Bob D. Gross

Gout and pseudogout of the temporomandibular joint

The temporomandibular joint is rarely affected by gout or pseudogout. The following article presents two case reports that demonstrate gout and pseudogout of the temporomandibular joint. The surgical treatment and diagnostic criteria for these entities are presented and discussed.

Epidermolysis bullosa dystrophica recessive: Oral surgery and anesthetic considerations

Abstract The patient with EBDR provides a unique challenge to the oral and maxillofacial surgeon and anesthesia team. After review of the literature and familiarization with the preoperative considerations, a successful and relatively atraumatic general anesthetic can be delivered in such a way that oral-facial surgery is accomplished without compromising the patients health.

Giant cell tumor of the mandible

A case of giant cell tumor of the mandible is presented, with treatment and follow-up for two and a half years. Although the lesion had characteristics of giant cell granuloma described by Jaffe, its aggressive clinical behavior influenced the diagnosis and treatment. Prosthetic rehabilitation was accomplished with a mandibular staple bone plate placed through a bone graft.

Lesch-Nyhan syndrome

Abstract Lesch-Nyhan syndrome is an inborn error of metabolism transmitted via an X-linked recessive pattern. It is characterized by hyperuricemia, uricosuria, mental retardation, self-mutilation, choreoathetosis, spasticity, and retarded physical growth. Allopurinol is used to normalize urate levels, but no improvement in mental functioning or decrease in attempts at self-mutilation results. Physical restraints and extraction of teeth protect the patient from self-mutilation.

ELECTRICAL STIMULATION OF MANDIBULAR OSTEOTOMIES IN RABBITS

The use of electrical stimulation to accelerate mandibular healing was studied in rabbits that had undergone bilateral mandibular slot osteotomies. Stimulation on the day of surgery and for 3 successive days thereafter (2 hours per day) produced accelerated healing as evaluated histologically 8 days after surgery. Stimulation during the entire postoperative period did not result in accelerated healing. Intermittent stimulation in the early postoperative period may be clinically useful for accelerating the healing of mandibular fractures.

Aspiration of an unerupted permanent tooth during maxillofacial trauma

Abstract Aspiration of teeth during maxillofacial trauma can occur whether or not there is loss of consciousness. Even when all erupted teeth are clinically present, there is a possibility of aspiration of unerupted teeth avulsed from the line of fracture. Many aspirated foreign bodies occur without presenting signs and symptoms and may be missed on the chest radiography because of superimposition by other radiodense structures. When broken or missing teeth or parts of dentures are unaccounted for, aspiration must be considered. In symptomless cases, expiratory anteroposterior chest radiographs are useful in detecting obstructive emphysema or overinflation. Deep inspiratory films or fluorscopy may show a shift of the mediastinum to the affected side. Bronchoscopy is the treatment of choice. Prophylactic steroids and antibiotics are no longer considered effective in reducing morbidity and mortality due to aspiration.

Isolated fracture of the first rib associated with facial trauma

Isolated fractures of the first rib are rare and often, though not always, indicative of severe trauma. The causes of first rib fracture are various, as are the sometimes serious complications of such a fracture. Since the oral and maxillofacial surgeon is involved many times in the primary care of the trauma patient, he must consider the possibility of first rib fracture and be alerted to the possible sequelae.

Use of pocket inlay grafts and tuberoplasty in maxillary prosthetic construction

A method of surgical and prosthetic rehabilitation of the severely atrophic maxillae using pocket inlay grafts and tuberoplasty is presented. At 2 1/2 years postoperatively, the denture in a patient treated in this manner remains stable with good retention and function. The principles presented may be applied in a variety of situations to achieve greater retention and stability of the maxillary denture.