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Biomedical subjects

K E Kahnberg

Publications and source records attributed to K E Kahnberg.

At least 19 recordsLinked to original sources
PubMed1996

Open reduction of subcondylar fractures. A study of functional rehabilitation.

Open reduction of dislocated subcondylar fractures was carried out in 19 adult patients between 1990 and 1992. A comparison of the results between two groups of patients was made 1 year after trauma. The reference group consisted of patients with the same type of fracture but treated with only intermaxillary fixation (IMF) and moderate jaw exercises after release of IMF. Dysfunction of the masticatory system was noticed in only a few cases of either group. Open reduction with plate osteosynthesis made it possible to avoid IMF in 12 of 19 patients. The results in the two groups did not differ significantly from a functional point of view. There are, however, specific indications for open reduction based on the degree of dislocation and concomitant subjective symptoms.

Adolescent↗
PubMed1995

Leucocyte accumulation and leukotriene B4 release in response to polyglactin 910 and expanded polytetrafluoroethylene in hollow chambers in the rat.

The acute inflammatory reaction elicited after implantation of polymer membranes used clinically to promote bone healing and augmentation was studied in a soft tissue titanium chamber model. The two materials compared were non-degradable expanded polytetrafluoroethylene (ePTFE) and degradable polyglactin 910, a copolymer of 90% polyglycolic acid and 10% polylactic acid. The membranes were implanted in the titanium chamber for 24 h and 6 d. The number of leucocytes increased for both materials, whereas the leukotriene B4 (LTB4) content decreased over time. In both groups polymorphonuclear granulocytes predominated. The number of leucocytes was significantly higher in chambers with polyglactin 910 than ePTFE. In contrast, the LTB4 content was higher in chambers with ePTFE than polyglactin 910. No differences in cell viability were observed between the materials tested. This study shows that both degradable and non-degradable polymers elicit a marked influx and activation of inflammatory cells during early healing in soft tissues.

Animals↗
PubMed1995

Combined use of bone grafts and implants in the severely resorbed maxilla. Postoperative evaluation by computed tomography.

Combined horseshoe-shaped iliac bone grafts and Brånemark fixtures were used to rehabilitate patients with severely resorbed maxillae. Twenty patients were followed-up by computed tomography (CT) examination with axial slices to assess the fixture sites and to study the changes in height and width of the bone graft 3 weeks and 3, 6, 12, and 24 months postoperatively. The mean height of the bone graft at the 3-week postoperative examination was 8.2 mm; after 2 years the mean value had decreased to 6.2 mm. The height reduction occurred mainly between the 3-month and 1-year examinations. The mean width of the bone graft at the 3-week postoperative examination was 12.2 mm, and it decreased to 8.6 mm after 2 years. Most of the width reduction took place during postoperative months 1-3. From 1 year after the grafting procedure, the rate of reduction of both height and width was very low.

Adult↗
PubMed1995

Evaluation of TMJ surgery in cases not responding to conservative treatment.

The aim of the study was to evaluate the treatment outcome after temporomandibular joint (TMJ) surgery, which was performed in 33 patients (27 women and six men) between 1970 and 1986. Before surgery, the patients received different types of conservative treatment for an average time of 29 months. The most common diagnosis was anterior disk displacement (ADD) with or without reduction (n = 10), followed by unspecified arthralgia (n = 8), osteoarthrosis (n = 7) and ankylosis (n = 4). Standardized clinical records served as the basis for comparison of symptomatology at comparable time points. Furthermore, 31 of the 33 patients were subjected to a clinical follow-up, including anamnestic, clinical, radiological and cast analysis, 2-17 years after operation. Pain, sleeping problems and consumption of analgesics were significantly reduced after surgery. The anamnestic, as well as the clinical dysfunction indices, according to Helkimo, were also significantly reduced. TMJ clicking was reduced, but crepitations increased in number. The best improvements were seen in patients with ADD without reduction and in patients with ankylosis.

Ankylosis↗
PubMed1995

Functional evaluation after TMJ surgery.

Oral function was evaluated in 30 patients (25 women and five men) after TMJ surgery by means of bite force measurements. Twenty-seven discectomies and three condylectomies had been performed. The follow-up period was, on average, 2.5 years. The mean bite force values on the function level 'biting as when chewing' was for the whole group 125.3 N on the right side and 128.8 N on the left side. The maximal bite force was on average 362.5 N and maximal endurance time on average 32 s. All test results showed big ranges. No significant differences between right and left side or operated and non-operated side could be found on the tested function level 'biting as when chewing'. The found bite force values were high in comparison with another similar study. The results were also compared with another group of patients (n = 6) who were examined before and 6 months after surgery. As far as bite force reflects oral function the results are indeed very encouraging.

Bite Force↗
PubMed1994

Correction of open bite by maxillary osteotomy. A comparison between bone plate and wire fixation.

A clinical and cephalometric standardized study of surgical correction of open bite deformity was performed on 19 individuals. The mode of fixation of the maxilla after surgical correction was by direct wires in 9 of the patients combined with suspension wires to the infraorbital rim and in 10 patients plate fixation. The follow-up time was 18 months and the results in both groups were clinically and cephalometrically stable in the short (2 and 6 months) and medium terms (18 months). No statistically significant difference was found between the groups regarding tendency to relapse. It was, however, concluded that the advantages of plate fixation both on clinical grounds and for patient comfort are factors in favour of using miniplates for maxillary surgical procedures.

Adolescent↗
PubMed1994

Effects of conservative treatment in patients who later will be candidates for TMJ surgery.

In an attempt to evaluate the effect of conservative treatment in 33 patients with longstanding symptoms from the joint and later subjected to temporomandibular joint surgery, a retrospective study was made based on careful case records and personal follow-up. The treatment period varied widely between the patients but was on average 2.5 years. The result of the conservative treatment in these patients was, however, very slight and limited to a minor increase in mouth-opening capacity. All TMJ-patients, including those with the diagnosis ADD and suspected ankylosis, ought to have a strict treatment and follow-up programme in order to reduce doctor's delay if and when surgical intervention should be necessary. Efforts should be focused on development of diagnostic methods to support the selection of patients for TMJ surgery earlier so as to avoid prolonged unsuccessful conservative treatment.

Adolescent↗
PubMed1993

Reactivated herpes simplex virus infection as a possible cause of dry socket after tooth extraction.

This study was designed to evaluate a possible association between reactivated herpes simplex virus type 1 (HSV-1) infection after lower third molar extraction and development of dry socket (DS). The HSV-1 antibody response was analyzed before and after tooth removal by enzyme-linked immunosorbent assay and immunoblotting in 208 patients. History of previous possible oral herpes reactivation was evaluated by a questionnaire that was based on self-rated frequency of oral cold sores. Tobacco users were identified. The anatomic proximity of the root apex to the mandibular nerve canal was classified radiographically before extraction. Fifteen patients (7%) developed DS after tooth extraction. Eleven of the 15 DS patients (73%) were HSV seropositive as compared with 7 of 15 (47%) in the matched control group. Seven of the 11 seropositive DS patients have shown HSV-1 reactivation by an increase of specific polypeptides, predominantly gB, gC, gD and ICP 4 and 6, in the immunoblot test. No change in HSV-1 reactivity was observed in control sera. DS patients reported a high frequency of oral cold sores (64%) compared with the controls (33%). Tobacco use was not found to influence the frequency of cold sores or the development of DS. A close radiographic proximity between the mandibular canal and root apex was more common (P < .05) in DS patients. The results indicate that extraction of a mandibular third molar could be a possible cause of reactivation and recurrence of an HSV-1 infection.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1993

The use of preformed HTR polymer implants for chin augmentation. A preliminary report.

Ten patients with microgenia had their chins augmented with HTR polymer implants. The implants were inserted intraorally and fixed rigidly with a titanium screw. The postoperative course was uneventful except in one patient who had wound dehiscence and was resutured. This patient and all the others were clinically and radiographically stable at one year follow up.

Adult↗
PubMed1993

Combined use of hydroxy-apatite and Tisseel in experimental bone defects in the rabbit.

An experimental study in the rabbit has been undertaken to evaluate differences in bone regeneration in and around solid (Alveograf) and porous (Interpore 200) hydroxyapatite granulae. Material was placed into experimentally made bone defects and in half of the defects HA was also mixed with fibrin sealant (Tisseel). Material alone or mixed with Tisseel was also placed subperiosteally adjacent to the mandibular bone. The observation time was six months. The study showed, however, no difference in bone regeneration around solid or porous hydroxyapatite granula nor could we see differences when mixed with Tisseel or not. Implant material placed subperiosteally did not induce bone formation nor did it provoke bone resorption. The use of fibrin sealant (Tisseel) made the hydroxyapatite material much more easy to handle and to retain in the tissue.

Alveolar Bone Loss↗
PubMed1993

Treatment of the severely resorbed maxillae with bone graft and titanium implants: histologic review of autopsy specimens.

One of a series of patients with extremely resorbed maxillae treated with bone grafts from the hip in combination with Brånemark self-tapping fixtures died in a car accident 4 months after implant surgery. Autopsy specimens from this patient were analyzed to evaluate the amount and extent of "osseointegration" after 4 months of healing. Histologic examination revealed that minimal bone was in direct contact with the titanium and the general pattern was that of soft tissue screw anchorage. There were no signs of sequestering of the transplanted bone. The connection between the nasal cavity and the sinus mucosa with respect to the transplants seemed to be without adverse reactions. The superior part of the transplant did show signs of newly formed bone. The grafted specimens showed indications of delayed bone response compared to the nongrafted situation. All implants were clinically stable as studied postmortem.

Alveolar Bone Loss↗
PubMed1993

Bone grafts and Brånemark implants in the treatment of the severely resorbed maxilla: a 2-year longitudinal study.

A combination of horseshoe-shaped iliac bone grafts and Brånemark implants was used in 30 patients with severely resorbed maxillary alveolar ridges. All patients were followed clinically for 2 years and evaluated with regard to prosthesis stability, fixture survival, wound healing complications, and soft tissue conditions. Surgery was performed by the same oral surgeons using identical procedures, and the prosthetic treatment was performed by the same prosthodontist. The development group included the first 10 patients and the routine group included the following 20. Fixture survival in the development group was 54.4%, whereas 88.3% of the fixtures in the routine group have survived after 2 years. The average fixture survival in the study was 77.4%. Three patients in the development group lost all fixtures, primarily the result of trauma to the grafted region. With respect to the difficult situation many of these patients experienced, the survival rate should be considered most acceptable.

Adult↗
PubMed1992

Soft tissue response to genioplasty procedures.

The soft tissue response to genioplasty procedures was studied in 65 patients. The patients were divided into four groups depending on the direction of the genioplasty. In 17 patients straight anterior repositioning was made (group I), in 12 patients posterior repositioning of the chin (group II), in 19 patients vertical reduction of the chin (group III) and in group IV superior-anterior repositioning of the chin. The predictability of the procedures varied. The soft tissue response was equal to the bone movement in the anterior repositioning but less predictable in the posterior direction or when combined with vertical reduction.

Adolescent↗
PubMed1992

Psychological factors in orthognathic surgery.

27 patients subjected to various orthognathic surgery procedures were studied preoperatively and during a period of 18 months postoperatively by a team of psychologists to evaluate the patients' own opinions concerning the indication for surgery, information about the surgical procedure, the postoperative period and the long-term aesthetic and functional results. The patients were interviewed 5 times: 2 days before surgery, 2 days after surgery and 2, 6 and 18 months after surgery. The decision to undergo surgery was taken after a long period of time, 4 years on average, and half of the patients were influenced by their family or dentist before they made their decision. 60% gave three or more reasons for surgery, 85% mentioned functional problems, 74% facial appearance and 59% craniomandibular symptoms. 63% indicated that the facial appearance problems had negatively influenced their personal life and 44% their social life. Women experienced this problem more often than men. The results showed that the overall majority of patients were relieved of their presurgical problems. The aesthetic improvement was better than expected. It was found that improvements in facial features had a beneficial influence on the patients as individuals and also on their social life situation.

Adolescent↗
PubMed1992

Combined use of bone graft and Biotes fixtures in the treatment of the severely resorbed upper jaws.

Horse-shoe shaped bone grafts from the hip together with biotes self-tapping fixtures were used to rehabilitate patients with extremely resorbed upper jaws. Our experience and results from the 10 first consecutive case have been analyzed to form the base for further use of the method. We have lost eight fixtures out of 57 so far. Surgical complications with exposure of the bone transplant have occurred in three patients. A surprisingly good recovery from the hip has been seen in all of the patients. Certain technical precautions such as construction of a splint in the dentulous or partially dentulous jaw to prevent occlusal trauma towards the transplant have been made to avoid complications such as rupture of the mucosal flap. The method should be used with great care and the case meticulously chosen to avoid individuals who do not have the right motivation for the long-lasting and demanding surgical and prosthetic procedures. The combined use of implants and transplants should not be used routinely until a long-term evaluation of the method has been made to minimize potential drawbacks.

Adult↗
PubMed1991

Use of miniplates in the treatment of jaw fractures.

The use of miniplate-osteosynthesis in fracture treatment has been evaluated in 47 patients. In 25 of the patients plate fixation of the fracture was used without intermaxillary fixation and in 22 a supplementary IMF was used. Nine of the 47 patients had alcohol or drug addiction problems. The most common cause of fracture was assault and traffic accidents. The rate of complications including sensibility disturbances, occlusal disturbance and infection was evenly distributed among the two groups. The frequency of postoperative sensibility disturbances was however high, fifteen of the patients, although the sensibility returned in seven of these patients. Postoperative infections developed in five patients where the time between trauma and treatment exceeded three days. In no single case did the plate insertion make any damage to adjacent teeth.

Adult↗
PubMed1990

Intraradicular bacteria and fungi in root-filled, asymptomatic human teeth with therapy-resistant periapical lesions: a long-term light and electron microscopic follow-up study.

Light and electron microscopy were used to analyze nine therapy-resistant and asymptomatic human periapical lesions, which were removed as block biopsies during surgical treatment of the affected teeth. The cases that required surgery represented about 10% of all of the cases which received endodontic treatment and root fillings during the period 1977 to 1984. These cases revealed periapical lesions when they were examined 4 to 10 yr after treatment. The biopsies were processed for correlated light and electron microscopy. Six of the nine biopsies revealed the presence of microorganisms in the apical root canal. Four contained one or more species of bacteria and two revealed yeasts. Of the four cases in which bacteria were found, only in one biopsy could they be found by light microscope. In the other three specimens, the bacterial presence could be confirmed only after repeated electron microscopic examination of the apical root canal by serial step-cutting technique. Among the three cases in which no microorganisms could be encountered, one showed histopathological features of a foreign body giant cell granuloma. These findings suggest that in the majority of root-filled human teeth with therapy-resistant periapical lesions, microorganisms may persist and may play a significant role in endodontic treatment failures. In certain instances such lesions may also be sustained by foreign body giant cell type of tissue responses at the periapex of root-filled teeth.

Adult↗