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Biomedical subjects

N Trieger

Publications and source records attributed to N Trieger.

At least 19 recordsLinked to original sources
PubMed1991

Anesthesiology for dentists.

Finding the course to satisfy the requirement is not an easy matter. Fortunately, new educational programs are being developed.

Anesthesiology↗
PubMed1989

Intravenous sedation in dentistry and oral surgery.

IV administration is the most precise and effective means of sedating a patient. Its desired effect is a comfortable and cooperative patient whose pain is alleviated by regional local anesthesia. It requires a patient who understands the difference between being lightly sedated and unconscious. Its primary purpose is to diminish anxiety and apprehension rather than to obtund protective reflexes. At all times, the patient should remain conscious and appropriately responsive to questions or commands. This state can be readily achieved in most patients by carefully titrating a single drug such as diazepam or midazolam to effect. The use of multiple drugs is to be discouraged, since it generally increases the level of sedation and the number of complications. Dosing should be individualized rather than averaged or arbitrary. The end point of titration is the patient's verbal acknowledgement of feeling more relaxed and the physical evidence of such relaxation. The "Verrill sign" indicates a level of deep sedation--too deep for most cases of conscious sedation in the office setting. I strongly oppose the routine use of narcotics for office sedation. Monitoring of vital signs before, during, and after surgery ensures the safety of the consciously sedated patient. The use of a pulse oximeter is an evolving standard in general anesthesia and may eventually prove important for patients receiving conscious sedation in the office setting.

Ambulatory Care↗
PubMed1988

An oral surgeon's approach to the fearful patient. Intravenous sedation and general anesthesia.

The oral surgeon's role in the management of the very apprehensive and/or phobic patient presents multiple challenges. It is important for the surgeon to recognize and even analyze some of the subtle changes that he and members of his staff feel when presented with these special patients. In general, they tend to disrupt the usual flow of practice and elicit behavior that may be defensive and threatening. Surgeons are temperamentally task oriented and may not be able to effectively manage such patients short of resorting to full general anesthesia. Appropriately administered and monitored, it may answer the acute surgical need while bypassing the underlying emotional situation. Referral of the patient to a special "dental phobia clinic" for follow-up care is definitely indicated, once the acute pain, swelling, or traumatic injury has been treated.

Anesthesia, Dental↗
PubMed1978

Clinical application of the functional matrix: mandibular reconstruction and monobloc functional therapy.

A 13-year-old black girl with an extensive ameloblastoma of the mandible required subtotal mandibular resection and immediate reconstruction with use of an autogenous, ipsilateral, corticocancellous graft from the iliac crest and monobic functional therapy. Twenty-seven months later, clinical evaluation showed normal mandibular function and no facial asymmetry. Bony architectural changes after 27 months included reformation of the coronoid process, angular process, and external oblique ridge; preservation of mandibular length and thickness; and maintenance of the alveolar ridge height. The reformation of the coronoid process suggests the importance of the functional matrix (temporalis muscle) in skeletal tissue growth. The monobloc appliance in conjunction with bone grafting is an effective means for transmission of biophysical stimuli and for maintenance of appropriate stress for remodeling of bone in the mandible.

Activator Appliances↗
PubMed1978

The art of history taking.

The art of history taking involves the ability to recognize the interrelationship between the details of the medical history and the patient's personal history. For the oral surgeon, this provides important insights into how the patient has reacted to illness in the past as well as how he is most likely to react to current treatment. Specific problems have been reviewed as well as suggested interview techniques to guide the oral surgeon in his management of his patient's reactions. No one expects the doctor to be an iconoclast. He cannot be all things to all patients. He should recognize a problem, acknowledge it as a problem, and be flexible enough to deal with it or refer the patient to someone who can. This kind of understanding will enable the oral surgeon to fulfill his role with appreciation from his patients and an inner sense of professional and personal achievement.

Adolescent↗
PubMed1976

Pain control.

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Anesthesia, Dental↗
PubMed1975

[Analgesia].

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Anesthesia, Dental↗