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Biomedical subjects

T Mattsson

Publications and source records attributed to T Mattsson.

At least 19 recordsLinked to original sources

Implant treatment without bone grafting in severely resorbed edentulous maxillae.

PURPOSE: This article describes the surgical technique for implant treatment in severely resorbed edentulous maxillae without any alveolar reconstruction before or combined with implant placement. PATIENTS AND MATERIAL: Fifteen patients with severely resorbed edentulous maxillae were treated with osseointegrated implants and fixed dental prostheses. All patients were initially considered to be treated with bone grafting because of a lack of sufficient bone volume for conventional treatment. Preoperative radiographic examinations showed that the height of the alveolar crest was on average 7.4 mm at the 4-mm-width level (Classes V to VI). RESULTS: By fenestration of the maxillary sinus and uncovering the nasal floor, the maxillary bone could be visualized and used maximally for installation of implants. By angulation of the implants and permitting two to five uncovered fixture threads on the palatal aspect, implants of optimal length could be installed. Eighty-six implants were placed (four to six implants in every patient). One implant was lost during the observation time (range, 36 to 54 months; mean, 45 months). All patients had stable fixed prostheses at the end of the observation time. CONCLUSION: This cost-effective surgical technique may be considered as an alternative to more resource-demanding techniques such as bone grafting in patients with severely resorbed edentulous maxillae. However, further prospective comparative studies are necessary for full evaluation.

Adult↗

Immunological responses to maxillary on-lay allogeneic bone grafts.

4 patients with severely resorbed maxillae underwent rehabilitation with on-lays of allogeneic femoral head bone grafts, titanium implants (Brånemark System) and fixed prostheses. Donors and recipients were matched according to blood groups (ABO/Rh). Potential immunological responses were monitored by determining autoantibodies in peripheral blood, and inflammatory reactions in the recipient site. Biopsies from the bone graft 6 months after grafting showed vital bone. After a mean observation period of 19.5 months, 22 of 23 implants were osseointegrated. None of the investigated autoantibodies were detected in peripheral blood, and there was no local inflammatory response. Allogeneic bone grafts in combination with titanium implants can be used in reconstruction of edentulous severely resorbed maxillae without immunological reactions directed against the graft.

Aged↗

A comparative immunological analysis of the oral mucosa in chronic graft-versus-host disease and oral lichen planus.

Oral mucosal biopsies of 12 allogeneic marrow transplant recipients with chronic graft-versus-host disease (GVHD) involving the mouth were compared with biopsies taken before transplantation. They were also compared with biopsies from otherwise healthy patients with oral lichen planus, and with those from a control group of normal individuals. Biopsies from chronic GVHD exhibited a low number of infiltrating T lymphocytes (CD3 cells) compared with those from oral lichen planus, which showed intense cell infiltration (p less than 0.005). The ratio of CD4 to CD8 cells in biopsies taken after the manifestation of chronic GVHD exhibited no consistent variation compared with those taken before transplantation or with biopsies of oral lichen planus. The CD4/CD8 ratio in all groups investigated varied between 4:1 and 6:1. The number of natural killer cells (CD57), was increased in biopsy specimens taken before transplantation compared with the other groups. The frequency of homing receptor, Leu-8 bearing T cells was low in the biopsy specimens of all groups, compared with the corresponding frequency in peripheral blood (10-45 and 60-90%, respectively; p less than 0.001). In the biopsies from chronic GVHD and oral lichen planus the number of lymphocytes with transferrin receptors was increased compared with the pretransplant and control groups. Virtually no infiltrating cells were carrying interleukin-2 receptors (CD25) in any of the groups studied. Langerhans cells (CD1) were more frequently found in the specimens from chronic GVHD and oral lichen planus than in the pretransplant specimens and the control group (p less than 0.001).(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗

Oral and nutritional status in allogeneic marrow recipients treated with T-cell depletion or cyclosporine combined with methotrexate to prevent graft-versus-host disease.

To investigate how the use of T-cell-depleted marrow or a combination of cyclosporine and methotrexate to prevent graft-versus-host disease affect oral health and the ability to maintain adequate nutrition during the neutropenic phase after allogeneic bone marrow transplantation, 48 allogeneic bone marrow recipients were studied. From a group of adult leukemic marrow recipients of HLA identical sibling marrow, 23 patients were randomly chosen to receive T-cell-depleted marrow and 25 were selected to receive cyclosporine and four doses of methotrexate to prevent graft-versus-host disease. Before the transplantation, all patients were given all necessary dental treatment as well as oral hygiene and nutrition instructions. The oral mucosal and nutritional status in all patients (except one who died) were followed from 5 days before the procedure, during the neutropenic period after transplantation, and until discharge from the hospital. The number of oral lesions was similar in both groups. The subjective experience of orally related problems, such as pain from the oral cavity and number of days with total parenteral nutrition, was less in the T-cell-depleted recipients compared with those who received a graft-versus-host disease prophylaxis with cyclosporine and methotrexate (p less than 0.005). The oral cavity was considered to be the port of entry in four of six patients in the cyclosporine and methotrexate group who developed septicemia, compared with only one of six patients in the T-cell-depleted group with septicemia. The difference in the frequency of septicemia derived from the oral cavity did not, however, reach the significant level.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗

Alterations in taste acuity associated with allogeneic bone marrow transplantation.

Taste detection and recognition thresholds were monitored in 10 patients for up to 1 yr after allogeneic bone marrow transplantation (BMT). As well as a control group of 12 healthy volunteers, taste acuity was tested in 10 patients, who had undergone BMT 2-5 yr previously. Immediately after transplantation, there was significant hypogeusia of all four taste modalities compared to registrations one week before the aplastic phase and also compared to the healthy control group. Although some normalization of taste thresholds was registered 3-6 months after transplantation, most subjects still experienced dysgeusia. Of the four taste modalities, the most frequently recorded change was a raised threshold for salt. In about 80% of the patients taste acuity had recovered to the control values one year after transplantation. The group tested 2-5 yr after BMT had normal values for taste acuity.

Bone Marrow Transplantation↗

Craniofacial growth in bone marrow transplant recipients treated with growth hormone after total body irradiation.

The effect of growth hormone (GH) treatment on craniofacial development was studied in five children exhibiting growth retardation following bone marrow transplantation. Linear and angular measurements were made on lateral radiographic cephalograms taken prior to the start of GH treatment and after an average treatment time of 1.2 yr. The results showed that the mean growth increments of mandibular length in the GH treated children, exceeded the corresponding values of the control group by 150% during the period of investigation. It is suggested that this dimensional increase in the patients was due to GH stimulation on the chondral growth process in the mandibular condyles.

Adolescent↗

A longitudinal comparative histometric study of the biocompatibility of three local hemostatic agents.

The biocompatibility was studied of 3 hemostatic agents (Astroplast, Hemastogen and bone wax) implanted into experimental bone cavities together with their clearance from the implantation sites. The 3 agents had an acceptable hemostatic effect during the surgical procedure. However, marked differences regarding tissue reactions in the experimental bone cavities, as well as at the internal bone surfaces, were found between them. Astroplast and Hemastogen appear to provoke more adverse tissue reactions, including foreign body giant cell formation, compared with bone wax. All 3 hemostatic implants showed markedly delayed bone healing. It was concluded that their biocompatibility was not ideal but acceptable in view of the clinical advantages.

Alginates↗

Radiographically detectable degenerative changes of the lumbar spine among concrete reinforcement workers and house painters.

In this study of lumbar degeneration and the role of mechanical loading in its development, lateral lumbar radiographs of 216 concrete reinforcement workers and 201 house painters aged 25-54 years were examined. Disc space narrowing occurred at about 10 years and spondylophytes at about 5 years younger age in the former than in the latter group. Risk ratios (RR) were estimated from the regression coefficients of logistic regression models. RR for the univariate effect of occupation on disc space narrowing was 1.8, and adjustment for age, earlier back accidents, height, body mass index and smoking had only a minor effect on this relationship, adjusted RR 1.8. The crude RR for spondylophytes was 1.5, and the adjusted RR 1.6. Earlier back accidents showed a significant univariate relationship with DSN, but in multivariate analysis this variate did not retain its significance. It was concluded that heavy physical work enhances the degenerative process of the lumbar spine. Materials handling and postural loading are proposed to be occupational factors of importance in the development of both disc space narrowing and spondylophytes.

Adult↗

ACP and Surgicel in bone hemostasis. A comparative experimental and histologic study.

The search for a biodegradable material which may prevent or stop bleeding in bone tissue and ensure healing is of continuous interest. ACP, an absorbable collagen paste, is a new hemostatic agent. The present study was devised to compare ACP with another commonly used hemostatic agent, Surgicel, in order to determine the tissue response during bone healing. The materials were implanted in the mandibular bone of New Zealand white rabbits. The observation times were 1, 2, 4 and 8 weeks. The result showed that the healing was uneventful for both the hemostatic agents even though healing was slightly retarded compared to natural healing. Both the hemostatic agents were completely resorbed within 4-8 weeks and also the bone healing was completed after this observation period.

Animals↗

The oral cavity as a port of entry for early infections in patients treated with bone marrow transplantation.

Before treatment of 181 patients with bone marrow transplantation (BMT) for leukemia, severe aplastic anemia, or metabolic disorders, the oral condition was examined clinically and roentgenologically. Fifty-three patients (29%) had chronic dental infections (osteitis) that needed treatment before BMT. In 10 of 181 cases (6%), BMT was postponed because of oral infections. Septicemia during the neutropenic phase was caused by oral microorganisms (alpha streptococci) in 24 of 59 (41%) patients with microbiologically proven septicemia. Septicemia with alpha streptococci was associated with graft-versus-host disease prophylaxis with methotrexate and subsequent increased frequency of oral ulcerations. No difference was observed in the frequency of reactivation of latent herpes simplex virus infection between different graft-versus-host disease prophylaxis regimens. Reactivation was more frequent in patients conditioned with total body irradiation than in patients conditioned without total body irradiation. Antiviral prophylaxis, with subsequent decreased frequency of oral herpes simplex reactivation, appeared to contribute to a low frequency of septicemia with alpha streptococci.

Adolescent↗

Radiographically detectable lumbar degenerative changes as risk indicators of back pain. A cross-sectional epidemiologic study of concrete reinforcement workers and house painters.

The association between radiographically detectable degenerative changes in the lumbar spine and back symptoms was studied, along with the possible effect of occupational work load. The subjects were 216 concrete reinforcement workers and 201 house painters. A questionnaire provided information on work history and earlier back accidents, and a standardized interview produced data on back symptoms. The occurrence of disc space narrowing, anterior and posterior spondylophytes, and end-plate sclerosis was recorded separately for each intervertebral space from lateral lumbar radiographs. Moderate to severe degenerative changes were associated with increased risk of sciatic pain but not with the occurrence of lumbago or nonspecific back pain. The different types of degenerative changes provided no further information. In a multivariate logistic regression analysis degenerative changes and earlier back accidents were significant independent predictors of sciatic pain. When these two variates were allowed for, the effect of occupation was not significant.

Adult↗

Absele in bone hemostasis--a clinical and experimental investigation.

Control of bleeding from bone tissue may sometimes be difficult to maintain. Existing methods of haemorrhage control with standard bone wax can interfere with subsequent healing. This paper presents clinical and experimental results of the use of a new absorbable bone sealant, Absele a paste made from stabilised fibrin and soluble collagen.

Adolescent↗

Symptoms of vibration syndrome and radiographic findings in the wrists of lumberjacks.

In a cross sectional study 279 lumberjacks exposed to chain saw vibration and a reference group of 178 peat bog workers were examined. The mean ages of the two groups were 34.6 and 33.1 years, respectively. The lumberjacks' mean duration of exposure to vibration was 10.4 years. The study consisted of a questionnaire and a clinical examination, including radiographs of the wrists. The prevalence of reported white finger symptoms was 18% for the lumberjacks and 3% for the referents, whereas that of numbness in the upper extremities was 51% and 22%, respectively. Among lumberjacks the occurrence of white finger symptoms increased significantly with the duration of exposure to vibration but was not associated with age or smoking. The prevalence of the numbing of the upper extremities increased linearly with age in both groups, but it was not associated with duration of exposure after adjustment for age. Among lumberjacks there was a significant association between the numbing symptom and the white finger symptom, but not among the referents. A high prevalence of numbing in the upper extremities among the lumberjacks could be at least partly explained by occupational factors other than vibration--work posture, for example. Radiographically, cysts were found in the wrist bones of 8-9% of both groups. The exposure to chain saw vibration no longer seems to be a determinant in the development of vacuoles in the carpal bones.

Adult↗

Knee degeneration in concrete reinforcement workers.

The loads on the knees in concrete reinforcement work and maintenance painting were analysed on eight construction work sites. A total of 352 reinforcement workers and 231 painters. Finnish men aged 20-64, were clinically and radiologically examined to determine the condition of the knee joints in active workers. The loads on the knees and the occurrence of minor injuries and accidents were higher in reinforcement work than in painting, but the occurrence of symptoms, clinical signs, and radiological findings was equally common in both groups. Reinforcement work seemed to provoke more symptoms from degenerated knees than painting.

Adult↗

Frequency and location of pelvic phleboliths.

Pelvic phleboliths were demonstrated in 1000 subjects aged 16--79 years (mean 42.1, s.d. 12.7). They occurred in 44.2% of the subjects, in 37.3% of the males and 50.1% of the females. Among subjects between the ages of 35 and 54, phleboliths occurred more frequently in the females than in the males. In addition the older the subject the greater the number of phleboliths. Their distribution in the pelvic region was not symmetrical. They occurred more often on the left side than on the right. Of the 1582 phleboliths found, 643 were located on the right and 939 on the left. Their distribution suggests the possibility of an aetiology similar to that of other venous disorders.

Adolescent↗