[Determining indications for primary removal of regional lymph drainage vessels in lip cancer].
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Biomedical subjects
Publications and source records attributed to H Fassauer.
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Bite injuries by animals in the maxillo-facial-region require special managements of the treating physician or dentist. In the foreground stands the prophylaxis of the rabies. According to the lawful definitions the patient has to be transferred as quick as possible to the next department for rabies and inoculation. The local wound of bite must be treated with rabies-virucid medicaments. Because of aesthetic and functional reasons the primary plastic operation should be done even in cases of extensive wounds and defects in the facial region. By means of 19 cases these demands are based.
The clinical picture of 6 women suffering from selective IgA immunodeficiency were studied in a 2-13 years lasting period of immunological outdoor patients care. Despite of respiratory infections, otitis media, sinusitis, aphtosis and exogenous allergy the first detection of IgA deficiency was delayed til adulthood (mean age 42 years). A case of a 22 years old women with complicated fistula after molar tooth extraction showed the problems of dentistry in such diagnosis. No significant deviation concerning periodontitis and caries has been demonstrated in all patients. However, the rate of IgA deficiency demands basic knowledge about diagnosis, prevention of local and systemic complications in this disease by all practising dentists.
On the basis of a clinical epidemiological study of 312 patients are made biostatistical investigations about prevalence and Severity of dental caries and marginal periodontitis. The situation of oral hygiene is evaluated by means of the PI of Løe and Silness and the OHI-S of Greene and Vermillion. The DMF/T-Index is used for the evaluation of the set of teeth and the GI of Løe and Silness like the PDI of Ramfjord for the evaluation of the periodontal state. It is shown that caries and marginal periodontitis are more seldom and of less severity in comparison with the situation in the population of industrialized countries. Causitive seems to be possible besides special habits the smaller consumption of sugar. With the increasing socio-economic standard a changing of the situation in the direction of industrialized countries is visible.
Functional disturbances of the orofacial system are permanent increasing in the European countries. These are so called psychosomatic diseases which you can find very often in patients with psychic evident personality profile. For the objective evaluation of the structure of personality are described various methods in the literature. 65 Ethiopian patients from the Gondar-region who showed parafunctional abrasions-facettes on the teeth are investigated by means of the Beck-Inventory and the Self-Control-Schedule of Rosenbaum. The influence and importance of psychosocial factors for the evocation of myoarthropathies could been demonstrated.
Systemic diseases--like diabetes mellitus--are able to injure the local and common resistance of an organism. Therefore we must expect a more intensive and severer progress of gingivitis and periodontitis in diabetic patients in comparison with a non-diabetic control-group. On the Gondar College of Medical Sciences in Northwest-Ethiopia are investigated 77 Insulin-obliged diabetics and 312 persons for control by means of the plaque-Index, the Oral-Hygiene-Index simplified. The DMF/T-Index and the Gingivitis-respectively Periodontal-Disease-Index for evaluation of the oral health situation. The comparison shows that the diabetic group has a moderate higher Plaque-pictures of gingivitis or periodontitis. This confirms our opinion that the diabetes mellitus is a risk-factor for the development of periodontal diseases. Therefore patients with diabetes mellitus should perform a very intensive care for mouth-hygiene.
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Waiting periods in public health institutions not only stress the patients and the personnel, but they are also attended by considerable economic disadvantages. For this reason, the waiting periods of patients of a maxillofacial outpatient department in the various examination and treatment stations were analyzed with the help of accompanying leaflets. According to the results obtained, the sequence of examinations and treatments was verified and reorganized with regard to the three main processes: research, medical care, and education and training. The control by a second analysis evidenced a reduction of the total waiting period from 46.0 to 36.9 minutes per patient. Further possibilities of reducing the waiting periods are indicated, and reasons are given for the necessity for scientific work organization in public health institutions.
Affections of the major salivary glands are relatively rare in stomatology; but according to the indications of several authors, the proportion of sialolithiasis to the total amount of affections of the salivary glands (ranging from 20.5 to 55.5%) is great. The concretions are, as a rule, located in the duct system of the submandibular gland where they may reach, circumstances permitting, considerable sizes. The author's own investigations evidence that these calculi have a partly regular, partly irregular shell-like structure around a non-calcified centre. Chemical analysis by means of X-ray diffractometry revealed hydroxyapatite varying in the degree of cristallinity as the major component. Precursors in the form of octacalcium phosphate and dicalcium phosphate dihydrate have been disclosed. Salivary calculi must be removed (most frequently by surgical intervention) to avoid secondary diseases of the duct system of the respective gland.
Compound preparations containing trimethoprim and sulphonamide have been available in the pharmacies of the GDR since 1974. These are the preparations Berlocombin 200 (trimethoprim + sulphamerazine) and Sulprim 120 and 480 (trimethoprim + sulphamethoxazole) which are of great efficacy and have a broad spectrum of action. The mode of action, side-effects, dosage, commercial dosage forms and contraindications are described. Clinical tests have shown that a success-rate of 80.3% may be expected from treating pyogenic processes. Compound preparations of this kind might fill, at least in part, the gap caused by the increasing ineffectiveness of penicillin which is due to bacterial resistance.
The biological action of microwave therapy is due to the conversion of high-frequency electromagnetic waves to heat that is produced directly in the tissue at the radiation area. It is a deep heating procedure of limited range with low-level exposure to the subcutaneous fatty tissue; it may be used in subacute and chronic infectious inflammatory conditions, after surgical interventions, in affections of the salivary glands and of the maxillary sinuses, and also in temporo-mandibular joint disorders and facial neuralgias. As a rule, irradiation by microwaves is only a supporting treatment. Its advantages are above all: easy application; great economy; versatility; uniform, locally limited distribution of heat with low-level exposure to the fatty tissue; virtual safety.
Morphological-functional changes occur in the oral cavity also in depended from the age. The morphological changes of the enamel, dentin, dental pulp, periodont, oral mucosa, salivary glands, tongue, maxillary bone and temporo-mandibular-joint change not only the functional cooperation of all parts in the orofacial system. They show effects for the whole body also. A complete gerostomatological standard does not exist for the whole gnathological system. But single indices for some partial components are known. For the judgement of the caries involvement it is possible to use the DMF-index, for which a special gerostomatological type exist. The periodontal diseases are classified adequately to the ARPA-nomenclature. For the judgement of odontolithiasis and oral hygienic conditions you can use the so called odontolith-Index (CI), the OH (oral hygienic debris) and the so called calculus-index (OHI-S). It is refered to different possibilities for classification of dentition with gaps.
Affections of the temporo-mandibular joint are rare clinical pictures; but their incidence is ever increasing. Their scientific elucidation is imperative, especially since discrepancies concerning the terminology, definitions and practical treatment methods hinder uniform conceptions from becoming effective. From the clinico-statistical analysis of 587 cases the authors deduce statements regarding the frequency of the different diagnosis groups and the distribution according to age, sex and side affected. The distribution according to occupational groups is also presented. A uniform nomenclature (according to Birke) of the affections of the temporo-mandibular joint being now available, the next step must be to dilimitate the validity of different diagnostic methods and to arrive at clear-cut treatment directives, interdisciplinary cooperation being absolutely necessary.
The rate of complications of the healing process observed during or after oral surgical intervention on an outpatient basis amounts to 9.75% of the cases. Most frequently occur tooth-root fractures, alveolitis/osteitis, osteomyelitis, soft-tissue infections, haematomas, postoperative bleedings, antral perforations, sinusitis and perception disorders. The great medical and economic importance of such complications is pointed to on the basis of personal results and relevant data from the literature. An improvement in treatment results can be aimed at by reducing the rate of complications as well as by shortening the duration of treatment. Some relevant suggestions are given.