Assessment of changes in the oral tactile function of the soft tissues by implant placement in the anterior maxilla: a prospective study.

The aim of the present study was to assess the somatosensory function in the peri-implant soft tissues in the anterior jaw bone by means of two psychophysical tests. Light-touch sensation (LTS) and two-point discrimination (2PD) were performed before, and at planned intervals until 18 months after the placement of one or two implants in the anterior maxilla. The same tests were used on the contralateral control sites. The psychophysical threshold was determined by performing the staircase method. The mean values and standard deviation of LTS and 2PD, pooled over the four sessions at each test area, were calculated. Despite a large intersubject variation in both the LTS and 2PD, significantly high intra-individual correlations were found (P < 0.005). For LTS, the thresholds were not significantly affected over time (P > 0.05) on both implant and control sites. The 2PD increased significantly after surgery and maintained the higher discriminatory sense for 1 year (P-value 0.005). The control sites remained stable over time. However, no correlation was revealed between LTS and 2PD perception (Pearson correlation test). In this prospective study, no major differences between the different sites and testing sessions were reported; except for the 2PD thresholds which were lowered after implant surgery. These findings suggest that the regenerated nerves may be responsible for the increased 2PD sensitivity in the peri-implant soft tissue. The unchanged LTS thresholds did not allow confirming this hypothesis.

Improved clinical status and length of care with low-fat nutrition support in burn patients.

BACKGROUND: The optimal amount and type of fat in the nutrition support of burned patients have not been determined. The aim of this study was to test low-fat nutritional solutions, with or without fish oil, on protein metabolism, morbidity, and length of care in severely burned adults. METHODS: In a prospective randomized clinical trial, 43 patients were assigned to one of the following groups: control (35% fat), low-fat solution (ie, 15% of total calories as fat), low-fat with fish oil, given for 30 days. Nitrogen balance, urinary 3-methylhistidine excretion, urinary cortisol, and clinical status were measured daily. Corticosteroid-binding globulin and total and free serum cortisol were measured every 3 days. RESULTS: Compared with controls, patients on low-fat support had fewer cases of pneumonia: 3/24 vs 7/13 (p = .02), better respiratory and nutrition status, and shorter time to healing: 1.2 vs 1.8 days/% burned area (p = 0.01). There was no difference in nitrogen balance between groups, and 3-methylhistidine excretion was higher and serum free cortisol was lower in log-fat--fed patients than in controls. There was no difference between the two low-fat groups in any of the parameters measured. CONCLUSIONS: This study showed that low-fat nutrition support decreases infectious morbidity and shortens length of stay in burn patients. Fish oil does not seem to add clinical benefit to low-fat solutions. In addition, this study provides the first evidence that nutrition intervention modulates cortisol-binding globulin and the concentration of free circulating cortisol after a severe stress.

[Angiomas of the jaws. Diagnostic and therapeutic problems (apropos 12 cases)]. / Angiomes des maxillaires. Problèmes diagnostiques et thérapeutiques (à propos de 12 cas).

Difficulties encountered during surgery on maxillary angiodysplasias were studied in relation to case-reports of patients treated in the stomatology and maxillofacial surgery unit directed by professor Vaillant, Hôpital Salpêtrière, Paris. Findings allowed certain conclusions to be drawn with respect to diagnostic and therapeutic features and to compare these with those reported in the international literature.

[Giant mandibular exostosis. Apropos of a case. Description, therapeutic approach. Review of the literature]. / Exostose mandibulaire géante. A propos d'un cas. Description, attitude thérapeutique. Revue de la littérature.

The authors present a cases of localised exostosis of the angle and the ascending ramus of the mandible. They stress the technical problems posed by this giant exostosis and they propose an original operative approach together with a complete review of the literature.