John V. Haley

The short-term and long-term soft-tissue profile changes accompanying mandibular advancement surgery

To provide an improved data base for predicting the soft-tissue changes that accompany mandibular advancement surgery, short- and long-term serial cephalograms from the records of eighteen patients were analyzed. Hard- and soft-tissue landmarks were located on serial tracings and later were reduced to rectangular X-Y coordinates for computer-generated measurement data and statistical analyses. The interpretation of mean value, ratio, and regression equation data showed that the lower lip, inferior labial sulcus, and chin tissues moved forward and downward. The mandibular short-term (mean = 3.7 months postsurgery) horizontal change means were greater than the long-term (mean = 18 months postsurgery) horizontal change means. The posteriorly directed long-term means may result from functional adaptations that follow the short-term surgery-related spatial changes. These data also show the need for long-term prediction data to supplement the short-term data base.

On the perceived meaning of symptoms.

The importance of understanding the manner in which symptoms are interpreted is generally recognized, but has received relatively little direct research attention. In an attempt to obtain some evidence on the meaning attached to each of a set of 45 symptoms, subjects were asked to rate the symptoms on eight semantic properties. The symptom ratings on the various properties were then correlated and the correlation matrix subjected to a principal components factor analysis. Three factors of perceived meaning emerged. The first factor is defined by the extent to which symptoms are perceived as threatening, disruptive and painful. The second factor consists of the familiarity of symptoms and the perceived personal responsibility for their occurrence. The third factor reflects how embarrassing the symptoms are. This structure of preceived meaning of symptoms is discussed with reference to the literature on delay in seeking medical care.

Processing changes in complete dentures: Posterior tooth contacts and pin opening

Abstract Dentures were constructed for 50 patients. The centric relation contacts were marked and photographed before removing the finished trial dentures from the articulator and again on the same articulator and same stone mountings after processing. The amount of incisal pin opening was measured and recorded after processing. An attempt was made to analyze the patterns of centric relation contacts after processing and to determine if there was a correlation of pin opening and tooth contacts. It was found that there was a definite shift of the tooth contacts to the more posterior teeth after processing but that the amount of pin opening did not seem to be related to the number or location of the tooth contacts. The magnitude of pin opening seems to depend upon the amount of shift rather than the direction.

Patient compliance—A factor in facial trauma repair

The clinical records of 25 consecutive patients who were treated for facial trauma were reviewed and analyzed to ascertain what effect patient cooperation had on the outcome of facial fracture repair. The study was designed to establish the incidence of complications and to discover what factors contributed to untoward sequela in such patients. Overall, 15 patients (60%) were noncompliant in one or more aspects of their care. Six patients (24%) had significant postoperative complications associated with their facial injuries. Four of these patients were not fully cooperative.

Zinc sulfate and wound healing

The assumption that wounds heal at a constant rate over time, when measured by volume or area, was questioned. Data from two studies indicate that healing rate changes over time. When this bias was taken into consideration, the conflicting findings of studies of zinc sulfate and wound healing support the hypothesis that zinc therapy is effective for patients with low serum zinc. It was concluded that in order to study the effect of zinc therapy, lesion size and zinc intake should be controlled and serum zinc should be monitored.

Behavioral factors and denture status.

The experiences and impressions for most of the 64 patients who entered the project in 1968 reveal that the opportunity to obtain new dentures, prepared according to the best available technology by highly skilled dentists and dental laboratory technicians, has had an identifiable impact on each of the several behavioral variables for which changes were predicted before the study began. There has been general improvement in self-image, confidence, and relaxation, and these changes often were associated with perceived improvement in fit of dentures, ability to eat, ability to talk, and general health. Although some patients experienced serious health problems during the 6 year study period, neither were these attributed to nor did they appear associated in any way with denture status. The patient population, in general, was very cooperative. Fifty-three patients stayed with the study for 6 years. Most kept their appointments and followed the instructions and advice of their dentists on all matters but one--that of removing their dentures at night. In explaining why they did not remove their dentures at night, most of the patients gave evidence of a high degree of sexual symbolism associated with teeth and denture status.

Standardization of a test for dental sensitivity to cold.

T hc relation of thermal sensitivity to pathologic changes in the pulp has been of interest to t.he diagnost.ician for a long t.imc. Attcmpt,s to clarify this pmhhn have been hampered by the fact that there is 11o standard reliable, and practical method for measuring sensitivity to cithcr cold or heat. The objectives of our study were to dcterminc whether, by using a simple cone! of kc as ;I. testing agent, (1) there might be a. relat.ionship between t.hc length of time thca colt1 stimulus was a.pplietl and the t.hclrmal reactivity of the. tooth, (2) a rc4ationship could bc established between t.hc sensitivity elicit.etl by such a test and the scnsit.ivitv noted b,v the patient whila eating cold foods in a routine manner, and (3) a consistent response by a patient to the same stimulus applictl 011 different clays coultl 1~ obtainetl.

Denture modification during adjustment phase of complete denture service.

Abstract Records were kept on the adjustment phases of treating 64 patients with new complete dentures. Five dentists treated the patients independently of each other. All dental laboratory procedures were performed by the same dental laboratory technician under the same conditions.

Histocompatibility-antigen distribution in patients with cervical and endometrial carcinomas

Abstract Thirty-eight patients with cervical carcinoma and seventeen patients with endometrial carcinoma were HLA-ABC typed using a N1H microcytotoxicity test. Results were compared with normal control values obtained from a random population of age-matched, unrelated females from the same geographical area as the tumor patients. Antigen frequencies were calculated for each of the groups of patients with cervical and endometrial cancers and compared to normal control values by χ 2 and regression analysis. Differences were studied for significance using Fishers exact test, and P values were corrected for the total number of paired comparisons possible in each distribution. The frequency of HLA-AW31 was significantly increased in the cervical carcinoma group (21%), as compared to normal control values (4%) ( P P

Identification of patients at risk for unnecessary or excessive TMJ surgery

Musculoskeletal pain in the head and neck may be associated with a variety of psychological and psychiatric conditions. Therefore, patients with persistent temporomandibular (TMJ) and masticatory muscle complaints must also be evaluated for affective disorders. Identification of patients at risk for unnecessary or excessive TMJ surgery is enhanced when the surgeon is aware of a pattern of persistent pain and illness insistence that characterizes these patients. This article presents a list of characteristics that may identify a patient with an undiagnosed affective disorder who may be exposed to unnecessary treatment.