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Biomedical subjects

H R Haanaes

Publications and source records attributed to H R Haanaes.

At least 19 recordsLinked to original sources

A randomized, double-blind crossover trial of paracetamol 1000 mg four times daily vs ibuprofen 600 mg: effect on swelling and other postoperative events after third molar surgery.

AIMS: To evaluate the effect of a 3-day regimen of ibuprofen 600 mg x 4 on acute postoperative swelling and pain and other inflammatory events after third molar surgery compared with a traditional regimen of paracetamol 1000 mg x 4. METHODS: A controlled, randomized, double-blind, cross-over study where 36 patients (26 females, 10 males) with mean age 23 (range 19-27) years acted as their own controls. All patients were subjected to surgical removal of bilateral third molars. After one operation the patients received tablets of ibuprofen 600 mg x 4 for 3 days. After the other operation they received an identical regimen of paracetamol 1000 mg tablets. Swelling was objectively measured (mm) with a standardized face bow and the patients scored their pain intensity (PI) on a 100-mm visual analogue scale. RESULTS: There was no statistically significant difference between paracetamol and ibuprofen treatment with respect to effect on acute postoperative swelling. Swelling after paracetamol on the third postoperative day was 1.8% less than that after ibuprofen. Mean (95% CI) difference between treatments was -0.3 (-4.7, 4.1) mm. On the sixth postoperative day swelling after ibuprofen was 2.3% less than that after paracetamol. Mean (95% CI) between treatments was 0.2 (-2.4, 2.8) mm. There was no statistically significant difference in pain intensity between the paracetamol and the ibuprofen regimen on the day of surgery. The mean (95% CI) difference between the treatments for summed pain intensity on the day of surgery (SUMPI 3.5-11) was 3.31 (-47.7, 54.3) mm. Two patients developed fibrinolysis of the blood clot (dry socket) after receiving ibuprofen while none did this after paracetamol treatment. There was no noticeable difference between treatments with respect to appearance of haematomas/ecchymoses or adverse effects which all were classified as mild to moderate. CONCLUSIONS: A 3-day regimen of ibuprofen 600 mg x 4 daily does not offer any clinical advantages compared with a traditional paracetamol regimen 1000 mg x 4 daily with respect to alleviation of acute postoperative swelling and pain after third molar surgery.

Acetaminophen↗

Ketoprofen 75 mg qid versus acetaminophen 1000 mg qid for 3 days on swelling, pain, and other postoperative events after third-molar surgery.

A randomized, double-blind, within-patient, crossover study was carried out after bilateral "identical" surgical procedures using local anesthesia only. A 3-day tablet regime of racemic ketoprofen 75 mg or acetaminophen 1000 mg qid (x 4) was given starting 3 hours after surgery. Ketoprofen reduced objectively measured swelling 27.8% (p < 0.04) better than acetaminophen 3 days after surgery and 70.8% (p < 0.02) better than acetaminophen 6 days after surgery. The pain intensity (PI) was lower after ketoprofen than after acetaminophen from 2 to 6 hours after the first drug intake (all p-values < or = 0.03). Sum PI during the first (SUMPI3.5-6, p = 0.003) and second dose intervals (SUMPI6.5-9, p = 0.007) was lower for ketoprofen than for acetaminophen but not different for the third dose interval (SUMPI9.5-11, p = 0.53). Ketoprofen was a more effective analgesic than acetaminophen on the day of surgery (SUMPI3.5-11, p = 0.005). There was no difference (p > 0.05) between the treatments with respect to mouth opening, drug preference, global evaluation, or adverse reports. Adverse reports included stomach pain and diarrhea in both treatment groups. Ketoprofen 75 mg x 4 for 3 days reduces subjectively assessed pain and objectively measured swelling (i.e., anti-inflammatory effect) following third-molar surgery.

Acetaminophen↗

Naproxen 500 mg bid versus acetaminophen 1000 mg qid: effect on swelling and other acute postoperative events after bilateral third molar surgery.

A controlled, randomized, double-blind crossover study, in which the patients acted as their own controls, was carried out to test the efficacy of naproxen 500 mg x 2 versus acetaminophen 1000 mg x 4 for 3 days on the postoperative course following third molar surgery. Acetaminophen reduced the mean swelling on the 3rd postoperative day by 22.4% (p = 0.023) compared to that after naproxen. On the 6th postoperative day, there was 20.9% less mean swelling with naproxen (p = 0.44), although the total swelling measurements were much less than those measured on the 3rd postoperative day. Summed pain intensity (SUMPI3.5-11) on the day of surgery revealed no statistically significant difference between the acetaminophen or naproxen regimen with the exception of 0.5 hours (p = 0.002) and 1 hour (p = 0.009) after first medication when acetaminophen gave less pain than naproxen. Since the drug regimens were different, summed PI for the first acetaminophen dose interval (SUMPI3.5-6) and the first naproxen dose interval (SUMPI3.5-9) was calculated. There was a tendency toward a statistically significant difference in favor of acetaminophen for SUMPI3.5-6 (p = 0.055) but no statistically significant difference (p = 0.41) between the treatments with respect to SUMPI3.5-9. Naproxen was statistically superior (p < or = 0.002) to acetaminophen at 08:00, 12:00, and 16:00 hours on the 1st postoperative day and at 08:00 hours on the 2nd postoperative day, when the pain intensity level was lower than that on the day of surgery. A 3-day acetaminophen regimen reduces acute postoperative swelling better than naproxen on the 3rd postoperative day after third molar surgery but not on the 6th postoperative day when the total swelling is less.

Acetaminophen↗

Discectomy of the temporomandibular joint: an experimental study in monkeys.

Postoperative changes have been observed in the temporomandibular joint (TMJ) after discectomies. Animal models have often shown that interventions in the TMJ may heal uneventfully. Discectomies were performed on 14 Macaca fascicularis and macroscopic and microscopic examination performed after sacrifice of the animals. Two of the animals did not show any apparent macroscopic or microscopic changes. The remaining 12 joints showed minor to major changes. The most serious changes were seen in three joints with fibrous ankylosis and five joints showed marked destruction of the articular cartilage.

Animals↗

Glandular odontogenic cyst (sialo-odontogenic cyst): report of two cases and literature review of 45 previously reported cases.

The clinical, radiological, histopathological and immunohistochemical (cytokeratin) features of two cases of glandular odontogenic cyst (GOC) are presented and discussed in a review of 45 cases of GOC hitherto reported. Of cases with available information, 34 occurred in the mandible and 6 in the maxilla; the male:female ratio was 19:28, and the mean age was 46.7 years in males and 50.0 years in females. Six cysts recurred once after 2-8 years (mean 2 years 8 months) and 2 (5.3%) recurred twice after 2 and 5 years and after 3 and 5 years, respectively, giving a rate of recurrence of 21%. The identification of osteodentin in one of the present cases and the co-expression of cytokeratins (CK) 13, 19 and 8 strongly support the concept of odontogenic differentiation in the GOC. Careful surgical removal of the lesion succeeded by a 5-year follow-up period is recommended.

Adult↗

Preliminary study of low-level laser for treatment of long-standing sensory aberrations in the inferior alveolar nerve.

PURPOSE: The incidence of inferior alveolar nerve (IAN) damage during removal of third molar teeth has been reported to be as high as 5.5% and up to 100% during sagittal split osteotomy. Sensory aberrations in the IAN persisting for longer than 6 months leave some degree of permanent disability. The purpose of this double-blind, clinical trial was to examine the effects of low-level laser (LLL) treatment using a GaAIAs laser (820 nm, Rønvig, Denmark) on touch and temperature sensory perception after a long-standing postsurgical IAN injury. PATIENTS AND METHODS: Thirteen patients were divided into two groups, one of which received real LLL (4 x 6 J per treatment along the distribution of the IAN to a total of 20 treatments) and the other placebo LLL. The degree of mechanoreceptor injury as assessed by Semmes Weinstein Monofilaments (North Coast Medical, San Jose, CA) were comparable in the two groups before treatment. The degree of thermal sensitivity disability as assessed using a Thermotester (Somedic AB, Stockholm, Sweden) to examine the indifferent temperature threshold was also comparable between the two groups before LLL. RESULTS: Subsequent to LLL, the real laser-treated group showed a significant improvement in mechanoreceptor sensory testing (P = .01) compared with the placebo group, as manifested by a decrease in load threshold (g) necessary to elicit a response from the most damaged area. In addition, the real LLL group reported a subjective improvement in sensory function. There was no significant improvement in thermal sensitivity post-LLL for either the real or placebo laser-treated groups. CONCLUSION: It was concluded that LLL can improve mechanoreceptor perception in long-standing sensory aberrations in the IAN.

Adolescent↗

Effect of low-level laser treatment on neurosensory deficits subsequent to sagittal split ramus osteotomy.

OBJECTIVES: Low-level laser treatment has been advocated as a possible treatment for patients with paresthesia. An objectively verified improvement in sensory function is relevant if, at the same time, it is perceived as a subjective improvement by the patient. The aim of this double blind clinical study was to see if low-level laser treatment with a GaAlAs laser (820 nm, Rønvig, Denmark) resulted in objectively verified improvement in sensory function and whether this correlated with the patient's subjective evaluation subsequent to treatment. STUDY DESIGN: The 13 patients in this study had all undergone saggittal split ramus osteotomy resulting in either compression or traction of the inferior alveolar nerve as reported by the surgery notes. The material was collected from a consecutive series of patients at the Karolinska Hospital, all of whom had shown reduced sensibility at their final 2-year postoperative checkup. The patients were randomly divided into two groups; one (eight subjects) group received real low-level laser treatment (4 x 6 J per treatment along the distribution of the inferior alveolar nerve, at the following points extraoral: lateral third of lower lip, intraoral; buccally to the apex of the second premolar tooth and the apex of the second molar tooth; lingually in the region of the mandibular foramen; for a total of 20 treatments). The other group received an equivalent placebo treatment. The study was conducted in a double blind fashion for both patient and doctor as the low-level laser equipment had two settings, A and B, one of which was an unknown void setting. The degree of mechanoceptor neurosensory deficit was assessed by Semmes Weinstein monofilaments (North Coast Medical, USA) and the degree of thermoceptor neurosensory deficit was assessed by a Thermotester (Somedic, Sweden). The degree of subjective neurosensory deficit was assessed by means of a visual analogue scale. Both variables and the degree of subjective injury were comparable between the two groups before starting treatment. RESULTS: The patients in the real low-level laser treatment group experienced a subjective improvement in both lip (p = 0.01) and chin (p = 0.02) after completion of the course of treatment. In addition, this group showed a significant decrease in the area of mechanoperception neurosensory deficit (p = 0.01) compared with no difference in the placebo group. The real low-level laser treatment group exhibited a strong tendency toward improvement in mechanoreceptor neurosensory deficit in the areas of most damage for both lip and chin. This improvement was especially pronounced in the lip region (p = 0.06). No similar tendency was demonstrated in the placebo group. Neither group showed any significant change or tendency to improvement in thermoception on completion of the course of treatment. CONCLUSION: In conclusion GaAlAs low-level laser treatment results in both a subjective and objective improvement in mechanical sensory perception in long-standing neurosensory deficit in the inferior alveolar nerve.

Adult↗

Bonding capacity in bone of HIP-processed HA-coated titanium: mechanical and histological investigations.

The main problems using plasma-sprayed hydroxyapatite (HA) as a coating material on metallic implants are its porosity, low fatigue strength, and weak adherence to the metallic substrate. To overcome these problems a new technique using hot isostatic pressing (HIP) has been developed for producing HA-coated titanium (Ti) implants. Specimens produced at a maximum temperature of 850 degrees C and a maximum pressure of 720 bar displayed a dense, glassy, 25-microns thick coating with small amounts of porosity and a mean surface roughness of 0.7 microns, as compared with 1.6 microns for sandblasted Ti. Twenty conical HA-coated (720 and 100 bar pressure) and 10 noncoated Ti implants were inserted through the cortex of the lower margin of the mandibles of sheep and allowed to heal for 60 days. Push-out tests for implants processed at 720 bar pressure showed substantially higher bone/implant bonding values than for sandblasted Ti implants. Histological studies indicated a direct contact and probably chemical bonding between bone tissue and the HA coatings. The area of contact was almost 3 times as large as for the Ti implants. The adherence of the 100-bar coating to the Ti surface was inferior to the 720-bar coating, as shown by the loosening of the coatings in several areas.

Animals↗

The effects of low level laser treatment on recovery of nerve conduction and motor function after compression injury in the rat sciatic nerve.

An animal study is presented examining the effect of low level laser (LLL) treatment on nerve regeneration following axonotmesis. Twenty animals received a standardised injury to the right sciatic nerve using a time, load and length sequence (10 min, 150 N, 5 mm) known to cause extensive axonal degeneration of the rat sciatic nerve. The LLL treatment was administered using a hand-held laser probe in light contact with the skin on the dorsal aspect of the hind leg overlying the site of the axonotmesis injury to the sciatic nerve. A group of 10 animals were treated with 6J of LLL (GaAlAs 830 nm) daily for a period of 28 d. Ten more animals were treated daily with a sham exposure setting and served as controls. Nerve function was assessed by a recognised method of walking tract print analysis; the "Sciatic Functional Index" (SFI), and nerve regeneration was assessed by recording the evoked compound action potentials (cAP) in the common peroneal nerve. At 21 d post-injury, the laser-treated group had a significantly lower median SFI than the sham laser-treated group, indicating that the real laser treatment had improved functional recovery in the nerve. However, no differences were found between the evoked cAP parameters that were measured in the laser-treated and sham laser-treated groups. Histological examination reiterated the lack of difference between the two groups. Consequently, the effects of LLL on recovery must have occurred more peripherally to the point measured.

Animals↗

Degenerative changes in the temporomandibular joint after diagnostic arthroscopy. An experimental study in goats.

Arthroscopic procedures for diagnosis and treatment of temporomandibular joint (TMJ) diseases are widely used. Few adverse effects of the procedures have been reported. In this in vivo study, diagnostic arthroscopy was performed in the left TMJ of seven castrated male goats, the right TMJ serving as a control. The goats were killed 1, 2, and 3 months after the arthroscopy. Macroscopic and microscopic examination revealed no apparent pathologic changes in two animals, minor changes in two, and severe degenerative changes in three. This study indicates that arthroscopic intervention in the TMJ may cause irreversible changes in the articular tissues.

Animals↗

Titanium implant insertion into dog alveolar ridges augmented by allogenic material.

The purpose of this investigation was to evaluate whether titanium endosseous implants would osseointegrate in dog alveolar ridges augmented by allogenic material. In 8 dogs en bloc resection, including 2 pre-molars, was performed bilaterally in the maxilla and the mandible. After a healing period of 6 weeks allogenic, demineralized and lyophilized dentin or bone was implanted subperiosteally. Titanium implants were installed 5.5 months later in some of the regions. Light and fluorescence microscopic evaluation revealed fibrous encapsulation of the implanted allogenic material, no osteoinduction and only minimal osteoconduction, few multinuclear giant cells and a sparse inflammatory reaction. The titanium implants healed mainly by fibrous encapsulation.

Alveolar Process↗

The effect of soft-laser application on postoperative pain and swelling. A double-blind, crossover study.

The effect of soft-laser application on postoperative pain and swelling was evaluated in a double-blind, crossover study. Twenty-five healthy adults with bilateral identically impacted lower third molars were selected for this study. The teeth were removed in two separate operations. Laser treatment was tested in comparison with placebo laser, with a 40-mW, 830-nm Biophoton laser (Roenvig Dental, Denmark). All surgical procedures and measurements were done by the same surgeon. The following features were statistically analyzed: swelling, trismus, and subjective registration of pain on a visual analog scale. No statistically significant differences were observed in comparison of the experimental side with the placebo side. It may be concluded that soft-laser treatment has no beneficial effect on swelling, trismus, and pain after third molar surgery.

Adolescent↗

Increased epithelial expression of HLA-DQ and HLA-DP molecules in salivary glands from patients with Sjögren's syndrome compared with obstructive sialadenitis.

Salivary gland specimens from 10 patients with primary Sjögren's syndrome (pSS) were examined by two-colour immunofluorescence with various combinations of monoclonal and polyclonal antibody reagents of the following specificities: human leucocyte antigen (HLA) class I and II (DR, DP and DQ), CD3, CD45 (leucocyte common antigen), various cytokeratins, and factor VIII-related antigen. Tissue specimens from 10 normal glands and 10 glands with obstructive sialadenitis (no known autoimmunity) served as controls. Only some intercalated ducts and scattered acini of the normal major glands expressed HLA class II determinants (< 5% of total epithelial area); the relative proportion of positive elements indicated differential expression (DR > DP > DQ). SS glands contained substantial T cell infiltrates and increased numbers of activated (DR+) T cells; adjacent epithelium showed extensive differential expression of HLA class II determinants (DR > DP > DQ). Glands with obstructive sialadenitis showed similarly increased epithelial expression of HLA-DR but with surprisingly small amounts of concomitant HLA-DP and -DQ expression. Epithelial HLA class II expression probably depends on cytokines as an inductive event, which is not unique for SS but particularly prominent in this disorder. Our results suggest that epithelial expression of HLA-DP or -DQ, rather than -DR, might be a prerequisite for the autoimmune process of SS to develop in genetically susceptible individuals.

Adult↗

Chemical, physical, and histologic studies on four commercial apatites used for alveolar ridge augmentation.

The purpose of this study was to evaluate four commercial apatite products. Subperiosteal alveolar ridge augmentation was performed on the maxilla of rats by implantation of granules of two dense products and of two porous products, and the tissue response was compared with the material characteristics obtained by chemical analysis and infrared spectrometry. None of the apatites caused osteoinduction or osteoconduction; fibrous encapsulation with multinuclear giant cells was observed around all four types. One of the apatites was fluorapatite and not hydroxylapatite, as claimed by the manufacturer. The tissue response to this implant material was dominated by multinuclear giant cells.

Alveolar Process↗

Surgical treatment of temporomandibular joints in patients with chronic arthritic disease: preoperative findings and one-year follow-up.

Twenty-nine temporomandibular joints (TMJs) in 19 patients with chronic arthritic disease were surgically treated. Nine patients had rheumatoid arthritis (including two with juvenile type), six had ankylosing spondylitis and four had psoriatic arthropathy. Using a preauricular approach, diskectomies with synovectomies were performed in 23 joints (14 patients) with chronic arthritic abnormalities. Diskectomies without synovectomies were performed in six joints (five patients), which proved to have internal derangements unrelated to their chronic arthritic disease. Joints with chronic arthritis showed considerable variation in inflammatory reactions, but were characterized by increased vascularization, synovial proliferation to the articulating surfaces and mostly pannus formation and bone resorption. A response in pain relief was seen in 85% of the patients three months postoperatively and in 79% of the patients 12 months postoperatively, indicating that diskectomy with synovectomy may be favorable in patients with severe TMJ problems due to involvement of chronic arthritic disease.

Adolescent↗

Alveolar ridge augmentation by osteoinductive materials in goats.

The purpose of the present study was to determine whether alveolar ridge augmentation could be induced in goats. In 12 male goats allogenic, demineralized, and lyophilized dentin or bone was implanted subperiosteally on the buccal sides of the natural edentulous regions of the alveolar process of the mandible. Light microscopic evaluation revealed fibrous encapsulation, a few multinuclear giant cells, little inflammatory reaction, and no osteoinduction. It was concluded that no osteoinduction took place in goats.

Alveolar Ridge Augmentation↗

The efficacy of two-stage titanium implants as orthodontic anchorage in the preprosthodontic correction of third molars in adults--a report of three cases.

Orthodontic movement of teeth is often required to satisfactorily treat a variety of oral rehabilitation problems. Considerable limitations in the clinical application of orthodontic treatment may result from the lack of teeth suitable for anchorage. Three patients with edentulous posterior segments are presented illustrating how implants can be utilized for preprosthodontic correction of impacted third molars rendering them suitable as bridge abutments. The patients have been followed for 8-10 years. Two-stage titanium implants were used as orthodontic anchorage as no dental anchorage was available. Edgewise orthodontic mechanics were used to move the third molars mesially with forces up to 2.5 N (about 250 g). No movement of the implants occurred and they were radiologically and clinically intact at the end of the orthodontic loading and were, therefore, subsequently used as bridge abutments.

Adolescent↗

Alveolar ridge augmentation in rats by combined hydroxylapatite and osteoinductive material.

The purpose of this study was to examine if increased bony ingrowth developed when hydroxylapatite was implanted together with an osteoinductive substrate. Dense hydroxylapatite granules (HA) (Calcitite, Calcitek, San Diego, CA, USA) were mixed with equal volumes of allogenic, demineralized, lyophilized dentin or bone and implanted subperiosteally for alveolar ridge augmentation purposes and heterotopically in the abdominal muscles in rats. Light microscopic evaluation revealed that HA was surrounded by fibrous connective tissue containing foreign body giant cells and it had neither an osteoinductive nor an osteoconductive effect. The newly formed bone induced from the implanted allogenic, demineralized, lyophilized dentin or bone was never found in close contact with the HA and did not incorporate the implant.

Abdominal Muscles↗