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Biomedical subjects

J Lindström

Publications and source records attributed to J Lindström.

At least 73 records · Page 4Linked to original sources
PubMed1981

Mandibular reconstruction using the preformed autologous bone graft.

Preformed bone grafts (PBG) were inserted in large jaw bone defects in 5 patients. The grafts in all cases healed-in rapidly. Two patients died of metastatic sarcoma 1 year after grafting. The other patients are healthy with excellently functioning grafts 3, 5 and 8 years after transplantation, respectively. The preformation of bone grafts is, however, regarded as a resource consuming technique that should be used only in selected cases of mandibular reconstruction. Particularly in young individuals, the better results achieved with PBG, in comparison with other types of grafts, seem to justify the more complicated surgical procedure. Apart from a description of the preformation technique, the present paper also introduces advice as how to minimally traumatize the hard tissues in bone graft surgery.

Adult↗
PubMed1981

Osseointegrated titanium implants. Requirements for ensuring a long-lasting, direct bone-to-implant anchorage in man.

A total of 2895 threaded, cylindrical titanium implants have been inserted into the mandible or the maxilla and 124 similar implants have been installed in the tibial, temporal or iliac bones in man for various bone restorative procedures. The titanium screws were implanted without the use of cement, using a meticulous technique aiming at osseointegration--a direct contact between living bone and implant. Thirty-eight stable and integrated screws were removed for various reasons from 18 patients. The interface zone between bone and implant was investigated using X-rays, SEM, TEM and histology. The SEM study showed a very close spatial relationship between titanium and bone. The pattern of the anchorage of collagen filaments to titanium appeared to be similar to that of Sharpey's fibres to bone. No wear products were seen in the bone or soft tissues in spite of implant loading times up to 90 months. The soft tissues were also closely adhered to the titanium implant, thereby forming a biological seal, preventing microorganism infiltration along the implant. The implants in many cases had been allowed to permanently penetrate the gingiva and skin. This caused no adverse tissue effects. An intact bone-implant interface was analyzed by TEM, revealing a direct bone-to-implant interface contact also at the electron microscopic level, thereby suggesting the possibility of a direct chemical bonding between bone and titanium. It is concluded that the technique of osseointegration is a reliable type of cement-free bone anchorage for permanent prosthetic tissue substitutes. At present, this technique is being tried in clinical joint reconstruction. In order to achieve and to maintain such a direct contact between living bone and implant, threaded, unalloyed titanium screws of defined finish and geometry were inserted using a delicate surgical technique and were allowed to heal in situ, without loading, for a period of at least 3--4 months.

Adult↗
PubMed1981

Osseointegrated titanium implants in the temporal bone. A clinical study on bone-anchored hearing aids.

The purpose of this study is to investigate the possibilities for attaching a new type of direct bone conduction hearing aid. Using a gentle surgical technique, titanium screws were inserted into the temporal bone of fourteen patients suffering from hearing impairment. The implants became integrated with the living bone tissue and have remained so for a follow-up period of, at present, two to four years. It is therefore concluded that titanium implants may be osseointegrated in the temporal bone in a similar manner to that previously described for long bones. The bone-anchored titanium screws were connected to a permanently skin-penetrating abutment, which in turn was used for attachment to a hearing aid. In this way a direct bone conduction without obstructing soft tissue layers is secured. The permanent skin penetration caused no adverse soft tissue effects. The new system has improved pure-tone hearing threshold by about 15 dB. Further research is aimed at the construction of a new hearing aid that is better adapted to the impedance situation existing in the directly bone-anchored cases.

Adolescent↗
PubMed1981

The bone-anchored auricular episthesis.

Total ablation of the pinna gives an unsatisfactory cosmetic result which has to be corrected. Plastic surgery procedures are generally not very successful and some sort of episthesis is preferred by many. The attachment of an episthesis is, however, often a problem. This paper is a case report of a new type of episthesis fixation arrangement. In a first session four titanium screws were implanted into the temporal bone above and behind the external meatus with a technique ensuring minimal tissue violation. Three months later when these screws were firmly integrated in the living bone, skin-penetrating titanium abutments were connected and a gold bridge was adapted to the abutments. A silicon rubber episthesis was attached to the bridge with a snap fastener. Behind this new method of episthesis attachment are several years of clinical experience of titanium implants directly anchored into various living bones and allowed to permanently penetrate skin or mucous membrane.

Carcinoma, Squamous Cell↗
PubMed1978

Carcinoma of the tonsillar region. Aspects on treatment modalities with reference to a study on patients treated by irradiation.

Irradiation is the most common form of treatment of tonsillar region carcinomas in Scandinavia. During recent years, encouraging results have been reported when surgery has been performed. Therefore, an effort was made to compare different treatment principles on the basis of a study on patients treated by irradiation. This retrospective study comprised 37 patients over a 20-year period. The relative 5-year survival was 33%. Most of the patients died in the next two years after diagnosis. Seventy-three percent of the patients initially had signs of regional metastasis. Hardly 20% of these were still alive after 5 years, while patients without evidence of metastasis had a 5-year survival of 50%. Neither the size, nor the histopathological features of the primary tumor seemed to affect the incidence of regional metastasis. The duration of symptoms before diagnosis, however, seemed to influence prognosis. Surgical consideration alone, or in combination with irradiation, should be made in cases with large primary tumor with regional lymph node involvement. In other cases, however, there was no evidence suggesting surgery as a better form of therapy than irradiation alone.

Humans↗
PubMed1978

The preformed autologous bone graft. An experimental study in the rabbit.

The preformation of bone grafts involves a two-step procedure. Primarily a mould is inserted in the donor bone. After a healing period of about 6 weeks (rabbits) the mould is removed. The performed bone graft (PBG) consists of the former cortical bone that has remodelled according to the shape of the mould. PBGs are today used clinically in selected cases of mandibular reconstruction. The present paper is the first in an animal experiment series investigating the PBG. It is shown that the PBG vascular supply is rearranged towards a more marrow-dominated circulation. Six weeks after the mould installation the bone showed evidence of accretion in the form of new-developed bone protrusions along the inner mould walls. A histochemical investigation revealed that the PBG surface cells survived the surgical trauma in a higher percentage than was the case when corresponding control grafts were examined.

Angiography↗
PubMed1978

Integrated prosthetic and surgical treatment of malignant tumours of the maxilla. A new acrylic plate device.

Surgery for malignant tumours involving the palate often leads to postoperative problems for the patient. Most commonly a stent or a tampon is used to fill the resection cavity. Both materials have disadvantages, however. To overcome these we have since 1972 used a preoperatively made acrylic plate to separate the oral cavity from the resection cavity in 20 patients. This plate is fixed to the mucosa or to the remaining teeth by sutures and is left in place for 10-14 days postoperatively.

Acrylic Resins↗
PubMed1977

Adenomatosis of accessory salivary glands of the lip. Report of two cases.

Two cases of an unusual tumour of accessory salivary glands are presented. The histological examination revealed that this tumour was benign and not malignant as has been suggested by others. Clinical follow-up for 8 years showed no signs of recurrence or metastases. We suggested to call it 'adenomatosis'. No extensive surgery is indicated.

Choristoma↗
PubMed1975

Fibro-osseous lesion of the mandible mimicking chronic osteomyelitis.

An account is given of the clinical, radiologic, and pathologic, features of a special form of fibro-osseous lesion of the mandible. The material consists of fifteen cases (eleven females and four males). Two cases are described in detail. Together with Case 1, a probably unique series of radiographic pictures is presented, showing the development of the disease.

Adolescent↗
PubMed1975

Long-term treatment and prognosis of malignant tumors of the nasopharynx.

A wholly unselected material of 56 patients with malignant tumors in the nasopharynx is presented. The individual course of each patient is tabulated. On the basis of the given therapy, mainly radiotherapy, the poor long-term prognosis of these patients is discussed. Stress is laid on the important problem of palliation in the final stage.

Adult↗
PubMed1975

Malignant tumours of the oral cavity. A study of 177 cases.

An unselected material of 177 patients with malignant tumours of the oral cavity is presented and classified according to the TNM system. A therapeutic classification based on the TNM system is proposed. The material is analyzed regarding the 5-year survival rate and the frequency of recurrences in different therapeutic groups.

Adolescent↗
PubMed1975

Reconstruction of the defective mandible.

In a clinical material consisting of 31 cases of mandibular defects, caused by tumour resection or by trauma, reconstruction has been carried out by means of a stabilizing titanium splint and autologous bone and marrow transplantation, the longest period of observation being 9 years. The functional results obtained are assessed with reference to the cause of resection. Different technical procedures are described and the objectives and the planning of reconstruction of the lower jaw are discussed.

Adult↗