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Biomedical subjects

M S Dover

Publications and source records attributed to M S Dover.

15 recordsLinked to original sources
PubMed2005

Cortical bone screw fixation in ionically modified apatite cements.

Hydroxyapatite cements are used in reconstruction of the face; usually in well-defined cavities where the cement can be stabilized without the need for internal fixation. A hydroxyapatite cement that could enable screw fixation and some loading therefore has considerable potential in maxillofacial reconstruction. It has been demonstrated recently that water demand of calcium phosphate cements can be reduced by ionically modifying the liquid component. This study investigated the capacity of an ionically modified precompacted apatite cement to retain self-tapping cortical bone screws. Screw pullout forces were determined in the direction of the screw long axis and perpendicular to it, using cortical bone and polymethylmethacrylate cement as a control. In bending pullout tests, measured forces to remove screws from ionically modified precompacted cement were insignificantly different from cortical bone. However, pullout forces of bone screws from hydroxyapatite cement decreased with aging time in vitro.

Bone Cements↗
PubMed2005

Removal of miniplates in maxillofacial surgery: a follow-up study.

PURPOSE: We sought to follow-up a cohort of patients who had miniplates (plates) inserted in the oral and maxillofacial region during a 13-month period over 4 years to study the incidence and factors associated with plate removal. PATIENTS AND METHODS: One hundred fifty-three patients had plates inserted in the oral and maxillofacial region in the Department of Oral & Maxillofacial Surgery, University Hospital Birmingham, UK, between November 1, 1998, and November 30, 1999. All 153 patients' records were revisited on or after October 31, 2002, giving a minimum follow-up of 3 years and a maximum of 4 years. RESULTS: During a period of 13 months (November 1, 1998 through November 30, 1999), 308 plates were inserted into 153 patients. A total of 32 plates were removed from 21 patients by October 31, 2002, (10.4%) over 4 years; 27 plates were removed from 16 patients for purely plate-related symptoms, with infection being the most common cause accounting for 16 plates (50%) in 9 patients. Symptoms necessitating plate removal occurred within 52 weeks after insertion in 16 patients, accounting for 23 of the plates removed (72%). The age of the patient at plate insertion may have some influence on plate removal but this was not significant. Seniority of the operator did not affect plate removal. CONCLUSION: Our experience with the removal of miniplates compares with previously published reports. Longitudinal follow-up at 4 years indicates that plate-related problems leading to removal are likely to occur in the first year after insertion.

Adolescent↗
PubMed2004

Cranioplasty in children.

OBJECTIVE: The objective was to assess the outcome and complications associated with different cranioplasty implant materials in children. MATERIALS AND METHODS: A retrospective review was conducted of 28 consecutive cranioplasties carried out on 24 children between 1994 and 2001 (age range, 9 months to 15 years; minimum follow-up 18 months). The indications were: defect from previous craniectomy for trauma, tumour, infection or evacuation of haematoma (n=21), intradiploic dermoid cysts (n=2), growing fractures (n=4) and residual bony defect following craniofacial reconstruction (n=1). The materials used were: patient's craniectomised bone flap (n=16), split calvarial graft (n=8), acrylic (n=3) and titanium (n=1). All patients were assessed for bony fixation, cosmesis, wound healing and flap infection. RESULTS: There was no mortality and 18% morbidity (n=5: 3 infected flaps, 1 sterile wound dehiscence and 1 sterile wound discharge; overall infection rate 10%). Out of the 14 patients who had their own craniectomised bone flaps implanted initially, 3 became infected (2 in patients with bilateral defects) necessitating flap removal. Two of these were successfully re-implanted. No donor or recipient bone flap complications were seen in the 8 split calvarial grafts, wound discharge was seen in 1, requiring wound toilet. No complications were seen with acrylic or titanium cranioplasties. CONCLUSION: In this series, the use of the patients' own craniectomised flap had a low infection rate, and was mainly seen in patients who had bilateral flaps re-implanted soon after removal. There were no complications arising from the use of split calvarial and allograft material. Use of autologous implant material should be preferred whenever possible due to obvious resource and biological advantages, and can even be re-implanted if infected.

Adolescent↗
PubMed2002

Links between anaesthetic modality and nerve damage during lower third molar surgery.

OBJECTIVE: To investigate the relationships between eruption status, gender, social class, grade of operator, anaesthetic modality and nerve damage during third molar surgery. DESIGN: Two centre prospective longitudinal study. SETTING: The department of oral and maxillofacial surgery, University Hospital Birmingham NHS Trust and oral surgery outpatient clinics at Birmingham Dental Hospital. SUBJECTS: A total of 391 patients had surgical removal of lower third molars. Sensory disturbance was recorded at one week post operatively. Patients with altered sensation were followed up at one month, three months and six months following surgery. RESULTS: 614 lower third molars in 391 patients were removed. Forty-six procedures (7.5%) were associated with altered sensation at one week with three procedures (0.49%) showing persistent symptoms at six months. Of these 46 nerve injuries, 26 (4.23%) involved the lingual nerve and 20 (3.25%) the inferior dental nerve (IDN). All three persistent sensations were IDN related. A logistic regression model found that the use ofa lingual retractor chi2 = 11.559, p = 0.003 was more significant than eruption status chi2 = 12.935, p = 0.007. There was no significant relationship between anaesthetic modality, age, social class, sex and seniority of operator. CONCLUSIONS: There was no link between the choices of local or general anaesthesia and nerve damage during lower third molar removal when difficulty of surgery was taken into account.

Adolescent↗
PubMed2002

A method of skeletal anchorage for maxillary distraction.

A simple method of providing skeletal anchorage in maxillary distraction is described. The method utilizes cheap and readily available miniplates and provides rigid fixation to the fragment. It can be utilized at multiple levels in high-level osteotomies and situations with an inadequate dentition for anchorage.

Bone Plates↗
PubMed1999

Anchoring the detached temporalis muscle in craniofacial surgery.

The temporalis muscle is often detached to enable craniofacial tumour and trauma access surgery. Failure to carefully handle and reattach the muscle often leads to a cosmetic and functional deformity. The authors discuss the principles of elevation of the whole temporal muscle within its surrounding fascia to reduce atrophy. The temporalis muscle is then reattached to its point of origin, using suspensory absorbable sutures attached to 3 mm titanium microscrews placed inferior to the limits of the muscle, to make them non-palpable. The aim is to reduce the postoperative temporal hollowing often seen when these principles are not observed. A series of cases using this technique are reported.

Adolescent↗
PubMed1992

Breast abscesses and cigarette smoking.

An 11-year retrospective review of women with breast abscesses presenting to a district general hospital was performed. A total of 122 women were identified with a breast abscess: 85 (70 per cent) with non-lactational abscesses and 37 (30 per cent) with an abscess in the puerperium. Six of 37 lactational and 24 of 85 non-lactational abscesses recurred. Sixteen mammillary fistulae developed, all following incision and drainage of non-lactational breast abscesses. Women with non-lactational breast abscesses were more likely to smoke cigarettes (P less than 0.005). Breast abscesses containing anaerobic bacteria were significantly more likely to occur in current cigarette smokers (P less than 0.05). Women with non-lactational breast abscesses who were heavy cigarette smokers were more likely to suffer recurrent abscesses (P less than 0.01). There was histological evidence of duct ectasia on biopsy in 25 women with non-lactational abscesses and 21 of 25 were current smokers. Mammillary fistulae developed more frequently in current smokers (P less than 0.03). Cigarette smoking is important in the natural history of non-lactational breast abscesses and may predispose to anaerobic breast infections and the development of mammillary fistulae.

Abscess↗
PubMed1988

The effect of collagen and indomethacin on inflamed dental pulp wounds of baboon teeth.

Following the induction of experimental pulpitis in baboon teeth, calf skin collagen, indomethacin, or zinc oxide-eugenol was used to dress exposed dental pulp wounds in selected teeth. The teeth were extracted after 7, 35, and 90 days fixed in formalin, and processed, for histopathologic examination. The inflammatory response to zinc oxide-eugenol remained moderate throughout the experiment, whereas the inflammatory response to indomethacin and collagen was present from the outset and became progressively more severe, especially with collagen. The amount of irritation dentin production, however, was greater in those dental pulps dressed with collagen and indomethacin.

Animals↗