CURRENT LITERATURE

Symptoms of Temporomandibular Joint Dysfunction and Predisposing Factors. Meng HP, Dibbets JMH, van der Weele LTh, et al. J Prosthet Dent 57:215, 1987

This study analyzes the etiologic factors often asso- ciated with temporomandibular joint (TMJ) dysfunction. The following variables were determined for each sub- ject: 1) symptoms defining dysfunction; 2) symptoms in- dicating dysfunction; and 3) predisposing factors. The symptoms defining dysfunction included presence or ab- sence of joint sounds (clicking, snapping), pain in the TMJ region, locking or limitation of movement in one or both joints, and objective symptoms as determined by the clinician. Radiographic changes were determined from subcranial or infracranial radiographs made with the mouth opened maximally. The symptoms indicating dys- function or resulting from it were interlabial line, chin de- viation, level of the gonial notches, slope of the occlusal plane, deviation of the chin in position of maximal mouth opening, course of the open-close cycle, midline corre- spondence, and degree of mobility of the mandible on the subcranial or infracranial radiograph. The predisposing factors possibly defining or indicating symptoms of TMJ dysfunction were: developmental stage of the dentition; sex; trauma; scars; attrition; difference in the capacity to masticate; forced bite; thumb- or finger-sucking: nail biting; and gnashing of the teeth. The conclusions drawn from the present study suggest: 1) there is hardly any re- lationship between the most frequently recorded symptoms defining dysfunction and the so-called predis- posing factors reported in the literature. In addition, no relationship between combinations of symptoms and pre- disposing factors could be demonstrated; 2) the incidence of single symptoms increased with the further develop- ment of the de&ion; and 3) the symptoms indicating so- matic characteristics of the so-called TMJ dysfunction such as chin deviation, reduced amount of maximal mouth opening, difference in the level of the gonial notches, and non-horizontal slope of the interlabial line and occlusal plane showed no relationship with single symptoms defining dysfunction. The only correlation ob- served was between the course of the open-close cycle and the objectively determined symptoms of clicking and snapping.- K. PATEL

Reprint requests to Dr. Meng: Schulzahnklinik Bern, Markt- gasse 6, CH-3011 Bern, Switzerland.

Evaluation of Implanted Durapatite Particles in Fresh Ex- traction Sockets to Maintain the Alveolar Ridge in Beagle Dogs. Sherer AD, Slighter RG, Rothstein SS, et al. J Prosthet Dent 57:33 1, 1987

This present study evaluates the use of durapatite (Ca,,(PO,),(OH),) supplied as granules or particles, im- planted in fresh sockets after posterior odontectomy in dogs to determine whether the alveolar ridge could be maintained. The particles were implanted on one side, and on the contralateral side the arch was left to heal un- supported by any implant and served as a control. The gingival edges around the sockets were not sutured. Soft diet was provided for about one month. The material within the alveoli was easily discernable radiographically immediately after implantation and, in most instances,

Abstracts

the particles filled the alveoli from the crest to apex. Ex- amination of the maxillae and mandibles after one month showed the alveolar ridges to be thoroughly covered with the gingival tissues. The gross observation at autopsy substantiated the clinical and radiographic evaluation that the general conformation of the alveolar ridge of the implanted sockets was wider and more rounded in con- tour than the unimplanted ridge, which appeared atro- phied with a knife edge conformation. The results of the histopathologic examinations in this study suggest that, in the dog, hydroxylapatite granules implanted into fresh extraction sockets maintain a near normal ridge conformation and prevent atrophy of the alveolar bone. -K. PATEL

Reprint requests to Dr. Sherer: Toxicology Department, Ster- ling-Winthrop Research Institute, Columbia Turnpike, Rensse- laer, NY 12144.

Inaccuracy of Peranesthetic Gastric Intubation for Emp- tying Liquid Stomach Contents. Adelhoj B, Petring OU, Hagelsten JO. Acta Anesthesiol Stand 30:41, 1986

The purpose of this study was to clarify this issue in a prospective evaluation of 80 patients undergoing general anesthesia. Half of the patients had a double-barrelled 16F-Argyle Salem sump tube, length 120 cm, size 16 CH, inserted and the other half had a single-barrelled stomach tube, length 80 cm, size 25 CH inserted. After emptying the stomach with the tubes, a glucose solution was given through the gastric tube to half of the Salem tube group and half of the stomach tube group. After instillation of 25 ml or 100 ml, the Salem tube recovered 21.0 2 9.1 ml (median 24 ml, range 6-36 ml) or 86.8 c 26.9 ml (median 92 ml, range 18-136 ml), respectively, and the stomach tube recovered 17.1 * 10.8 ml (median 18 ml, range 2-34 ml) or 54.0 2 28.5 ml (median 50 ml, range 14-104 ml), respectively. These findings suggest that gastric intuba- tion for emptying the liquid stomach contents is an incon- sistent procedure.-R. E. MACK, JR

Reprint requests to Dr. Adelhoj: Department of Anesthesiology. Kommunehospitalet, Copenhagen, Denmark.

Aspiration During Anesthesia: A Computer-Aided Study of 185,358 Anesthetics. Olsson GL, Hallen B, Hambraeus- Jonzon K. Acta Anesthesiol Stand 30:84, 1986

This retrospective computer-aided study of 185,358 an- esthetics was designed to estimate the incidence of aspi- ration of stomach contents during anesthesia, to identify risk groups, and to study the severity of this complication in modern anesthesia. Of 132 individual cases of aspira- tion recorded in the computer-based anesthetic record- keeping system, 83 cases of aspiration during anesthesia were retrieved from the file of anesthetic records and four from the inpatient register. This constitutes an incidence of 4.7 per 10,000 anesthetics, or one in 2131. The patients generally affected were children and the elderly. A greater proportion of males were also observed. In 83% of the cases there were one or more preoperative factors indicating an increased risk for aspiration, such as emer- gency operation (38 cases, 43%), upper abdominal or emergency abdominal surgery (14 cases, 16%), a history

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