck was operated and radiated before, and anastomosis may be critical. Further advantages are virtual absence of postoperative pain in the donor area and an invisible scar. With this method we can reach satisfying functional and esthetic results.

Adult↗