PubMed Health⌕ Search

Biomedical subjects

Richard H Haug

Publications and source records attributed to Richard H Haug.

At least 19 recordsLinked to original sources
PubMed2006

Maxillary sinus augmentation.

Attention to the principles of bone grafting, bone healing, and maxillary sinus physiology as well as anatomy is critical to the successful placement of dental implants in the posterior maxilla. The integration of these principles must take into account the restorative dental requirements and the patient's autonomy in guiding implant reconstruction. As in so many clinical disciplines, additional research is needed to provide better guidance for clinicians. Despite some gaps in our knowledge, however, sinus augmentation procedures have proven to be safe and effective and have permitted the placement of implants in sites that would have otherwise been impossible to treat. This article summarizes techniques and technologies related to maxillary sinus augmentation.

Alveolar Ridge Augmentation↗
PubMed2006

Progression of periodontal disease in the second/third molar region in subjects with asymptomatic third molars.

PURPOSE: To assess the change in periodontal status over time by periodontal probing depth (PD) in the third molar region. SUBJECTS AND METHODS: The data for these analyses are part of a study of subjects enrolled with 4 asymptomatic third molars with adjacent second molars in an institutional review board-approved longitudinal trial. Full mouth periodontal probing was conducted to determine periodontal status at baseline and follow-up. Panoramic radiographs were analyzed for angulation and degree of eruption of third molars. Subjects were categorized as those who exhibited at least a 2 mm change in periodontal PD between baseline and follow-up in the third molar region, the distal of a second molar or around a third molar, and those who did not exhibit a 2 mm or greater change. Subjects with and without changes in PD were compared with Cochran-Mantel-Haenzsel statistics. Level of significance was set at 0.05. RESULTS: Data from 254 subjects with at least 2 annual follow-up visits were available for analysis. Mean age at baseline was 27.5 years. Median follow-up from baseline to the second follow-up visit was 2.2 years (interquartile range 2.0, 2.6). At enrollment, 59% of the subjects had at least 1 PD > or =4 mm in the third molar region, one quarter had a PD > or =5 mm. Twenty-four percent of the subjects had at least 1 tooth that had an increased PD > or =2 mm in the third molar region at follow-up. If subjects had at least 1 PD > or =4 mm at baseline, 38% had at least 1 PD deepen by 2 mm or more at follow-up. Only 3% of those who had all teeth with a PD of less than 4 mm at baseline exhibited a change of > or =2 mm (P < .001). CONCLUSION: Increased periodontal PDs > or =2 mm were often found in the third molar region for asymptomatic subjects with at least 1 PD > or =4 mm at enrollment, clinical measures that indicated increased periodontal pathology, and a deteriorating periodontal condition.

Adolescent↗
PubMed2006

Change in third molar angulation and position in young adults and follow-up periodontal pathology.

PURPOSE: This study was designed to assess changes in third molar position and angulation in young adults and the resulting third molar periodontal probing (PD) status. PATIENTS AND METHODS: Data derived from patients with 4 asymptomatic third molars with adjacent second molars enrolled in an institutional review board approved longitudinal trial. Inclusion criteria for the trial dictated that patients be healthy and 14 to 45 years of age. Panoramic radiographs were analyzed for third molar angulation as compared with the long axis of the second molar (mesial/horizontal > or =25 degrees ) and eruption to the occlusal plane. Full mouth PD including third molars was conducted at follow-up. At follow-up, PD > or =4 mm distal of second molars or around third molars was considered important clinically. RESULTS: Data from 237 patients were available. Median age was 25.9 years (interquartile range [IQ], 22.1 years, 32.8 years). With a median follow-up of 2.2 years (IQ, 2.0 years, 3.7 years), 44% of impacted maxillary third and 26% of impacted mandibular third molars changed angulation or position. One third of vertical/distal impacted third molars in both jaws and 11% mesial/horizontal mandibular third molars erupted to the occlusal plane during follow-up from baseline. If mandibular third molar angulation as compared with the long axis of the second molar was mesial/horizontal > or =35 degrees , only 3% erupted to the occlusal plane. At follow-up, 11% of the 125 impacted maxillary third and 29% of the 133 impacted mandibular third molars had PD > or =4 mm. Similarly, 11% of the 307 maxillary third molars at the occlusal plane had PD > or =4 mm, but 51% of the 312 erupted mandibular third molars were affected. CONCLUSION: A change in third molar position or angulation was common. Erupted mandibular third molars were more likely to have PD > or =4 mm.

Adolescent↗
PubMed2006

A biomechanical comparison of 2 techniques for reconstructing atrophic edentulous mandible fractures.

OBJECTIVES: The purpose of this investigation was to evaluate and compare the biomechanical behavior of 2 techniques for the reconstruction of atrophic edentulous mandible fractures. MATERIALS AND METHODS: Thirty polyurethane atrophic edentulous mandible replicas (Sawbones, Vashon Island, WA) were used in this investigation (10 controls, 10 replicas of 2 different fixation techniques). The first reconstruction technique was a traditional titanium locking reconstruction plate affixed to the lateral border (buccal surface) of the mandible. The second reconstruction technique used the same type of plate, but placed it on the inferior border of the mandible. Both constructs were subjected to vertical loading at the symphysis and torsional loading at the body regions of the mandible replicas by an Instron 1331 (Instron, Canton, MA) servohydraulic mechanical testing unit. Mechanical deformation data within a 0-900 N range were recorded. Maximum load, displacement at maximum load, and stiffness were determined. Means and standard deviations were derived and compared for statistical significance using a Fisher's Protected Least Significant Differences Test with a confidence level of 95% (P < .05). Second- and third-order polynomial best-fit curves were also created for each group to further evaluate the mechanical behavior. RESULTS: For symphysis loading, statistically significant differences were noted between the control group and both of the plating techniques for displacement at maximum load. However, no differences were noted between the experimental groups for displacement at maximum load, stiffness, or maximum load. For body loading, statistically significant differences were noted between the control group and the inferior border plating group for displacement at maximum load. However, no differences were noted between the experimental groups for displacement at maximum load, stiffness, or maximum load. CONCLUSION: During this bench top investigation, there were no significant differences noted in mechanical behavior between the 2 specific experimental groups for any of the conditions measured. When placed in the context of functional parameters, both of the plating techniques met or exceeded the requirements for loading.

Alveolar Bone Loss↗
PubMed2006

Chronic oral inflammation and the progression of periodontal pathology in the third molar region.

PURPOSE: To assess the association between risk markers of chronic oral inflammation and changes over time in periodontal probing depth (PD) in the third molar region, the distal of a second molar, or around a third molar. SUBJECTS AND METHODS: The data from these analyses are part of a study of subjects enrolled with 4 asymptomatic third molars with adjacent second molars in an institutional review board-approved longitudinal trial. Full-mouth periodontal probing was conducted at enrollment and follow-up. Enrollment levels of periodontal pathogens and gingival crevicular fluid inflammatory mediators were assayed as indicators of the degree of oral inflammation. Subjects were categorized as those who had at least a 2 mm change in periodontal PD between baseline and follow-up in the third molar region and those who did not. The relationship between aggregated subject baseline PD, levels of periodontal pathogens, and gingival crevicular fluid IL-1 beta, and the proportion of subjects with changes in PD >or=2 mm versus those with PD <2 mm were compared with Cochran-Mantel-Haenzsel statistics. Level of significance was set at 0.05. Risk assessment models for a change in PD >or=2 mm were developed using logistic regression analysis. RESULTS: Twenty-four percent of 254 subjects exhibited a change in PD from baseline to follow-up of >or=2 mm in the third molar region. Of these, 95% had a baseline PD of >or=4 mm. Both high (>or=10(5)) "orange" and "red" complex bacteria and PD of >or=4 mm detected at enrollment were significantly associated with a change in PD >or=2 mm. Odds of a change in PD >or=2 mm were increased if baseline pathogen levels were >or=10(5) or a PD of >or=4 mm was detected at enrollment. CONCLUSION: Our findings are consistent with chronic oral inflammation leading to a progression of periodontal disease in the third molar region.

Adolescent↗
PubMed2005

Incidence of occlusal dental caries in asymptomatic third molars.

PURPOSE: We sought to determine the incidence of caries experience on the occlusal surface of asymptomatic third molars erupted to the occlusal plane and to examine the association between the prevalence of caries experience in third molars and other molars. PATIENTS AND METHODS: Clinical data were collected from healthy patients (ASA Class I, II) with asymptomatic third molars enrolled at 2 clinical centers in an institutional review board-approved clinical trial. All patients with at least one third molar at the occlusal plane and with data at baseline and from the most recent of at least 2 follow-up visits were compared in the analysis. At each visit, the presence or absence of caries experience on the occlusal surface of third molars and on any surface of the first and second molars was recorded during clinical and radiographic examinations. RESULTS: Median time between baseline and the most recent follow-up examination was 2.9 years (interquartile range, 1.6 to 4.0 years). Patients (N = 211) were more often female (55%) and white (79%). Median age at baseline was 26.6 years (interquartile range, 22.7 to 32.6 years). At baseline, 29% of patients were affected by third molar occlusal caries, increasing to 33% at follow-up. Older patients at baseline had more caries in a third molar than those younger than 25 years (43% versus 9%). However, patients who were younger at baseline were more likely to develop caries in third molars at follow-up (9% versus 19%). Mandibular third molars were affected more often than maxillary third molars: 25% versus 19% at baseline and 29% versus 22% at follow-up. At baseline and at follow-up, nearly all patients with third molar caries, 98% and 99%, also had caries in first/second molars. CONCLUSIONS: The 3-year caries incidence in third molars erupted to the occlusal plane was highest among younger patients and mandibular teeth. The presence of caries in first/second molars at baseline was highly predictive of the development of third molar caries during the ensuing 3 years.

Adolescent↗
PubMed2005

The American Association of Oral and Maxillofacial Surgeons Age-Related Third Molar Study.

PURPOSE: The purpose of this investigation was to assess the frequency of complications of third molar surgery, both intraoperatively and postoperatively, specifically for patients 25 years of age or older. MATERIALS AND METHODS: This prospective study evaluated 3,760 patients, 25 years of age or older, who were to undergo third molar surgery by oral and maxillofacial surgeons practicing in the United States. The predictor variables were categorized as demographic (age, gender), American Society of Anesthesiologists classification, chronic conditions and medical risk factors, and preoperative description of third molars (present or absent, type of impaction, abnormalities or association with pathology). Outcome variables were intraoperative and postoperative complications, as well as quality of life issues (days of work missed or normal activity curtailed). Frequencies for data collected were tabulated. RESULTS: The sample was provided by 63 surgeons, and was composed of 3,760 patients with 9,845 third molars who were 25 years of age or older, of which 8,333 third molars were removed. Alveolar osteitis was the most frequently encountered postoperative problem (0.2% to 12.7%). Postoperative inferior alveolar nerve anesthesia/paresthesia occurred with a frequency of 1.1% to 1.7%, while lingual nerve anesthesia/paresthesia was calculated as 0.3%. All other complications also occurred with a frequency of less than 1%. CONCLUSION: The findings of this study indicate that third molar surgery in patients 25 years of age or older is associated with minimal morbidity, a low incidence of postoperative complications, and minimal impact on the patients quality of life.

Absenteeism↗
PubMed2005

The relationship between enophthalmos, linear displacement, and volume change in experimentally recreated orbital fractures.

PURPOSE: The purpose of this investigation was to establish the relationship between enophthalmos, linear displacement, and volume change for various patterns of experimentally recreated orbital fractures. MATERIALS AND METHODS: We fabricated an experimental apparatus that permitted uniform displacement of simulated orbital wall fractures. Measurements of linear displacement, volume change, and degree of simulated enophthalmos were taken for 1- and 2-walled displacements. Means and standard deviations were derived, and analysis of variance was used to compare means for statistically significant differences ( P < .05) between groups and among major categories. RESULTS: No statistically significant differences were found for any uniform displacement caused by 1-walled defects or for any given displacement caused by 2-walled defects The linear coefficient for displacement and enophthalmos or for displacement and volume change approached 1.0 for all groups (range, 0.9802 to 0.9999). However, statistically significant differences in mean enophthalmos and mean volume change at uniform displacements were found between 1- and 2-walled defects. CONCLUSIONS: Displacement of 1- and 2-walled orbital defects results in a direct and linear change in both orbital volume and enophthalmos, regardless of the location of the defect.

Enophthalmos↗
PubMed2005

A biomechanical evaluation of bilateral sagittal ramus osteotomy fixation techniques.

OBJECTIVES: The purpose of this investigation was to evaluate and compare the biomechanical behavior of various rigid internal fixation plates designed to aid in the condylar positioning of bilateral sagittal ramus osteotomies, to positional screws in an inverted-L pattern, and a control. MATERIALS AND METHODS: Fifty polyurethane synthetic mandible replicas (Synbone, Laudquart, Switzerland) were used in this investigation. Five controls and 5 each of 4 different fixation modalities (3 bicortical positional screws in an inverted-L pattern, monocortical 4-hole straight plates, monocortical 6-hole curved plates, and monocortical adjustable 4-hole slide plates) were subjected to vertical loading at the incisal edge and torsional loading at the molar region by an Instron 1331 (Instron, Canton, MA) servohydraulic mechanical testing unit. Mechanical deformation data within a 0 to 900 N range were recorded. Yield load, yield displacement, and stiffness were determined. Means and standard deviations were derived and compared for statistical significance using a Fisher's Protected Least Significant Differences Test with a confidence level of 95% (P < .05). Second-order polynomial best-fit curves were also created for each group to further evaluate mechanical behavior. RESULTS: For incisal edge loading, statistically significant differences were noted between the control group and all other groups for yield load and stiffness, and between the control group and straight, curved, and slide plates for yield displacement. Differences were also noted between the inverted-L and straight, strut, and slide plates for yield load; and inverted-L and straight, curved, and slide, as well as straight and slide for yield displacement. For molar loading, statistically significant differences were noted between the control group and all other groups for yield load and stiffness. Differences were noted between the slide and straight, curved, and control; as well as between the inverted-L and straight and strut plates for yield displacement. Lastly, differences were noted between the straight and curved plates, and the slide and straight, curved, and inverted-L for stiffness. CONCLUSION: In this in vitro study, differences were noted between the control and all experimental groups in their abilities to resist loads under all of the conditions tested. Differences were also noted among specific experimental groups. Yet when placed in the context of functional parameters, only the bicortical positional screws in an inverted-L pattern met the requirements for both molar loading and incisal edge loading.

Biomechanical Phenomena↗
PubMed2005

An in vitro comparison of an adjustable bone fixation system.

PURPOSE: The purpose of this study was to biomechanically compare an adjustable plating system and several variations with an inverted-L pattern of 3 bicortical screws to fix a bilateral sagittal split osteotomy. MATERIALS AND METHODS: Sixty polyurethane mandible replicas (Synbone, Laudquart, Switzerland) were used in this study. Ten uncut mandibular replicas served as control models. Fifty experimental synthetic mandibles had bilateral sagittal split osteotomies created with a 7-mm advancement. Fixation modalities included 3 bicortical screws in an inverted-L pattern, a 4-hole sagittal split plate with adjustable slider (slide 0), an adjustable plate with an additional bicortical screw (slide 1), an adjustable plate with 2 additional bicortical screws (slide 2), and an adjustable plate with 3 additional bicortical screws (slide 3). The alloplastic mandibles were secured in a custom fabricated jig and subjected to vertical loads at the incisal edge and torsional loading at the molar region by an Instron 1331 (Instron, Canton, MA) servohydraulic mechanical testing unit. Mechanical deformation data within a 0- to 900-N range were recorded. Yield load, yield displacement, and stiffness were determined. Means and standard deviations were derived and compared for statistical significance using a Fisher's Protected Least Significant Differences Test with a confidence level of 95% (P < .05). Second-order best-fit polynomials were created for the experimental data curves. RESULTS: For incisal edge loading, the control was significantly greater for yield load than the experimental models. No significant difference was noted between slide 0, slide 1, and slide 2, but significant differences were seen with slide 3 and the inverted-L. There were no significant differences between slide 1, slide 2, slide 3, and inverted-L. For molar load, the control was significantly different than the experimental models. However, there was no significant difference between the experimental models. CONCLUSIONS: Mandibular advancements of 7 mm in a synthetic mandible fixed with a 4-hole sagittal split plate with adjustable slider alone is resistant to torsional forces and comparable to that seen with 3 bicortical screws placed in an inverted-L fashion. However, when loading at the incisal edge, additional bicortical screws are necessary to achieve the similar resistance to vertical load as that seen with 3 bicortical screws.

Biomechanical Phenomena↗
PubMed2004

Biomechanical evaluation of fixation techniques for bridging segmental mandibular defects.

OBJECTIVE: To compare biomechanical properties of currently available plating systems used to reconstruct segmental mandibular defects. DESIGN: Controlled in vitro investigation. SETTING: Academic medical center laboratory. INTERVENTIONS: Thirty-two polyurethane mandibles were equally divided among 4 groups: mandibles with a 4-cm lateral segmental defect that was bridged with a (1) 3.0-mm locking-screw reconstruction plate, (2) 2.4-mm low-profile reconstruction plate, or (3) 2.4-mm reconstruction plate and (4) uncut (control) mandibles. All plates were contoured and secured to the synthetic mandibles with 4 bicortical screws on either side of the defect. Three constructs from each group were subjected to contralateral-molar single-load-to-failure testing. Mean yield displacement, yield load, and bending stiffness were quantified and compared among the 4 groups. The single-load-to-failure data were used to establish conditions for fatigue testing; such testing was then performed on the remaining 5 samples in each group. Mean cycles to failure were measured and compared among the 4 groups. RESULTS: Mean yield displacement, yield load, and bending stiffness were comparable among the plated groups. Both the 3.0-mm locking-screw and 2.4-mm low-profile reconstruction plate designs withstood 1580 and 1124 times more cycles to failure, respectively (P = .005), than did the control group. The other reconstruction plate was also superior to the unplated controls, offering an 865-fold improvement. CONCLUSIONS: All 3 mandibular fixation device systems tested produce comparable levels of single load to failure biomechanical integrity; however, the higher-profile plating system design offered slightly superior fatigue performance. No differences in performance were observed between the locking and nonlocking designs; neither failed at the screw-substrate interface.

Biomechanical Phenomena↗
PubMed2004

Occlusal caries experience in patients with asymptomatic third molars.

PURPOSE: Our goals were to determine the prevalence of caries experience, carious lesions, or restorations on the occlusal surface, in asymptomatic third molars erupted to the occlusal plane, and to examine the association between caries experience in other molars and third molars within the same mouth and quadrant. PATIENTS AND METHODS: Clinical data assessing oral health were collected from healthy patients (ASA I, II). The presence or absence of caries experience on the occlusal surface of third molars and on any surface of the first and second molars was recorded during clinical and radiographic examinations. The occurrence of caries experience for younger and older subjects was compared using the general association Cochran-Mantel-Haenszel statistic and the association of occurrence in the maxilla and mandible by the McNemar test. The association between caries experience in a third molar and caries experience in first and second molars also was assessed. RESULTS: Overall, 28% of the 303 patients with at least 1 third molar at the occlusal plane were affected by third molar caries. Patients 25 years or older had more caries experience in a third molar than those younger than 25 years, 39% versus 11% (P <.0001). Mandibular third molars were affected more often than maxillary third molars, 24% versus 18% (P <.0001). Nearly all patients, 76 of 80 (95%), with third molar caries experience also had caries experience in first/second molars, but only 80 of 223 (36%) of patients with first/second molar caries experience had a history of third molar caries. CONCLUSIONS: The prevalence of caries in third molars erupted to the occlusal plane in these young patients was high, but not unique to third molars, particularly in those 25 years of age and older. Although these results provide a baseline description of the association between caries experience in first/second molars and associated third molars, data are needed from longitudinal studies to determine the value of first/second molar caries experience in predicting the risk of caries in third molars.

Adolescent↗
PubMed2004

Biomaterials for use in frontal sinus obliteration.

Although fractures of the frontal sinus are infrequent (2-15% of victims of facial trauma), because of their proximity to the brain and eyes, the consequences of their management may have a significant impact on the patient. For frontal sinus injuries that affect the nasofrontal ducts or posterior wall, obliteration is indicated. Although frontal sinus surgery has been documented since 1750, a consensus as to the best material for obliteration has not been achieved. The particular autogenous and alloplastic materials for use in frontal sinus obliteration will be the focus of this review, with particular attention paid to assessing their physical properties, advantages, disadvantages, and complications. While numerous new alloplastic materials show promise for frontal sinus obliteration, autogenous fat remains the most popular and most frequently used material with the longest history of use, and it is versatile and reliable.

Adipose Tissue↗
PubMed2003

Plates, screws, and children: their relationship in craniomaxillofacial trauma.

The ideal modality for fixation of pediatric craniomaxillofacial fractures remains elusive for a number of reasons. Surgeons who manage these injuries have replaced wiring techniques with the introduction of some form of reconstructive implant. The most commonly used implants are either resorbable or semi-rigid titanium. This presentation is a synopsis of the past 30 years of the English-speaking scientific literature including plastic and reconstructive surgery, otolaryngology, head and neck surgery, oral and maxillofacial surgery, pediatric, trauma, craniofacial, materials, and biomaterials publications. While no consensus on ideal management was observed, various implant treatment options are discussed, including their indications, contraindications, considerations, and consequences after implant placement.

Absorbable Implants↗