Franklin Dolwick - Academia.edu (original) (raw)

Papers by Franklin Dolwick

Fortschritte der Kiefer- und Gesichts-Chirurgie, 1990

American Journal of Roentgenology, May 1, 1980

A series of 1 04 arthrotomographic examinations of the temporomandibular joint in 89 patients is ... more A series of 1 04 arthrotomographic examinations of the temporomandibular joint in 89 patients is described. Those patients with symptoms referable to the temponomandibular joint and not responsive to conservative methods of therapy were selected. The mean patient age was 29 years with a 3:1 female to male ratio. Operative confirmation of arthnotomographic findings was obtained in 40 joints. The arthrotomogram was consistently reliable in predicting the type of internal joint derangement. Anterior meniscus displacement without reduction, anterior meniscus displacement with reduction, and perforation of the posterior attachment of the meniscus were the most significant abnormalities encountered. Jaw locking was definitely associated with meniscus displacement without reduction and meniscus displacement with reduction. The most important pathophysiologic mechanism explaining the arthrotomographic findings seems to be incompetence of the posterior attachment of the meniscus with anterior displacement. Arthrotomography of the temporomandibular joint is a clinically valuable diagnostic test.

International Journal of Oral and Maxillofacial Surgery, Oct 1, 2011

stage will prevent the development of chronic pain (Gatchel, Stowell, et al., 2006). Moreover, th... more stage will prevent the development of chronic pain (Gatchel, Stowell, et al., 2006). Moreover, there were significant costsavings associated with early intervention (Stowell, Gatchel, et al., 2007). These results are quite promising because of their potential to decrease the high costs of chronic TMJMD. They have also demonstrated the construct validity of our high-low risk dichotomy. We are now conducting our fourth NIH-supported project in which we are "translating" this early assessment-intervention approach to actual community dental clinics. Indeed, these findings are in keeping with a seminal article on TMJMD treatment by Stohler and Zarb (1999), who made a plea for a "lowtech, high prudence therapeutic approach."

Journal of Oral and Maxillofacial Surgery, Apr 1, 1984

International Journal of Oral and Maxillofacial Surgery, Apr 1, 2012

The purpose of this study was to determine if a temporomandibular joint (TMJ) replaced by a custo... more The purpose of this study was to determine if a temporomandibular joint (TMJ) replaced by a custom joint prosthesis could have been replaced by a stock joint prosthesis. Stereolithic models of patients treated with TMJ Concepts 1 patient fitted joint prosthesis (e.g. custom) were obtained. Biomet Microfixation 1 TMJ prostheses (e.g. stock) were adapted to these models. Intra-operative insertion of prosthesis, fit and size of stock joints were simulated and evaluated. Adaptability and stability of condyle and fossa as well as their articulation were recorded. 20 models consisting of 34 joints were examined by two oral and maxillofacial surgeons who were blinded to the patient's diagnosis. Overall, 77% of the stock TMJ system fit the stereolithic models. 3 mm or less of bone modification was necessary to achieve an acceptable fit. In the majority of the cases examined, a stock TMJ prosthesis had good anatomical adaptation to stereolithic models of patients previously treated with custom TMJ prosthesis, so a stock TMJ prosthesis could have been an acceptable option for these patients. Further prospective clinical studies to compare both systems are necessary.

Journal of Oral and Maxillofacial Surgery, Oct 1, 2008

v r l m b v c enioplasty is generally performed as the final step in n orthognathic surgery case.... more v r l m b v c enioplasty is generally performed as the final step in n orthognathic surgery case. Although the soft tissue hanges associated with an advancement genioplasty re predictable, in some cases the surgeon may need o make intraoperative decisions regarding the need or and the amount of genial advancement. After completion of maxillary and/or mandibular urgery, the surgeon directs attention to the chin– eck angle, as well as the labiomental fold, to evaluate hether genial advancement should follow. This evalation process is subjective and allows the surgeon to magine the anticipated changes. The method decribed in this note allows the surgeon to intraopertively visualize the changes associated with an adancement genioplasty before performing the actual urgery.

Journal of Prosthetic Dentistry, Mar 1, 1983

Oral and Maxillofacial Surgery Clinics of North America, Aug 1, 2018

The impact of orthognathic surgery on the signs and symptoms of temporomandibular disorders (TMDs... more The impact of orthognathic surgery on the signs and symptoms of temporomandibular disorders (TMDs) has been unclear. Many studies have not evaluated single jaw surgeries; instead, TMD outcomes assessments were the result of a mixture of osteotomies combined with preorthodontic and postorthodontic therapy. Most clinical studies on the effects of orthognathic surgery on TMD signs and symptoms did not include a control group and, when included, most control groups were not matched on age and sex. The best evidence in the current literature supports the concept that orthognathic surgery does not increase the overall frequency of TMD signs and symptoms at a follow-up of 2 years or more. However, correction of a retrognathic mandible with a counterclockwise rotation increased masticatory muscle myalgia and, combined with a 7 mm advancement, elicited an increase in myalgia and TMJ arthralgia.

Journal of Oral and Maxillofacial Surgery, Sep 1, 2012

nathic surgical procedures were then performed to optimize occlusion, function, and esthetics. Cl... more nathic surgical procedures were then performed to optimize occlusion, function, and esthetics. Clinical and radiographic evaluation was performed before surgery (T1), immediately after surgery (T2), and at the longest follow-up (T3). Results: Average follow-up for the patients was 51 months (range: 60-84 months). No recurrence of the tumor was encountered in any of the cases. No difference in clinical outcomes was reported between the 2 groups. Subjective and objective evaluations of postsurgical TMJ function and range of mandibular motion were unremarkable. Associated maxillary and/or mandibular orthognathic procedures were found to be stable. Conclusions: The study is retrospective and has some limitations, especially as the surgeon chose the option based on 2 main factors: size of lesion, and patient preference. However, the results do demonstrate that both conservative and/or complete condylectomy are viable options for treatment of osteochondromas of the mandibular condyle. When indicated, a conservative approach may have some advantages including eliminating the need for autogenous or alloplastic TMJ reconstruction while allowing for effective removal of the tumor.

Archives of Otolaryngology-head & Neck Surgery, Jun 1, 1981

• Temporomandibular joint (TMJ) dysfunction may cause facial or aural pain. Conventional roentgen... more • Temporomandibular joint (TMJ) dysfunction may cause facial or aural pain. Conventional roentgenograms are useful to define bony pathologic conditions. However, TMJ arthrotomography may disclose joint meniscus abnormalities in two thirds of patients with persistent dysfunction despite normal roentgenograms. ( Arch Otolaryngol 1981;107:337-339)

Oral Surgery Oral Medicine Oral Pathology Oral Radiology and Endodontology, Aug 1, 2008

Background. Ludwig's angina is a rapidly spreading cellulitis that may produce upper airway obstr... more Background. Ludwig's angina is a rapidly spreading cellulitis that may produce upper airway obstruction often leading to death. There is very little published information regarding this condition in the pregnant patient. Case. A 24-year old black female was admitted at 26 weeks gestation with tooth pain, submandibular swelling, severe trismus, and dysphagea, consistent with Ludwig's angina. Her treatment included emergent tracheostomy, incision and drainage of associated spaces, teeth extraction, and antibiotic therapy. Conclusions. During a life threatening infectious situation such as the one described, risks of maternal and fetal morbidity include both septicemia and asphyxia. Furthermore, the healthcare provider must consider the risks that the condition and the possible treatments may cause the mother and her unborn child.

Evidence-Based Oral Surgery, 2019

This chapter focuses on diagnosis and treatment of temporomandibular joint disorders (TMD) includ... more This chapter focuses on diagnosis and treatment of temporomandibular joint disorders (TMD) including myofascial pain disorder (MPD) and disorders of the joint itself. Noninvasive treatments include physical therapy, pharmacotherapy, massage, thermotherapy, and occlusal appliance therapy. Lastly minimally invasive procedures such as arthrocentesis and arthroscopy as well as surgical procedures such as arthroplasty and total joint replacement will be discussed.

n the 1960s arthrocentesis of large joints, the knee in paricular, became a recognised treatment.... more n the 1960s arthrocentesis of large joints, the knee in paricular, became a recognised treatment. Physicians went on o develop various techniques of lysis and lavage for other oints, such as the hip, shoulder, tarsus, and wrist.1–4 It was hen found that the mechanical lysis of adhesions and lavage f the temporomandibular joint (TMJ) was often successul in treating various internal derangements.5 Lavage of the pper joint compartment forces the flexible disc apart from he fossa, washes away degraded particles and inflammatory omponents, and decreases the intra-articular pressure whenver the joint is inflamed. Arthrocentesis has been reported to educe joint pain, improve function, and reduce clicking. It is ost commonly used to treat patients with anterior disc dislacement without reduction (closed lock) and disc adhesion. t is also used as a palliative for acute episodes of degenerative r rheumatoid arthritis.5–7

Clinics in Geriatric Medicine, 1992

Older adults can present with a broad range of oral and maxillofacial diseases and conditions, an... more Older adults can present with a broad range of oral and maxillofacial diseases and conditions, and many of these are best treated surgically. This surgical therapy includes dental surgery, surgery of the alveolar bone surrounding the teeth, surgery performed in preparation for a dental or facial prosthesis, management of orofacial infections and orofacial trauma, excision of pathologic lesions, diagnosis and treatment of salivary gland disease, management of disorders of the temporomandibular joint (TMJ), and reconstructive surgery. The most common surgical need in older adults is tooth extraction because of caries or periodontal disease. In edentulous older adults, however, preprosthetic surgery may be required to treat the long-term sequelae of tooth loss and prostheses use. Additionally, middle-aged and older adults have a greater probability of developing oral/pharyngeal carcinoma, and excision of the lesion with surgical reconstruction may be required. Oral and maxillofacial surgical techniques for older adults differ little from those employed on younger age groups. Rather, geriatric surgery is different because older adults present with higher prevalences of potentially complicating medical disorders, present with different prevalences of surgically treatable oral and maxillofacial conditions, and may require different treatment planning strategies than their younger counterparts.

Oral Surgery, Oral Medicine, Oral Pathology, 1979

The use of technetium 99m pyrophosphate (99mTcPP) imaging in the evaluation of benign and maligna... more The use of technetium 99m pyrophosphate (99mTcPP) imaging in the evaluation of benign and malignant tumors of the head and neck has been limited. In a clinical prospective study, twenty-one patients with suspected benign or malignant lesions of the temporomandibular joint, temporal bone, maxilla, or mandible were evaluated with regard to clinical presentation, radiographic findings, preoperative 99mTcPP bone scan, and final pathologic diagnosis. Eleven of twenty-one patients had positive scans at the site of biopsy-proven disease. In three cases, a bone scan was the single positive diagnostic test prior to surgical intervention. 99mTcPP imaging offers an additional noninvasive technique in the preoperative evaluation of patients with lesions of the osseous structures of the head and neck.

Dental clinics of North America, 2007

Surgery of the temporomandibular joint (TMJ) plays a small, but important, role in the management... more Surgery of the temporomandibular joint (TMJ) plays a small, but important, role in the management of patients who have temporomandibular disorders (TMDs). There is a spectrum of surgical procedures for the treatment of TMD that ranges from simple arthrocentesis and lavage to more complex open joint surgical procedures. It is important to recognize that surgical treatment rarely is performed alone; generally, it is supported by nonsurgical treatment before and after surgery. Each surgical procedure should have strict criteria for which cases are most appropriate. Recognizing that scientifically proven criteria are lacking, this article discusses the suggested criteria for each procedure, ranging from arthrocentesis to complex open joint surgery. The discussion includes indications, brief descriptions of techniques, outcomes, and complications for each procedure.

$Research paper thumbnail of Monocular blindness developing 7 days after repair of zygomaticomaxillary complex fracture$

Oral Surgery, Oral Medicine, Oral Pathology, 1985

Blindness following zygomaticomaxillary complex (ZMC) fracture and surgical repair is an unfortun... more Blindness following zygomaticomaxillary complex (ZMC) fracture and surgical repair is an unfortunate and uncommon complication. A review of the literature reveals fewer than 25 cases of monocular blindness resulting from zygomaticomaxillary fracture or repair. The case presented here is that of a man who was assaulted with a baseball bat and suffered a mildly displaced ZMC fracture. On admission, the patient had light perception only in his left eye. During his convalescence, vision in his left eye gradually improved to the point of allowing him to read a newspaper without difficulty. Then, 9 days after the injury (7 days after surgical repair), the patient awoke with complete blindness of the left eye. The possible mechanisms for such loss of vision are discussed.

Oral Surgery, Oral Medicine, Oral Pathology, 1994

The morbidity of bone harvest was compared between anterior lateral and medial surgical approache... more The morbidity of bone harvest was compared between anterior lateral and medial surgical approaches in a randomized prospective study. Forty consecutive patients, each requiring a minimum 40 cc of loose corticocancellous bone for maxillofacial reconstruction, were randomly placed into two equal groups. Morbidity vectors assessed included bone volume, blood loss, length of surgery, length of hospital stay, incidence of seroma, incidence of anterior thigh paresthesia, postoperative pain, and gait disturbance. The results demonstrated no significant difference in morbidity between these two approaches; therefore selection of either approach is the surgeon's personal preference. A thorough understanding of the osseous anatomy of the anterior ilium and its muscular attachments, a good surgical technique, an efficient surgical team, and a continuous flow of required surgical instruments are essential to reduce the morbidity of bone harvest.

Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, and Endodontology, 1997

Surgery of the temporomandibular joint (TMJ) has made considerable progress, although significant... more Surgery of the temporomandibular joint (TMJ) has made considerable progress, although significant failures have plagued this field in recent years. Despite the controversies, surgery of the TMJ continues to have a small but important role in the management of specific temporomandibular disorders. This article presents an overview of TMJ surgery. It is concluded that careful case selection is the most important aspect for a successful outcome.