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Surgical techniques in orbital roof fractures: Early treatment and results
732 titanium were found in the submandibular and cervical nodes in 12 of 19 animals (63%) in the test group, but none in the control group. In five animals, the titanium was noted bilaterally. Scanning electron microscopy reveals particles which could be mechanically dislodged while inserting the implant into a tight-fitting site. It is conjectured that small metallic particles are transported to the nodes by phagocytes. No correlation was found between the number of implants and titanium in the regional nodes. The authors emphasize that they observed no foreign body reactions or toxic reactions were seen in the lymph node specimens.--R.E. ALEXANDER Reprint requests to Dr Weingart: Department of Oral and Maxillofacial Surgery, University of MUnster, Waldeyerstrasse 30, 48129 MOnster, Germany.
A Comparison of Different Imaging Modalities and Direct Inspection After Periosteal Stripping in Predicting the Invasion of the Mandible by Oral Squamous Carcinoma. Brown JS, Griffith JF, Phelps PD, et al. Br J Oral Maxillofacial Surg 32:347, 1994 A group of 35 patients, who required a mandibular resection as part of their treatment for oral squamous carcinoma, were prospectively studied, to compare the predictability o f orthopantomograms (OPG), bone scans, computerized tomography (CT), magnetic resonance imaging (MRI), and periosteal stripping with direct inspection in predicting both the presence and extent of tumor invasion of the mandible. The prediction of the extent of bone invasion for each of the investigations and direct inspection after periosteal stripping was judged for accuracy against the assessment of the definitive histological specimen. Each of the investigations was interpreted by a panel of maxillofacial surgeons, dental radiologists, medical radiologists, and nuclear physicists without any knowledge of the histological findings. The average of the measurements was used in the final predictions. The OPG underpredicted width and depth by an average of 13 mm and 2 mm, with five false-negative reports. Bone scans overpredicted the width and depth by 14 mm and 15 mm, with one false-negative. CT scans underpredicted the width by 5 mm and overpredicted the depth by 3 mm but had seven false-negative reports. MRI scans overpredicted the width and depth by 19 mm and 10 mm with only one falsenegative. Direct inspection after periosteal stripping underpredicted width and depth by 5 mm and 3 mm with only one false-negative. It was concluded that OPGs and bone scans were of main use for initial assessment. MRI is a more useful investigation than CT in the assessment of mandibular invasion. Periosteal stripping at the time of the resection can accurately predict the presence of tumour invading the mandible.--ST.J. Cl~EAN Reprint requests to Mr Brown: Maxillofacial Unit, Walton Hospital, Rice Lane, Liverpool L9 1AE, England.
Surgical Techniques in Orbital Roof Fractures: Early Treatment and Results. Piotrowski WP, Beck-Mannagetta J. J Craniomaxillofac Surg 23:6, 1995 The outcome of treatment for 101 patients treated for orbital roof fractures were analyzed in a retrospective study with special reference to the timing of operative intervention. Indications for surgical intervention included displaced bone fragments, intracranial displacement of orbital contents, prolapse of brain into the orbit, and dysfunction of the superior
CURRENT LITERATURE rectus muscle. The majority of the patients treated (87.1%) had surgery on the day of admission. Head injury and polytrauma were the main causes for the delay in treatment. Operative techniques used were reduction with no fixation (45.%), reduction followed by osteosynthesis with mini plates (34.6%), and plastic reconstruction using vicryl-polydioxanon patch, homologous lyophilized costal cartilage, or autologous bone graft. The overall mortality rate was 11.8%. Postoperative complications or unsatisfactory functional or cosmetic results occurred in 12.9% of the patients. Despite the high incidence of open head injury or open fractures, no postoperative wound infection was encountered. In 79.2% of the cases, the operative results were considered to be good. In unsatisfactory cases, severity of the primary injury was the major contributory factor. It is suggested that with early intervention, accurate reduction and low infection rate was achieved resulting in superior functional and cosmetic outcome.--M. MANISALI Reprint requests to Dr Piotrowski: Department of Neurosurgery, Landesnervenklinik Salzburg, Ignaz-Harrer-Str 79, A 5020 Saltzburg, Austria.
New Book Annotations New Concepts in Craniomandibular and Chronic Pain Management. Gelb H (ed), with 22 contributors. London, England, Mosby-Wolfe, 1994, 373 pages, illustrated, $142.00 This book attempts to link postural alterations to the etiology of craniomandibular and other chronic pain conditions. Contributions have been made by persons with backgrounds in medicine, dentistry, osteopathy, physical medicine, chiropractic, podiatric medicine, and the behavioral sciences. Based on the concepts presented, treatments ranging from manual mobilization, body awareness and centering, and exercises for functional strengthening and movement, to acupuncture, sclerotherapy, trigger point injections, and orthotics for the feet are suggested.
Implant Prosthodontics: Clinical and Laboratory Procedures. Fredrickson EJ, Stevens PJ, Gress ML (eds), with 6 contributors. St Louis, MO, Mosby-Year Book, 1994, 182 pages, 609 illustrations (585 in color) Although this text was developed as a teaching manual on implant prosthodontics, surgical members of the implant team must also have an awareness of the restorative aspects. This book provides information on diagnostic and surgical splints, fixed implant-retained maxillary and mandibular full arch prostheses, fixed prosthesis for partially edentulous patients, the single tooth prosthesis, and the implant-retained overdenture. Also discussed are complications and their management, and guidelines for hygiene and maintenance.
Current Controversies in Surgery for Internal Derangements of the Temporomandibular Joint. Laskin DM (ed), with 14 contributors. Oral and Maxillofacial Clinics of North American, Volume 6, No. 2, 1994, Philadelphia, PA, Saunders, 140 pages, illustrated The 13 articles in this monograph present the advantages and disadvantages of the various surgical procedures used to treat internal derangements of the temporomandibular joint.
A Comparison of Different Imaging Modalities and Direct Inspection After Periosteal Stripping in Predicting the Invasion of the Mandible by Oral Squamous Carcinoma. Brown JS, Griffith JF, Phelps PD, et al. Br J Oral Maxillofacial Surg 32:347, 1994 A group of 35 patients, who required a mandibular resection as part of their treatment for oral squamous carcinoma, were prospectively studied, to compare the predictability o f orthopantomograms (OPG), bone scans, computerized tomography (CT), magnetic resonance imaging (MRI), and periosteal stripping with direct inspection in predicting both the presence and extent of tumor invasion of the mandible. The prediction of the extent of bone invasion for each of the investigations and direct inspection after periosteal stripping was judged for accuracy against the assessment of the definitive histological specimen. Each of the investigations was interpreted by a panel of maxillofacial surgeons, dental radiologists, medical radiologists, and nuclear physicists without any knowledge of the histological findings. The average of the measurements was used in the final predictions. The OPG underpredicted width and depth by an average of 13 mm and 2 mm, with five false-negative reports. Bone scans overpredicted the width and depth by 14 mm and 15 mm, with one false-negative. CT scans underpredicted the width by 5 mm and overpredicted the depth by 3 mm but had seven false-negative reports. MRI scans overpredicted the width and depth by 19 mm and 10 mm with only one falsenegative. Direct inspection after periosteal stripping underpredicted width and depth by 5 mm and 3 mm with only one false-negative. It was concluded that OPGs and bone scans were of main use for initial assessment. MRI is a more useful investigation than CT in the assessment of mandibular invasion. Periosteal stripping at the time of the resection can accurately predict the presence of tumour invading the mandible.--ST.J. Cl~EAN Reprint requests to Mr Brown: Maxillofacial Unit, Walton Hospital, Rice Lane, Liverpool L9 1AE, England.
Surgical Techniques in Orbital Roof Fractures: Early Treatment and Results. Piotrowski WP, Beck-Mannagetta J. J Craniomaxillofac Surg 23:6, 1995 The outcome of treatment for 101 patients treated for orbital roof fractures were analyzed in a retrospective study with special reference to the timing of operative intervention. Indications for surgical intervention included displaced bone fragments, intracranial displacement of orbital contents, prolapse of brain into the orbit, and dysfunction of the superior
CURRENT LITERATURE rectus muscle. The majority of the patients treated (87.1%) had surgery on the day of admission. Head injury and polytrauma were the main causes for the delay in treatment. Operative techniques used were reduction with no fixation (45.%), reduction followed by osteosynthesis with mini plates (34.6%), and plastic reconstruction using vicryl-polydioxanon patch, homologous lyophilized costal cartilage, or autologous bone graft. The overall mortality rate was 11.8%. Postoperative complications or unsatisfactory functional or cosmetic results occurred in 12.9% of the patients. Despite the high incidence of open head injury or open fractures, no postoperative wound infection was encountered. In 79.2% of the cases, the operative results were considered to be good. In unsatisfactory cases, severity of the primary injury was the major contributory factor. It is suggested that with early intervention, accurate reduction and low infection rate was achieved resulting in superior functional and cosmetic outcome.--M. MANISALI Reprint requests to Dr Piotrowski: Department of Neurosurgery, Landesnervenklinik Salzburg, Ignaz-Harrer-Str 79, A 5020 Saltzburg, Austria.
New Book Annotations New Concepts in Craniomandibular and Chronic Pain Management. Gelb H (ed), with 22 contributors. London, England, Mosby-Wolfe, 1994, 373 pages, illustrated, $142.00 This book attempts to link postural alterations to the etiology of craniomandibular and other chronic pain conditions. Contributions have been made by persons with backgrounds in medicine, dentistry, osteopathy, physical medicine, chiropractic, podiatric medicine, and the behavioral sciences. Based on the concepts presented, treatments ranging from manual mobilization, body awareness and centering, and exercises for functional strengthening and movement, to acupuncture, sclerotherapy, trigger point injections, and orthotics for the feet are suggested.
Implant Prosthodontics: Clinical and Laboratory Procedures. Fredrickson EJ, Stevens PJ, Gress ML (eds), with 6 contributors. St Louis, MO, Mosby-Year Book, 1994, 182 pages, 609 illustrations (585 in color) Although this text was developed as a teaching manual on implant prosthodontics, surgical members of the implant team must also have an awareness of the restorative aspects. This book provides information on diagnostic and surgical splints, fixed implant-retained maxillary and mandibular full arch prostheses, fixed prosthesis for partially edentulous patients, the single tooth prosthesis, and the implant-retained overdenture. Also discussed are complications and their management, and guidelines for hygiene and maintenance.
Current Controversies in Surgery for Internal Derangements of the Temporomandibular Joint. Laskin DM (ed), with 14 contributors. Oral and Maxillofacial Clinics of North American, Volume 6, No. 2, 1994, Philadelphia, PA, Saunders, 140 pages, illustrated The 13 articles in this monograph present the advantages and disadvantages of the various surgical procedures used to treat internal derangements of the temporomandibular joint.