The sagittal split osteotomy of the mandible

Modifications of the sagittal split osteotomy of the mandible have essentially reduced the major drawbacks of the procedure, such as condyle displacement, short-term skeletal relapse, and protracted maxillomandibular fixation and mental nerve dysesthesia. These techniques have proved effective over a period of 4 years in fifty-seven patients treated.     

Salivary concentrations of steroid hormones in males and in cycling and postmenopausal females with and without periodontitis

Concentrations of testosterone, dehydroepiandrosterone, eslradiol, progesterone, 17α-hydroxyprogesterone, and cortisol were measured in the saliva by radioimmunoassay. Saliva from male and cycling and postmenopausal female patients with and without periodontitis was studied.
It was found that salivary concentration of progesterone was increased in all patients with periodontitis. While testosterone was significantly increased in the female diabetic and non-diabetic patients with periodontitis, no difference in its concentration was found in the saliva of non-diabetic males with and without periodontitis. Salivary dehydroepiandrosterone was also increased in postmenopausal females with periodontitis. In contrast, estradiol was significantly decreased or not measurable in all patient groups with periodontitis. The concentration of cortisol and 17α-hydroxyprogesterone showed no significant differences in postmenopausal patients with and without periodontitis. In addition, the salivary concentration of all hormones in postmenopausal females showed circadian variation. Moreover, results obtained in postmenopausal and ovariectomized females provided evidence for extragonadal production of sex steroid hormones in postmenopausal females.
The present results suggest that there is a relationship between the altered production of sex steroid hormones and the incidence of periodontal pathology.     

Perturbation of cobalt 60 radiation doses by metal objects implanted during oral and maxillofacial surgery

The influence on cobalt 60 dose distributions of typical metal parts used in oral and maxillofacial surgery was studied. Relative doses were determined by exposing x-ray films in a polystyrene phantom set-up containing samples of Vitallium, titanium, and stainless steel. Optical densities were converted to doses with the aid of sensitometric curves. The results show that for normal incidence there is a 25% to 40% increase in dose at the entrance side of the metal and a 20% to 25% decrease in dose at the exit side. The enhancement effect falls off rapidly and becomes negligible at about 1 mm from the interface. The reduction effect decreases more gradually and is still evident at distances of a few centimeters. These dose perturbations should be taken into account in the planning of radiation therapy for patients in whom metal objects have been implanted.     

Construction of composite slides

This article describes a method for constructing composite slides without destroying the original slide. A conventional slide projector, rear-projector screen, modified 35 mm camera, and slide-duplicating film are required for this technique.     

Radiology instruction and use of ionizing radiation in U.S. dental schools

In fall 1980, the Commission on Dental Accreditation of the American Dental Association conducted a comprehensive survey of radiology instruction and the use of ionizing radiation in dental education. All 60 dental schools in the United States responded to the survey. Data were collected on course objectives, course content, clock hours of instruction, radiology content in other clinical courses, the number, educational background, and years of teaching experience of radiology faculty, clinical requirements in radiology and the measures used to assess student competency, and the use of radiographs in providing patient care. Attention was directed to practices used in monitoring radiation protection and hygiene. These data provide a frame of reference for evaluating the status of radiology instruction at the respective schools. More important, they provide faculty with a baseline for determining what changes, if any, are needed in the current radiology curriculum.     

Analyses of layer-thickness effects in bilayered dental ceramics subjected to thermal stresses and ring-on-ring tests.

OBJECTIVES: The purpose of this study was to analyze the stress distribution through the thickness of bilayered dental ceramics subjected to both thermal stresses and ring-on-ring tests and to systematically examine how the individual layer thickness influences this stress distribution and the failure origin. METHODS: Ring-on-ring tests were performed on In-Ceram Alumina/Vitadur Alpha porcelain bilayered disks with porcelain in the tensile side, and In-Ceram Alumina to porcelain layer thickness ratios of 1:2, 1:1, and 2:1 were used to characterize whether failure originated at the surface or the interface. Based on (1) the thermomechanical properties and thickness of each layer, (2) the difference between the test temperature and the glass transition temperature, and (3) the ring-on-ring loading configuration, the stress distribution through the thickness of the bilayer was calculated using closed-form solutions. Finite element analyses were also performed to verify the analytical results. RESULTS: The calculated stress distributions showed that the location of maximum tension during testing shifted from the porcelain surface to the In-Ceram Alumina/porcelain interface when the relative layer thickness ratio changed from 1:2 to 1:1 and to 2:1. This trend is in agreement with the experimental observations of the failure origins. SIGNIFICANCE: For bilayered dental ceramics subjected to ring-on-ring tests, the location of maximum tension can shift from the surface to the interface depending upon the layer thickness ratio. The closed-form solutions for bilayers subjected to both thermal stresses and ring-on-ring tests allow the biaxial strength of the bilayer to be evaluated.     

Mutations in SH3BP2, the cherubism gene, were not detected in central or peripheral giant cell tumours of the jaw

Giant cell granulomas of the jaw (GCGJ) are non-familial, generally unilateral osteoclast-rich lesions that are histopathologically indistinguishable from cherubism. Cherubism is an autosomal dominant disease that is characterised by bilateral radiolucencies of the jaw, and caused by mutations that occur in SH3BP2 exon 10. The aim of the study was to screen lesional GCGJ tissue for SH3BP2 mutations. Lesional mononuclear stromal or spindle cells were microdissected from paraffin-embedded tissue from GCGJ, and DNA was then extracted and sequenced for SH3BP2 mutations associated with cherubism. No mutations were detected in 26 GCGJ (15 central, 11 peripheral), which indicated that people with GCGJ do not harbour cherubism-related germline SH3BP2 mutations, and that GCGJ do not harbour somatic SH3BP2 mutations. This suggests that cherubism and GCGJ arise on a different genetic background, and therefore detection of SH3BP2 mutations can be a useful means of distinguishing between them.     

Relationship between kinematic center and TMJ anatomy and function

The kinematic center (KC)-defined by coinciding jaw-opening/-closing and protrusion-retrusion trajectories-has been proposed in the literature as a reference point to represent TMJ movements. In this study, we tested whether the KC lies in a peculiar anatomical point and whether its trajectory reflects intra-articular distance. In 11 asymptomatic individuals (seven females, four males, aged 24-37 yrs), 4 openings/closings and 4 protrusions/retrusions were tracked with dynamic stereometry. In a 3D lattice (0.5 mm grid) constructed solidly around each condyle, the KC was the point with maximal cross-correlation between opening-closing and protrusion-retrusion paths. KC trajectories were more cranial on closing than on opening, consistent with intra-articular distances being smaller on closing than on opening. However, KCs were never located on condylar main axes (distance, 4.5 +/- 2.9 mm), nor did they coincide with points best approximating fossa shapes (distance, 12.5 +/- 6.4 mm). The kinematic center's anatomical and functional significance therefore appears to be questionable.