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Biomedical subjects

N Zerman

Publications and source records attributed to N Zerman.

14 recordsLinked to original sources
PubMed2006

Ultrasonic bone cutting for surgically assisted rapid maxillary expansion (SARME) under local anaesthesia.

Ultrasonic bone-cutting surgery has been recently introduced as a feasible alternative to the conventional tools of cranio-maxillo-facial surgery, due to its technical characteristics of precision and safety. The device used is unique in that the cutting action occurs when the tool is employed on mineralized tissues, but stops on soft tissues. This technical note illustrates the use of Piezosurgery for all osteotomies of surgically assisted rapid maxillary expansion (SARME). The procedure, including pterygo-maxillary detachment, can be completed under local anaesthesia. Other advantages include minimal risk of jeopardizing critical anatomic structures (e.g. palatine artery), minimal intraoperative bleeding and postoperative swelling, and minimal thermal damage to bone surfaces. Narrow and rectilinear osteotomies can be easily performed with varying vibrating scalpels, at the cost of a longer operative time.

Anesthesia, Dental↗
PubMed2006

Femoral nerve palsy after mandibular reconstruction with microvascular iliac flap: a complication under anticoagulation therapy.

Pharmacological prophylaxis and intervention are used extensively in head and neck reconstructions with microvascular flaps. There is no universally accepted protocol, but the microvascular surgery literature recommends intraoperative anticoagulation with heparin. Here is reported a case of iliacus haematoma with subsequent femoral nerve palsy after the harvest of a microvascular iliac flap for mandibular reconstruction in a patient who had been treated with heparin. The association between femoral nerve palsy and anticoagulant therapy has been well described. It remains unclear as to why the iliacus muscle is particularly vulnerable to intramuscular haemorrhage. Femoral nerve neuropathy is also an uncommon but recognized complication after abdominopelvic surgery. Iliacus haematoma secondary to microvascular surgery has not been previously reported. This case illustrates the need to be aware of this type of complication and its clinical manifestations for patients under anticoagulant therapy in the perioperative period during microvascular reconstructions.

Adult↗
PubMed2005

Resorbable plates in maxillary fixation. A 5-year experience.

AIM: Metallic plates and screws have become the routine way of stabilizing the facial skeleton; however, there are many disadvantages in the use of metallic devices. Fixation systems made of biocompatible absorbable material, with appropriate load-bearing properties and sufficient degradation rate can overcome these disadvantages. Recently, resorbable materials were tested in maxillary, mandibular and chin osteotomies. Despite a lot of reports on the use of resorbable bone fixation devices in cranio-maxillo-facial application are now available, their use in preprosthetic surgery has yet to be adequately documented. The Authors report their 5-year experience in the employment of resorbable fixation in surgery of the superior maxilla, involving orthognathic and preprosthetic procedures of the upper jaws. The surgical technique is described and usefulness and advantages are discussed. METHODS: Plates and screws were composed of an 82% poly-L-lactic acid/18% polyglycolic acid copolymer (PLLA-PGA); 50 orthognathic and 5 preprosthetic procedures of upper jaws were involved, performing Le Fort I osteotomies in all cases. RESULTS: Our operations were were carried out without complications. Follow-up ranged from 6 months to 5 years. One patient developed a localized buccal space infection which resolved after a course of antibiotics given orally. CONCLUSIONS: Resorbable fixation should be considered adequate for fixation in maxillary surgery.

Biocompatible Materials↗
PubMed2005

Bone biological plate for stabilization of maxillary inferior repositioning.

AIM: Inferior repositioning of the maxilla to correct vertical maxillary deficiency has been one of the more unstable orthognathic procedures performed. Different surgical techniques have been proposed to stabilize downward movement of the maxilla. The aim of this study was to evaluate the skeletal stability of maxillary anterior downgrafting using bone biological plates in association to bone plates and bone graft for skeletal stabilization. METHODS: The records of 6 patients were evaluated cephalometrically, analyzing the presurgical, immediate postsurgical and long-term follow-up radiographs. All patients had one-piece Le Fort I osteotomy with anterior downgraft of at least 2 mm at point A. Any horizontal movement of the maxilla concomitant with the downgraft was no more than 5 mm. Rigid fixation with titanium miniplates and screws and with bone biological plate was used to stabilize the maxilla. In the sample of 6 patients, 3 underwent one-jaw (maxilla only) surgery and 3 two-jaw surgery. RESULTS: The mean surgical inferior downgrafting at point A was 5+/-1.4 mm (P<0.001) with a relapse of 0.16+/-1. 63 mm (3.2% of surgical movement). The mean surgical inferior downgrafting at the anterior nasal spine (ANS) was 5.66+/-1.36 mm (P<0.001) with a relapse of 0.41+/-1.56 mm (7.32% of surgical movement). Relapse in the vertical dimension failed to reach any statistical significance for all maxillary landmarks. CONCLUSIONS: Anterior downgrafting of the maxilla with this fixation method seems to be a stable and predictable procedure. The use of bone biological plates seems to substantially improve skeletal stability even if further investigations with a more consistent sample of patients is required.

Biocompatible Materials↗
PubMed1995

Traumatic crown fractures in permanent incisors with immature roots: a follow-up study.

A follow-up study of crown fractured permanent incisors with incomplete root formation was carried out in a group of patients, aged 6-12 years, over a 5-year period in the Dental Clinic of the University of Verona, Italy. The number of injured patients was 55, representing 84 injured incisors. All patients were followed clinically and radiographically using a standardized follow-up protocol. The most common type of trauma was fracture of enamel and dentine without pulpal exposure (80%) and the most common type of treatment was restoration with the acid-etch composite resin technique (46%). Bonding of the crown fragment was performed in 10 instances (12%). At the 5-year-control all teeth with fracture of the enamel had no pulp complications. Four of 67 teeth (6%) with fracture of the enamel and dentine without pulpal involvement showed pulp necrosis and 1 tooth showed pulp obliteration (1.5%). Eight of 14 teeth (57%) with fractures of the enamel and dentine with pulp involvement showed pulp necrosis. Aesthetically 36 of the restored teeth were deemed satisfactory (43%). In 9 teeth the bonded fragment had to be rebonded. 14 teeth were considered unsatisfactorily restored due to wear of the composite (17%). 34 restored teeth had to be retreated because of a new trauma (40%). In one tooth a previous bonded fragment had to be rebonded. These results confirmed that crown fractures without pulp involvement in permanent incisors with incomplete root formation hav a low percentage of pulp complications, while 60% of the teeth with crown fractures with pulp involvement had pulp complications.

Chi-Square Distribution↗
PubMed1994

Lack of correlation between salivary Streptococcus mutans and lactobacilli counts and caries in IDDM children.

In a previous clinical study regarding the incidence of caries and the periodontal health, a group of young patients with various levels of glyco-metabolic control was studied and the results showed that the decayed-missing-filled teeth (DMFT) index was higher in insulin dependent diabetes mellitus (IDDM) type 1 patients with a poor glyco-metabolic balance than in a control group or in IDDM patients with sufficient glyco-metabolic balance. In light of these results, the purpose of this study was to find an explanation for these clinical observations by searching at a microbiological level. The results indicate that salivary counts of Streptococcus mutans and lactobacilli were higher in patients with active caries whether or not they be diabetic, than in people with no active caries, but the count of S. mutans was not directly correlated to the DMFT index. No significant alterations were found in salivary flow, pH, buffer capacity and glucose concentration in all the groups in this study. We conclude that the salivary count of S. mutans is not sufficient alone to account for the higher susceptibility to active caries of young IDDM patients with poor glyco-metabolic control.

Adolescent↗
PubMed1993

Traumatic injuries to permanent incisors.

The prevalence of traumatic injuries to permanent incisors and their distribution according to type and some clinical factors, were analysed in a total population of 2798 patients, aged 6-21 years, examined over a 5-year period in the Dental Clinic of the University of Verona, Italy. The material consisted of case histories and radiograms taken during the examination of injured teeth. The number of injured patients was 178 (131 males and 47 females), the number of injured incisors was 326. The prevalence of injuries was 7.3%. A very large number of dental injuries occurred to children aged between 6 and 13 years. The ratio of boys to girls was 2.7:1. Most frequent causes of injuries were falls and traffic accidents. Most injuries involved two teeth. About 80% of the teeth were maxillary central incisors. The most common type of injury was non complicated crown fracture. In 87 cases (48%) there was an associated injury to soft tissue. Alveolar fractures occurred in 22 cases (12%). Traumas involving periodontal ligament constituted nearly 40% of the total. This study noted the following points: 1) preventive education programs should be instituted in the region, directed at parents and school teachers, to inform them about the problems of dental trauma and to obtain cooperative attitude to treatment and good motivation in controls; 2) the necessity to unify the diagnostic and therapeutic protocol to provide reliable information in clinical investigations, to permit valid comparison with other studies and to improve the long-term prognosis of many cases.

Accidental Falls↗
PubMed1990

[The diagnosis and treatment of traumatic root fractures of the coronal third in the mature permanent anterior teeth].

Diagnostic and treatment implications of traumatic root fractures in the coronal third of permanent anterior teeth are reported. A review of the literature imposes a reevaluation of the treatment of these fractures. The teeth with root fractures should not be extracted and endodontic therapy should not be performed unless there is evidence of a pulp necrosis. The authors suggest trying a conservative treatment by repositioning, fixation and relief of occlusion of the teeth with fractures. The fixation is maintained over six months to improve the possibility of recovery. The clinical cases presented prove the long-term prognosis is good even if the location of fracture is near the gingival crevice. The conservative treatment doesn't preclude in case of failure, endodontic, orthodontic and prosthetic therapy. Moreover, according to the authors, conservative treatment represents the most simple, immediate and physiologic solution of functional aesthetic and psychologic problems, especially in young patients.

Adult↗
PubMedDate not supplied

[Clinical evaluation of a posterior photopolymerizing composite: results 4 years after application].

The aim of this study was to examine clinical results of class I and class II composite restorations of forty two posterior teeth, considering pulpal vitality, dentinal sensitivity, marginal integrity, contact areas, color, gingival irritation and secondary decay. The restorations were evaluated over a four-year period. The results are considered satisfactory both from a chemical-physical and biological point of view. The Authors wish to outline the importance to improve the operative technique to minimize the disadvantages of these materials and to obtain better results. The Authors propose to carry out a later control to confirm these results.

Adolescent↗
PubMedDate not supplied

[Histologic changes in human periodontal tissue after transplantation of teeth with completely formed roots].

Authors present the histological evolution of the periodontal tissues after complete-root teeth transplantation in human. They point out that there is a great distinction between the histological and clinical results. It is difficult to obtain the neoformation of a normal periodontal ligament. In spite of the histological failure, they obtained a good clinical result: there fore the complete-root tooth transplantation must be considered an acceptable surgical procedure.

Adolescent↗
PubMedDate not supplied

[Clinico-therapeutic considerations in a serious case of amelogenesis imperfecta].

The Authors present a case of a young female patient affected with a serious hypoplasic form of Amelogenesis Imperfecta, involving all the teeth which has been completely restabilished using composite resin. The therapy used has been developed thanks to the chemical-physical qualities of last generation of composites, which allow the compete reconstruction of teeth. Such a therapy has not to be considered definitive, however it has been used as a temporary solution, waiting for final prosthetic rehabilitation. The Authors estimate that such a temporary long term treatment, that utilize composite resins, represent the ideal therapeutical choice thanks to its characteristics of endurance, cost and benefice. In our opinion this therapy prevents tooth deterioration, secures a better mastication, a partial reduction of the teeth sensibility, facilitates teeth cleaning and solves the esthetical problems with great psychological advantage.

Amelogenesis Imperfecta↗