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Biomedical subjects

M Alder

Publications and source records attributed to M Alder.

12 recordsLinked to original sources
PubMed2001

Hemifacial microsomia. Etiology, diagnosis and treatment.

BACKGROUND: Three percent of all newborns have significant structural anomalies. Hemifacial microsomia, or HFM, is the second most common facial anomaly, second only to cleft lip and palate. New therapeutic and clinical management techniques offer promising interventions that can allow many patients to have more normal childhoods at earlier ages. DESCRIPTION: Due to a unilateral deficiency of the mandible and lower face, patients who have HFM have specific dental needs that require restorative, orthodontic and surgical correction. CLINICAL IMPLICATIONS: Oral and maxillofacial malformations present diagnostic and treatment challenges unique to the dental profession. The etiology, diagnosis and treatment modalities discussed in this article can be used to help effectively rehabilitate patients who have HFM.

Child↗
PubMed1999

Factors influencing condylar position after the bilateral sagittal split osteotomy fixed with bicortical screws.

PURPOSE: Multiple articles have discussed condylar position after bilateral sagittal split osteotomy (BSSO). However, previous studies have been limited to two-dimensional evaluation of condylar position. The purpose of this study was to evaluate change in condylar position after a BSSO fixed with bicortical screws using three-dimensional computed tomography to assess the factors that may influence the ultimate position of the condyle after surgery. PATIENTS AND METHODS: Seventeen patients underwent isolated mandibular advancement involving a BSSO with rigid fixation. Reformated axial computed tomography was done 1 week before and 8 weeks after surgery. Movements evaluated included 1) medial-lateral, 2) superior-inferior, 3) anterior-posterior, and 4) condylar angulation. Three separate factors were analyzed to study their effects on the four movements noted: 1) amount of mandibular advancement, 2) amount of proximal segment rotation, and 3) preoperative shape of the mandible. A linear regression analysis was used with statistical significance set at P<.05. RESULTS: Eight weeks after a BSSO and mandibular advancement, most cases showed displacement of the condyle medially, posteriorly, superiorly, and angled medially. The amount of mandibular advancement did not correlate with medial-lateral change of the condyle. The amount of advancement correlated with the condyle angulation and superior-inferior changes in condyle position. There was no correlation between amount of advancement and medial or anterior-posterior change in condyle position. There also was no correlation between any of the condylar movements and the degree of proximal segment rotation or the shape of the mandible. CONCLUSIONS: There are obvious changes in condyle position after a BSSO. These changes appear to be influenced mainly by factors other than amount of advancement, degree of proximal segment rotation, and shape of the mandible.

Adolescent↗
PubMed1997

Minor physical anomalies in older patients with late-onset schizophrenia, early-onset schizophrenia, depression, and Alzheimer's disease.

The authors assessed five groups of older subjects (age > 45) for evidence of minor physical anomalies. The groups were patients with early-onset schizophrenia (onset at age < 45; n = 15), late-onset schizophrenia (onset at age > 45; n = 8), Alzheimer's disease (AD; n = 11), and unipolar depression (n = 11), and normal comparison (NC) subjects (n = 15). Patients with late- and early-onset schizophrenia, and unipolar depression were found to have significantly more anomalies than NC subjects. Patients with AD did not have significantly more anomalies than NC subjects, although the patients with AD were significantly older than the NC subjects. The authors discuss implications of these findings on the pathophysiology of schizophrenia.

Aged↗
PubMed1997

A feasibility study evaluating rhBMP-2/absorbable collagen sponge for maxillary sinus floor augmentation.

This 16-week open-label study assessed the safety and technical feasibility of implanting human recombinant bone morphogenetic protein-2 delivered on an absorbable collagen sponge (rhBMP-2/ACS) for two-stage maxillary floor sinus augmentation. This first use of rhBMP-2/ACS in human clinical maxillary sinus floor augmentation included 12 patients with inadequate bone height in the posterior maxilla. The total delivered dose of rhBMP-2 implanted varied from 1.77 to 3.40 mg per patient. The rhBMP-2/ACS device was easily handled. Significant bone growth was documented by computerized tomographic scans in all evaluable patients (11/12). The overall mean height response for the maxillary sinus floor augmentation was 8.51 mm (95% confidence interval 6.07 to 10.95). There were no serious or unexpected immunologic or adverse effects and no clinically significant changes in complete blood counts, blood chemistries, or urinalysis results. The most frequent adverse effects were facial edema, oral erythema, pain, and rhinitis. Eleven patients have received dental implants and follow-up examinations are still being conducted. Histologic examinations of core bone biopsies obtained at the time of dental implant placement confirmed the quality of the bone induced by rhBMP-2/ACS. These results tend to indicate that rhBMP-2/ACS may provide an acceptable alternative to traditional bone grafts and bone substitutes for maxillary sinus floor augmentation procedures in humans.

Absorbable Implants↗
PubMed1997

A feasibility study evaluating rhBMP-2/absorbable collagen sponge device for local alveolar ridge preservation or augmentation.

This two-center human clinical trial evaluated recombinant human bone morphogenetic protein-2 delivered in an absorbable collagen sponge (rhBMP-2/ACS) for either alveolar ridge preservation after tooth extraction or augmentation of localized osseous defects. This 24-month study comprised two parts: a 4-month acute safety and bone induction period (Part I) followed by a 20-month, osseointegration, functional restoration, and long-term safety evaluation (Part II). The primary objective of Part I, discussed in this article, was to evaluate the short-term safety and technical feasibility of the rhBMP-2 device implantation. Twelve patients (six preservation and six augmentation) were enrolled in the investigation. Patient safety was monitored by oral examinations, radiographs, and the collection of blood samples to measure serum chemistries, hematology, and potential antibody formation. Technical feasibility was evaluated by collecting information relating to the handling properties of the rhBMP-2/ACS device. The ability of various evaluative tools to measure the bone-inducing activity of the rhBMP-2/ACS device was also assessed. The clinical results suggested that rhBMP-2/ACS was well tolerated locally and systemically, with no serious adverse events. The device was found to be easily handled and adapted to the ridge and extraction socket. Using direct measurements, all sites demonstrated firmness and fullness to palpation at 4 weeks; however, a loss of volume was noted in some treatment areas between 4 and 8 weeks. Augmentation of the alveolar ridge was not observed in the patients as assessed by the evaluation techniques. This trial indicated that the use of rhBMP-2/ACS to preserve alveolar ridge after tooth extraction or augmentation of localized defects is safe and feasible. Bone fill was observed in all alveolar sockets filled with the rhBMP-2 device.

Absorption↗
PubMed1996

Comparison of nickel-titanium and stainless steel hand-file instrumentation using computed tomography.

Computed tomography was used to evaluate root canals prepared by nickel-titanium (Ni-Ti) hand and stainless steel hand endodontic instruments. Thirty-six single-rooted teeth of similar shape and canal size were divided into three groups. The teeth were scanned by computed tomography before instrumentation. In group A, canals were instrumented using a quarter turn/pull technique with K-flex files. In group B, canals were prepared with Ni-Ti hand files (Mity files) using the same technique as group A. Group C was prepared with Ni-Ti hand files (Mity files) using a reaming technique. Instrumented teeth were again scanned using computed tomography, and reformated images of the uninstrumented canals were compared with images of the instrumented canals. Ni-Ti instruments (Mity file) used in a reaming technique caused significantly less canal transportation (p < 0.05), removed significantly less volume of dentin (p < 0.05), required less instrumentation time (p < 0.05), and produced more centered and rounder canal preparations than K-flex stainless steel files used in a quarter turn/pull technique. The computed tomography imaging system used in this study provided a repeatable, noninvasive method of evaluating certain aspects of endodontic instrumentation.

Analysis of Variance↗
PubMedDate not supplied

A pilot study of panoramic film density at selected sites in the mandible to predict osteoporosis.

Osteoporosis is the most common metabolic disease and presents a major public health problem among the elderly. This retrospective pilot study was designed to determine the strength of association of spinal bone density and the density of selected mandibular sites as determined from panoramic radiographs. Panoramic films of known low bone density and high bone density women between the ages of 50 and 75 were evaluated. These films were randomized and then converted to digital images for density analysis. Significant differences were noted between the groups at the 95th percentile. Further study is needed to ascertain the value of panoramic radiology as an adjunct diagnostic tool in the screening of patients thought to be at high risk of developing osteoporosis.

Aged↗