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Biomedical subjects

M Miloro

Publications and source records attributed to M Miloro.

17 recordsLinked to original sources
PubMed1998

The accuracy of clinical neurosensory testing for nerve injury diagnosis.

PURPOSE: The accuracy of the clinical neurosensory test to diagnose trigeminal nerve injuries has never been statistically evaluated. The purpose of this study was to determine the statistical efficacy of the clinical neurosensory test using surgical findings as the "gold" standard, and to determine whether a correlation existed between the sensory impairment score obtained by preoperative testing and the degree of nerve injury found at surgery. MATERIALS AND METHODS: A multisite, randomized, prospective, blinded, clinical trial was conducted on 130 patients with inferior alveolar nerve (IAN) and lingual nerve (LN) injuries. Preoperatively, patients were provided a sensory impairment score using a three-level drop-out clinical neurosensory test (NST), and blind comparisons were made with the surgical findings postoperatively. RESULTS: The positive predictive and negative predictive values for LN-injured patients were 95% and 100%, respectively. The positive predictive and negative predictive values for IAN patients were 77% and 60%, respectively. There were statistically significant differences in the distribution of age, duration of injury, cause of injury, presence of neuropathic pain, presence of trigger pain, and degree of injury between the IAN and LN patient populations. There was a statistically significant positive relationship found between the sensory impairment score and the degree of nerve injury. CONCLUSIONS: The NST is a clinically useful method to diagnose IAN and LN injuries. However, the NST results are less efficient for IAN injuries than LN injuries, and have a high incidence of false-positive (23%) and false-negative (40%) results when testing patients with IAN injuries. The different rates of statistical efficiency between the two groups of patients may be attributable to differences in prevalence and biologic covariates.

Adolescent↗
PubMed1997

Assessment of the lingual nerve in the third molar region using magnetic resonance imaging.

PURPOSE: The purpose of this study was to determine the precise in situ location of the lingual nerve in the third molar region using high-resolution magnetic resonance imaging. PATIENTS AND METHODS: Ten healthy volunteers (20 sides) with mandibular third molars underwent bilateral axial and coronal high-resolution magnetic resonance imaging (MRI) examinations of the posterior mandible and floor of the mouth from the lingula to the mental foramen. Three trained individuals made measurements of each image to determine the vertical and horizontal position of the lingual nerve in the third molar region. RESULTS: The mean vertical (2.75 +/- 0.97 mm [range, 1.52-4.61]) and horizontal (2.53 +/- 0.67 mm [range, 0.00-4.35]) distances to the lingual crest and lingual plate of the mandible were determined. In the third molar region, there were only 2 of 20 cases (10%) in which the nerve was above the lingual crest, and there were 5 of 20 instances (25%) in which the nerve was in direct contact with the lingual plate. CONCLUSIONS: This study precisely documents the in situ location of the lingual nerve in the third molar region, and reconfirms the relative vulnerable position of this structure during third molar surgery.

Adult↗
PubMed1993

The use of ultrasound to determine the position of the mandibular condyle.

A randomized, single blind study of 20 patients examined the accuracy of ultrasound in establishing the position of the mandibular condyle in relation to the glenoid fossa. The sonographic technique is described. The temporomandibular joint was imaged sonographically with the patients in an open- and a closed-mouth position as a model for condylar sag and proper condylar seating, respectively, during mandibular ramus osteotomy procedures. One radiologist identified condylar position correctly in 38 of 40 still ultrasound images, with a sensitivity and a specificity of 95%. During real time ultrasound examination, it is possible to visualize varying degrees of condylar movement in relation to the glenoid fossa. The results of this study support the potential use of ultrasound as an adjunct to mandibular orthognathic surgery.

Adult↗
PubMedDate not supplied

Comparison of resorbable and nonresorbable guided bone regeneration materials: a preliminary study.

The purpose of this study was to compare bone regeneration within a surgically created defect using three different resorbable membranes (polyglactin 910 knitted mesh/Vicryl, freeze-dried fascia lata, and crosslinked bovine type I collagen/BioMend) and two nonresorbable membranes (expanded polytetrafluoroethylene/Gore Tex, and polytetrafluoroethylene/Millipore). Each of three adult male dogs underwent surgical preparation of six bicortical defects of the calvarium, each 1.5 cm in diameter. The experimental barrier membranes were placed on both sides of the defects (inner and outer cranial tables). Five of the six defects were covered randomly by one of the five membrane materials, and one was left uncovered to serve as a negative control. The animals were sacrificed 10 weeks after membrane placement. Bone response was measured clinically, as well as radiographically, via densitometric examination. All surgical sites healed uneventfully. Variable degrees of new bone growth were present at all sites when evaluated by both clinical and radiographic examination. The general trend of observed osseous response indicates a greater, although not statistically significant, degree of bone growth using nonresorbable membranes. The animal model employed appears to be an efficient and reliable means of evaluating guided bone regeneration membranes.

Animals↗