Victor J. Matukas

Histologic study of hydroxylapatite as an implant material for mandibular augmentation.

Dogs were used to compare supraperiosteal implantation of hydroxylapatite with subperiosteal implantation with and without partial decortication of the underlying bone. Whereas supraperiosteal implants were unstable, nine months of observation indicated that the subperiosteal implants developed a strong attachment and mechanical stabilization as a result of formation of investing fibrous and osseous tissues. These results provide a basis for a technique of alveolar augmentation and denture construction.

The use of autologous auricular cartilage for temporomandibular joint disc replacement: A preliminary report

The technique of harvesting auricular cartilage and its use in 22 patients (35 joints) is described. Follow-up was from 3 to 24 months. Pain relief was achieved in 90% of the cases. Function was equal or better to the preoperative situation in all cases.

Evaluation of a subcutaneously implanted hydroxylapatite-avitene mixture in rabbits

Avitene, a microfibrillar collagen hemostatic agent was mixed with hydroxylapatite and implanted subcutaneously along the inferior border of the mandible in ten rabbits. This mixture clearly enhanced surgical manipulation of the implants. Radiographic and histologic examination of the implant sites at one, three, and six months showed an acceptable host response with no apparent alteration of the favorable characteristics of hydroxylapatite implants.

Craniofacial osseous restoration with osteoinductive proteins in a collagenous delivery system

Implants fabricated from mixtures of extracted bovine bone proteins and highly purified human type I collagen have been tested for efficacy in the restoration of osseous defects. Experimental implants composed of osteoinductive proteins and collagen, and control implants composed of collagen alone were placed in 15 x 15 mm cranial defects in New Zealand white rabbits. Implants harvested at 10, 12 and 14 week intervals were subjected to histological evaluation as well as quantitative analysis utilizing a computer morphometric planimeter. Defects filled with control implants displayed highly variable repair with a mean of 31% bony healing. Experimental implants were consistently effective in inducing significant bony regeneration with a mean of 91% repair within the time range of the study. In light of these results, it is apparent that an osteoinductive-collagenous implant system represents an efficacious treatment modality in osseous reconstruction and augmentation.

Zygomatic augmentation with hydroxylapatite: A preliminary report

This paper describes the use of hydroxylapatite in combination with microfibrillar collagen and blood to yield a cohesive mixture that can be sculptured to correct symmetry over the zygomatic bones. Eleven cases were studied retrospectively, and the augmentation was found to remain stable and esthetically pleasing.

Simultaneous rhinoplasty procedures in orthognathic surgery

22 septorhinoplasties were performed in conjunction with orthognathic surgery, and followed for at least 12 months. No significant difference could be established between 15 cases done with a LeFort I and 7 cases done with isolated sagittal split osteotomies. Rigid bicortical fixation of the mandible was required to change the endotracheal tube from nose to mouth. Plating of the maxilla is recommended to achieve a stable bony support for the nose. Patient satisfaction and perception were surveyed. Clinical results are presented with pre- and post-operative photographs, along with mean data for the total group.

Indications for simultaneous orthognathic and septorhinoplastic surgery

Orthognathic and rhinoplastic surgery can be combined successfully when certain guidelines are understood. Relative indications and contraindications have been established that generally yield predictable results. Tip position (rotation and projection) may be the most difficult aspect to predict and, therefore, is best avoided during simultaneous surgery. Major deformities of the dorsum can be easily corrected in conjunction with maxillary surgery. Three cases demonstrating these guidelines are presented and discussed.

Clinical evaluation of Durapatite submerged-root implants for alveolar bone preservation.

A study was undertaken to evaluate the safety and efficacy of Durapatite cones as an immediate submerged-root implant in the mandibular symphysis region. The study involved 30 patients of which 15 received 96 implants and the other 15 served as controls. The clinical and radiographic results revealed the implants to be well-accepted by alveolar bone. No evidence of rejection or major complications were observed. The principal problem which occurred was dehiscence of mucosa over some implants. This problem was attributed to operative technique. There was significantly less vertical bone loss and contour change in the anterior part of mandible in the implant group than in the control group.

Secondary management of the nose in the cleft patient

The management of the cleft lip and palate patient usually requires multiple primary and secondary surgical procedures to correct the deformity. This paper presents surgical methods in the secondary management of the cleft nose and presents three case reports to help illustrate these methods.

Malignant lymphoma of the palate: Report of two cases

There has been considerable controversy over the years regarding the distinctions between various disorders characterized clinically by necrotizing and granulomatous inflammation of the tissues of the upper respiratory tract and oral cavity. Three such disorders that have similar clinical, radiographic, and histologic features are malignant lymphoma of the palate, polymorphic reticulosis, and the so-called midline (nonhealing) “granuloma.” These destructive persistent midline lesions of the palate are thought by some to represent a spectrum of the same malignant process. The term midline (nonhealing) granuloma was introduced by Burston in 1957. * It was initally considered a clinical term, and it has been used to describe a wide spectrum of inflammatory and neoplastic diseases. The term polymorphic reticulosis was introduced by Eichel and associates in 19662 to designate a lesion characterized histologically by pleomorphic lymphoreticular cell proliferation with a perivascular pattern of growth and the presence of atypical cells. The disease is also known as midline malignant reticulosis. The third recognizable lesion presenting as a locally persistent destructive midline lesion is malignant lymphoma of the palate. This condition is a histologically distinctive lymphoproliferative disorder. The affected mucosa is thickened and ulcerated. Granulation tissue and inflammation may overlie the neoplastic component, and deep biopsy is often necessary to reach the lesion. The cellular pattern of polymorphic reticulosis is similar, if not identical to that of malignant lymphoma of the palate. This paper describes the clinical, radiographic, and microscopic features of two cases of palatal lesions in which the diagnosis was difficult. Autopsy in the first case revealed lung metastases that proved to be lymphoma. Lymphoma had been