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Biomedical subjects

T Kocher

Publications and source records attributed to T Kocher.

At least 19 recordsLinked to original sources
PubMed1992

[Laparoscopic cholecystectomy. Initial experiences and results in 278 patients].

Of 467 cholecystectomies (performed between 13. 6. 1990 and 12. 9. 1991) 278 were done by laparoscopy (196 women, 82 men; mean age 53 [18-86] years). Contraindications to a laparoscopic procedure were acute cholecystitis, severe chronic cholecystitis with adhesions, abnormal clotting and suspected gallbladder carcinoma. In 31 patients (11.1%) the initial laparoscopic cholecystectomy was continued as a conventional cholecystectomy, usually because of unclear conditions in severe chronic cholecystitis. Mean duration of hospital stay was 6.3 days for the laparoscopic procedure compared with 11.5 days for the conventional one. Complications occurred in four patients (in 12 with the conventional method): one occlusion (by clip) of the common bile duct, one bile leak, one bleeding and one pneumothorax, requiring re-operation in three patients. There were no deaths (compared with two in the conventional group). Assuming correct indications, laparoscopic cholecystectomy is a sparing method for the treatment of cholecystolithiasis.

Adolescent↗
PubMed1992

[Laparoscopic cholecystectomy--experiences and results with a new surgical technique].

Laparoscopic cholecystectomy is a genuine alternative to open cholecystectomy. Acute cholecystitis, chronic cholecystitis with adhesions and gallbladder cancer are absolute, and bile duct stones in rare situations and previous surgery relative contraindications. Ultrasound and intravenous cholecysto-cholangio-tomography are obligatory preoperative investigations. Over 14 months we performed 253 laparoscopic cholecystectomies. Mortality was 0%. Relaparotomy was necessary in 3 of 4 complications (injury of the common bile duct, bile leak and hemorrhage), the reoperation rate is 1.18%. The fourth complication was a pneumothorax after injury of the diaphragm with the electrohook. Conversion to open cholecystectomy was necessary in 10.7%, usually after severe chronic cholecystitis with adhesions. The length of hospitalization was 11 days after open cholecystectomy and could be reduced to 6.5 days after laparoscopic cholecystectomy. With similar results concerning mortality and reoperation rate, the advantages of laparoscopic cholecystectomy are reduced postoperative pain, a shorter recovery time, shorter hospitalization and a better cosmetic result.

Adolescent↗
PubMed1991

[Long-term study on the effects of the width of keratinized gingiva on the localization of the gingival margin].

In a 5-year longitudinal study we assessed the amount and frequency of gingival recessions in relation to the width of the keratinized gingiva and the already existing recessions in two groups (each n = 15). Group I (dental students) had nearly no recessions and group II (patients) had exposed roots on 24% of their teeth. In both groups there existed no correlation between the width of the keratinized gingiva or, respectively the existing recessions and the recessions occurring. Only 36 sites had a recession greater than or equal to 1 mm, these were accumulated in just a few probands.

Adult↗
PubMed1991

[Guided tissue regeneration for the treatment of different periodontal defects. A clinical study].

In 31 patients we implanted a teflon membrane (Gore-Tex) during flap operation for a duration of 6 weeks. The periodontal situation was assessed clinically and radiographically 1-1.5 years after surgery. The study comprised 18 upper and lower molars with furcation involvement and 15 single-rooted teeth with a 2-wall-, 3-wall- or combined bony defect. Clinical gain of attachment only occurred in furcation class II lesions (upper molars + 2.3 mm, lower molars + 2.5 mm), whereas the attachment level was unchanged in "through and through" furcation defects in the upper jaw and loss of attachment was observed at lower molars with class III furcations. In single-rooted teeth the gain of attachment varied between 0.5 and 8.5 mm, depending on the proportions of the defect and the number of the surrounding bony walls.

Adult↗
PubMed1990

[Root surface instrumentation].

The present status of root surface debridement is reviewed. Recently it was shown that the influence of root surface roughness and endotoxin-contaminated cementum was overestimated. The method of instrumentation (i.e., hand instrument, sonic or ultrasonic scaler) does not influence wound healing after periodontal surgery. The operator's technique is of utmost importance.

Dental Scaling↗
PubMed1990

[Interproximal tooth cleansing of abutment teeth and pontic design].

This clinical study was an attempt to find out if a patient's home care plaque control at his or her abutment tooth is more effectively enhanced by a modified ridge lap or a hygienic pontic design. Oral hygiene was performed either with a tooth brush alone or in combination with an interdental brush. We found that the effectivity of interproximal toothcleaning was not influenced by the pontic design and that only interdental brushes permit a good plaque control at the proximal area of the abutment tooth. This implies that "self cleansing" is non-existent in these tooth areas.

Dental Abutments↗
PubMed1990

[Periodontal treatment of furcally involved teeth: with or without root resection?].

A retrospective radiographical and clinical evaluation of 275 molars (59 patients) with different classes of furcation involvement was assessed. Flap operations with and without root resections had been performed and the patients were enrolled in a regular maintenance program for at least 4 years (up to 8 years). The life expectancy of molars with root resection was compared to molars conventionally treated by flap operation. Probing depth was reduced significantly on molars of the lower jaw even with class III involvement, progression of periodontal disease could be arrested. The progression of bone loss (mean 1.4 mm) in molars of the upper jaw with a class III involvement could be stopped only by root resection. During the observation period 12 teeth had to be extracted. 8 for nonperiodontal reasons. The long-term prognosis of class III furcations only treated by flap operation with or without tunnel preparations was as good as that of root resected molars.

Adult↗
PubMed1990

[Assessment of the acceptance of modern periodontal treatment].

In a retrospective study we assessed the acceptance of necessary modern periodontal treatment by more than 2200 patients in the years 1981-1987. 50% of the patients withdrew from treatment in the presurgical phase and 42% in the postsurgical maintenance phase; particularly during the first year the drop out rate was high (64%). One of the reasons could be a certain lack of health awareness and fading willingness of the patients for permanent cooperation as known from longstanding chronic diseases in general medicine. Therefore it remains necessary to enhance periodontal health awareness and to promote information on the cause and treatment of periodontitis and the subsequent maintenance care.

Health Education, Dental↗
PubMed1989

[Psychological aspects on the treatment with periodontal surgery].

In a pilot study on psychological aspects of periodontal treatment more than 90% of 95 patients gave a positive rating of our approach of periodontal surgery by quadrants in cases of profound periodontitis. On the basis of their own experience with this course of surgery more than 90% of patients would recommend periodontal treatment to others. The results of our questionnaire survey confirm that their is no reason for doing periodontal surgery at one appointment. About half of the patient showed a reduction of their anxiety level in the course of surgical periodontal treatment. With increasing interval (1 year) a minor part of the patients partly modified their opinion on some of the questions asked.

Periodontitis↗
PubMed1989

[Changes in the enamel surface after calculus removal].

A clinical trial examined the effect of calculus removal on the enamel surface using a Gracey curette 5/6, an ultrasound unit, and three air scalers with five different tips, in terms of the rate of surface lesions and the extent and depth of the defects. A total of 140 teeth were copied to assess and measure the surface lesions. The hand-held instrument did not damage the tooth surface. For calculus removal with automatic instruments surface lesions were observed to be a function of the type of equipment and the tip configuration used, with sharp-edged instruments causing the more severe destruction. Therefore automatic calculus removal instruments should not be used for routine tooth cleaning. They should be reserved for first-time removal of old, hard, and very tough calculus.

Adult↗