Edward C. Hinds

Proplast in dental facial reconstruction

Successful clinical applications since early 1970 have occurred with the use of temporomandibular condylar prosthesis and endosseous blade-vent implants coated with porous proplast. Proplast as a bulk material has also been used to augment atropic mandibular alveolar ridges and deficient facial contours in the mental, mandibular border, and zygomatic areas.

Classification and management of mandibular asymmetry

Abstract The condition of mandibular asymmetry associated with overgrowth of a condyle is discussed. A series of seventeen cases seen in the past four years is recorded. Subjective and objective findings, as well as treatment, have been discussed. On the basis of this study, the following opinions have been evolved: 1. 1. Mandibular asymmetry involving condylar overgrowth seems to fall in two categories. They are: unilateral condylar hyperplasia, and deviation prognathism (condyles approximately the same size). 2. 2. Of seventeen cases reviewed in this presentation, fifteen were considered to be unilateral condylar hyperplasia and two were deviation prognathism. 3. 3. Condylar hyperplasia makes up by far the largest number of this group, and is probably a true hyperplasia rather than an osteoma or osteochondroma. 4. 4. In rare instances mandibular asymmetry may involve hyperplasia or hypertrophy of parts of the mandible other than the condyle. Involvement of the ascending ramus is seen in Figure 1. It may be possible that the entire half of the mandible or half of the body (hemihypertrophy as mentioned by Rushton) may be involved. 5. 5. The bulk of these cases occur in the growth period, although some cases may arise later. 6. 6. There is considerable evidence that unilateral mandibular hyperplasia is not associated with familial incidence, evidence which favors acquired rather than genetic origin. 7. 7. The earlier the age of onset, the more diffuse distortion one is apt to see although onset after maturity usually leads to exaggerated distortion in the area of the condylar head per se. 8. 8. Mandibular asymmetry, unlike mandibular prognathism, produces many symptoms, including pain, joint noises and interference with motion. 9. 9. Mandibular asymmetry may be treated surgically by condylectomy, subcondylar osteotomy, ostectomy in the body of the mandible, or by more complicated procedures in isolated cases. A few are benefited by prosthetic appliances and a rather significant number do not require or desire treatment. 10. 10. Although this condition is not believed to be malignant or predisposed to malignancy, one must always keep in mind malignant disease in the differential diagnosis.

Central adenocarcinoma of the mandible

A seemingly straightforward clinical diagnosis of ameloblastoma was made of a large radiolucent, multicystic lesion in the mandible. Biopsy and metastatic tumor work-up revealed the tumor to be primary in the mandible. A histopathologic diagnosis of papillary adenocarcinoma of salivary gland origin was made. This article reports a well-documented primary mandibular salivary gland tumor. A review of the literature and light and electron microscopic interpretation of this tumor are presented.

Fibrosarcoma complicating polyostotic fibrous dysplasia

I n 1937 Fuller Albright? described a triad of pathologic manifestations which today is known as Albright’s syndrome. The triad includes (1) multiple bone lesions which have a tendency to be unilateral, (2) brown pigmented areas of the skin which tend to be on the same side as the bone lesions, and (3) endocrine dysfunction which, in females, is associated with precocious puberty. The disease had been reported on a number of occasions prior to 1937, but under different names.3l lop 12* I43 17-lgs 23y =* 311 341 3B The first report was published in 1922 by Wei13’ under the title “Precocious Puberty and Bone Brittleness.” Many reports found in the literature since that time81 11~ 16y 20-22~ 25p 2gl 3op 32f 38 refer to the condition as Albright’s syndrome; however, the newer name of polyostotic fibrous dysplasia24 is a more descriptive term and has become more generally accepted. The cause of the condition is unknown, but the fibrocystic bone lesions are probably the result of altered activity of the specific bone-forming mesenchyme. This concept, proposed by Lichtenstein,24 does not, however, account for the occurrence of pigmentation, the tendency for the condition to be unilateral, or the endocrine dysfunction. A more likely explanation may be the one hypothesized by Furst and Shapiro,13 namely, that in fibrous dysplasia there is a hypothalamic lesion in the region of the third ventricle which produces secondary disturbances in the anterior lobe of the pituitary, resulting in abnormal stimulation of its various component trophic hormones. The condition with which polyostotic fibrous dysplasia is most often confused is hyperparathyroidism. Furst and Shapiro,13 in their review of seventy-one cases reported in the literature, found that parathyroid exploration had been performed in 18.3 per cent of the cases because of an erroneous diagnosis of hyper-

Cartilage block arthroplasty for the correction of temporomandibular joint disturbances

Abstract A follow-up study is presented of three patients previously reported on, and five additional cases are described. The total group of eight cases may be divided as follows: postcondylectomy deformity, five; traumatic arthritis, two; ankylosis, one. One complication characterized by dislodgement of a Kirschner pin and overcorrection of vertical dimension is presented. Follow-up on these cases ranged from five years to three months.

The use of achromycin and neomycin in the treatment of actinomycosis

Abstract 1. 1. A review of the therapy of actinomycosis has been made, with emphasis on the sulfa and antibiotic drugs. 2. 2. A case has been described in which Achromycin and neomycin were used with most satisfactory results. 3. 3. Although this was, in the strict sense, “experimental therapeutics,” the excellent clinical results warrant further investigation of this antibiotic regimen in the treatment of cervicofacial actinomycosis. 4. 4. Full use of the bacteriologic and sensitivity tests now available should be made to confirm early diagnosis and aid in effecting an early cure.

Granular cell myoblastoma: Report of case in newborn

Abstract 1. 1. The granular cell myoblastoma is a comparatively rare tumor in the newborn; however, all cases reported in the newborn have been in the oral cavity, and 75 per cent of these have been on the maxillary gingiva. 2. 2. The histogenesis and pathogenesis of this tumor are uncertain. 3. 3. It is generally agreed that the granular cell myoblastoma is a benign lesion and local excision will effect a complete cure; however, it tends to recur if incompletely removed.

Current technical procedures employed in correction of prognathism

Summary Over one hundred years of experience with surgical correction of prognathism has taught us that this remains a difficult and serious problem still fraught with many possible complications. The most desirable and dependable procedures at the present time seem to be (1) the bilateral body ostectomy; (2) the open subcondylar (vertical) osteotomy and (3) oblique procedures through the ramus or angle ( Trauner & Obwegeser, 1957 ; Dal Pont, 1961 ; Schuchardt ). Not only true prognathism, but also relative prognathism such as that seen with cleft palate can be helped by the above procedures.