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Biomedical subjects

H Gelb

Publications and source records attributed to H Gelb.

At least 19 recordsLinked to original sources
PubMed1997

The relationship of tinnitus to craniocervical mandibular disorders.

Patients with craniocervical mandibular (TMD) disorders can present with tinnitus as a primary or secondary complaint. The embryology and functional anatomy of the middle ear, temporomandibular joint, muscles of mastication and associated tendons, ligaments, blood vessels, nerves and lymphatics was found to be helpful in establishing etiologic concepts which relate tinnitus to these temporomandibular disorders. In addition to etiologic concepts, treatment modalities are described. The authors relate their experiences as well as those of others with different patient populations.

Female↗
PubMed1996

The relationship between jaw posture and muscular strength in sports dentistry: a reappraisal.

From the late 1970s until the early 1990s, there have been several reports of improved appendage muscle strength and athletic performance. Much of the criticism of using a mouthguard alone or in conjunction with a splint, such as a mandibular orthopedic repositioning appliance (MORA), to enhance athletic performance has been aimed at study designs, controls, periods of time, double blindness, and the placebo effect. Although it would appear that designing a study which pleases both clinician and researcher would be a difficult task, studies have been performed that do meet the "gold standard." The results favor the premise that jaw repositioning can enhance appendage muscular strength and athletic performance. Studies performed during the mid-1980s, and to which the scientific community refers to continually, on closer examination are flawed.

Bite Force↗
PubMed1995

Relationship of muscular strength to jaw posture in sports dentistry.

From the late 1970s until the early 1990s there have been several reports of improved appendage muscle strength and athletic performance. Much of the criticism of using a mouthguard alone or in conjunction with a splint, such as a mandibular orthopedic repositioning appliance (MORA), to enhance athletic performance has been aimed at study designs, controls, periods of time, double blindness and the placebo effect. Although it would appear that designing a study that would please both clinician and researcher would be a difficult task, studies have been performed that do meet the "gold standard"; and the results favor the premise that jaw repositioning can enhance appendage muscular strength and athletic performance. Previous studies performed in the mid-1980s, and to which the scientific community refers to continually, on closer examination are flawed.

Dentistry↗
PubMed1994

In vivo inflammatory response to polymethylmethacrylate particulate debris: effect of size, morphology, and surface area.

Particulate debris, including that from polymethylmethacrylate (PMMA) cement, is observed commonly in the membrane surrounding loose joint prostheses. Such debris is assumed to cause an inflammatory response and contributes to osteolysis and failure of the implant. A subcutaneous rat air-pouch model was used to assess quantitatively the in vivo effects of the size, morphology, and surface area of PMMA particles on the acute inflammatory response. PMMA particles were divided into three groups. In Group A, mechanical grinding of cured bone cement produced irregularly shaped particles; Group B included spherical particles of PMMA powder (Simplex P); and Group C consisted of commercially prepared spherical latex particles. All three groups had two size distributions: < 20 microns and 50-350 microns. For a given mass or dose, the small, irregularly shaped mechanically produced particles in Group A elicited a significantly greater inflammatory reaction than the large particles in Group A, as expressed by the release of tumor necrosis factor (TNF), neutral metalloprotease (NMP), and prostaglandin E2 (PGE2) and the white blood cell (WBC) count within a 24-hour period. Similar findings were seen in Group B. Particles in Group C were used to compare the effect of absolute numbers of large and small particles and surface area. Large (10-126 microns) spherical PMMA particles at a dose of 1.7 x 10(6) particles/ml caused a significantly higher inflammatory response, as measured by WBC count and production of NMP and PGE2, than small (1-10 microns) spheres at a dose of 4 x 10(6) particles/ml. However, the production of TNF in the rats was significantly increased with small particles (p < 0.05) at a concentration 4-fold less than that with the large particles (4 x 10(5) compared with 1.7 x 10(6) particles/ml). This finding may reflect a different cellular mechanism for the TNF component of the inflammatory response than is measured by WBC counts or by levels of PGE2 and NMP. As the calculated surface area of the PMMA particles increased, a threshold level was reached, at which point the inflammatory response increased dramatically. The size of particles has a role in the prolongation and intensity of the release of specific cytokines. The total surface area of the particles appeared to be an important factor in determining the inflammatory response, as measured by WBC count, PGE2, TNF, and NMP.

Animals↗
PubMed1991

Gelb appliance: mandibular orthopedic repositioning therapy.

The authors discuss the philosophy, fabrication, and use of the Gelb appliance. They recommend the appliance for daytime use for anterior displacements with reduction, unloading of the temporomandibular joint, and cervical muscular dysfunction where mandibular displacement is a perpetuating factor. This chapter also details their clinical protocol for diagnosis and appliance management.

Dental Occlusion↗
PubMed1990

Treatment of chronic osteomyelitis complicating nonunion and segmental defects of the tibia with open cancellous bone graft, posterolateral bone graft, and soft-tissue transfer.

Forty-two consecutive patients with chronic osteomyelitis complicating persistent tibial nonunion and chronic osteomyelitis complicating tibial fracture with segmental bone loss were treated from January 1979 through December 1986 using a protocol including either open cancellous bone grafting (Friedlaender-Papineau technique), posterolateral bone grafting (Harmon technique), or local or microvascular soft-tissue transfer before cancellous bone grafting. Each patient had undergone surgical debridement and intravenous antibiotic therapy before inclusion in this study. Patients were classified using a staging system which included consideration of anatomic location of the infection within the bone; extent of bone involvement; quality of soft-tissue envelope and vascular integrity; and generalized host status. The overall success rate for arresting the osteomyelitis and healing the nonunion was 62% (26/42). If the six patients who refused additional bone graft surgery, the one patient who represented poor patient selection, and the patient who refused ankle arthrodesis are eliminated, the success rate for healing of the nonunion and resolving the osteomyelitis in this difficult patient population is: open bone cell graft, 66% (12/18); soft-tissue transfer 87.5%, (7/8); and posterolateral bone grafting, 87.5% (7/8). Use of a standardized classification system allows comparison of treatment results. Adequate debridement is crucial in treating osteomyelitis complicating established long bone fractures and nonunions. Determining the extent of debridement has proven to be the single most difficult aspect technically. Patient selection and pretreatment education are crucial. Caring for these patients is not only labor intensive and demanding of personnel and hospital resources, but demanding of the patients as well.

Adolescent↗
PubMed1989

Taking the mystique out of the diagnosis and treatment of craniomandibular (TMJ) disorders.

The temporomandibular joint (TMJ) is of great importance in the assessment, diagnosis and treatment of many craniofacial disorders. Frequently overlooked by medical practitioners as a source of patient discomfort, the key to understanding the joint and its role in abnormal conditions is the complex nature of its structure. Returning to biological fundamentals provides an essential foundation on which to build techniques for diagnosis and ultimately treatment regimens. In considering the aetiology of craniomandibular disorders many factors have to be sifted. These include predisposing factors such as size, shape and interrelation of the parts of the stomatognathic system. Precipitating causes may include trauma to the head and neck as well as stress to the individual, while perpetuating influences are manifested in the myospasm-pain-myospasm cycle. The complexity of the joint system is reflected in the range and diversity of the thorough examination which the clinician is required to perform. Listening to the patient's description of their symptoms is of crucial importance in the initial stages to provide guidance for the ensuing examination procedures. Relief of pain, generally caused by muscle spasm, is the primary treatment objective. Many modes of treatment are available in the long-term resolution of the disorders and these range from medicinal, nutritional and psychological therapies to occlusal equilibration and physiotherapy.

Humans↗