Biomedical subjects

R S R Buch

Publications and source records attributed to R S R Buch.

8 recordsLinked to original sources

PubMed2005

[Metallic condylar head prostheses to replace the temporomandibular joint].

BACKGROUND: Up to now the results after condylar reconstruction of the mandible have been regarded as less than satisfactory. PURPOSE: Functional and aesthetic long-term results after condylar head resection in traumatic and tumour cases with or without replacement by a metallic condylar head prosthesis were compared in a retrospective study. PATIENTS AND METHODS: From 1980 to 2001, 23 temporomandibular joints of 19 patients were reconstructed with metallic condylar head prostheses. The resected region, the contralateral joint, facial and masticatory muscles and the dental system were clinically and radiographically monitored for a mean period of 4 years and 9 months. Seven patients who underwent condylar resection without substitution were observed over an average follow-up time of 7 years and 11 months. RESULTS: Patients who underwent condylar resection without substitution reported more trouble with eating and speaking for a long time. TMJ endoprostheses preserved facial symmetry better. Maximum mandibular opening as well as lateral and protrusive excursions were slightly reduced in comparison with both unaffected controls and patients who underwent condylar resection without substitution. In this study bilateral condylar prostheses exhibited the same functional and aesthetic results as unilateral arthroplasty. CONCLUSIONS: Metallic condylar head prostheses originally developed for temporary replacement worked in some cases as long-term joint replacement but were not able to reach the total functional quality of natural temporomandibular joints.

Bone Plates↗

PubMed2005

[Dental injuries due to miniplate osteosynthesis. Classification, treatment management, complications, and prognosis].

BACKGROUND: In spite of a monocortical design, miniplate osteosynthesis can injure dental roots directly as well as damage dental substance indirectly by interrupting the apical blood stream. PURPOSE: The present retrospective study classifies different types of dental root trauma caused by monocortical screws, suggests therapeutic options based on diagnosis, and documents survival probability and prognosis after tooth trauma. PATIENTS AND METHODS: During a period of 11 years, 380 patients with permanent dentition underwent miniplate osteosynthesis for the treatment of mandibular fractures, 29 of whom sustained dental root trauma caused by drilling failure. These patients were clinically and radiographically examined for a follow-up time of not less than 38 months. RESULTS: The 29 patients could be classified into four different types of dental root trauma: 13 pulp injuries above the apical third of the root (type Ia), 6 pulp injuries in the apical third of the root or extradental lesions interrupting the apical blood stream (type Ib), 4 lesions to the central radicular dentin without pulp injury (type II), and 6 lesions to the peripheral radicular dentin and root cementum (type III). Of 13 type Ia injuries, 5 developed apical periodontitis and dilatation of the periodontal space. Therefore one root canal treatment and three apicoectomies were performed. One tooth had to be extracted. Three further type Ia injuries and two type Ib injuries showed root resorptions inducing two root canal treatments. One of six type Ib injuries required root canal treatment because of apical periodontitis. One of four type II injuries caused root resorption not requiring therapy. No relevant, pathological finding could be identified after type III injury. CONCLUSIONS: The type of dental root trauma caused by miniplate osteosynthesis determines therapy, complication rate, and survival of the injured tooth.

Adolescent↗

PubMed2003

[Adenomatoid odontogenic tumor in calcifying odontogenic cyst].

BACKGROUND: Adenomatoid odontogenic tumors (AOT) and calcifying odontogenic cysts (COC, Gorlin's cyst) are rare benign specificities of odontogenic tumors. Most odontogenic tumors are lesions of embryonic odontogenic tissue. Radiographically, odontogenic tumors may mimic an odontogenic follicular cyst. CASE REPORT: This paper describes the case of an 11-year-old female patient with a remarkable combination of these two entities. The lesions were found at the site of a retained first premolar and a persistent deciduous tooth 84 of the right lower jaw. Without clinical symptoms the tumor had expanded the vestibular cortical bone of the premolar region. Radiographically, the lesion appeared as a typical follicular cyst. During the operation, excochleation of the cyst was performed and the premolar was extracted. Finally, the epithelium of the cyst was treated by curettage. The histologic specimen revealed the diagnosis of an adenomatoid odontogenic tumor (AOT) in a calcifying odontogenic cyst (COC). DISCUSSION: The described case shows that symptoms of odontogenic tumors are usually nonspecific. For that reason one should always take a biopsy for histological investigation when patients present atypical cysts of the jaw. In rare cases even malignant odontogenic neoplasms could occur.

Bicuspid↗

PubMed2003

[Acute tongue necrosis provoked by epirubicin-cyclophosphamide treatment for invasive ductal breast cancer].

CASE: Unilateral necrosis of the tongue is an uncommon symptom of different rare diseases. Previously, it had only been described as an infrequent complication of temporal arteritis or as a side effect of therapy with ergotamine. We present a case of unilateral necrosis of the tongue in a 62-year-old woman with invasive ductal carcinoma of the breast treated with epirubicin and cyclophosphamide. RESULTS: The necrosis led to a rapid swelling of the tongue and consequently to an airway obstruction necessitating a tracheotomy. After excision of the necrosis, the swelling of the tongue and the airway obstruction subsided. DISCUSSION: Because of the temporal connection between the occurrence of the necrosis and the administration of chemotherapy, an adverse effect of the administered drugs seems most likely. However, a paraneoplastic pathogenesis cannot be completely excluded. The occurrence of unilateral necrosis of the tongue is a rare complication of the above-mentioned conditions. However, it is important to be aware of the different causes leading to this rare disease in order to initiate the right therapy.

Acute Disease↗

PubMed2003

[Partsch's chronic granulomatous inflammation, the cutaneous manifestation of a dental cause].

Dentogenous inflammatory diseases can lead to typical dermatological facial symptoms with formation of cutaneous sinuses. Partsch's chronic granulomatous inflammation can result from conducted inflammation of a nonvital tooth via a chronic apical inflammation. In this rare disease, the granulomatous tissue perforates the bone, channels through the overlying skin, and drains via cutaneous or oral sinuses. A frequent localization of the cutaneous sinus is the skin inferior to the body of the mandible, and it is caused by an inflammation of the lower molars. Treatment consists of identifying the responsible teeth and eliminating the focus of infection. Chronically progressive periradicular granuloma and/or radicular cysts can be present with impressive dermatological symptoms. Therefore, X-ray examinations are necessary to exclude possible dentogenic causes in cases of badly healing processes of the face or neck.

Adult↗

PubMed2002

[Patient satisfaction with dental implants].

BACKGROUND: Almost all implant systems available today achieve success rates of over 90%. The subjective satisfaction of patients with dental implants is only rarely considered in the definition of implant success and there are only limited data on the satisfaction of patients with dental implants in the literature. Therefore, a satisfaction analysis was carried out in a retrospective study. DESIGN OF STUDY: In addition to a clinical investigation, 330 patients with 1,273 implants (Astra, Frialit-2, IMZ TwinPlus and ITI) were asked to answer a standardized questionnaire to rate their personal opinion on the implant success. A total of 199 questionnaires (803 implants, 63%) were returned and could be analyzed. RESULTS: Of the patients, 67% participated in regular follow-up after implantation and 15% indicated postoperative discomfort. Patient satisfaction with the implants (rated on a scale of 1-6) was good or excellent (2 and 1, respectively) in 88% of cases. Satisfaction with the prosthetic treatment was 80%. The whole treatment was considered good or very comfortable by 86% of patients. If necessary, 91% of patients who underwent the procedure would do so again, and 94% would recommend the procedure to someone else. The Spearman correlation analysis did not reveal any statistically significant correlations between the clinical parameters and patient satisfaction scores. DISCUSSION: Despite the high number of patients involved ( n=330), the expected influence of objective clinical parameters on patient satisfaction could not be statistically evaluated. Nevertheless, in addition to the clinical parameters, subjective patient satisfaction should be included in the evaluation of implant success.

Dental Implants↗

PubMed2002

[Criteria of success in implantology].

BACKGROUND: So far there is no generally accepted definition of success in the case of dental implants, although criteria differing from country to country have been proposed, which evaluate the success of implants with reference to clinical and X-ray control parameters. The aim of the study was to examine the five most frequently used sets of criteria suggested for determination of the success or otherwise of implants ( Albrektsson, Jahn, Buser, NIH conference, Naert) and ascertain their relative values. METHODS: In a clinical review, 508 implants (Astra, Frialit-2, IMZ TwinPlus and ITI) were examined and a subjective evaluation of them was made by the patients. Subsequently a statistical analysis was executed (in situ rate, Kaplan-Meier, success criteria). RESULTS: The average observation time of all implants included in the study was 3.5 years, and the in situ survival rate was 95%; Kaplan-Meier survival analysis revealed that the probability of survival after 6 years was 93%. Application of different criteria for success gave very different results (Albrektsson 88%, Naert 89%, NIH 85%, Buser 88%, Jahn and dacute;Hoedt 75%). DISCUSSION: The increasing importance of quality assurance in medicine makes it necessary to establish standards that will permit reliable comparative analysis of how successful implants are in the future.

Dental Implantation, Endosseous↗

PubMed2002

[Acral ischemia as a rare paraneoplastic syndrome in the terminal phase of mouth floor carcinoma].

BACKGROUND: The term "paraneoplastic syndrome" describes a clinically apparent disease associated with a malignant neoplasm, which is not a direct consequence of invasive tumor growth. Acral ischemia and digital necrosis of multiple fingertips have been occasionally described as a paraneoplastic syndrome. However, the exact mechanisms of this phenomenon are still not adequately known. CASE REPORT: This paper describes a 72-year-old male patient with severe acral ischemia and multiple necroses on several fingertips. Symptoms evolved under palliative chemotherapy with gemcitabine for inoperable metachronous squamous cell carcinoma of the tonsil following a history of two simultaneous carcinomas of the alveolar crest. Digital ischemia was combined with severe pain, similar to Raynaud's syndrome, which required therapeutic intervention. The treatment objective is to improve perfusion and simultaneously reduce pain. A combination of iloprost, an analog of prostacyclin (50 micrograms intravenous Ilomedin once daily), and a CT-guided thoracic sympathectomy achieved a continuous positive effect on the intensity of acral ischemia and alleviated the pain.

Aged↗