H.P. van den Akker

Treatment of central giant cell granuloma of the jaw with calcitonin

Giant cell granuloma of the jaw is a benign lesion that may cause local destruction of bone and displacement of teeth. The common therapy is curettage or resection, which may be associated with loss of teeth and, in younger patients, loss of dental germs. An alternative treatment has recently been introduced, in which patients receive a daily dose of calcitonin. Four patients who have been treated with calcitonin in various concentrations for at least 1 year are reported. In all patients, complete remission of the giant cell granuloma was observed, without signs of recurrence. The working mechanism of calcitonin is discussed, as are length of treatment and optimal dose.

Mandibular atrophy and metabolic bone loss: a radiologic analysis of 126 edentulous patients

Radiological studies were performed on edentulous patients with and without atrophy of the mandible. Radiological, histomorphometrical and endocrinological studies were performed in edentulous patients with a severe atrophy of the mandible treated by ridge augmentation. The results of these studies showed that metabolic bone loss, histologically and endocrinologically characterized as a secondary hyperfunction of the parathyroid glands, is a causal factor in the pathogenesis of mandibular atrophy.

Treatment of chronic suppurative osteomyelitis of the mandible

Chronic suppurative osteomyelitis of the mandible is often considered difficult to treat and may lead to refractory osteomyelitis. Sixteen patients with chronic suppurative osteomyelitis of the mandible were treated with a relatively simple protocol, consisting of sequestrectomy or decortication and i.v. antimicrobial therapy for one week, followed by oral penicillin for three weeks. Only one case showed recurrence of symptoms, which was treated successfully in a second session. It is concluded that combined surgical and antimicrobial therapy should be sufficient to cure most cases of chronic suppurative osteomyelitis of the mandible.

HYPERBARIC-OXYGEN TREATMENT OF CHRONIC OSTEOMYELITIS OF THE JAWS

A review of the literature on treatment of chronic osteomyelitis of the jaws shows that hyperbaric oxygen is often recommended as an adjunct in treatment of this disease. Definite criteria to indicate this treatment and to evaluate the results have not been reported. The results of hyperbaric oxygen treatment of chronic osteomyelitis of the jaws in 16 patients are presented. In contrast to the good results reported in the literature, only 7 of our patients could be considered as cured. The reasons for this discrepancy are discussed. Our results, as well as the data from the literature, indicate that a combined antibiotic and surgical approach is the treatment of choice in chronic suppurative osteomyelitis. However, in chronic diffuse sclerosing osteomyelitis and in patients in whom decortication and antibiotic therapy have failed, hyperbaric oxygen treatment in combination with antibiotics and surgery seems to be indicated.

A false aneurysm of the facial artery as a complication of circumferential wiring

Abstract A case of a false aneurysm of the facial artery after circumferential wiring is described. Although this procedure is relatively safe, complications may occur. Treatment consisted of ligation of the facial artery, both proximal and distal to the aneurysm, and this proved to obtain a very satisfactory result.

Mandibular atrophy and metabolic bone loss: Mandibular ridge augmentation by combined sandwich-visor osteotomy and resorption related to metabolic bone state

Radiological studies in edentulous patients with and without atrophy of the mandible and radiological, histomorphometrical and endocrinological studies in edentulous patients with a severe atrophy of the mandible and treated by ridge augmentation has shown that: metabolic bone loss, histologically and endocrinologically characterized as a secondary hyperfunction of the parathyroid glands, is a causal factor in the pathogenesis of mandibular atrophy.

Laserlithotripsy of salivary stones: A comparison between the pulsed dye laser and the Ho-YSGG laser

The feasibility of laser lithotripsy of salivary stones was investigated. Two types of laser systems were evaluated: a 504 nm flashlamp pumped dye laser and a Ho-YSGG laser. With the dye laser, plasma flashes and acoustic phenomena could be observed. The number of laser shots per unit mass necessary to fragment the stone decreased in proportion to the energy per laser pulse to the power −2.7. With the Ho-YSGG laser, a more ablative kind of stone decomposition was observed. Here the number of shots per unit mass necessary for fragmentation was inversely proportional to the energy per laser pulse. For both lasers the total time necessary to fragment the stones is much too long to compete with conventional stone removal.

Mandibular atrophy and metabolic bone loss: Mandibular ridge augmentation by combined sandwich-visor osteotomy and resorption related to metabolic bone state. A 5-year follow-up

92 patients, 31 with and 61 without signs of metabolic bone loss, were treated with a combined sandwich-visor osteotomy. A 5-year follow-up showed a significantly higher rate of resorption in patients with radiographic signs of metabolic bone loss. The analysis was based upon lateral cephalometry.

Sequential scintigraphy of the salivary glands with special reference to the oral activity

Abstract In a series of 10 normal subjects, sequential scintigraphy of the salivary glands was carried out with a scintillation camera and data processing system after intravenous injection of 99m Tc pertechne-tate. Attention was focused on parotid and submandibular giand function during the first hour after injection and on the anatomic location of the oral activity. The quantitative pertechnetate function curves of the parotid and submandibular glands showed some variation between subjects, although curves of right and left glands were generally symmetric in each individual. In all subjects maximum activity was reached earlier in the submandibular gland than in the parotid gland. By comparing frontal and lateral scintiphotos made with the mouth closed and the mouth open, and by identifying the palate on the scintiphotos with the aid of a radioactive marker, it was concluded that the oral activity is located in the region of the tongue.