Biomedical subjects
Publications and source records attributed to W F Brogan.
Crouzon syndrome is an autosomal dominant condition characterized by craniosynostosis with associated dentofacial anomalies. This paper describes the variable clinical features in affected individuals over two generations of a family with particular reference to the dentofacial deformities and discussion of management strategies.
A prospective study of secondary alveolar bone grafting based on the Norwegian (Oslo) team approach has been conducted by the CLP Unit at the Princess Margaret Hospital for Children in Perth, Australia, since 1982. The 5-year results of 100 consecutive cases of uni- and bilateral cases are presented according to periodontal and radiographic parameters of tooth support. The vast majority of cases grafted (98%) resulted in the eventual eruption of the cleft side cuspid/lateral incisor within acceptable parameters of tooth support. The results confirm the predictability of this safe procedure when utilized within a strict clinical protocol involving the whole CLP team.
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We have formed a team consisting of plastic surgeons, dental specialists, Ear, Nose and Throat surgeons and speech therapists. Thus all the clinical needs of the patient can be provided for in the one hospital. The team meets regularly to examine the patients, assess what further treatment is required and to evaluate and criticise the work done on each case up to date. One of the most significant features of the team approach is that it makes possible the keeping of good records. Using this as a foundation a team drawn from various disciplines can assess the progress of the patient as he grows and develops. Changes in treatment can be monitored over the years and the results of new techniques thoroughly assessed.
Lateral videoradiography was carried out on nine babies, seven with clefts and two without, at rest and while feeding with a barium mixture. No discernible difference was found in tongue movement or position between the cleft and noncleft babies, nor did the presence or absence of a presurgical plate make any difference.
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The findings on the development of dental, facial and septal conditions from birth to about 6 years of age include the following: 1) Septal configuration can be readily tested at birth, and if deformity is present, then deformity will still be present at age 6 years. 2) The internal septal configuration can be categorized into three types: type A: The septum is in the midline. type B: There is unilateral bending or kinking of the septum at the vomerine junction. type C: The septum is deformed to both sides in an S configuration. 3) Height of the palate does not predispose to septal deformity. 4) Dental abnormalities of rotation, compression or crowding of the teeth, asymmetry of width and height of the palate, and shift of the mandibular arch from the midline occur most frequently in cases of type B (88%), much less in type C and least in type A. 5) At birth one can predict that type B babies will have considerably more likelihood of developing occlusal abnormalities than type A babies. 6) The dental abnormalities in many of these subjects are of sufficient degree to expect that malocclusion will undoubtedly develop. Thus the same etiological factors producing septal abnormalities at birth must be considered to be factors producing many malocclusions.
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This article describes the development of the Dental Department at Princess Margaret Hospital, Perth, Western Australia from its beginnings with the appointment of the first Honorary dentist in 1910. It details its state today as a comprehensive unit in which all dental specialities are represented and capable of handling any clinical or teaching duties which may present. Princess Margaret Hospital is a large general teaching children's hospital of three hundred beds which handles one third of child admissions in the State. In addition, virtually all congenital abnormalities and conditions requiring specialized unit treatment are admitted. Into this hospital the Dental Department has become fully integrated over the past thirteen years.
A total of 613 cases of cleft lip, cleft palate, and combinations of both (CLP(P)) has been ascertained in the period from 1958 to 1975 in Western Australia. Near-total ascertainment of cases during this period was obtained from multiple sources. There has been a significant decline in the total incidence and the cleft lip and palate (CLP) incidence in males. The hypothesis is presented that these changes are linked to the changing fertility pattern throughout Australia (as technological improvements are made in the simplicity and efficacy of birth control), and abortion (as social attitudes change); and as the birthrate drops towards zero population growth (ZPG). The paper presents two critical observations: (i) the link between CLP(P) incidence, and demographic changes; (ii) in differing behaviour of cleft lip (CL) and CLP, which were previously regarded as linked conditions.
The assessment and treatment by rapid maxillary expansion of 516 cases referred by medical practitioners for the treatment of poor nasal airway is reported. The technique is simple and most suitable for the correction of crossbite and Class III malocclusion and for establishing a nasal airway in habitual mouth breathers with a history of ENT problems.
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Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.