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Biomedical subjects

M A Pogrel

Publications and source records attributed to M A Pogrel.

At least 91 records · Page 5Linked to original sources
PubMed1994

Letter from California--health care reform.

Despite all the publicity, it appears that President Clinton's health care reform may turn out to be much less than people were expecting. It is still going to be a private system with health insurance coming from the employer for those who have a job, and via the state or federal government for those who do not.

California↗
PubMed1994

Stability of sagittal split osteotomies. A comparison of three stabilization techniques.

The objective of this study was to retrospectively evaluate stability of mandibular advancement after bilateral sagittal split osteotomies were performed. Three different fixation and immobilization protocols were examined. Thirty-three patients were evaluated with preoperative, immediate postoperative, and long-term (mean, 13 months) lateral cephalometric radiographs. The patients were divided into three groups: group 1 (n = 10) had nonrigid internal fixation and 6 weeks of maxillomandibular fixation, group 2 (n = 12) had rigid internal fixation and immediate postoperative function, and group 3 (n = 11) had rigid internal fixation with maxillomandibular fixation for a mean of 14 days. Group 3 had the least amount of sagittal and vertical relapse. Differences in sagittal relapse were statistically significant between groups 1 and 3. Group 2 demonstrated greater sagittal relapse than did group 3, although the result was not statistically significant. This study suggests that the use of rigid internal fixation with a period of maxillomandibular fixation appears to be more stable than nonrigid internal fixation with maxillomandibular fixation or rigid internal fixation without maxillomandibular fixation.

Adolescent↗
PubMed1994

Distribution of submental fat in relationship to the platysma muscle.

The results of submental lipectomy often remain suboptimal, and in some cases this may be due to the presence of residual fat deep to the platysma muscle. This study was undertaken to determine the relative amounts of fat superficial and deep to the platysma muscle. A dissection of the submental region of 20 cadavers revealed a mean weight of fat lying superficial to the platysma muscle of 8.4 grams. The mean weight of fat lying deep to the platysma muscle but superficial to the mylohyoid muscle was 3.7 grams. In three cases (15%), the weight of fat deep to the platysma muscle was greater than 50% of the total fat. This is of significance with respect to those submental lipectomy procedures that normally address only the fat superficial to the platysma.

Adipose Tissue↗
PubMed1994

Pharyngeal airway changes associated with mandibular advancement.

This study analyzes changes in the anteroposterior dimension of the oropharynx as determined from lateral cephalometric radiographs on 26 patients who have undergone mandibular advancement. Increases in the sagittal dimensions of the oropharynx were unpredictable and tended to decrease with time, suggesting that mandibular advancement may be an unreliable method of treating obstructive sleep apnea. The most stable long-term results were found in those cases with narrowing of the oropharynx preoperatively.

Adult↗
PubMed1994

The management of salivary gland tumors of the palate.

A study of 22 consecutive patients with palatal salivary gland tumors treated in a structured fashion with primary surgery followed by postoperative radiation therapy, where indicated, and followed for a mean of 7.6 years, showed excellent results clinically, esthetically, and functionally, with no recurrence or metastatic deposits to date. Depending on the type of tumor, the surgery consisted of local enucleation, wide local excision with localized flap closure, or inferior maxillectomy with reconstruction by means of an obturator.

Adenocarcinoma↗
PubMed1994

Anatomic evaluation of anterior platysma muscle.

The structure of the submental platysma muscle was evaluated in 20 preserved cadavers. Four distinct patterns were identified, depending on the pattern of merging of the right and left platysma bundles. Fifteen percent of cases showed a complete platysma diaphragm submentally, while in the other 85% there was some degree of midline dehiscence. In the 85% of cases where right and left fibers merged or crossed to form a V or U shape, the apex of the V or U was measured relative to the chin point. The distance between right and left fibers was measured at two locations posterior to the chin point. The width of the midline dehiscence (when present) was 6-24 mm (mean 11.8 mm) 1 cm posterior to its apex and 10-44 mm (mean 20.00 mm) 2 cm posterior to the apex. The wider and more divergent the dehiscence and the more U-shaped the dehiscence between left and right platysma bundles, the greater may be the tendency to a "turkey gobbler" deformity with inadequate medial support for the skin and subcutaneous tissues.

Anthropometry↗
PubMed1994

Antibiotics in general practice.

The human race has had to endure infections for as long as it has been on earth, and has developed efficient natural defence mechanisms to combat them. Modern medicine aims to augment these natural mechanisms, to help speed up resolution of infection and decrease morbidity and mortality.

Anti-Bacterial Agents↗
PubMed1994

Is it possible to identify the psychologically "bad risk" orthognathic surgery patient preoperatively?

Everyone involved in orthognathic surgery would like some means of identifying the so-called psychologically "bad risk" patient. This article reviews a number of techniques and concludes that, not only is this identification impossible to achieve, but it is probably unnecessary since most patients do well psychologically after orthognathic surgery regardless of their preoperative psychological profile. The few psychologically dissatisfied patients cannot be accurately identified preoperatively.

Body Image↗
PubMed1993

Structural changes in dental enamel induced by high energy continuous wave carbon dioxide laser.

The morphological changes in dental enamel exposed to a high energy continuous beam surgical carbon dioxide laser were studied with a wet-scanning electron microscope. Utilizing a 1 mm focused beam, energy levels of 5, 10, and 12.5 watts were applied to the external enamel surface of teeth for between 0.05 and 2 seconds. Subsequent examination showed melting and resolidification of the surface enamel. Examination in cross section revealed three different zones of change, which were consistent in thickness. The outer layer of melted and resolidified enamel approximates 100 microns in width, whereas the next zone of acid resistant amorphous enamel measures only 12 microns in width and the third zone of porous enamel measures approximately 110 microns in width. Though of no immediate practical value in dentistry, the exact physical chemical changes occurring in the enamel warrant further investigation.

Carbon Dioxide↗
PubMed1993

Structural changes in dentin induced by high energy, continuous wave carbon dioxide laser.

The effect of a continuous wave carbon dioxide laser on dentin was observed as a function of power density and exposure time utilizing a wet scanning electron microscope. Visible charring occurred for all conditions studied. Surface cratering and flaking were followed by melting of the dentin. Melting resulted in a porous layer or porous globules of resolidified material and partial sealing of the tubules. Beneath the melted zone is an area of altered dentin where the tubules appear to be filled by solidification of the melted dentin.

Dentin↗
PubMed1993

Long-term viability of the temporalis muscle/fascia flap used for temporomandibular joint reconstruction.

Temporalis muscle/fascia axial flaps (TFs) were used in 115 temporomandibular joints (TMJs) in 81 patients to correct ankylosis (n = 25 joints), traumatic defects (n = 8), congenital anomalies (n = 4), defects resulting from tumor resection (n = 2), degenerative joint disease (n = 52), autoimmune arthritides (n = 21), and lateral capsule flaccidity (n = 3). The follow-up period ranged from 6 months to 5.5 years. Seven patients (8.6% of the group; 10 TMJs) were reevaluated for recurrent symptoms (pain and decreased motion), with a mean of 1.7 years (range = 1 to 3 years) postoperatively. Four of these patients (seven TMJs) had magnetic resonance imaging (MRI) as part of their diagnostic workup and four patients (five TMJs) required a second operative procedure. This study reports the results of the MRI, intraoperative, and histologic evaluations of the TFs in these seven patients. The MRIs showed vascularized tissue between the condyle and roof of the glenoid fossa in all seven joints examined. The signal was consistent with muscle and/or fat as opposed to scar tissue. All flaps examined at the time of surgery (arthroscopy, n = 1; arthrotomy, n = 4) were in place and had the gross appearance of normal muscle. Histologic examination of biopsies of four flaps indicated the presence of viable muscle with normal-appearing nuclei. The results of this study indicate that the TF does survive when it is carefully dissected and inferiorly based to preserve blood supply.

Fascia↗
PubMed1993

Profile of hyaluronidase activity distinguishes carbon dioxide laser from scalpel wound healing.

Hyaluronic acid plays a key role in the process of wound repair. Deposition of this glycosaminoglycan polymer is in turn controlled by levels of the enzyme hyaluronidase. Hyaluronidase activity was examined in a rat incisional skin wound model comparing laser and scalpel wounds. A polyacrylamide gel electrophoresis (PAGE) hyaluronic acid substrate assay was used to detect differences in the rates of appearance, and level, of hyaluronidase activity in wound homogenates. The hyaluronidase activity in laser wounds appeared earlier, had a bimodal distribution, and increased to a higher level than that in scalpel wounds. The origin of hyaluronidase is not clear, but control of its appearance and modulation of its activity may be a more complex process than previously assumed.

Animals↗
PubMed1993

Injuries to the inferior alveolar and lingual nerves.

Both the inferior alveolar and the lingual nerve are at risk for damage following various surgical procedures. Sensory nerve function following potential damage should be tested and evaluated for treatment, with microneurosurgery considered under certain conditions. Repair between three and six months following injury has the best results. A study of 43 patients who underwent microneurosurgery for various types of injuries, and have been followed for at least one year, found four (9.3 percent) with essentially complete return of sensation; five (11.6 percent) with good return; 19 (44.2 percent) with some return; 13 (30.2 percent) with no return; and two (4.6 percent) with a decrease in sensation.

Dental Care↗
PubMed1992

The risk management of infections.

Unfortunately, risk management, that is avoiding lawsuits, is a retro-active pastime instead of being pro-active. What this means is that we often take action only after a problem has manifested itself, rather than identifying potential problems and correcting them. This is, however, only human nature and occurs in most other walks of life. In dental malpractice, what appears to have been happening during the past few years in California is that plaintiff's lawyers have identified a problem and then started to sue dentists for it (and even run courses on how to sue dentists for it!), after which the profession has tried to take steps to identify the cause of the problem, and has then attempted to reduce it or eliminate it altogether. In the past, the dental malpractice companies (the equivalent of the Medical Protection Society and Medical Defense Union) were merely bystanders who paid out on claims and subsequently raised premiums accordingly. Now that most of the malpractice companies in California are actually run by (and often owned by) members of the profession, they are much more interested in getting involved at a very early stage, as soon as a potential problem is identified, in order to take action so that premiums do not rise unnecessarily.

Anti-Bacterial Agents↗