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Treatment of sialolithiasis by extracorporeal shock wave lithotripsy — Alleviation of severe pain during treatment and common characteristics of successful cases
P22-1 Dentoalveolar surgery & Preprosthetic surgery and implantology 8. Treatment of Sialolithiasis by Extracorporeal Shock Wave Lithotripsy - Alleviation of severe pain during treatment and common characteristics of successful cases
Sawa, Y., Itou, M., Takemoto, T., Takagi, N., Miyagishima, T. Department of Oral and Maxillofacial Surgery and Dentistry, Fujieda Municipal HospitaL, Fujieda, Japan Extracorporeal shock wave lithotripsy (ESWL) is a successful method for excretion of fragments out of the body by shattering stones. We reported that ESWL could be applied to salivary stones and that it enables us to treat sialolithiasis non-surgically at the 41st Annual Meeting of Japanese Society of Oral and Maxillofacial Surgeons. We reported that enough countermeasures against severe pain during treatment are needed for successf. Thus we have developed methods of alleviation from severe pain, a n d performed this treatment for 11 patients since the last report (8 submandibular glands, 2 Whalton ducts, 1 parotid gland) using the Storz Modulith SL-20 Lithotripter. Through these countermeasures we were able to obtain increased shock wave levels, and the results were as follows: 1) In 5 cases, salivary stones disappeared completely. 2) In 4 cases, stone fragments were excreted without symptoms. 3) In 2 cases, the salivary glands required extirpation due to symptoms of remaining stones. In the above-mentioned 5 cases of complete disappearance, the presence of salivary duct dilation and salivary storage around stones in ultrasonography was pathognomonic. Here we report our consideration of the relation between ultrasonography diagnosis and stone shattering and excretion in successful cases, and our pain alleviation method.
9. Clinical Evaluation of a Collagen-Based Dermal Substitute (Terudermis) in Oral Mucosal Defects after the Operation of Jaw Bone Cysts and Benign Tumors
Takahashi, N, 1, Teranobu, 0.1, Nakajima, K. l, Nishimura, B. x, Ri, S. 2, Eida, Ko1, Oko, T.3, Shimada, K. a 1Department of Maxillofacial Surgery, Kobe Univ., 2Mitsubishi-Kobe Hospital, Kobe, 3Imperial Gift Foundation Ine. Saiseikai Hyogo-ken Hospital, Kobe, Japan Although many kinds of biomaterials, such as freeze-dried dura and freeze-dried porcine skin, have been used temporarily for oral mucosal defects, they have some disadvantages. For oral mucosal defects caused by the extirpation of cysts and tumors, we used a collagen dermal substitude (Terudermis), which consisted of a bottom layer of fibrillar aterocollagen and heat-denatured aterocollagen with dehydrothermal cross-linking and an upper layer of a silicone elastomer. We evaluated the techniques of the fixation, the effects of relieving pain and promoting hemeostasis, the degree of pro-
193
moting epithelization, and whether infection occurred or not. We used Terudermis in 22 patients having bone defects or mucosal defects from the whole extirpation of a cyst or tumor. The patients ranged in age from 13 to 80 years. Six were male and 16 were female. After the extirpation of the cyst or tumor, the material was put on the exposed bones, and gauze was inserted for good adherence. After one week, the silicone elastomer layer was removed, and we examined the conditions of recovery. The results suggest that the material is effective for use on exposed bone because it relieves pain, promotes hemeostasis, promotes rapid epithelization, and has no signs of infection.
10. Mechanical Study of Osseointegrated Implants Based on ,Long-Term Evaluation of Implant Treatment
lhara, K., Goto, 3/1., Miyahara, A., Toyota, J., Uchida, Y, Katsuki, T. Department of Oral and Maxillofacial Surgery, Saga Medical School, Saga, Japan Balanced distribution of bite force to each implant is an important factor in achieving long-term success of osse0integrated implants. The bite force distributed to implants varies by the length of the implant, location of implant placement and design of the superstructure. When distribution of bite force was unsuitable, destruction of bone and bone resorption around the implant were recognized in a long-term follow-up. In this study, the progress of each implant which could be observed over a three-year-plus follow-up was clinically classified into three groups: success, survival, and failure. The relation between the result of each implant and its internal force generated by the bite force is discussed. Twenty patients who underwent oral rehabilitation with Branemark Implants in the Department of Oral and Maxillofacial Surgery, Saga Medical School, were studied. The progress of each implant was classified into one of three groups of success, survival and failure by clinical and radiographic criteria. In this mechanical study, copies of the working model with abutment replica and superstructure were made, and the position and length of the implant, length of the superstructure and angle between the implant and the superstructure were measured. A model for the analysis was represented by nodal points and elements. Then data of the model, i.e., number of nodal points and elements, three-dimensional coordinates of the points, elastic properties of the materials and strength of bite force were entered into a threedimensional frame structure analysis program and the internal force of each implant was analyzed. Results showed that there were failure-prone cases where excessive bending moment occurred in an implant, particularly in cases in which implants were used after jaw reconstruction. There were also cases with mechanical problems in implants that were classified into success or survival in normal edentulous patients.
Sawa, Y., Itou, M., Takemoto, T., Takagi, N., Miyagishima, T. Department of Oral and Maxillofacial Surgery and Dentistry, Fujieda Municipal HospitaL, Fujieda, Japan Extracorporeal shock wave lithotripsy (ESWL) is a successful method for excretion of fragments out of the body by shattering stones. We reported that ESWL could be applied to salivary stones and that it enables us to treat sialolithiasis non-surgically at the 41st Annual Meeting of Japanese Society of Oral and Maxillofacial Surgeons. We reported that enough countermeasures against severe pain during treatment are needed for successf. Thus we have developed methods of alleviation from severe pain, a n d performed this treatment for 11 patients since the last report (8 submandibular glands, 2 Whalton ducts, 1 parotid gland) using the Storz Modulith SL-20 Lithotripter. Through these countermeasures we were able to obtain increased shock wave levels, and the results were as follows: 1) In 5 cases, salivary stones disappeared completely. 2) In 4 cases, stone fragments were excreted without symptoms. 3) In 2 cases, the salivary glands required extirpation due to symptoms of remaining stones. In the above-mentioned 5 cases of complete disappearance, the presence of salivary duct dilation and salivary storage around stones in ultrasonography was pathognomonic. Here we report our consideration of the relation between ultrasonography diagnosis and stone shattering and excretion in successful cases, and our pain alleviation method.
9. Clinical Evaluation of a Collagen-Based Dermal Substitute (Terudermis) in Oral Mucosal Defects after the Operation of Jaw Bone Cysts and Benign Tumors
Takahashi, N, 1, Teranobu, 0.1, Nakajima, K. l, Nishimura, B. x, Ri, S. 2, Eida, Ko1, Oko, T.3, Shimada, K. a 1Department of Maxillofacial Surgery, Kobe Univ., 2Mitsubishi-Kobe Hospital, Kobe, 3Imperial Gift Foundation Ine. Saiseikai Hyogo-ken Hospital, Kobe, Japan Although many kinds of biomaterials, such as freeze-dried dura and freeze-dried porcine skin, have been used temporarily for oral mucosal defects, they have some disadvantages. For oral mucosal defects caused by the extirpation of cysts and tumors, we used a collagen dermal substitude (Terudermis), which consisted of a bottom layer of fibrillar aterocollagen and heat-denatured aterocollagen with dehydrothermal cross-linking and an upper layer of a silicone elastomer. We evaluated the techniques of the fixation, the effects of relieving pain and promoting hemeostasis, the degree of pro-
193
moting epithelization, and whether infection occurred or not. We used Terudermis in 22 patients having bone defects or mucosal defects from the whole extirpation of a cyst or tumor. The patients ranged in age from 13 to 80 years. Six were male and 16 were female. After the extirpation of the cyst or tumor, the material was put on the exposed bones, and gauze was inserted for good adherence. After one week, the silicone elastomer layer was removed, and we examined the conditions of recovery. The results suggest that the material is effective for use on exposed bone because it relieves pain, promotes hemeostasis, promotes rapid epithelization, and has no signs of infection.
10. Mechanical Study of Osseointegrated Implants Based on ,Long-Term Evaluation of Implant Treatment
lhara, K., Goto, 3/1., Miyahara, A., Toyota, J., Uchida, Y, Katsuki, T. Department of Oral and Maxillofacial Surgery, Saga Medical School, Saga, Japan Balanced distribution of bite force to each implant is an important factor in achieving long-term success of osse0integrated implants. The bite force distributed to implants varies by the length of the implant, location of implant placement and design of the superstructure. When distribution of bite force was unsuitable, destruction of bone and bone resorption around the implant were recognized in a long-term follow-up. In this study, the progress of each implant which could be observed over a three-year-plus follow-up was clinically classified into three groups: success, survival, and failure. The relation between the result of each implant and its internal force generated by the bite force is discussed. Twenty patients who underwent oral rehabilitation with Branemark Implants in the Department of Oral and Maxillofacial Surgery, Saga Medical School, were studied. The progress of each implant was classified into one of three groups of success, survival and failure by clinical and radiographic criteria. In this mechanical study, copies of the working model with abutment replica and superstructure were made, and the position and length of the implant, length of the superstructure and angle between the implant and the superstructure were measured. A model for the analysis was represented by nodal points and elements. Then data of the model, i.e., number of nodal points and elements, three-dimensional coordinates of the points, elastic properties of the materials and strength of bite force were entered into a threedimensional frame structure analysis program and the internal force of each implant was analyzed. Results showed that there were failure-prone cases where excessive bending moment occurred in an implant, particularly in cases in which implants were used after jaw reconstruction. There were also cases with mechanical problems in implants that were classified into success or survival in normal edentulous patients.