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  • 1
    ISSN: 1434-3940
    Keywords: Schlüsselwörter Kraniofaziale Chirurgie ; Frontoorbitales Advancement ; Plattenosteosynthese ; Resorbierbare Platten und Schrauben ; Vorläufige Ergebnisse ; Key words Craniofacial surgery ; Frontoorbital advancement ; Plate-osteosynthesis resorbable plates and screws ; Preliminary results
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: In ten patients with craniosynostoses resorbable plates and screws (Lactosorb) consisting of poly-L-lactic acid (82%) and poly-glycolic acid (18%) were used to stabilize the segments after frontoorbital advancement. As our experience increased, an exact adaptation of the plates and simple handling proved to be possible. The plates were stable enough to retain a favorable functional and aesthetic result after redraping the soft tissue envelope. In one patient with Chotzen’s syndrome the intended use of the resorbable material was abandoned: the thin osseous structures did not offer enough primary stability to the high pitch of the screws. During an observation period of up to 21 months no infection, exposure, instability or dislocation was observed. The clinical use of the resorbable material in frontoorbital advancement proved to be a stable method of segment fixation if the bone was of sufficient thickness. These promising preliminary results will have to observed in a larger group and over a longer period of time.
    Notes: Bei 10 Patienten mit Kraniosynostosen wurden zur Stabilisierung der knöchernen Segmente nach frontoorbitalem Advancement resorbierbare Platten und Schrauben aus Poly-L-Milchsäure (82%) und Poly-Glykolsäure (18%) (Lactosorb ® ) verwendet. Die Methode zeigte bei fortgeschrittener Routine eine sehr einfache Handhabung und exakte Anpassung der Platten. Die Stabilität der Platten war ausreichend, um auch nach Zurückschlagen der Weichteile ein gutes funtionelles und ästhetisches Resultat zu erzielen. Bei 1 Patienten mit Chotzen-Syndrom mußte die geplante Anwendung der resorbierbaren Platten und Schrauben abgebrochen werden. Bei entsprechend dünnen Knochenlamellen war die Gewindesteigung der Schrauben zu groß, um eine ausreichende Primärstabilität zu gewährleisten. In einem Beobachtungszeitraum von bis zu 25 Monaten waren keine Infektion, keine Exposition, Instabilität oder Dislokation zu beobachten. Der klinische Einsatz des verwendeten resorbierbaren Oseosynthesematerials beim frontoorbitalen Advancement zeigte sich, eine Mindeststärke des Knochens vorausgesetzt, als stabile Maßnahme, um die Segmente zu stabilisieren. Die erfolgversprechenden vorläufigen Ergebnisse müssen in einem größeren Kollektiv über längere Zeiträume kontrolliert werden.
    Type of Medium: Electronic Resource
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  • 2
    ISSN: 1600-0501
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: In this article we describe the implantation of ITI implants in combination with bone grafts. Two different cases were considered: the augmentation of an atrophic maxilla or mandible where the transplant was fixed by means of ITI implants and the implantation into free transplants fixed by means of the THORP reconstruction plate system. These indications require 2-stage procedures with submerged implants and transplants during the healing period. For this new applications, standard ITI implants were combined with specially developed new transgingival units of high manufacturing precision. The new design resulted in a maximum tightening moment of 4.0 N.m versus 1.25 N.m achievable with a conventional 2-mm screw. Dynamic testing showed that, for the range of tightening moments of 0.25 N.m up to 1.0 N.m, the loosening moment after 2,000,000 cycles remained approximately 10% above the tightening moment. For the clinical application a tightening moment of 0.35–0.5 N.rn is recommended. The special design and the high precision of the extension parts results in a tight adaptation between the primary implant and the extension parts, which may be important for microbiological reasons.
    Type of Medium: Electronic Resource
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  • 3
    ISSN: 1435-0130
    Keywords: Wound healing model ; Split skin donor site ; Zinc oxide ointment ; Potassium/calcium chloride hydrogel
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Wound areas on the upper thigh following split thickness skin grafts can be standardized. They are, therefore, suitable as wound models for comparative investigations into the kinetics of epithelialization using various wound therapeutic agents. In a prospective clinical study, the epithelialization time in two split thickness graft donor sites was examined in an intraindividual comparison on 16 patients. Zinc oxide and potassium/calcium chloride hydrogel were used as the comparative substances. The results confirm the suitability of the study design for the testing of efficacy of topical wound therapeutic agents. The model can be standardized, is practical, and does not require additional stress to the patient.
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  • 4
    ISSN: 1436-3771
    Keywords: Key words Heart transplant ; Dental treatment ; Mortality
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract  The object of this study was to evaluate the effects of dental foci on survival rates and rejection episodes in heart transplant recipients. Therefore, in a retrospective longitudinal study we studied 74 heart transplant recipients at the Department of Maxillofacial Surgery and Department of Thoracic and Cardiovascular Surgery, University of Münster. Study patients were divided into groups: those in which dental foci had been verified (n=31) and those without dental foci (n=43). Statistical analysis was performed using the chi-square test, Kaplan-Meier life table analysis, and the log-rank test. Before heart transplantation, patients were screened clinically and radiographically to determine the extent of dental foci. Postoperatively, patients were evaluated dentally and medically to identify the impact of dental foci on the incidence of systemic and oral infections, frequency and severity of rejection episodes, mortality, and complications arising during dental treatment. By comparing the mortality, infection and rejection rates in the various groups no statistically significant differences (P〉0.05) were found between patients. Despite immunosuppression, extended inflammatory processes such as abscess formation or viral stomatitis were not found in the oral cavity. We therefore suggest that patients suffering from the symptoms of severe heart failure need not be subjected to rigorous preoperative dental treatment.
    Type of Medium: Electronic Resource
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