Biomedical subjects
Publications and source records attributed to J A Nespeca.
Although this procedure is not necessarily indicated for all patients, it is an alternative to subsequent soft tissue, osseous, or synthetic grafting procedures. The combination of extraction, hydroxylapatite graft, and acid-etched replacement is an alternative treatment that reduces patient treatment time.
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Osteomyelitis of the maxilla is not often found. A rare case of this condition secondary to a chronic vertical root fracture of a maxillary lateral incisor, with Pseudomonas aeruginosa as the primary pathogen, is presented. Interesting features of this case report are the occurrence of osteomyelitis in the maxilla, the rare isolate of P. aeruginosa, and the clinical problems associated with the diagnosis of vertical root fractures. The combination of surgical, endodontic, and antimicrobial therapy used is described.
Third molar surgery in the oral and maxillofacial surgery office has been a predictable model for evaluating the efficacy of sedatives and analgesics. In this setting, butorphanol plus diazepam and fentanyl plus diazepam were compared for surgical effectiveness and postoperative recovery. The comparison of butorphanol to a known sedative combination was clinically very satisfactory. It appears from this data that butorphanol has a pharmacologic place in outpatient conscious sedation.
A surgical technique for inferior repositioning of disk attachments is described. This reattachment of the disk permits much more flexibility and possibly more permanence of the repositioning of the disk and a greater surgical margin of safety by avoiding the disk-bilaminar zone junction. The technique has been used on patients in selected cases in the past 2 years with acceptable clinical results.
Splint design and universal form are neglected topics in the surgical literature. This article outlines a versatile and easy splint to use for all types of orthognathic surgery. Its design may not be entirely new, but its application is well documented and illustrated. This type of splint has been used in our training program for the past 5 years, with excellent success, in more than 450 patients.
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Noma is an infectious process involving the oral cavity and occasionally other structures. It is characteristically a childhood affliction, and it never occurs in healthy persons. Conservative treatment in debriding facial lesions greatly enhances reconstructive efforts.
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A rare metastatic lesion is presented in a 77-year-old black man. The primary disease was fulminating from the time of admission, and diagnosis was established by oral biopsies. The unusual features in this case, in addition to the rarity of the tumor, are the age and race of the patient, the peculiar metastases, and difficulty in identifying a primary site.
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Bupivacaine HCL is compared to lidocaine with respect to clinical use in oral surgery. Onset, potency, and duration of anesthesia with it are documented. The major advantage of its use is the long duration of its anesthetic effect, with a very slow return to full sensation, which eases the patient through the early postoperative period.
A solitary juvenile hemangioendothelioma on the maxillary gingiva of a newborn white male has been presented. No recurrence or evidence of systemic involvement has been noted in the 18 months following excision. The literature was reviewed with emphasis on the varying location and behavior of the lesion and the methods of treatment. Simple excision of the isolated, histologically benign neoplasm is recommended provided adequate follow-up is assured.
Patients' abilities to complete the Trieger modification of the Bender Motor Gestalt Test as an indicator of recovery time were compared following outpatient general anesthesia, using either enflurane or isoflurane on 100 patients who had their third molars removed. The time required for patients who received enflurane to satisfactorily complete the test averaged 32.7 minutes, compared with 34.6 minutes for patients who received isoflurane. Statistical analysis indicated that there was no significant difference in recovery time in this particular setting between enflurane and isoflurane.