- Email: [email protected]
Ozone therapy for chronic wound healing disorders in irradiated jaws
British Journal of Oral and Maxillofacial Surgery ( 1996) 34, 270-27 I 0 1996 The British Association of Oral and Maxillofacial Surgeons
Abstracts from Deutsche Zeitschrift ftir Mund-Kiefer-und (Volume 20 Number 2 1996) Results defects.
of using micro-titanium P. Kessler, N. Hardt.
meshes
in the reconstruction
genetic nature of facial clefts. This comparison requires the recording of minor forms of clefting, the ascertainment of all twins in a major patient collection, and especially exact diagnosis of zygosity. Ten out of 13 twin pairs of the same sex in a collection of 1045 cleft patients could be evaluated: Zygosity was determined by ‘genetic fingerprinting’ using 2 multi- and 4 single-locus-systems with a probability of a false positive diagnosis of less than 1 : 108. Besides this collective zygosity was determined in another 2 twin pairs of the same sex using Polymerase Chain Reaction (PCR)systems. This method requires a thousand times less quantity of DNA, which may also be degraded, and reaches a probability of error of about 1 : 4000 using 6 systems. Both mono- and di-zygosity could be proved in 5 pairs, and 2 out of 5 pairs showed concordance in both groups, however, 2 dizygotic twins with abortive clefts were classified as concordant. Both pairs who had been investigated using PCR-systems showed identical band patterns and were therefore monozygotic. The concordance rate of dizygotic twin pairs of 40% seems too high compared to other studies, which claim a ratio of concordance rates between mono- and di-zygotic pairs of more than 4: 1. However, these studies are not clearly defined concerning the collection and classification of twins with abortive clefts, and especially concerning zygosity determination. For a definite determination of monozygosity ‘genetic fingerprinting’ and PCR-systems, which have been used in a clinical twin study for the first time, prove to be superior to conventional methods. Therefore their use has to be recommended as a supreme prerequisite for modern twin research and for genetic counselling of monozygotic twins with hereditable conditions.
of sinus
(Dtsch Z Mund Kiefer Gesichts Chir
1996; 20: 2.) Operations of the maxillary sinus can lead to extensive bony defects of the facial and latero-dorsal walls of the sinus. If there is no autogenic bone material available, the question is where to find a suitable substitute for reconstruction. We examined the suitability of micro-titanium meshes for reconstruction of the walls of the maxillary sinus. In 13 adult patients large defects of the walls of the maxillary sinus were reconstructed using micro-titanium meshes. Indications for operation were tumours, large odontogenic cysts, traumatic bone loss and chronic inflammation within the sinuses which had been operated on previously. Clinical and radiological examinations were carried out immediately after surgery and at a 3 months’ interval. Control by sinoscopy was performed in all patients. Great importance was attached to the following aspects: (1) correctly shaped reconstruction of the maxillary sinus, (2) prevention of soft tissue prolapse into the sinus, (3) ventilation of the maxillary sinus and (4) preservation of the facial contours. In all cases healing was uneventful. With sufficient ventilation even neuralgic pain disappeared after reconstruction of the walls of the maxillary sinus. No reoccurrence of inflammatory disease or tumours has been observed. After removal of the micro-titanium meshes in five patients it was found that the former defects were perfectly covered with a dense fibro-osseous soft tissue layer. If autogenic bone material is not available, our results show that large defects of the walls of the maxillary sinus can be reconstructed successfully by using micro-titanium meshes. Correspondence: Dr Peter Kessler, Klinik fur Mund-KieferGesichts-Chirurgie, Kantonsspital Luzem, SpitalstraBe, CH-6000 Luzem 16. Ozone therapy jaws. R. Suder,
for chronic wound healing H.-F. Zeilhofer, H. Deppe.
disorders
Correspondence: Priv.-Doz Dr Dr Harald Eufinger, Univ.-Klinik f. MKG-Chirurgie, In der Schornau 23-25, D-44892 Bochum. The influence osteogenesis.
of augmentation membranes on induced suhpexiosteal G. Hotz, G. Herr, G. Krempian, M. Schwarz.
(Dtsch Z Mund Kiefer Gesichts Chir 1996; 20: 2.)
in irradiated
(Dtsch Z Mund Kiefer
A delivery system for partially purified water soluble BMP was created using porous collagenous cubes. This study experimentally evaluated the influence of two alloplastic augmentation membranes (Polymesolactic acid [PMLA] and Gore-Tex augmentation material [GTAM]) on the shape and size of the implant as well as on the amount of induced bone formation. Osteoinductive collagenous implants with or without overlaid membranes were tested against control collagenous implants with or without overlaid membranes. A total of implants were placed subperiosteally on the skull surface of rats. Implants harvested 28 days postsurgically were subjected to histological evaluation as well as quantitative analysis. A bioassay disclosed no osteoinductive capacity of the collagenous carrier at extraskeletal sites. Control collagenous implants with or without overlaid membranes are incapable of inducing new bone formation. The PMLA membrane is resorbed within 28 days and accompanied with a progressive resorption of the implant. The non-resorbable GTAM membrane significantly preserved the size of the implant and protected the implant against resorption. The osteoinductive collagenous implant overlaid with GTAM membranes protected the implant against resorption and showed significantly induced bone formation bridging the implant. Regarding the possible indications for osteoinductive biomaterials, these findings may stimulate ideas for the creation of osteoinductive biomaterials in a collagenous carrier resulting in predictable bone formation especially for the augmentation of bony contour deficiencies.
Gesichts Chir 1996; 20: 2.) Local ozone treatment represents an alternative new method of treatment in cases of chronic impaired wound-healing of the irradiated jaw. For the local effect, application is effective when there are only superficial osseous changes. Another restriction is caused by the necessity of affixing a low-pressure cup. The lack of side effects must be emphasized as well as the ease, simplicity and inexpensive use, which lead to a high patient compliance. This enables application especially in high risk patients, in which a hyperbaric oxygen therapy is contra-indicated. The mechanism of ozone treatment has not previously been described and clinical effects are only known from empirical observations. Therefore, further investigations are necessary to find the exact pattern of action. Correspondence: Dr med, Dr med dent, Robert Sader, Klinik und Poliklinik fur Mund-Kiefer-Gesichtschirurgie, der Technischen Universitat Mtinchen, Klinikum rechts der Isar, Ismaninger StraDe 22, D-81675 Mtinchen. Determination of the zygosity of twins with cleft deformities modern molecular genetic methods. H. Eufinger, St. P. Rand.
Gesichts-Chirurgie
using
(Dtsch
Z Mund Kiefer Gesichts Chir 1996; 20: 2.) By comparison of concordance rates of mono- and di-zygotic twins, twin studies play an important role in developing concepts for the 270
Abstracts from Deutsche Zeitschrift ftir Mund-Kiefer-und (Volume 20 Number 2 1996) Results defects.
of using micro-titanium P. Kessler, N. Hardt.
meshes
in the reconstruction
genetic nature of facial clefts. This comparison requires the recording of minor forms of clefting, the ascertainment of all twins in a major patient collection, and especially exact diagnosis of zygosity. Ten out of 13 twin pairs of the same sex in a collection of 1045 cleft patients could be evaluated: Zygosity was determined by ‘genetic fingerprinting’ using 2 multi- and 4 single-locus-systems with a probability of a false positive diagnosis of less than 1 : 108. Besides this collective zygosity was determined in another 2 twin pairs of the same sex using Polymerase Chain Reaction (PCR)systems. This method requires a thousand times less quantity of DNA, which may also be degraded, and reaches a probability of error of about 1 : 4000 using 6 systems. Both mono- and di-zygosity could be proved in 5 pairs, and 2 out of 5 pairs showed concordance in both groups, however, 2 dizygotic twins with abortive clefts were classified as concordant. Both pairs who had been investigated using PCR-systems showed identical band patterns and were therefore monozygotic. The concordance rate of dizygotic twin pairs of 40% seems too high compared to other studies, which claim a ratio of concordance rates between mono- and di-zygotic pairs of more than 4: 1. However, these studies are not clearly defined concerning the collection and classification of twins with abortive clefts, and especially concerning zygosity determination. For a definite determination of monozygosity ‘genetic fingerprinting’ and PCR-systems, which have been used in a clinical twin study for the first time, prove to be superior to conventional methods. Therefore their use has to be recommended as a supreme prerequisite for modern twin research and for genetic counselling of monozygotic twins with hereditable conditions.
of sinus
(Dtsch Z Mund Kiefer Gesichts Chir
1996; 20: 2.) Operations of the maxillary sinus can lead to extensive bony defects of the facial and latero-dorsal walls of the sinus. If there is no autogenic bone material available, the question is where to find a suitable substitute for reconstruction. We examined the suitability of micro-titanium meshes for reconstruction of the walls of the maxillary sinus. In 13 adult patients large defects of the walls of the maxillary sinus were reconstructed using micro-titanium meshes. Indications for operation were tumours, large odontogenic cysts, traumatic bone loss and chronic inflammation within the sinuses which had been operated on previously. Clinical and radiological examinations were carried out immediately after surgery and at a 3 months’ interval. Control by sinoscopy was performed in all patients. Great importance was attached to the following aspects: (1) correctly shaped reconstruction of the maxillary sinus, (2) prevention of soft tissue prolapse into the sinus, (3) ventilation of the maxillary sinus and (4) preservation of the facial contours. In all cases healing was uneventful. With sufficient ventilation even neuralgic pain disappeared after reconstruction of the walls of the maxillary sinus. No reoccurrence of inflammatory disease or tumours has been observed. After removal of the micro-titanium meshes in five patients it was found that the former defects were perfectly covered with a dense fibro-osseous soft tissue layer. If autogenic bone material is not available, our results show that large defects of the walls of the maxillary sinus can be reconstructed successfully by using micro-titanium meshes. Correspondence: Dr Peter Kessler, Klinik fur Mund-KieferGesichts-Chirurgie, Kantonsspital Luzem, SpitalstraBe, CH-6000 Luzem 16. Ozone therapy jaws. R. Suder,
for chronic wound healing H.-F. Zeilhofer, H. Deppe.
disorders
Correspondence: Priv.-Doz Dr Dr Harald Eufinger, Univ.-Klinik f. MKG-Chirurgie, In der Schornau 23-25, D-44892 Bochum. The influence osteogenesis.
of augmentation membranes on induced suhpexiosteal G. Hotz, G. Herr, G. Krempian, M. Schwarz.
(Dtsch Z Mund Kiefer Gesichts Chir 1996; 20: 2.)
in irradiated
(Dtsch Z Mund Kiefer
A delivery system for partially purified water soluble BMP was created using porous collagenous cubes. This study experimentally evaluated the influence of two alloplastic augmentation membranes (Polymesolactic acid [PMLA] and Gore-Tex augmentation material [GTAM]) on the shape and size of the implant as well as on the amount of induced bone formation. Osteoinductive collagenous implants with or without overlaid membranes were tested against control collagenous implants with or without overlaid membranes. A total of implants were placed subperiosteally on the skull surface of rats. Implants harvested 28 days postsurgically were subjected to histological evaluation as well as quantitative analysis. A bioassay disclosed no osteoinductive capacity of the collagenous carrier at extraskeletal sites. Control collagenous implants with or without overlaid membranes are incapable of inducing new bone formation. The PMLA membrane is resorbed within 28 days and accompanied with a progressive resorption of the implant. The non-resorbable GTAM membrane significantly preserved the size of the implant and protected the implant against resorption. The osteoinductive collagenous implant overlaid with GTAM membranes protected the implant against resorption and showed significantly induced bone formation bridging the implant. Regarding the possible indications for osteoinductive biomaterials, these findings may stimulate ideas for the creation of osteoinductive biomaterials in a collagenous carrier resulting in predictable bone formation especially for the augmentation of bony contour deficiencies.
Gesichts Chir 1996; 20: 2.) Local ozone treatment represents an alternative new method of treatment in cases of chronic impaired wound-healing of the irradiated jaw. For the local effect, application is effective when there are only superficial osseous changes. Another restriction is caused by the necessity of affixing a low-pressure cup. The lack of side effects must be emphasized as well as the ease, simplicity and inexpensive use, which lead to a high patient compliance. This enables application especially in high risk patients, in which a hyperbaric oxygen therapy is contra-indicated. The mechanism of ozone treatment has not previously been described and clinical effects are only known from empirical observations. Therefore, further investigations are necessary to find the exact pattern of action. Correspondence: Dr med, Dr med dent, Robert Sader, Klinik und Poliklinik fur Mund-Kiefer-Gesichtschirurgie, der Technischen Universitat Mtinchen, Klinikum rechts der Isar, Ismaninger StraDe 22, D-81675 Mtinchen. Determination of the zygosity of twins with cleft deformities modern molecular genetic methods. H. Eufinger, St. P. Rand.
Gesichts-Chirurgie
using
(Dtsch
Z Mund Kiefer Gesichts Chir 1996; 20: 2.) By comparison of concordance rates of mono- and di-zygotic twins, twin studies play an important role in developing concepts for the 270