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Replantation of avulsed immature permanent teeth: results in 39 cases after 2.5 years on average
72
British
Journal
of Oral and Maxillofacial
Surgery
femurs underneath the patella. The flattened surfaces were coated with either a 150~Km APS-H-A.C. layer or a 150-pm VPS-H-A.C. layer plasma sprayed on an underlying 50-pm porous titanium layer. The animals were killed after 84 or 365 days. After 84 days histomorphologic evaluation revealed that more than 86% of each surface was covered with mature bone, while the VPS-H-A.C. coating demonstrated an almost two times greater tensile strength than the APS-H-A.C. coating. After 365 days both coatings showed a bony coverage of more than 94%. Again the tensile strength testing revealed much higher values for the VPS-H-A.C. coating. This study demonstrates that after 84 days as well as after 365 days in vivo, the VPS-H-A.C. coating had a significantly greater load capacity than an H-A.C. coating applied under atmospheric condition, and an equal affinity for bone. Correspondence: Dr Dr R. Kettner, KandelfeldstraDe 24, D-52074 Aachen, Germany.
Replantation of avulsed immature cases after 2.5 years on average. C Ruda, H. Hulla, K. Glockner,
permanent teeth: results in 39 K. A. Ebeleseder, S. Friehs, C. Pertl. (Mund Kiefer
GesichtsChir 1997; 1: 340-345). The aim of this investigation was a critical assessment of the shortand medium-term results of replantation of immature, avulsed permanent teeth. Thirty-nine teeth were investigated after 2.5 years on average. Only 7 teeth (18%) had been replanted within 5 min after avulsion. Sixteen teeth (41%) showed revascularisation or ingrowth of alveolar bone into the pulp. Twenty-two teeth (56%) showed signs of ankylosis, 6 (15%) had been exfoliated or extracted. Seventeen teeth (77% of the ankylotic ones) exhibited an alveolar growth arrest of 1.5 mm per 10 cm body growth. By planimetric assessment, the yearly loss of root dentin by replacement resorption was about 15%. The appearance was compromised in 11 cases (33%) by severe discoloration. In spite of intense therapeutic effort and partial success,the results must be classified as unsatisfactory. In avulsions of immature permanent teeth, replantation therefore has to be considered an intermediate solution. Since the main reason for a failure is extended extra-oral unphysiologic storage, replantation by lay helpers immediately after the accident should be propagated as a first-aid treatment to improve the situation of the replanted tooth. In addition, more attention should be paid to preserving teeth in tissue cultures before replantation. Correspondence: Dr K. A. Ebeleseder, Universitltsklinik fiir Zahn-, Mund und Kieferheilkunde, Abteilung fiir Zahnerhaltungskunde, Auenbruggerplatz 12, A-8010 Graz, Austria.
Inflammatory activity of the oral mucosa from patients leukaemia under q&static treatment. r Bieneigriiber, R.-M Teseler. 0. Anders. (Mund Kiefer GesichtsChir 346348).
acute leukaemia after treatmeni with cytotoxic drugs, even when the oral mucosa is clinically inconspicuous, as the inflammatory activity may take place subclinically in strongly stressed or vulnerable regions of mucosa. Correspondence: Prof. Dr Dr V. BienengrLber, Abteilung Experimentelle Zahnheilkunde, Klinik und Poliklinik fiir Zahn-, Mund- und Kieferheilkunde, Universitlt Restock. Postfach 100 888, D-18055, Restock, Germany
Synovial chondromatosis: a contribution to differential diagnosis of diseases of the temporomandibular joint. 7: Plath, H. Dallenbach, I. Ohnesorge, B. Hoffmeister. (Mund Kiefer GesichtsChir 1997; 1: 349-352).
A rare case of synovial chondromatosis of the temporomandibular joint with unspecific symptoms is presented. This causes difficulties in classifying the different clinically and technically acquired features at differential diagnosis. The concept of chondrometaplasia as being triphasic and self-limiting is strongly supported and extreme care should be taken during therapy in order to avoid any unnecessary destruction and mutilation. This case seems to indicate that chronic parafunctional overload was the initiating stimulus for this reactive metaplastic process. Non-physiologic overstrain of any cause should be diagnosed and corrected. Correspondence: Dr Dr Th. Plath, Klinik fiir Kieferchirurgie und Plastische Gesichtschirurgie, UniversiWtsklinikum Benjamin Franklin, Freie Universitlt Berlin, Hindenburgdamm 30, D-12200 Berlin, Germany.
Synovial chondromatosis of the articular joint with invasion middle cranial fossa. I! Kessler, N Hardt, J Kuttenberger.
of the
(Mund Kiefer GesichtsChir 1997; 1: 353-355). Synovial chondromatosis of the temporomandibular joint is a rare occurrence. Resorption of the floor of the skull base caused by the tumour with invasion into the middle cranial fossa has only been described a few times. We report on diagnosis, histologic examination and therapy of a patient with synovial chondromatosis in the articular tubercle of the right temporomandibular joint invading the middle and cranial fossa. After tumour exstirpation the defect in the floor of the middle cranial fossa was reconstructed using a split-skull graft via an intracranial approach. Correspondence; Dr Dr P. Kessler, Klinik fiir Mund-, Kiefer- und Gesichtschirurgie, Kantonsspital Luzern, SpitalstraOe, CH-6000 Luzern 16, Switzerland.
with acute
1997: 1:
Angiosarcoma of the oral mucosa at multiple sites. C. M. Ziegler, C. Hofele, A. Kiibler, J ZLiller, A. Born. (Mund Kiefer GesichtsChir
1997; 1: 356-358). The aim of this study is the registration and the chronological control of inflammatory alterations in the oral mucosa of patients with acute leukaemia under cytostatic treatment. Thirteen patients with acute myeloid leukaemia or acute lymphatic leukaemia were investigated in three oral regions (gingiva, buccal and palatine mucosa) before, during and after cytotoxic drug application for a period of 46 weeks by means of exfoliative cytology. Before therapy, patients with leukaemia showed a significant increase in the number of cells from deeper epithelial layers and a significant decrease of the keratinization index for all investigated regions. This is a consequence of the general inflammatory alteration in all mucosal areas. During cytotoxic drug application these findings were modified only for the palatine mucosa. Immediately after the end of cytotoxic drug application only the buccal mucosa showed a slight but not significant tendency for normalization. At this time, only for the palatine mucosa was there a signifant tendency toward regression. The study underlines the necessity for intensive dental care of patients with
A 6&year-old man presented with a bluish, livid swelling in the region of the lateral alveolar processes of all four quadrants. Evaluation and histopathological findings resulted in the diagnosis of an angiosarcoma at multiple sites. A survey of the literature and an epidemiologic review of our own patients prove this to be an extremely rare occurrence. A partical resention of the maxilla and the mandible on both sides was performed in sano. After discharge, however, a sarcoma was detected in the region of the right scapula 5 months after surgery. Therefore radiation treatment was initiated. The patient died 4 weeks later. The course confirms the poor prognosis of this tumor. Correspondence; Dr Dr C. M. Ziegler, Klinik fiir Mund-, Kiefer-, Gesichtschirurgie, Universitlt Heidelberg, Im Neuenheimer Feld 400, D-69120 Heidelberg, Germany.
British
Journal
of Oral and Maxillofacial
Surgery
femurs underneath the patella. The flattened surfaces were coated with either a 150~Km APS-H-A.C. layer or a 150-pm VPS-H-A.C. layer plasma sprayed on an underlying 50-pm porous titanium layer. The animals were killed after 84 or 365 days. After 84 days histomorphologic evaluation revealed that more than 86% of each surface was covered with mature bone, while the VPS-H-A.C. coating demonstrated an almost two times greater tensile strength than the APS-H-A.C. coating. After 365 days both coatings showed a bony coverage of more than 94%. Again the tensile strength testing revealed much higher values for the VPS-H-A.C. coating. This study demonstrates that after 84 days as well as after 365 days in vivo, the VPS-H-A.C. coating had a significantly greater load capacity than an H-A.C. coating applied under atmospheric condition, and an equal affinity for bone. Correspondence: Dr Dr R. Kettner, KandelfeldstraDe 24, D-52074 Aachen, Germany.
Replantation of avulsed immature cases after 2.5 years on average. C Ruda, H. Hulla, K. Glockner,
permanent teeth: results in 39 K. A. Ebeleseder, S. Friehs, C. Pertl. (Mund Kiefer
GesichtsChir 1997; 1: 340-345). The aim of this investigation was a critical assessment of the shortand medium-term results of replantation of immature, avulsed permanent teeth. Thirty-nine teeth were investigated after 2.5 years on average. Only 7 teeth (18%) had been replanted within 5 min after avulsion. Sixteen teeth (41%) showed revascularisation or ingrowth of alveolar bone into the pulp. Twenty-two teeth (56%) showed signs of ankylosis, 6 (15%) had been exfoliated or extracted. Seventeen teeth (77% of the ankylotic ones) exhibited an alveolar growth arrest of 1.5 mm per 10 cm body growth. By planimetric assessment, the yearly loss of root dentin by replacement resorption was about 15%. The appearance was compromised in 11 cases (33%) by severe discoloration. In spite of intense therapeutic effort and partial success,the results must be classified as unsatisfactory. In avulsions of immature permanent teeth, replantation therefore has to be considered an intermediate solution. Since the main reason for a failure is extended extra-oral unphysiologic storage, replantation by lay helpers immediately after the accident should be propagated as a first-aid treatment to improve the situation of the replanted tooth. In addition, more attention should be paid to preserving teeth in tissue cultures before replantation. Correspondence: Dr K. A. Ebeleseder, Universitltsklinik fiir Zahn-, Mund und Kieferheilkunde, Abteilung fiir Zahnerhaltungskunde, Auenbruggerplatz 12, A-8010 Graz, Austria.
Inflammatory activity of the oral mucosa from patients leukaemia under q&static treatment. r Bieneigriiber, R.-M Teseler. 0. Anders. (Mund Kiefer GesichtsChir 346348).
acute leukaemia after treatmeni with cytotoxic drugs, even when the oral mucosa is clinically inconspicuous, as the inflammatory activity may take place subclinically in strongly stressed or vulnerable regions of mucosa. Correspondence: Prof. Dr Dr V. BienengrLber, Abteilung Experimentelle Zahnheilkunde, Klinik und Poliklinik fiir Zahn-, Mund- und Kieferheilkunde, Universitlt Restock. Postfach 100 888, D-18055, Restock, Germany
Synovial chondromatosis: a contribution to differential diagnosis of diseases of the temporomandibular joint. 7: Plath, H. Dallenbach, I. Ohnesorge, B. Hoffmeister. (Mund Kiefer GesichtsChir 1997; 1: 349-352).
A rare case of synovial chondromatosis of the temporomandibular joint with unspecific symptoms is presented. This causes difficulties in classifying the different clinically and technically acquired features at differential diagnosis. The concept of chondrometaplasia as being triphasic and self-limiting is strongly supported and extreme care should be taken during therapy in order to avoid any unnecessary destruction and mutilation. This case seems to indicate that chronic parafunctional overload was the initiating stimulus for this reactive metaplastic process. Non-physiologic overstrain of any cause should be diagnosed and corrected. Correspondence: Dr Dr Th. Plath, Klinik fiir Kieferchirurgie und Plastische Gesichtschirurgie, UniversiWtsklinikum Benjamin Franklin, Freie Universitlt Berlin, Hindenburgdamm 30, D-12200 Berlin, Germany.
Synovial chondromatosis of the articular joint with invasion middle cranial fossa. I! Kessler, N Hardt, J Kuttenberger.
of the
(Mund Kiefer GesichtsChir 1997; 1: 353-355). Synovial chondromatosis of the temporomandibular joint is a rare occurrence. Resorption of the floor of the skull base caused by the tumour with invasion into the middle cranial fossa has only been described a few times. We report on diagnosis, histologic examination and therapy of a patient with synovial chondromatosis in the articular tubercle of the right temporomandibular joint invading the middle and cranial fossa. After tumour exstirpation the defect in the floor of the middle cranial fossa was reconstructed using a split-skull graft via an intracranial approach. Correspondence; Dr Dr P. Kessler, Klinik fiir Mund-, Kiefer- und Gesichtschirurgie, Kantonsspital Luzern, SpitalstraOe, CH-6000 Luzern 16, Switzerland.
with acute
1997: 1:
Angiosarcoma of the oral mucosa at multiple sites. C. M. Ziegler, C. Hofele, A. Kiibler, J ZLiller, A. Born. (Mund Kiefer GesichtsChir
1997; 1: 356-358). The aim of this study is the registration and the chronological control of inflammatory alterations in the oral mucosa of patients with acute leukaemia under cytostatic treatment. Thirteen patients with acute myeloid leukaemia or acute lymphatic leukaemia were investigated in three oral regions (gingiva, buccal and palatine mucosa) before, during and after cytotoxic drug application for a period of 46 weeks by means of exfoliative cytology. Before therapy, patients with leukaemia showed a significant increase in the number of cells from deeper epithelial layers and a significant decrease of the keratinization index for all investigated regions. This is a consequence of the general inflammatory alteration in all mucosal areas. During cytotoxic drug application these findings were modified only for the palatine mucosa. Immediately after the end of cytotoxic drug application only the buccal mucosa showed a slight but not significant tendency for normalization. At this time, only for the palatine mucosa was there a signifant tendency toward regression. The study underlines the necessity for intensive dental care of patients with
A 6&year-old man presented with a bluish, livid swelling in the region of the lateral alveolar processes of all four quadrants. Evaluation and histopathological findings resulted in the diagnosis of an angiosarcoma at multiple sites. A survey of the literature and an epidemiologic review of our own patients prove this to be an extremely rare occurrence. A partical resention of the maxilla and the mandible on both sides was performed in sano. After discharge, however, a sarcoma was detected in the region of the right scapula 5 months after surgery. Therefore radiation treatment was initiated. The patient died 4 weeks later. The course confirms the poor prognosis of this tumor. Correspondence; Dr Dr C. M. Ziegler, Klinik fiir Mund-, Kiefer-, Gesichtschirurgie, Universitlt Heidelberg, Im Neuenheimer Feld 400, D-69120 Heidelberg, Germany.