PubMed Health⌕ Search

Biomedical subjects

H F Sailer

Publications and source records attributed to H F Sailer.

At least 55 records · Page 3Linked to original sources
PubMed1996

A new method for assessing the temporomandibular joint quantitatively by dental scan.

The objective of this study was to assess the applicability of a multiplanar reformatting program (dental scan) for delineation and quantitative evaluation of the temporomandibular joint (TMJ) in the sagittal and coronal planes using the data of axial computed tomography. The resulting images were compared with standardized linear tomograms and direct sagittal and frontal computed tomography. Standardized linear tomograms and computed tomography of the TMJ in axial, frontal and sagittal planes were obtained in 11 patients. The axial computed tomography slices were then reconstructed in oblique frontal and sagittal planes according to the horizontal condylar angle of the TMJ by dental scan software. For each patient and each of the three imaging methods, 14 measurements were undertaken and 24 qualitative characterizations were assessed. Axial computed tomograms in combination with their corresponding coronal and sagittal reconstructions were more accurate than conventional tomograms. Direct coronal and sagittal scans gave the most detailed images, but required additional radiation dose, time and cost. Reconstructions of axial computed tomography slices of the TMJ using the dental scan software show several advantages over linear tomograms. They allow qualitative as well as quantitative evaluation of the TMJ.

Adolescent↗
PubMed1996

Complications following arthroscopy of the temporomandibular joint: analysis covering a 10-year period (451 arthroscopies).

451 arthroscopies of the temporomandibular joint (TMJ) have been performed on 373 patients during 10 years of clinical experience. The complication rate was low (1.77%). Most complications were transient, consisting mainly of temporary deficits of the 5th and 7th cranial nerves. No patient required arthrotomy because of complications, but one patient had to undergo angiography and embolization of a traumatic aneurysm of the superficial temporal artery secondary to arthroscopy.

Adolescent↗
PubMed1996

[Mandibular fractures due to implant management--incidence, mechanism of injury and therapeutic characteristics].

We report of 5 of 337 patients (1.48%), in whom a fracture of the edentulous atrophied mandible occurred after dental implants had been inserted. In 79 patients a sandwich osteotomy (anterior and/or lateral mandible) had been carried out together with the insertion of implants. The reason for a fracture was infection in 3 patients and weakening of the atrophied mandible by the additional osteotomies in 2 patients. One of the latter two was seen intraoperatively and fixed immediately using miniplates. The other occurred about 4 weeks postoperatively and was not discovered until callus had been developed. Consequently only 4 of the 5 patients were treated by osteosynthesis. In two patients no implants were lost. The application of bone morphogenetic protein (BMP) helped to avoid the loss of implants because it accelerated ossification of the fracture and the integration of the implants.

Bone Plates↗
PubMed1996

[The measurement of orbital volume in reconstruction of the orbital walls].

Before reconstruction of the orbital walls and other surgical procedures involving the orbits leading to a modification of pathologically altered orbital volumes, it is useful to measure these volumes in order to allow a more precise correction. Orbital volumetric studies on 22 patients and 6 dry skulls were performed using high resolution computer tomography. Fourteen patients presented enophthalmos of various origin, 3 patients fibrous dysplasia involving the orbits and 5 patients showed orbital pathology. In 10 patients with unilateral post-traumatic 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 enlargement, followed by a change in soft-tissue shape and position is the usual cause of posttraumatic enophthalmos. Changes in volume of soft-tissues themselves are less significant.

Cadaver↗
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↗
PubMed1995

Influence of craniofacial surgery on the social attitudes toward the malformed and their handling in different cultures and at different times: a contribution to social world history.

A historic overview including the European, American, Asian, and African continents is given on attitudes toward and the handling of humans with congenital malformations in ancient cultures and on pertinent customs in some prehistoric peoples. Figures of early works of art showing malformed individuals are presented testifying to this worldwide and timeless problem of humankind. In parallel, analogous patient photographs from our hospital before and after reconstructive surgery are shown. Philosophies of ancient Greece, rome, and China on the subject of malformed infants essentially did not differ from the known attitudes of the less developed tribes in Europe and pre-Columbian America, although the means of elimination of unwanted offspring were rather passive (exposure) than active (manual killing). A radical change in attitudes and practices occurred with the spread of the Christian religion and its political installment in Europe. The care for the underprivileged including the malformed ones was considered a Christian duty to be performed with compassion and love. In our century, the clocks have been and apparently are turned back again. Atheistic and Darwinian influences, political atheism, and the belief in "higher ethics" issued by "superman" have led to a relapse into barbarism, also within the medical system. We, as craniofacial surgeons, are privileged to have the means to turn the clocks forward again by rehabilitating the physically most underprivileged: those with conspicuous craniofacial malformations. The necessary techniques exist and are applied, as the figures of patients from our hospital demonstrate, but the will and the emotional strength for their consequent application require more than our hands.

Africa↗
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↗