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Biomedical subjects

S L Bronstein

Publications and source records attributed to S L Bronstein.

17 recordsLinked to original sources
PubMed1990

Osteophytic reaction to a polytetrafluoroethylene temporomandibular joint implant. Report of a case.

Alloplastic disk substitutes of polytetrafluoroethylene (PTFE) used in the management of late stage temporomandibular joint disease have often been accompanied by morbid tissue reactions and resultant destructive changes. Numerous clinicians have reported cases of severe radiographic and clinical bony destruction and degeneration accompanied by marked foreign body giant cell reactions in the adjacent soft tissues. The case reported here demonstrates just the opposite event. Osteophytic enlargement of the lateral portion of the zygomatic arch and glenoid fossa, with adaptation to the contours of the implant, along with severe condylar osteophytosis, was diagnosed through tomographic and CT imaging and was confirmed at surgery.

Adult↗
PubMed1989

Arthroscopic diagnosis of perforation and adhesions of the temporomandibular joint: correlation with postmortem morphology.

Arthoscopy was performed in the upper joint compartment of 28 temporomandibular joints in 16 fresh cadavers to investigate the accuracy of arthroscopic diagnoses of perforation and adhesion. Subsequent dissections revealed that only three of nine perforations were seen arthroscopically and that three of four joints with adhesions were arthroscopically diagnosed. There was no overdiagnosis of perforation or adhesions. Intra-articular hyperplastic soft tissue formation (crab meat) was arthroscopically seen in ten joints (36%) and was with only two exceptions associated with either a perforation or adhesions. Histologically, the adhesion and the hyperplastic soft tissue consisted of fibrous connective tissue with collagen fibers and fibroblasts. It was concluded that a positive arthroscopic diagnosis of adhesion or perforation is reliable whereas a negative diagnosis of perforation is not reliable.

Aged↗
PubMed1987

Retained alloplastic temporomandibular joint disk implants: a retrospective study.

The surgical treatment of intermediate- to late-stage temporomandibular joint disease often involves disk removal. In many instances, disks have not been replaced; long-term postsurgical findings of crepitation and osseous remodeling have been noted although subjective signs and symptoms have been few. Attempts to decrease the noises and bony changes, to enhance biologic resurfacing, and to prevent adhesions, recurrent pain, and dysfunction have prompted many surgeons to use various alloplastic materials to replace the disk, either in a planned permanent (retained) or a planned temporary (retrievable) manner. However, a certain degree of morbidity remains. This article reports clinical responses and radiographic findings in a series of patients who received retained alloplastic temporomandibular joint disk implants.

Adolescent↗
PubMed1987

Temporomandibular joint: comparison of single- and double-contrast arthrography.

Lower-space, single-contrast arthrography and dual-space, double-contrast arthrotomography were sequentially applied to 58 fresh temporomandibular joint (TMJ) autopsy specimens, and the findings were compared with observations in corresponding cryosections. Both modalities had high accuracy rates (greater than or equal to 84%) and no statistically significant differences between the two techniques were found. A side-by-side comparison of the two types of arthrograms, however, revealed that video tape recording of lower-space, single-contrast arthrography was superior in demonstrating joint dynamics and that dual-space, double-contrast arthrotomography was superior in demonstrating the soft-tissue anatomic features of the joint. It appears that lower-space, single-contrast arthrography can be recommended for examination of patients with clicking, catching, and intermittent locking, and that dual-space, double-contrast arthrotomography is preferable when information about morphologic alterations is clinically more important than information about joint dynamics.

Arthrography↗
PubMed1986

Temporomandibular joint: correlation between single-contrast videoarthrography and postmortem morphology.

Arthrography of the temporomandibular joint is widely performed in clinical practice. The diagnostic accuracy of this technique has not been systematically evaluated. Therefore, findings from transcranial single-contrast, lower-compartment videoarthrography of 58 temporomandibular joint autopsy specimens were correlated with postmortem morphology. Arthrographic diagnosis of disk position and perforation was confirmed in 47 joints (81%). Misinterpretations were made in 11 joints; nine concerned disk position and two concerned perforation. Analysis of the misinterpretations revealed that inability of arthrography to allow differentiation of lateral from medial resulted in four false-negative diagnoses and one false-positive diagnosis. Variation of joint anatomy with disk deformation resulted in four false-positive diagnoses of anterior disk position. The number of false diagnoses in clinical practice might be reduced if transcranial single-contrast, lower-compartment videoarthrography is followed by multilayer arthrotomography in cases with an unclear diagnosis.

Adult↗
PubMed1985

Internal derangement of the temporomandibular joint: morphologic description with correlation to joint function.

Internal derangement of the temporomandibular joint has mainly been studied arthrographically from the standpoint of anterior disk displacement with or without reduction. Frequent clinical observations of disk deformation in joints with internal derangement implied the need for a systematic study of morphologic alterations associated with internal derangement. Therefore, morphology, internal derangement, and joint function were studied in 58 randomly selected autopsy specimens of the temporomandibular joint. The results showed that joints with superior disk position rarely demonstrated morphologic alterations. In joints with partially anterior disk position, disk deformation occurred somewhat more frequently (31%) and was consistently located in the part of the disk that was positioned anteriorly. Joints with completely anteriorly positioned disks showed disk deformation in 77% and irregularities of the articular surfaces in 65%. It appears that anterior disk position precedes disk deformation. Therefore, early causal treatment to correct symptomatic internal derangement appears indicated to decrease the possibility of development of disk deformation. Disk deformation was also closely associated with disturbed joint function and should therefore be an important consideration when one is planning treatment of internal derangement of the temporomandibular joint.

Adult↗
PubMed1985

Temporomandibular joint surgery: patient-based assessment and evaluation.

Surgery has been important in the treatment of internal derangement of the TMJ. Many patient series have been reported concerning surgeons' evaluation of the surgery but only a few articles regarding patient-based assessment can be found. This study presents responses of 83 patients to personal interviews and mail questionnaires. A high degree of patient acceptance of the surgery and satisfaction with the results are reported. Eighty percent consider their joint status better and would repeat the surgery if faced with the same problems, 70% are essentially pain-free, and 18% experience pain mainly during heavy chewing. Diligent preoperative patient preparation and postsurgical care are recommended for success.

Adolescent↗
PubMed1984

Sublingual gland salivary fistula and sialocele.

A case of cutaneous salivary fistula and sialocele in the submental area, arising from the sublingual gland, is reported and its etiology, development, and management are discussed. The entity of plunging ranula is compared to the lesion the case presented, and the literature regarding this lesion is reviewed. The successful surgical treatment of this case supports the theory that the sublingual gland is the source of the disorder. The effect of the altered salivary function on the adjacent submandibular gland and duct presented an operative complication.

Child↗
PubMed1981

Internal derangements of the temporomandibular joint: correlation of arthrography with surgical findings.

The diagnosis of dysfunctional temporomandibular joint (TMJ) disorders unresponsive to nonsurgical treatments heretofore has often been empirical. With the development of TMJ arthrography, diagnosis has been greatly improved; an accurate picture of the condition of the joint now provides a substantial base on which to build a rational and reasonable treatment plan. Clinical symptoms can be accurately correlated with the radiographic picture, a valid surgical procedure can be performed because the joint condition is known, and a meaningful prognosis can be determined. Successful management, however, very often requires multifaceted treatment consisting not only of surgery but also of bite-plate, occlusal, restorative, and physical therapy, both preoperatively and postoperatively.

Cartilage, Articular↗
PubMed1979

Dantrolene sodium in the management of patients at risk from malignant hyperthermia.

Malignant hyperthermia is a dominantly inherited, usually subclinical, disease that occurs in individuals who have an underlying muscular disorder and connotes the gravest possible consequences. When it occurs, it is usually during the use of muscle relaxants in anesthesia and potent anesthetic agents such as halothane. Patients at risk must be identified through careful history and screening procedures; however, a patient susceptible to this condition may have had general anesthesia in the past without complications. A careful monitoring regimen must be established for the procedure and some means of cooling the patient must be ready in case pyrexia occurs. Dantrolene sodium is currently the preferred drug for prevention of the syndrome and may be valuable for its treatment.

Adult↗
PubMedDate not supplied

TMJ arthroscopy.

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Arthroscopy↗