PubMed Health⌕ Search

Biomedical subjects

S Sindet-Pedersen

Publications and source records attributed to S Sindet-Pedersen.

At least 37 records · Page 2Linked to original sources
PubMed1997

Comparison of the reliability of craniofacial anatomic landmarks based on cephalometric radiographs and three-dimensional CT scans.

OBJECTIVE: Conventional cephalometry is an inexpensive and well-established method for evaluating patients with dentofacial deformities. However, patients with major deformities, and in particular asymmetric cases are difficult to evaluate by conventional cephalometry. Both two- and three-dimensional computed tomography (CT) have been proposed to alleviate some of these difficulties. Only a few studies using metallic markers have indicated 3-D CT to be a useful diagnostic method, whereas no studies have evaluated the reliability of the anatomic cephalometric points used in 3-D CT. The aim of our study therefore was to compare the reliability of anatomic cephalometric points from conventional cephalograms and 3-D CT. METHODS: Nine human dry skulls were CT scanned. In addition standard lateral and frontal cephalograms were obtained. The CT scans were 3-D image reconstructed, and the cephalometric points were recorded as x, y, and z co-ordinates by two investigators. Computerized cephalometrics were performed-on the lateral and frontal cephalograms. Intra- and interindividual variations were calculated for each method and tested for statistical significance. RESULTS: Lateral cephalogram measures were more reliable than 3-D CT, with interobserver variations less than 1 mm for most points compared to about 2 mm for 3-D CT. Lateral cephalometrics also showed significantly less interobserver variation for six variables. This was, however, less obvious when 3-D CT was compared to frontal cephalograms. Frontal cephalometrics showed significantly less interobserver variation for three of the investigated variables. CONCLUSIONS: For standard lateral and frontal cephalometric points, there is no evidence that 3-D CT is more reliable than the conventional cephalometric methods in normal skull, and the benefit of 3-D CT cephalometric is indicated to be in the severe asymmetric craniofacial syndrome patients, as conventional cephalometrics is known to be inferior in these cases.

Adult↗
PubMed1996

IL-8 induces T cell chemotaxis, suppresses IL-4, and up-regulates IL-8 production by CD4+ T cells.

Interleukin-8 (IL-8), a neutrophil-activating cytokine, also activates certain T cell functions such as chemotaxis. We additionally find (n = 6) that recombinant (rIL-8; 1-100 ng/ml), when added to 24 h culture of human CD4+ T cells, suppressed the spontaneous production of IL-4 (50-85%). Steady state production of Il-4 was typically around 30 pg/ml, determined by use of a solid- phase immunoabsorbant assay. De novo synthesis of IL-4 from CD4+ T cells cultured for 3 days was also evaluated by use of detection of [35S]methionine incorporation, as visualized by autoradiography of 2-D gels, and showed that IL-8 suppressed IL-4 production. This suppression of IL-4 production was confirmed in the cytosol fraction by use of Western blotting. The effect of IL-8 (100 ng/ml) was comparable to that of 10 ng/ml recombinant interferon-gamma, both strongly suppressing IL-4 production. The regulatory effect of IL-8 on IL-4 production was also indicated by the fact that addition of a neutralizing monoclonal anti-IL-8 antibody (WS.4) enhanced the spontaneous IL-4 production when added to the culture of CD4+ T cells, thereby probably inactivating the effect of IL-8 originating from the cultured T cells. Also, we observed that IL-4 mRNA expression was down-regulated when the CD4+ T cells were cultured for 12 h in the presence of 100 ng/ml IL-8. The suppression of IL-4 mRNA expression could be prevented by adding anti-IL-8 (20 microgram/ml) or IL-10 (100 ng/ml) l h before adding rIL-8. Thus, IL-8 may be an important regulator of CD4+ T cell-derived IL-4, thereby possibly regulating the balance between humoral and cellular T cell-dependent responses.

CD4-Positive T-Lymphocytes↗
PubMed1996

Pain control after dental surgery: a double-blind, randomised trial of lornoxicam versus morphine.

Lornoxicam is a new non-steroidal anti-inflammatory drug of the oxicam class. This randomised, double-blind, placebo controlled trial compared the analgesic efficacy and tolerability of intramuscular (IM) injections of lornoxicam (4, 8, 16 and 20 mg) with morphine (10 and 20 mg) and placebo in 252 patients with mainly moderate to severe pain following surgical removal of an impacted mandibular third molar. Patients treated with lornoxicam or morphine experienced a significantly greater cumulative pain relief over the 4-h post-injection period (TOTPAR0-4) than placebo recipients. This effect appeared to be dose-dependent, with patients in the lornoxicam 4 mg or morphine 10 mg groups recording significantly lower TOTPAR0-4 scores than patients in the higher dosage groups of these drugs. No significant difference was detected between the morphine 20 mg group and the lornoxicam 8, 16 and 20 mg groups. Lornoxicam was well tolerated at all doses and was associated with a significantly lower incidence of adverse events than morphine 10 or 20 mg. Thus, the analgesic efficacy of IM lornoxicam at doses > or = 4 mg is superior to placebo, and doses > or = 8 mg are at least as effective as IM morphine 20 mg. Furthermore, lornoxicam possesses a more favourable tolerability profile than morphine and thus represents an attractive alternative for the treatment of moderate to severe acute pain.

Adolescent↗
PubMed1996

A comparison of three-dimensional computed tomography scans and stereolithographic models for evaluation of craniofacial anomalies.

PURPOSE: This article describes the use of stereolithographic (SL) models as an adjunct to treatment planning in patients with Apert's syndrome, scaphocephaly, brachycephaly, and turricephaly. PATIENTS AND METHODS: Four syndrome patients had computed tomography (CT) scans done presurgically, and one of these patients was additionally scanned postoperatively. SL models and three-dimensional (3D) CT image reconstructions were produced from the CT data, and linear measurements were compared between the two modalities. RESULTS: All cases showed mean differences between measurements with 3D-CT and SL models of -0.3 to 0.8 mm, except on the CT scans with a gantry tilt (-1.7 mm) and the brachycephalic patient in whom larger deviations were demonstrated (-9.5 mm). CONCLUSION: The results of the study indicate that the accuracy of the SL technique is not always sufficient, necessitating additional validation studies before it can be recommended for routine clinical use.

Acrocephalosyndactylia↗
PubMed1996

An extended Le Fort I osteotomy for correction of midface hypoplasia: a modified technique and results in 35 patients.

PURPOSE: This report analyzes the long-term results of a transoral high Le Fort I osteotomy (mean observation period, 37 months). PATIENTS AND METHODS: Thirty-five patients were treated with high Le Fort I osteotomies in which the zygomatic prominence was included in the osteotomy and advanced together with the maxilla. Twenty of the 35 patients were seen for long-term follow-up (mean, 37 months), which included clinical and radiographic examinations and anamnestic evaluation of the results. In nine patients it was possible to evaluate stability of the osteotomy by cephalometry. RESULTS: The treatment results clinically appeared stable, with good occlusion and, in most patients, improved function of the masticatory system. Patients reported satisfactory esthetic results. Radiologically the SNA angle was unaltered in six of seven non-CLP (cleft lip and palate) patients and was decreased in two of two CLP patients. There were few complications; one patient had the maxilla reoperated because of a lack of osseous healing and one patient had pulp necrosis of three maxillary teeth. CONCLUSION: The results achieved with the described method indicate that the use of minor modifications of routine surgical procedures in conventional orthognathic surgery can improve esthetic results in patients with extended midfacial hypoplasia.

Adolescent↗
PubMed1996

Transverse dentofacial structure of young men who have undergone surgical correction of unilateral cleft lip and palate: a posteroanterior cephalometric study.

The transverse dentofacial structure of 34 young adult males with unilateral cleft lip and palate, studied by means of posteroanterior cephalograms, was compared to that of a normal sample of 102 young adult males. All cleft patients had been treated surgically and orthodontically in accordance with a standardized protocol. Orthognathic surgical treatment was carried out when growth had ended in a few subjects. In studying the posteroanterior cephalograms, eight lengths, 10 ratios, and three angular variables were used. Comparison of the cephalometric values of the subjects with cleft palate and the normal sample of young adult males indicated (1) the absence of any significant differences in angular variables describing the transverse dentoalveolar relationships in the maxillary and mandibular incisal regions as well as the mandibular position; (2) the absence of any significant differences in the ratios of the nasal, maxillary, and mandibular widths to the interorbital width; (3) the presence, in the cleft group of significantly decreased ratios of maxillary intermolar width to interorbital width, mandibular intermolar width to interorbital width, maxillary intermolar width to mandibular intermolar width, and maxillary intermolar width to maxillary width; (4) the presence, in the cleft group, of a significantly increased ratio of innerorbital width to interorbital width; and (5) significant correlations between the maxillary and mandibular molar widths in the cleft group.

Adult↗
PubMed1995

A randomized, double-blind, placebo-controlled, dose-response study of the analgesic effect of lornoxicam after surgical removal of mandibular third molars.

The aim of the present study was to investigate the dose-effect relationship of single doses of 4 to 32 mg of lornoxicam (LNX), a new nonsteroidal antiinflammatory drug belonging to the oxicam group, compared with placebo and 10 mg ketorolac (KET) in the treatment of pain after oral surgery. Also, it was the aim of the study to evaluate the relationship between adverse events and different doses of LNX. After the surgical removal of a mandibular third molar, test medication was taken when the patients experienced at least moderate pain. After medication, pain relief, pain intensity, and any discomfort from the medication were noted in a questionnaire. Paracetamol was used as rescue medication. A total of 278 patients completed the study according to the protocol. The primary efficacy parameter was total pain relief after 6 hours, and all active treatments showed significantly better effect than placebo, with LNX 16 and 32 mg being significantly superior to LNX 4 mg. All other efficacy parameters showed the same dose-effect relationship. A total of 37 adverse events were reported evenly distributed in the 6 treatment groups; only 3 of these were considered severe, and all disappeared without treatment. In conclusion, the study showed a dose-effect relationship of LNX without a rise in adverse events. The effect of 10 mg KET seemed to be at the level of 8 to 16 mg LNX.

Adolescent↗
PubMed1994

Varying treatment strategies for reconstruction of maxillary atrophy with implants: results in 98 patients.

This report describes the outcome of maxillary implant reconstruction in 98 consecutively treated patients assigned to three groups based on the degree of maxillary atrophy as noted on radiographic examination and method of treatment. In group 1, 33 patients had 83 implants installed following sinus and/or nasal mucosal lift procedures. In group 2, 26 patients had 56 implants placed that penetrated the sinus and/or nasal cavities. The penetrating portion of the implant was covered with autogenous particulate bone harvested from the lateral aspect of the ipsilateral sinus. In group 3, 39 patients had 152 implants fixed to autogenous mandibular bone grafts placed either in the antral and/or nasal floors and/or as an onlay over the residual alveolar ridge. The age range of the patients was 15 to 76 years, with a mean of 56 years. Follow-up periods ranged from 12 to 58 months, with a mean of 26 months. Of the 291 implants installed, 19 have been lost. The importance of considering different treatment strategies when reconstructing the edentulous maxilla is discussed.

Adolescent↗
PubMed1994

Nerve transposition and implant placement in the atrophic posterior mandibular alveolar ridge.

The results obtained with a modified surgical technique for transposition of the inferior alveolar nerve followed by immediate placement of endosseous implants in mandibles with moderate to severe atrophy are presented. Ten transpositions of the inferior alveolar nerve together with the installation of 21 implants were performed in six patients. The mean postoperative follow-up time was 23 months, with a range of 12 to 46 months. All implants with functioning pontics remained stable, with no mobility nor signs or symptoms of pain and infection during the follow-up period. Postoperative radiographic evaluation disclosed no pathologic bone loss around the implants. Neurosensory evaluation was performed using the two-point discrimination test. One patient with unilateral transposition had objective neurosensory dysfunction at 12 months postoperative, although all the nerve function were reported as normal by the patients. Strict patient selection criteria are necessary, with full awareness by the patient of the possibility of long-term or even permanent nerve paresthesia, when this procedure is contemplated.

Aged↗
PubMed1994

A retrospective analysis of 279 patients with isolated mandibular fractures treated with titanium miniplates.

PURPOSE: This article addresses the suitability of semirigid fixation for the treatment of mandibular fractures. MATERIALS AND METHODS: Between 1986 and 1991, 279 patients with 447 isolated mandibular fractures were treated with miniplate fixation using the tension-band principle of Champy et al. The time from trauma to treatment, etiology, number and location of the fractures, and the presence of preoperative infection and neurosensory disturbances were recorded. Postoperative complications such as infections, neurosensory disturbances, malocclusion, and nonunions also were recorded, as well as the reasons for removal of the miniplates. RESULTS: Postoperative infection occurred in 10 patients (3.6%). These infections were controlled by antibiotics and the miniplates were removed after the acute phase. Occlusion disturbances were noted postoperatively in 13 patients (4.7%), and they were corrected by minimal occlusal grinding in the majority of cases. Neurosensory disturbances were noted preoperatively in 26.9% of the patients and 12 months postoperatively in 1.4% of the patients. Forty-seven plates (8.1%) in 32 patients (11.5%) were removed for a variety of reasons. No cases of nonunion occurred. CONCLUSION: Semirigid fixation of mandibular fractures with miniplates is a viable treatment option for the management of such injuries.

Adult↗
PubMed1993

Central hemangioma of the mandible.

Central hemangioma of the mandible is a relatively rare condition; when it occurs, the clinical and radiographic presentation are often nonspecific. A proper diagnosis can be made with a high level of clinical suspicion, and imaging studies such as angiography can confirm the suspicion that a vascular lesion exists and can contribute valuable information to the preoperative data base. We report three cases of central hemangioma of the mandible demonstrating the variability of signs and symptoms and review the various treatment alternatives in the literature. We suggest that the treatment of choice for this entity is surgery, including reconstruction as necessary.

Adult↗
PubMed1993

Pediatric condylar fractures: a long-term follow-up study of 55 patients.

Fifty-five patients between 5 and 20 years old who were previously treated conservatively for a fracture of the mandibular condyle were recalled for follow-up examination with a mean postoperative observation time of 10.1 years. Anamnestic information was obtained from a questionnaire, and clinical and radiologic examinations were performed. Anamnestic and clinical dysfunction indices were obtained. When the patients were divided into four different age groups it was found that the dysfunction index values increased significantly with increasing age at the time of trauma. Radiologic abnormalities such as reduced ramus height, deviation of the mandibular midline, and irregular shape of the condyle were seen frequently, but could not be correlated with the severity of dysfunction. No cases of ankylosis or serious asymmetry were found. The results support the opinion that conservative treatment is sufficient in pediatric patients, but in older age groups the results of conservative treatment are less satisfactory.

Adolescent↗
PubMed1993

Prevention of postsurgical bleeding in oral surgery using tranexamic acid without dose modification of oral anticoagulants.

The hemostatic effect of tranexamic acid solution (4.8%) used as a mouthwash was compared with a placebo solution in 93 patients on continuous, unchanged, oral anticoagulant treatment undergoing oral surgery. The investigation was a randomized, double-blind, placebo-controlled, multicenter study. Before suturing, the surgically treated region was irrigated with 10 mL of tranexamic acid (46 patients) or placebo (47 patients) solution. The patients then performed mouthwash with 10 mL of the solution for 2 minutes four times daily for 7 days. The treatment groups were comparable regarding age, smoking habits, and surgery. Laboratory variables measuring vitamin K-dependent coagulation factors were within therapeutic ranges (international normalized ratio 4.00 to 2.10). One of the clinics used a different method for these measurements and therefore the levels of coagulation factor X in plasma obtained for the three clinics were compared. No significant difference in the range at which surgery was performed was found between clinics. In the placebo group, 10 patients developed bleeding requiring treatment, while none of the patients treated with tranexamic acid solution had bleeding. This difference was statistically significant (P < .01). The treatment with mouthwash was well tolerated. It was concluded that patients on oral anticoagulants can undergo oral surgery within the therapeutic range without reducing the dosage of anticoagulants, provided that local antifibrinolytic treatment with tranexamic acid solution is instituted.

Adult↗
PubMed1992

Rigid fixation in reconstruction of craniofacial fractures.

Ninety-four patients had either isolated fractures of the skull or midface, or combined fractures of the skull, periorbit, and/or midface. Thirty-five of these patients were treated by conventional methods, including maxillomandibular fixation (MMF) 4 to 6 weeks postoperatively, wire osteosynthesis, suspension ligatures, or a head frame. The remaining 59 patients were treated with either mini-, low-profile, micro-, or 3-D titanium plate fixation (rigid internal fixation [RIF]) and comprise the patient population for this study. Of the 59 patients, 11 were female and 48 male, ranging in age from 6 to 85 years, with a mean age of 34 years. Six patients had isolated skull fractures, 9 had combined skull and periorbital fractures, 31 had isolated midface fractures, and 13 patients had combined skull and midface fractures. The follow-up period ranged from 3 to 48 months. Patients with midface fractures were placed in MMF intraoperatively, and MMF was released at the completion of the procedure. At 2 to 4 days postoperatively, the occlusion was evaluated. Fifteen of the 38 dentate patients with either midface or combined skull and midface fractures were without MMF postoperatively. Twenty-three patients showed slight occlusal discrepancies and were treated with elastic MMF for 3 to 28 days (mean, 10 days). All reductions were judged to be stable throughout the postoperative course. Based on the results, use of RIF is recommended for primary reconstruction in craniofacial trauma patients whenever possible, thereby achieving three-dimensional stability, sufficient functional and cosmetic results, and often avoiding or reducing the need for MMF.

Adolescent↗
PubMed1992

Arthroscopy of the human temporomandibular joint.

This paper reviews the indications, technique and results of arthroscopy of the human TMJ. Our results in arthroscopic treatment of 36 patients (48 joints) are reported and the results are comparable with previously reported results. Mainly internal derangements with closed lock and preauricular pain have been treated and in all cases a single puncture technique followed by a blunt sweep procedure was used. All patients have before arthroscopy received a conservative treatment with insufficient result. It is concluded that arthroscopy is an excellent tool in diagnosis and treatment of TMJ disorders. However TMJ arthroscopy should be regarded as a supplement to conventional therapy and an alternative to open joint surgery.

Adolescent↗