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Biomedical subjects

S W Rosenstein

Publications and source records attributed to S W Rosenstein.

At least 19 recordsLinked to original sources
PubMed1997

Long-term assessment of early alveolar bone grafts using three-dimensional computer-assisted tomography: a pilot study.

Fifteen patients with complete unilateral cleft lip and palate who had primary alveolar bone grafting were studied with computer-assisted tomography at a mean age of 12 years. Keeping the maxillary alveolar crest parallel to the plane of the scan, 1.5-mm cuts of the maxilla were made from the infraorbital rim to the gingival third of the crowns of the teeth. A single operator reformatted the data into three-dimensional images using the Maxiview 3200 computer workstation. This allowed examination of the position, size, and spatial relationship of the grafted area and quantification of the amount of bone coverage of root surface and bone height of the alveolus in or adjacent to the graft site. Ten patients showed a lateral incisor in the line of the cleft. The average bony coverage of these tooth roots was 76.5 percent. In the five patients in whom there was lateral incisor agenesis, the canine root had average bony coverage of 82.6 percent. The average height of bone at the lateral incisor was 8.7 mm; at the canine, 14.1 mm. In two patients in whom there was only 42 percent tooth root coverage, the teeth were still viable, stable, and without mobility. Computed tomographic (CT) scans of the 15 patients demonstrated good graft survival with adequate volume. The functional and aesthetic status of the dentition in the area of the cleft also was demonstrated.

Adolescent↗
PubMed1997

Comparison of 2-D calculations from periapical and occlusal radiographs versus 3-D calculations from CAT scans in determining bone support for cleft-adjacent teeth following early alveolar bone grafts.

OBJECTIVE: This investigation was conducted to determine the agreement between three-dimensional (3-D) calculations from CAT scans and two-dimensional (2-D) calculations from standard dental radiographs in evaluating bone support for cleft-adjacent teeth after primary bone grafting. DESIGN: This retrospective study utilized CAT scans and dental radiographs taken of the alveolar cleft in patients an average of 11 years after primary bone grafting. SETTING: The subjects were patients treated by the Cleft Palate Team at Children's Memorial Hospital and Loyola University Medical Center, Chicago, Illinois. PATIENTS: Fourteen UCLP patients (9 males, 5 females) agreed to participate in this study by undergoing CAT scan assessment of their alveolar cleft sites. They also had to have periapical or occlusal radiographs of the grafted cleft site taken within 6 months of the CAT scan. INTERVENTIONS: All patients underwent primary lip repair, placement of a passive palatal plate, primary alveolar bone grafting (mean age 6.4 months), and palatoplasty before 1 year of age. Major tooth movement through final orthodontics was completed by the time of the radiographic assessment. MAIN OUTCOME MEASURES: CAT scan sections were reformatted and reconstructed to three-dimensionally calculate the percentage of root covered by bone support for the 15 teeth adjacent to the graft cleft sites. Dental radiographs of the same teeth were also traced and digitized. Percentages of root supported by bone were also established using the dental radiographs by dividing the amount of root covered by bone, by the anatomic root length. RESULTS: A paired, two-sample t test revealed no significant differences between the two methods of assessment, while linear regression showed a statistically significant correlation between the CAT scan assessment and the percentages found on the radiographs. CONCLUSIONS: Routine dental radiographs were able to estimate the total 3-D bone support for the roots of cleft adjacent teeth as determined by CAT scan to a statistically significant degree when groups where compared. The clinical significance for evaluation of individual cases was less impressive with a wide range of variability and a level of agreement that required acceptance of differences up to 25%.

Adolescent↗
PubMed1996

Comparison of facial form in primary alveolar bone-grafted and nongrafted unilateral cleft lip and palate patients: intercenter retrospective study.

The purpose of this study was to describe and compare posttreatment craniofacial morphology in samples of complete unilateral cleft lip and palate (CUCLP) patients treated at two leading clinics: The Children's Memorial Hospital Cleft Palate Clinic, Chicago, Illinois, and the Lancaster Cleft Palate Clinic, Lancaster, Pennsylvania. These centers have well-defined treatment protocols that allow the long-term effects on craniofacial form of the following treatment regimes to be contrasted: (1) Chicago--primary alveolar bone grafting, with definitive lip repair at age 4 to 6 months and hard and soft palate repair at 6 to 12 months; and (2) Lancaster--definitive triangular-flap lip repair at 3 months of age, followed by staged surgeries of the hard and soft palates, both completed by 18 months of age, but without primary alveolar bone grafting. Although the Lancaster center now performs secondary alveolar bone grafting, the majority of the patients studied here were treated before this procedure became part of their protocol. Patients were eligible for inclusion if they had no other congenital anomalies and no previous orthodontic treatment. A sample of 43 (24 male, 19 female) CUCLP patients was obtained from the Chicago Center, each of which was then matched to a nongrafted Lancaster CUCLP patient. The matching criteria were age, sex, and sella-nasion distance (to control, at least in part, for size differences). Lateral cephalometric radiographs of these 86 CUCLP patients were traced, digitized, and analyzed. Additionally, all linear data were adjusted to a standard magnification of 8% because the cephalograms from each center featured different enlargements. The Chicago and Lancaster samples had mean posttreatment ages of 10.32 years (SD = 1.96) and 10.40 years (SD = 2.18), respectively. The grafted Chicago group had faces that were on average less maxillary protrusive compared with the nongrafted Lancaster sample; it appeared, however, that the mandible compensated for the maxillary position by downward and backward rotation. As a result, a similar maxillomandibular relationship was noted in both groups, although, in the Chicago group, the lower anterior facial height increased.

Alveolar Process↗
PubMed1994

A Class II, division 1 malocclusion offering a myriad of treatment options. What would you have done?

This young man presented for treatment with an orthodontic problem that did not necessarily command a straight forward, uncomplicated plan even though the diagnosis and Angle classification of his problem did. The fact that so many options are available reaffirms once again that orthodontic treatment planning in the face of definitive records is indeed as much an art of personal conviction as well as scientific dictum.

Adolescent↗
PubMed1984

Early osteoplasty.

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Alveoloplasty↗
PubMed1983

The correction and preservation of arch form in complete clefts of the palate and alveolar ridge.

A simple but effective means of guiding the cleft alveolar ridge into good contour of the upper dental arch is presented. When apposition of the alveolar ridge is achieved, the position is stabilized with a rib graft at from 4 to 9 months of age. The palate is not repaired until the bone graft is well fixed. The contour of the alveolar ridge in severe clefts is markedly improved over that previously achieved.

Acrylates↗
PubMed1982

The case of early bone grafting in cleft lip and cleft palate.

To date there are conflicting reports in the literature as to the efficacy of early maxillary orthopedic procedures and primary osteoplasty in newborns with complete clefts of the lip, alveolus, and palate. Ross accounts for the disagreement by stating that the critical variable may be the surgical procedure utilized in closing the palate, not necessarily the placement of the graft. Friede has also postulated that perhaps it is principally a difference in the graft techniques. Cephalometric evaluation of our sample at 13 years 11 months of age compared with a like sample wherein the primary osteoplasty had not been done showed the two samples to be clinically the same. We feel that in utilizing our sequence of procedures and carefully monitoring facial growth of these children we do not adversely influence facial growth and, in fact, present a more favorable maxillary segment alignment and teeth in better overall occlusion than if we had not done these procedures. From our results, we conclude that there should be no condemnation of the principle of this treatment because of individual failings and failures. Although differences in techniques can and do influence results, the concept of maxillary orthopedics and primary osteoplasty need not be thrust aside even if some techniques are found wanting.

Age Factors↗
PubMed1980

A case report.

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Child↗