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Biomedical subjects

R D Marciani

Publications and source records attributed to R D Marciani.

At least 37 records · Page 2Linked to original sources

Healing following conventional and cryosurgical discoplasty in the monkey temporomandibular joint.

The techniques of conventional discoplasty and the scar producing potential of cryosurgical treatment of the bilaminar region were examined in a study of 17 adult female cynomologous monkeys. Temporomandibular joint (TMJ) tissues were obtained at four and 10 days, four, 20, 52, and 78 weeks after surgery, and compared to TMJ tissues in unoperated control animals. No clinically observable changes in weight, occlusion, or jaw function were identified. All the surgical sites healed normally. At necropsy, lesions of the articular surface of the condyle were apparent in areas that had been surgically "shaved." The anterior, intermediate, and posterior zones of the surgically-treated discs were generally free of change. Two cryosurgically-treated discs showed lesions and perforations. Histologic and autoradiographic observations suggested that the bilaminar area heals quickly with minimal scarring, following both conventional surgical manipulation and cryosurgery. Under the conditions of this experiment the cryosurgical technique was judged not to be superior to the conventional surgical approach.

Animals↗

Freeze treatment of the monkey mandibular condyle.

Monkey mandibular condyles were frozen in situ and subsequently examined clinically and histologically. The frozen bone served as a structural matrix for the formation of new, vital bone. No ankylosis, open-bite deformity or loss of function was observed.

Animals↗

Osteoradionecrosis of the jaws.

One hundred nine cases involving patients who had received radiation therapy for head and neck cancer were reviewed. Osteoradionecrosis of the mandible developed in only three patients in this group. Postirradiation extractions were not identified as a significant risk factor for such necrosis.

Cobalt Radioisotopes↗

Facial pain complaints in the elderly.

The incidence of facial pain and mandibular dysfunction was studied in a population of elderly, middle-class Americans (median age, 71 years) using a self-report questionnaire. The questionnaire was mailed to 839 volunteer subjects of both sexes; responses were obtained from 562 (67%) individuals. Results showed that 536 respondents (95.4%) were free of facial pain and that only 25 (4.4%) had temporomandibular joint pain. Joint sounds and teeth clenching and grinding were associated with facial pain in 50% of those who reported this combination.

Aged↗

Autologous transfusion in orthognathic surgery.

The principles of autologous transfusion are discussed. Autologous blood can be transfused for about the same cost as conventional donor blood, but there is decreased risk of the transmission of infectious disease or the formation of antibodies directed against red-cell antigens. Intraoperative blood replacement requirements for almost all orthognathic surgical procedures may be met by autologous liquid storage according to the schedule provided.

Adult↗

Treatment of facial fractures in neurologically injured patients.

The clinical records of 53 patients who had head injury and facial trauma were reviewed and analyzed to ascertain what affect head injury had on the repair of facial fractures. The study was designed to establish the incidence of complications and to discover what factors contributed to untoward sequela in such patients. It was found that the neurologically injured patient developed postoperative facial fracture complications, particularly in the mandible, more frequently than those facial trauma patients who were not neurologically compromised.

Adolescent↗

Temporomandibular joint surgery: a review of fifty-one operations.

The clinical records of thirty-six patients previously treated with fifty-one TMJ surgical procedures were reviewed and analyzed. Each patient was sent a questionnaire designed to elicit a perception of the results of the surgical treatment. Seventy-seven percent of the respondents reported that their TMJ area discomfort was "much better", and 94 percent would have the surgery again. Fifteen patients had preoperative interincisal openings of less than 35 mm. Of these patients, eleven had postoperative interincisal openings of 35 mm., or more with a mean increase of 13 mm. The findings of this study indicate a high percentage of patient satisfaction with the results of TMJ surgery and a general improvement in ability to function.

Adult↗

Healing of freeze-treated hemimaxillary bone.

Earlier studies suggested that the combined techniques of excision, freezing, and reimplantation of mandibular bone may provide a new method for the treatment of intraoral bone tumors. An experiment was conducted to investigate the bone healing and revascularization associated with resected, frozen, and reimplanted maxillary bone. In all the FT and NFT hemimaxillas evaluated, complete reconstitution occurred. The degree of revascularization was similar in both FT and NFT monkeys, suggesting that freezing does not adversely effect subsequent revascularization. Compared to the sham operated sides, both FT and NFT hemimaxillas showed a high degree of revascularization; this phenomenon was greatest at six weeks postoperatively. Microscopically, in all the animals, periosteal osteoblastic activity was present in variable amounts. The interstitial tissue was predominantly fibrous rather than fatty marrow, and no detectable differences were noticed between FT and NFT animals in the same time interval.

Animals↗

Cancellous bone marrow grafts in irradiated dog and monkey mandibles.

A pilot study was conducted to investigate the osteogenic potential of autogenous cancellous marrow grafts placed in irradiated tissue. Five dogs and three monkeys received either 4,100 or 6,520 rads of cobalt-60 irradiation during a 5- or 8-week period. Postirradiation discontinuity mandibular defects were created surgically and restored with autogenous cancellous bone marrow grafts held in position by a titanium mesh basket. Bony union occurred in all the mandibles. Intraoral ulceration was common in the dogs, and extraoral wound dehiscence was found in the monkeys. Hematopoietic marrow was present in the graft sites of both species 6 months to 1 year after surgery.

Animals↗

Treatment of the fractured edentulous mandible.

Fifty-three cases of fractures of edentulous mandibles were reviewed and analyzed. Thirty-three cases were sufficiently documented to assess the entire treatment course. Two nonunions were identified. Major factors contributing to the difficulty of repair of fractures include the location of the fracture, the height of the horizontal ramus, and the patient's systemic condition. Closed reduction of fractures of atrophic mandibular bodies is advocated. Although anatomical alignment may not be achieved by this approach, it may preclude nonunion and a prolonged clinical course.

Adult↗

Senior residents' opinions about oral surgery programs.

A questionnaire for senior oral surgery residents was distributed to elicit their opinions about various phases of their oral surgical training. Of 206 questionnaires sent to members of house staffs in approved programs, 122 responses (59%) were received. The average senior resident felt well prepared in exodontia, trauma, and orthognathic surgery. He considered himself much less prepared in pediatric oral surgery and tumor management. The average resident believed oral surgery was well regarded and would again choose his own program for training.

Curriculum↗

Autogenous cancellous-marrow bone grafts in irradiated dog mandibles.

A pilot study was conducted to investigate the osteogenic potential of autogenous cancellous-marrow grafts placed in irradiated tissue. Three dogs received 4,100 rads in ten treatments ooer 32 days. Postirradiation discontinuity mandibular defects were created. These defects were restored with cancellous-marrow autogenous bone supported in position by a titanium mesh basket. Bony union occurred in all the mandibles. The titanium mesh partially eroded through the oral mucosa in two animals. The quantity of new bone formed in the surgical defect varied. Two dogs had complete restoration of the resected mandible. Histologic observations were documented in both the graft area and the surgically uninvolved contralateral side of the mandible.

Animals↗

Fracture-dislocation of the mandibular condyle: report of case.

A rare type of ramus fracture-dislocation has been presented. The inadequacy of standard mandibular fracture radiographic views for proper diagnosis of variable dislocations has been stressed. It was noted that proper positioning of the mandible in panoramic radiography would facilitate a satisfactory radiographic survey of the glenoid fossa and the condyle. In this case, interpositional silastic gap arthroplasty was performed to correct an extraarticular ankylosis and to restore mandibular function.

Adolescent↗

Cryotherapy in the treatment of ameloblastoma of the mandible: report of cases.

Two cases of ameloblastoma treated in part by cryotherapy have been presented. The first case was of particular interest because of the extensive intraoral involvement and history of recurrences. The second case evolved as an example of the rare peripheral ameloblastoma. In both cases, cryotherapy was used as an adjunctive modality to conserve mandibular bone without compromising the primary objective of adequately treating the tumor. We contend that the judicious use of cryotherapy offers the advantage of treating a broad area of bone without destruction of the basic structural matrix of this tissue.

Ameloblastoma↗

Applicants' opinions about the selection process for oral surgery programs.

A survey of applicants to oral surgery graduate programs was distributed to 170 candidates requesting application forms from the University of Kentucky. Eighty-five applicants responded. The average candidate was approximately 28 years old, married, and attended dental school in the southeast or midwest. He applied to ten programs and viewed a personal interview as an important part of the application process. Traditional criteria such as basic science grades and class rank were not uniformly considered as important factors in the initial screening of candidates. Other views and criticisms of the applicants are examined and suggestions are provided to reduce some of the apparent inequities now inherent to the system.

Curriculum↗

Cancellous-marrow bone grafts in irradiated tissue.

Discontinuity defects of the mandible have been successfully treated by means of cancellous-marrow grafting techniques. This method of reconstruction has not been widely reported in the repair of defects in mandibles that have been exposed to radiation therapy. In the two cases presented in this article, the patients were previously treated for oral squamous-cell carcinoma by irradiation and partial mandibulectomy. Later, cancellous-marrow grafts were implanted. One patient received 3,000 rads of Cobalt-60 and had the body of the right mandible resected. The subsequent grafting procedure was successful in this patient. The second patient received 6,000 rads of Cobalt-60 and underwent resection of the mandible anterior to the molar region. The subsequent graft failed in this case.

Bone Marrow Cells↗