Biomedical subjects
Publications and source records attributed to N M Girdler.
The rare complication of fatal venous air embolism arising as a direct result of dental implant surgery in the mandible is depicted. The deaths arose from the erroneous use of an air/water coolant mixture with internally irrigated implant drills. The pathogenesis and consequence of air embolism is discussed. Practitioners are warned about the dangers of using air-driven equipment during implant surgery.
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This investigation aimed to identify the behaviour of primate mandibular condylar cartilage cells in an in vitro model. Cells were harvested from the mandibular condyles of 1-year-old marmosets and maintained in primary culture for up to 30 d. Cell proliferation, structure, and phenotype were assessed at regular intervals by phase-contrast microscopy, cytologic staining, and immunocytochemistry. Cell growth increased progressively, and cultures reached confluence after 22 d. Cells were initially small and round but later became enlarged and heterogeneous in shape. Polygonal and hypertrophic chondroblast-like cells dominated the mature cultures. Glycosaminoglycan synthesis increased as cultures aged. Type I collagen was produced by early cultures, whereas type II collagen predominated in mature confluent monolayers. It is suggested that this mixed population of cells underwent phenotypic changes in primary cell culture that closely resemble the normal in vivo maturation process.
Unlike hyaline cartilage, mandibular condylar cartilage can respond to injury by complete healing. We have used the reparative potential of mandibular cartilage to promote repair of defects in a hyaline cartilage joint surface. In 12 adult marmosets, articular fibrocartilage from the mandibular condyles was transplanted into full-thickness defects created in the femoral condyles. Additional defects acted as an ungrafted control group. The grafted defects showed good incorporation of the transplant with restoration of the articular surface within six months. Repair was by proliferation of the fibrocartilaginous graft and chondrogenesis of hyaline cartilage. The repopulating cells were distributed in a matrix of maturing collagen and sulphated glycosaminoglycans. Ungrafted control defects were only partly repaired with fibrous tissue, leaving articular deficiencies. We conclude that transplanted mandibular fibrocartilage can promote reconstitution of wounded hyaline cartilage joint surfaces in primates.
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Out-patients attending for removal of at least one lower third molar were randomly allocated to treatment with temazepam elixir (n = 7) or intravenous midazolam (n = 8), as well as local analgesia. Patients were tested prior to drug administration and at the end of surgery. Both drugs increased heart rate and midazolam also decreased diastolic blood pressure. The two drugs caused significant, equal increases in ratings of sedation, but the reduction of anxiety was significant only for midazolam. There was significant amnesia for material presented after drug administration, as well as for dental events and this was significantly greater for midazolam. The effects of these drugs in dental patients were compared with those in normal volunteers treated in an identical manner, but without oral surgery. The drugs had similar significant cardiovascular and amnesic effects in the volunteers and the same effects on mood ratings, even though volunteers and patients differed in their pretreatment levels of anxiety and discontent. The dentist's ratings of the sedation and operating conditions were excellent in both cases. Thus temazepam elixir provided a useful sedative for oral surgery, avoiding the complications of intravenous administration. However, for equivalent levels of sedation, midazolam had greater anxiolytic and amnesic effects than temazepam.
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A new technique which uses mandibular lingual plate as a source of cortical bone for reconstructing orbital floor defects is described. The mandible provides a readily available alternative source of bone for grafting, whilst minimising postoperative complications and morbidity.
The medical and higher academic qualifications of the current membership of the British Association of Oral and Maxillofacial Surgeons were analyzed. Of the total membership, 69.3% possessed a postgraduate dental fellowship, 28.3% held a formal medical qualification and 16.5% held a higher academic degree. Half (45.9%) of the Fellows (Consultants), one-third (28.1%) of the Members and one-tenth (10.9%) of the Associate Members were medically qualified. Consultants in NHS positions and Members in higher training grades accounted for the majority of medically qualified individuals. Higher academic qualifications were held by one-fifth (20.8%) of Fellows, one-tenth (11.4%) of Members and one-fifth (17.7%) of Associate Members. Most of those possessing higher academic qualifications were consultants in University appointments, Members not in training and overseas Associate Members. A dental basis for the specialty was upheld by the finding that 99.7% of Fellows held a post-graduate dental fellowship. These results are discussed in relation to current recommendations for clinical and academic training in oral and maxillofacial surgery in the UK.
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