Robert A. Bruce

The Second Chalmers J. Lyons Academy Study of Fractures of the Edentulous Mandible

A review of 167 fractures in 104 edentulous mandibles treated by several surgeons using a variety of methods was undertaken. Most patients (81.5%) had open reduction and internal fixation using bone plates. Problems in healing, either delayed or fibrous union, occurred in 21 of 167 fractures (12.6%) in 16 of 104 patients (15%). One fourth of patients treated by closed reduction techniques had problems with union, whereas extraoral open reduction with bone plate fixation produced very good results. The factors involved in treating these challenging fractures is discussed and comparisons are made with the previous Chalmers J. Lyons Academy study.

Ameloblastic carcinoma. Report of an aggressive case and review of the literature

Odontogenic carcinomas of the jaws are classified as malignant ameloblastoma, ameloblastic carcinoma or primary intraosseous carcinoma. Because these lesions are extremely rare, microscopic diagnosis is difficult. An aggressive case of ameloblastic carcinoma of the mandible is presented. In spite of radical surgery and radiotherapy, the patient expired eight months following initial diagnosis. - A review of the literature seems to indicate that so called simple ameloblastomas rarely can dedifferentiate and metastasize following multiple inadequate surgical procedures. Although radical surgery is not necessary, local excision should be thorough. - Ameloblastic carcinoma and primary intraosseous carcinomas may be histogenetically similar. They are highly malignant tumours which should be treated aggressively. Metastasis is common and prognosis is poor.

Management of dental extractions in two hemophilia a patients with factor VIII inhibitor

Abstract Significant advances in the care and management of the patient with hemophilia have been made over the past two decades. Hospitalization of these patients has become an occasional event, and most patients are on home treatment programs and enjoying normal daily activities. 1 Elective surgery is no longer delayed indefinitely, and can be performed with minimally increased risk to the patient. Proper oral hygiene and dental care have become routine, while they were often prohibited in the past. The presence of a factor VIII inhibitor, on the other hand, continues to be a problem, since no uniformly reliable management plan can be applied to all inhibitor patients. 2 In this report, we describe two patients undergoing dental extractions on six separate occasions at different times. No single plasma product was consistently effective, even in the same individual.

The effect of antenatal surgery on postnatal palatal growth in sheep

It has been suggested that repair of skin and mucosal wounds carried out in animals in utero leaves little or no trace of the operative procedure when examined at birth. This study examined the palates of lambs affected surgically in utero postnatally for scarring and transverse palatal growth. Nineteen pregnant sheep were affected at 120 days gestation. Surviving lambs followed for 6 months demonstrated altered palatal morphology.

Differentiation of the organic matrix in bone repair

This study describes the sequence of production and distribution of collagen, collagen types, proteoglycans, and calcium during bone repair in rabbits utilizing histologic and biochemical techniques. Proteoglycan content peaked 11 days following surgery and total collagen peaked 19 days after surgery, after which both levels decreased. Collagen Types I and III were present in the bone defect throughout the healing process but Type II was found only in the mid stages of repair. In the surrounding external callus Types I, II, and III were present, but Type III was not noted in the later stages of healing. These results are similar to those found in studies of fracture repair and developing bone.

Oral and maxillofacial surgery in China

The primary author is a 41-year-old oral and maxillofacial surgeon on the attending staff of the Stomatology Hospital of Nanjing Medical University in Nanjing, China. He is currently a visiting scholar at the University of Michigan and has a wide variety of experience in medicine and dentistry, including 11 years of general surgery, plastic surgery, and tumor surgery training in addition to his stomatology education. His experiences during the past 20 years have prompted his American colleagues to encourage him to present his views with respect to oral and maxillofacial surgery in China today. The purpose of this article is to promote understanding among colleagues in China and in the West.