Delayed assessment of the nasolacrimal system at naso-orbito-ethmoid fractures and a modified technique of dacryocystorhinostomy

Nineteen patients between 8 and 65 years of age (mean age 32) who were treated for naso-orbito-ethmoid area traumas and suffering from epiphora were evaluated. The time after the trauma was at least 4 months. The patients were divided into two groups. The first group consisted of 10 (52.7%) patients who have undergone a surgical procedure for the fractures before. The second group has 9 (47.3%) members who have never been surgically treated after trauma. All of the patients were evaluated with dacryocystography. Obstruction was found to be in the bony nasolacrimal canal in 13 (68.4%) patients. The nasolacrimal canal was intact in six (31.6%) of the patients. Dacryocystorhinostomy (DCR) was essential for five (50%) of the patients in the first group and eight (88.8%) of the patients in the second group. No additional surgical intervention was carried out for nasal deformities of the patients resulting from naso-orbito-ethmoid fractures. Palpebral malposition was present in six (32%) patients. Relief in tear flow was supplied in all patients. Our aim is to compare the outcomes of a modified technique of DCR and incidence of nasolacrimal system injury in patients with naso-orbito-ethmoid fractures and epiphora on whom reduction was or was not carried out. In conclusion, early surgical reduction of naso-orbito-ethmoid fractures should be performed to prevent problems and deformities of the nasolacrimal system.     

Treatment of noncomminuted zygomatic fractures with percutaneous screw reduction and fixation

The standard treatment modality of zygomatic fractures is open reduction and rigid fixation of the fractured segments. Although most of the zygomatic fractures deserve this attentive surgical manipulation to prevent late residual asymmetry, minimally depressed noncomminuted zygomatic fractures can be reduced and fixed percutaneously. Percutaneous intervention causes minimal scarring and morbidity than open techniques and it is possible to align fragments precisely by using high-quality three-dimensional computed tomography (3-D CT) imaging. Six patients with noncomminuted fractures of the zygomaticomaxillary skeleton were evaluated with plain radiographs of facial bones, axial, coronal and 3-D CT. Reduction of the displaced bone segments were achieved by traction of percutaneously applied screw. Either reduced segments were not fixated at all or one of the two new fixation techniques, described in detail in the article, were used for stabilization of reduced segments. In all patients, accurate reduction was obtained. None of the patients showed any recurrent displacement or infection during the follow-up period of six months. The screws were removed in the clinical settings without difficulty. Although percutaneous reduction and external fixation of noncomminuted zygomatic fractures has limited indications, it has its own advantages over open techniques. This method is a less invasive technique and can be performed without any problem in selected cases. Our technique is not suitable for complex zygomatic and periorbital fractures.     

Vascular reactions in the periodontal ligament incident to trauma from occlusion

Abstract The experiments were performed in 13 dogs; nine of the animals had initially a healthy periodontium and four had experimental periodontitis. Trauma from occlusion was created in all dogs according to a technique described previously. The dogs were sacrificed after 7, 14, 30 and 180 days of the experiment. Prior to sacrifice colloidal carbon was injected intravenously. The degree of vascular labelling and leucocyte infiltration as well as osteoclastic activity and the size of the marginal periodontal ligament were assessed in biopsy sections. The findings showed that dogs with a healthy periodontal lesion (Group A) differed in their reactions to a jiggling type of occlusal trauma when compared to dogs with an established periodontal lesion (Group B). Whereas the periodontal ligament in Group A had become adapted to the altered occlusion by the end of 6 months of experiment, that of Group B still showed increased vascular leakage, leucocyte migration and osteoclastic activity.     

The effect of antibacterial compounds on glucosyltransferase activity from Streptococcus mutans.

The effect of several plaque-inhibiting and/or antibacterial compounds on glucan synthesis by glucosyltransferases purified from the cariogenic bacterium Streptococcus mutans strain 6715 was determined. Drugs were tested at concentrations of 0.2–2.0 mM at pH values between 6.5 and 6.8. Bis-biguanides, quaternary ammonium salts and aliphatic amines were found to be potent inhibitors of enzyme activity. The strong anionic detergent, sodium lauryl sulphate and the phenol derivative, hexylresorcinol, also caused significant inhibition. Basic nitrogen compounds lacking a functional hydrophobic group were less inhibitory or stimulated enzyme activity. Both electrostatic and hydrophobic interactions appear to be occurring between the cationic test-agents and the glucosyltransferases, with hydrophobic interaction being more important for enzyme inhibition.     

Assessment of correlation between computerized tomography values of the bone, and maximum torque and resonance frequency values at dental implant placement

summary The aim of this study was to determine the bone density in the designated implant sites using computerized tomography (CT), the fastening torque values of dental implants, and the implant stability values using resonance frequency analysis. Further aim was to evaluate a possible correlation between bone density, fastening torque and implant stability. Eighty‐five patients were treated with 158 Brånemark System implants. CT machine was used for preoperative evaluation of the jawbone for each patient, and bone densities were recorded in Hounsfield units (HU). The fastening torque values of all implants were recorded with the OsseoCare equipment. Implant stability measurements were performed with the Osstell machine. The average bone density and fastening torque values were 751·4 ± 256 HU and 39·7 ± 7 Ncm for 158 implants. The average primary implant stability was 73·2 ± 6 ISQ for seventy implants. Strong correlations were observed between the bone density, fastening torque and implant stability values of Brånemark System TiUnite MKIII implants at implant placement (P < 0·001). These results strengthen the hypothesis that it may be possible to predict and quantify initial implant stability and bone quality from pre‐surgical CT diagnosis.