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Mandibular dysfunction in adolescents, Part I—Prevalence of symptoms
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CURRENT LITERATURE
gested that induction chemotherapy may actually have a potential to produce deleterious effects. An increase in morbidity with treatment by surgery and chemotherapy was not reported previously. The author discourage the uncritical use of induction therapy and encourage further randomized trials to establish the optimal role for this modality.-K. L. FRIDRICH
The intraoral soft tissues were assessed by sharp probing, light touch response to cotton-wool. and a two-point discrimination test. Dental tissues were assessed by electric pulp testing and the application of cold ethyl chloride on a cotton-wool pledget. A statistically significant reduction in response was shown in both dental tissues and soft tissues in the maxilla following Le
Reprint requests to Dr. Corey: Department of OtolaryngologyHead and Neck Surgery. West Virginia University Medical Center, Morgantown. WV 26506.
Fort I osteotomy within the period of review. This reduction in response did not give rise to any clinical problems. It was suggested that recovery of sensory function was random.-K. L. FRIDRICH
Blindness After Trauma Insufficient to Cause Boney Injury. Case Report and Review. Babajews A, Williams JL. Br J Oral Maxillofac Surg 24:7, 1986
Reprint requests to Dr. de Jongh: Department of Oral and Maxillofacial Surgery and Department of Orthodontics, Queen Alexandria Hospital, Portsmouth, England.
Blindness secondary to maxillofacial trauma has been reported over the years by many authors. Although various mechanisms have been proposed, blindness in the absence of any boney or direct penetrating injury is rare. The authors present the case of a 15-year-old boy who fell from his bicycle and struck the right side of his head on the ground. The patient did not lose consciousness but sustained immediate loss of vision in the right eye. Results of clinical examination were normal except for an absent right direct pupillary reflex. Standard radiographs of the skull vault and facial bone showed no fractures, tomograms of the optic foramina showed no fractures, and CT scans showed no abnormalities. Despite a megadose steroid regimen (4 mg/kg body weight of dexamethasone), there was no recovery of vision, and funduscopic examination later showed right optic atrophy. The authors relate that blindness without damage to the globe has a multifactorial etiology but believe that acute deceleration of the globe causes hemorrhage and compression of the nutrient vessels, as opposed to fracture and boney compression of the nerve in the optic canal. The authors conclude the article with recommendations of current medical therapy for visual disturbances following trauma.-K. L. FRIDRICH Reprint requests to Dr. Babajews: Maxillofacial Unit. Richards Hospital, Chichester, West Sussex. England.
St.
Nerve Morbidity Following Le Fort I Osteotomy. De Jongh M, Barnard D, Birnie D. J Maxillofac Surg 14: 10, 1986
Sensory
The Le Fort I osteotomy has been used with increasing frequency in the management of dentofacial deformities since the wide acceptance of the downfracture technique. Access is improved by this technique, and movement of the Le Fort I maxillary segment is possible in three planes. The authors briefly review the neuroanatomy of the surgical area involved in the Le Fort osteotomy. The surgical technique is described, with specific reference to how it interferes with the sensory nerve supply. Sensory nerve function was reviewed in 10 patients who had undergone Le Fort I osteotomy. The patients were asked for their subjective impressions of any alterations in sen-
sory function.
Mandibular Dysfunction in Adolescents, Part I-Prevalence of Symptoms. Wgnman A, Agerberg G. Acta Odontol Stand 44:47, 1986
Two hundred eighty-five 17-year-old Swedish subjects answered a questionnaire concerning the occurrence of headache, pain in the jaws, problems with the temporomandibular joint, awareness of oral parafunctional habits, such as grinding or clenching, and the possible effects of pain from the head, neck, or jaws on schoolwork or work performance. The sample was derived from all adolescents born in 1964 who had been referred to one of two dental clinics in an urban Swedish district. The sample consisted of 5 1.2% boys and 48.8% girls. The results revealed that 12% of the adolescents experienced headaches once a week or more. Headaches were more common in girls. The most common symptom of mandibular dysfunction was joint sounds (13%). The second most common symptom of mandibular dysfunction was joint fatigue, being reported more commonly in females. Overall, 20% of the sample reported symptoms of mandibular dysfunction. Six per cent reported that symptoms were troublesome once a week or more. Four per cent of the girls reported that their work or studies were affected by the symptoms. Seventy-five per cent of the adolescents chewed on both sides. Nail-biting was found in 42.6%. Tooth clenching and grinding occurred in approximately lo%, with tooth grinding being more common in girls. Forty-two per cent of the subjects reported having had orthodontic treatment at some time. A history of jaw trauma was reported in 32% of the boys and 12% of the girls. The authors concluded that symptoms of mandibular dysfunction appear early. Screening for symptoms of mandibular dysfunction and headache during routine dental examinations are justified to identify patients who should be observed more closely. Subsequent reports from this study will describe clinical findings and the longitudinal development of signs and symptoms of mandibular dysfunction.S. J. MCKENNA Reprint requests to Dr. Wsnman: Department of Stomatognathic Physiology, Faculty of Odontology, University of Ume& S-901 87 UmeA, Sweden.
New Book Annotations Oral Pathology. Soames JV, Southam JC. New York, Oxford University Press, 1985, 269 pages, illustrated, paperback, $27.95. Written predominantly
for undergraduate
students,
this
is a concise review of the more common oral diseases. The illustrations are mainly photomicrographs, and only limited references are provided. Rehabilitation
and Treatment
of Head and Neck Cancer.
CURRENT LITERATURE
gested that induction chemotherapy may actually have a potential to produce deleterious effects. An increase in morbidity with treatment by surgery and chemotherapy was not reported previously. The author discourage the uncritical use of induction therapy and encourage further randomized trials to establish the optimal role for this modality.-K. L. FRIDRICH
The intraoral soft tissues were assessed by sharp probing, light touch response to cotton-wool. and a two-point discrimination test. Dental tissues were assessed by electric pulp testing and the application of cold ethyl chloride on a cotton-wool pledget. A statistically significant reduction in response was shown in both dental tissues and soft tissues in the maxilla following Le
Reprint requests to Dr. Corey: Department of OtolaryngologyHead and Neck Surgery. West Virginia University Medical Center, Morgantown. WV 26506.
Fort I osteotomy within the period of review. This reduction in response did not give rise to any clinical problems. It was suggested that recovery of sensory function was random.-K. L. FRIDRICH
Blindness After Trauma Insufficient to Cause Boney Injury. Case Report and Review. Babajews A, Williams JL. Br J Oral Maxillofac Surg 24:7, 1986
Reprint requests to Dr. de Jongh: Department of Oral and Maxillofacial Surgery and Department of Orthodontics, Queen Alexandria Hospital, Portsmouth, England.
Blindness secondary to maxillofacial trauma has been reported over the years by many authors. Although various mechanisms have been proposed, blindness in the absence of any boney or direct penetrating injury is rare. The authors present the case of a 15-year-old boy who fell from his bicycle and struck the right side of his head on the ground. The patient did not lose consciousness but sustained immediate loss of vision in the right eye. Results of clinical examination were normal except for an absent right direct pupillary reflex. Standard radiographs of the skull vault and facial bone showed no fractures, tomograms of the optic foramina showed no fractures, and CT scans showed no abnormalities. Despite a megadose steroid regimen (4 mg/kg body weight of dexamethasone), there was no recovery of vision, and funduscopic examination later showed right optic atrophy. The authors relate that blindness without damage to the globe has a multifactorial etiology but believe that acute deceleration of the globe causes hemorrhage and compression of the nutrient vessels, as opposed to fracture and boney compression of the nerve in the optic canal. The authors conclude the article with recommendations of current medical therapy for visual disturbances following trauma.-K. L. FRIDRICH Reprint requests to Dr. Babajews: Maxillofacial Unit. Richards Hospital, Chichester, West Sussex. England.
St.
Nerve Morbidity Following Le Fort I Osteotomy. De Jongh M, Barnard D, Birnie D. J Maxillofac Surg 14: 10, 1986
Sensory
The Le Fort I osteotomy has been used with increasing frequency in the management of dentofacial deformities since the wide acceptance of the downfracture technique. Access is improved by this technique, and movement of the Le Fort I maxillary segment is possible in three planes. The authors briefly review the neuroanatomy of the surgical area involved in the Le Fort osteotomy. The surgical technique is described, with specific reference to how it interferes with the sensory nerve supply. Sensory nerve function was reviewed in 10 patients who had undergone Le Fort I osteotomy. The patients were asked for their subjective impressions of any alterations in sen-
sory function.
Mandibular Dysfunction in Adolescents, Part I-Prevalence of Symptoms. Wgnman A, Agerberg G. Acta Odontol Stand 44:47, 1986
Two hundred eighty-five 17-year-old Swedish subjects answered a questionnaire concerning the occurrence of headache, pain in the jaws, problems with the temporomandibular joint, awareness of oral parafunctional habits, such as grinding or clenching, and the possible effects of pain from the head, neck, or jaws on schoolwork or work performance. The sample was derived from all adolescents born in 1964 who had been referred to one of two dental clinics in an urban Swedish district. The sample consisted of 5 1.2% boys and 48.8% girls. The results revealed that 12% of the adolescents experienced headaches once a week or more. Headaches were more common in girls. The most common symptom of mandibular dysfunction was joint sounds (13%). The second most common symptom of mandibular dysfunction was joint fatigue, being reported more commonly in females. Overall, 20% of the sample reported symptoms of mandibular dysfunction. Six per cent reported that symptoms were troublesome once a week or more. Four per cent of the girls reported that their work or studies were affected by the symptoms. Seventy-five per cent of the adolescents chewed on both sides. Nail-biting was found in 42.6%. Tooth clenching and grinding occurred in approximately lo%, with tooth grinding being more common in girls. Forty-two per cent of the subjects reported having had orthodontic treatment at some time. A history of jaw trauma was reported in 32% of the boys and 12% of the girls. The authors concluded that symptoms of mandibular dysfunction appear early. Screening for symptoms of mandibular dysfunction and headache during routine dental examinations are justified to identify patients who should be observed more closely. Subsequent reports from this study will describe clinical findings and the longitudinal development of signs and symptoms of mandibular dysfunction.S. J. MCKENNA Reprint requests to Dr. Wsnman: Department of Stomatognathic Physiology, Faculty of Odontology, University of Ume& S-901 87 UmeA, Sweden.
New Book Annotations Oral Pathology. Soames JV, Southam JC. New York, Oxford University Press, 1985, 269 pages, illustrated, paperback, $27.95. Written predominantly
for undergraduate
students,
this
is a concise review of the more common oral diseases. The illustrations are mainly photomicrographs, and only limited references are provided. Rehabilitation
and Treatment
of Head and Neck Cancer.