Phyllis Clark

Revascularization and healing of onlay particulate allogeneic bone grafts in primates

Particle size of allogeneic bone grafts was investigated to determine its effect on revascularization and healing. Freeze-dried chips of different sizes were placed on the monkey lateral mandibular cortex, and the subsequent healing and revascularization were studied by histologic, autoradiographic, and microangiographic techniques. It appears that allogeneic bone is a reasonable substitute for autologous bone in mandibular ridge augmentation procedures.

Use of capnography and transcutaneous oxygen monitoring during outpatient general anesthesia for oral surgery

The combination of the capnograph (respired CO2 monitor) and the transcutaneous oxygen monitor was evaluated as a non-invasive system for monitoring of respiratory function in 10 ASA class I patients undergoing ultralight general anesthesia for removal of third molars. Capnography proved to be a sensitive and accurate method for detecting apnea and airway obstruction using the continuous display of the CO2 waveform. All episodes of apnea or obstruction were immediately detected as the respired CO2 level fell to zero baseline. The end-tidal CO2 (PetCO2) obtained via nasal prong sampling was not significantly different from the PaCO2. PetCO2 values served as useful indicators of hypoventilation. During steady-state conditions of respiration, transcutaneous oxygen tensions (PtcO2) correlated well with simultaneously measured PaO2 (r = 0.93). However, during any period when oxygenation was rapidly changing (step increase in FIO2, step decrease in FIO2, or apnea) the PtcO2 lagged behind changes in PaO2 even after a five-minute equilibration period, thereby not accurately reflecting the true state of oxygenation. Consequently, the transcutaneous oxygen monitor does not appear to be optimal as a respiratory monitor in the setting of ultralight general anesthesia where rapid, critical changes in oxygenation must be detected without delay.

Application of direct magnification radiographic technique to the jaws

Direct magnification radiography is widely applicable to situations in which enhanced definition and enlarged images are desirable. This technique is capable of providing high subject resolution when conventional radiography is not definitive. It serves as a variable supplementary radiograph for the diagnosis of conditions in the oral and maxillofacial region. The general mechanics of the technique as well as its possible use as a supplementary high detail film are discussed. Three cases are reported in which this technique was applied in the diagnosis of oral and maxillofacial surgery patients.