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The objective of this study was to retrospectively evaluate stability of mandibular advancement after bilateral sagittal split osteotomies were performed. Three different fixation and immobilization protocols were examined. Thirty-three patients were evaluated with preoperative, immediate postoperative, and long-term (mean, 13 months) lateral cephalometric radiographs. The patients were divided into three groups: group 1 (n = 10) had nonrigid internal fixation and 6 weeks of maxillomandibular fixation, group 2 (n = 12) had rigid internal fixation and immediate postoperative function, and group 3 (n = 11) had rigid internal fixation with maxillomandibular fixation for a mean of 14 days. Group 3 had the least amount of sagittal and vertical relapse. Differences in sagittal relapse were statistically significant between groups 1 and 3. Group 2 demonstrated greater sagittal relapse than did group 3, although the result was not statistically significant. This study suggests that the use of rigid internal fixation with a period of maxillomandibular fixation appears to be more stable than nonrigid internal fixation with maxillomandibular fixation or rigid internal fixation without maxillomandibular fixation.

The results of submental lipectomy often remain suboptimal, and in some cases this may be due to the presence of residual fat deep to the platysma muscle. This study was undertaken to determine the relative amounts of fat superficial and deep to the platysma muscle. A dissection of the submental region of 20 cadavers revealed a mean weight of fat lying superficial to the platysma muscle of 8.4 grams. The mean weight of fat lying deep to the platysma muscle but superficial to the mylohyoid muscle was 3.7 grams. In three cases (15%), the weight of fat deep to the platysma muscle was greater than 50% of the total fat. This is of significance with respect to those submental lipectomy procedures that normally address only the fat superficial to the platysma.

This study evaluated the width of tissue necrosis lateral to carbon dioxide laser incisions on human intraoral excisional biopsy specimens. Measurements were made on specimens including epithelium, muscle, dense and loose connective tissue, and salivary gland. Results showed a mean width of tissue necrosis of 86 microns in epithelium, 85 microns in muscle, 51 microns in loose connective tissue, 96 microns in dense connective tissue, and 41 microns in salivary gland. The range of thermal necrosis in different tissue types is probably based on the water content within each type. A cellular partially homogenized zone of reversible thermal damage up to 500 microns in width was visible adjacent to the zone of thermal necrosis. The relatively narrow width of tissue necrosis with this technique may account for the claimed superior properties of laser-induced wounds compared with those created by electrosurgery.

With the carbon dioxide surgical laser, the liquid nitrogen cryoprobe, and the scalpel, wounds were created on the shaved abdomen of 24 rats, and the patterns of healing were studied. The laser wounds were the first to epithelialize, followed by the scalpel wounds, with the cryosurgery wounds the slowest to epithelialize. The results were confirmed histologically.

Results are reported from a series of twenty-four patients who received intraoral dermis grafts for a variety of conditions and have been followed for between 6 months and 4 years. Advantages and disadvantages of dermal grafting, including contracture, the final histologic and clinical appearance of the graft, and problems with the donor area, are discussed.

With the use of an infrared thermographic camera; temperature patterns over the crowns of teeth were recorded. The temperature of upper incisor teeth decreased from gingival margin to incisal edge by approximately 2.5 degrees C. Vital and nonvital teeth were the same temperature at rest, but after cooling with cold air, nonvital teeth were slower to rewarm than vital teeth. The infrared thermographic camera could provide a method of testing tooth vitality based on blood supply rather than nerve supply.

Thrombocythemia is characterized by an increase in platelet numbers coupled with abnormal function. Three cases diagnosed after referral to an oral surgeon are presented. In each case the reason for referral concerned excessive dental hemorrhage. Thrombocythemia should be included in the differential diagnosis in cases of oral hemorrhage.

One hundred patients with a severe relapse of cutaneous psoriasis underwent a full intraoral examination. Nineteen patients had "ectopic geographic tongue" of the palate or buccal mucosa, and there appeared to be an increased incidence of periodontal disease. All other findings were within the normal range. HLA antigen studies of eight patients were carried out and showed an increased incidence of DR7.

The surgical carbon dioxide laser has the ability to vaporize soft tissues with little bleeding, pain, swelling, or wound contraction. The laser was evaluated on 27 patients requiring soft tissue preprosthetic surgery, including frenectomies, tuberosity reduction, hyperplasia removal, and sulcus deepening. Surgery was performed on an ambulatory basis with no bleeding or infection. Swelling was minimal and pain, as measured on a linear pain scale, was moderate. One third of the patients required no analgesics. Wound contraction did occur but was less than is historically quoted for scalpel wounds. The carbon dioxide laser would appear to have advantages for soft tissue preprosthetic surgery that warrant further evaluation.

The uptake of radioisotope in the temporomandibular joints of normal subjects was quantified to act as baseline in studies of unilateral condylar hyperplasia. Any difference in activity between the right and left sides greater than 10% appears to be significant.

A highly sensitive infrared thermographic camera was evaluated in a variety of physiologic and pathologic conditions associated with the head and neck. Although it may have clinical applications, particularly in the field of facial pain and the temporomandibular joint, such wide variations in normal values were noted that any standardization was extremely difficult.

That patients with salivary gland cancer are at increased risk of second primary tumors has been suggested in several studies. This report presents the case of a 53-year-old woman with an epithelial-myoepithelial carcinoma of intercalated duct origin occurring in the parotid gland synchronously with a follicular cell carcinoma of the thyroid gland. This is believed to be the first report of such an association.