Sten Jacobsson

Roentgen stereometry with the aid of metallic implants in hemifacial microsomia.

Displacement of the mandible and the maxilla with growth in relationship to the frontal bone was recorded in eleven children with hemifacial microsomia, aged 3 to 14 years at the initial examination. The goals were to assess the efficiency of the method for accurate recording of articular growth and to obtain information on facial development in each of these children. Correction of the skeletal asymmetry was not attempted during observation periods of from 707 to 1,484 days. In continued observations three of the children were treated with functional appliances. Roentgen stereometry with the aid of metallic implants proved to be an efficient method for highly accurate recordings of articular facial growth in relationship to the frontal bone. Displacement of the jaws was asymmetrical in all of the examined children as determined in the frontal and transverse planes of the head. In about 50 percent of the children the degree of asymmetry increased in one plane while it decreased in the other plane. No correlation was found between the extent of the mandibular deformity, as seen on orthopantomograms, and the displacements of the mandible. Generally, the displacement of the maxillary bones corresponded with the displacement of the mandible. Articular growth of the jaws was redirected toward a more favorable pattern in two of the children during the time they used a functional appliance. In the third child the use of a functional appliance had no such effect.

Pigmented Nevi and Malignant Melanomas as Studied with a Specific Fluorescence Method

A specific fluorescence is developed in melanocytes, nevus cells, and cells of malignant melanoma by treatment of the tissue with dry formaldehyde gas. The fluorescence is often stronger in melanocytes adjacent to nevi or melanomas than in normal melanocytes. The strongest fluorescence occurs in cells of malignant melanoma. Among the limited number of compounds that condense with formaldehyde to fluorescent derivatives, DOPA [β(3,4-dihydroxyphenyl)L-alanine] seems the most likely substance to give rise to the fluorescence observed in these lesions.

Von Langenbeck or Wardill procedures for primary palatal repair in patients with isolated cleft palate--speech results

Sixty-six patients operated on for isolated cleft palate were evaluated as adults, and their speech was assessed clinically. Forty-four had undergone a von Langenbeck repair at the age of 7 months and 22 a Wardill repair at the age of 18 months. Speech was judged subjectively by the patients themselves, and perceptual assessment was made by three speech pathologists. The remaining speech problems, mainly hypernasality, were moderate or severe in 7 (16%) of the patients in the von Langenbeck group, and in 7 (32%) in the Wardill group. On the other hand, the patients in the Wardill group had fewer fistulas closed, and fewer velopharyngoplasties. There were no significant differences between the two methods regarding speech in adulthood. The Wardill method produced significantly more scar tissue clinically, which carries the potential risk of inhibition of facial growth. The present speech results will therefore be weighed against the outcome of maxillofacial growth for these patients.Sixty-six patients operated on for isolated cleft palate were evaluated as adults, and their speech was assessed clinically. Forty-four had undergone a von Langenbeck repair at the age of 7 months and 22 a Wardill repair at the age of 18 months. Speech was judged subjectively by the patients themselves, and perceptual assessment was made by three speech pathologists. The remaining speech problems, mainly hypernasality, were moderate or severe in 7 (16%) of the patients in the von Langenbeck group, and in 7 (32%) in the Wardill group. On the other hand, the patients in the Wardill group had fewer fistulas closed, and fewer velopharyngoplasties. There were no significant differences between the two methods regarding speech in adulthood. The Wardill method produced significantly more scar tissue clinically, which carries the potential risk of inhibition of facial growth. The present speech results will therefore be weighed against the outcome of maxillofacial growth for these patients.

Fibrinolytic Activity in Wound Secretions

Debrisan, a highly hydrophilic dextran polymer, was previously shown to be effective in cleaning infected wounds. The dry beads remove wound secretions from the wound surface under gel formation. The gel can then be analysed. A high fibrinolycic activity on fibrin plates and high levels of fibrin/fibrinogen degradation products were found in the secretions from 12 wounds. Low of plasminogen, antithrombin III and the absence of coagulable fribinogen also indicated a high fibrinolytic activity. A higher fibrinolytic activity on heated than on unheated fibrin plates, and the insignificant effect of local application of EACA suggest the presence of other proteolytic enzymes than plasmin.

On the Relation Between Transcutaneous Oxygen Tension and Skin Blood Flow

Transcutaneous oxygen tension (pTcO2) varies with pAO2, circulatory parameters, skin metabolism and oxygen diffusion. The necessity to heat the skin beneath the electrode to allow transcutaneous oxygen diffusion limits the use of pTcO2 in the study of skin blood flow. The oxygen measured probably emanates from the capillaries of the superficial dermis. A large number of arteriovenous shunts in the skin may modify the pTcO2 response. The heat-dilated vessels beneath the electrode behave passively in most circumstances. Differences in local blood temperature with secondary shifts in the release of oxygen from oxyhemoglobin may affect pTcO2 at high and low flow rates respectively. pTcO2 may vary with the perfusion pressure and possibly also with the resistance of the blood vessels outside the area heated by the electrode, but only at low flow rates.

Movement of maxillary segments after expansion and/or secondary bone grafting in cleft lip and palate: A roentgen stereophotogrammetric study with the aid of metallic implants

The study was undertaken to examine the effects of expansion treatment and secondary bone grafting in cleft lip and palate. Movement of the lateral maxillary segments in four patients with complete bilateral cleft lip and palate (BCLP) was complicated and asymmetric, and a greater relative widening of the dental arch was observed. The least expansion was found in the oldest patient. Bone grafting did not bring about a stable relationship between the segments. The width of the dental arch was mostly maintained despite segmental movement. In one patient with unilateral cleft of the lip and primary palate (UCL) growth in the midpalatal suture followed the pattern observed in noncleft patients but was less extensive. Accurate and comprehensive recording of the relatively small maxillary movements requires that implant stability is checked and that a reference is established outside the maxilla.

Roentgen Stereophotogrammetry Applied to the Cleft Maxilla of Infants: I. Implant Technique

A new roentgen stereophotogrammetric method was developed for the study of the kinematics of the skeletal system. Based upon the use of metallic implants, this method determines the relationship between the implants as well as the change in position between skeletal segments provided with implants. The object and its positional changes or motion are reconstructed from two roentgenograms with the aid of photogrammetric principles and computer technique. The method requires insertion of three or more implants in each skeletal segment. When the implants remain in a stable interrelationship during the observation period a rigid-body model is obtained. In the analysis this represents the segment and motion is computed according to the kinematics of a rigid body. The present study is concerned with early establishment of rigid-body models in the segments of a cleft maxilla (part I) and registration of postoperative motion between the segments (part II). The experimental set-up consists of two X-ray tubes (0.6×0...

Posteroanterior traction in maxillonasal dysplasia (Binder syndrome): A roentgen stereometric study with the aid of metallic implants☆

The study was undertaken to examine the effect of posteroanterior traction in an 11-year-old boy with maxillonasal dysplasia. Movement of the maxillary bones and of the mandible was recorded, by means of roentgen stereophotogrammetry, in relationship to the frontal bone during and after treatment. In the examined child face-mask therapy mainly influenced the position of the mandible while the recorded advancement of the maxillary bones was slight (0.6 mm.). It is possible that the limited maxillary response to traction may be due to insufficient growth capacity of the circummaxillary sutures in a child with maxillonasal dysplasia. While movement of the maxillary bones and of the mandible during traction conformed with the pattern of treatment effect described by Delaire a total maxillary relapse occurred in the posttreatment observation period (no retention), possibly in adaptation to the retropositioned mandible. In our patient, posteroanterior traction accomplished improvement of the maxillary retrusion in relationship to the mandible only.

Fluorescence histochemical demonstration of dopa thioethers by condensation with gaseous formaldehyde.

SummaryThe usefulness of the formaldehyde (FA) and glyoxylic acid (GA) methods for the fluorescence histochemical demonstration of dopa thioethers has been tested using protein droplet models. Similar fluorescence intensities were recorded from these compounds after either FA or GA treatment. Cysteinyldopa gave a high fluorescence yield similar to that obtained from dopamine and dopa in the FA reaction, whereas glutationedopa showed a lower, although clearly visible fluorescence. Since the FA method seemed to be the most useful one for demonstration of catechol thioethers, the FA-induced fluorophores of these compounds were further characterized by microspectrofluorometry. The spectral characteristics of the thioether fluorophores (excitation maxima at 420 nm and emission maxima at 480–485 nm) distinguish these substances from dopa and other compounds fluorogenic in the Falck-Hillarp method. Dopa thioethers are proposed to form fluorophores with FA in a manner analogous to that of the primary catecholamines i.e. via low-fluorescent tetrahydroisoquinolines, along two different pathways, to strongly fluorescent 3,4-dihydroisoquinolines and 2-methyl-dihydroisoquinolinium compounds. These dihydroisoquinolines are in a pH-dependent tautomeric equilibrium with their quinoidal forms as reflected by a characteristic spectral shift upon acidification. The results of this study provide the guide-lines for the characterization of fluorogenic compounds in pigment-forming cells.

Dental replacement resorption after bone grafting to the alveolar cleft

In a review of 100 consecutively performed bone grafts to the alveolar cleft, replacement resorption was found in 7 teeth adjacent to the cleft. Damage to the periodontal tissues during surgery is considered to be the main cause of this complication; granulation tissue from the bone graft may have some influence. Treatment of the affected teeth eventually includes extraction or surgical removal. To minimize the risk for this complication, we suggest that bone grafting should be done when the canine (or lateral incisor) is in an early stage of eruption and that orthodontic uprighting of the medial incisor should be done after surgery.