Wolfgang Eichhorn

Publications of Wolfgang Eichhorn

• Bleeding incidence after oral surgery with continued oral anticoagulation.

  Authors: Wolfgang Eichhorn, Jens Burkert, Oliver Vorwig, Marco Blessmann, Georg Cachovan, Jürgen Zeuch, Marc Eichhorn, Max Heiland

  Clinical oral investigations. 12/2011;

  OBJECTIVES: The aim of this retrospective study was to assess the incidence of postoperative hemorrhage in patients treated with coumarins without interruption of the anticoagulant treatmentOBJECTIVES: The aim of this retrospective study was to assess the incidence of postoperative hemorrhage in patients treated with coumarins without interruption of the anticoagulant treatment undergoing oral surgical procedures, mostly osteotomies for tooth removal, when compared with patients who had never been anticoagulated. MATERIAL AND METHODS: Six hundred thirty-seven patients underwent 934 oral surgical procedures on an outpatient basis. The INR was measured preoperatively being 2.44 in the mean SD 0.61. Local hemostasis was carried out routinely (80%) with collagen fleece, local flap, and acrylic splint. RESULTS: Of these 637 patients, 47 presented with a postoperative hemorrhage (7.4%), 15 of these 47 cases had to be treated in hospital (2.4%). All patients showed up finally with a good wound healing, no administration of blood was necessary, and local measures revealed to be sufficient in all cases except for two patients, where the preoperative anticoagulant treatment had to be changed for 6 days. The bleeding incidence in 285 patients with comparable oral surgical procedures, who had never been anticoagulated, was 0.7%. CONCLUSIONS: The results suggest that oral surgical procedures can be performed safely without alteration of the oral anticoagulant treatment. CINICAL RELEVANCE: Local hemostasis with collagen fleece, local flap, and acrylic splint seems to be sufficient to prevent postoperative bleeding.

• Influence of lip closure on alveolar cleft width in patients with cleft lip and palate.

  Authors: Wolfgang Eichhorn, Marco Blessmann, Oliver Vorwig, Gerd Gehrke, Rainer Schmelzle, Max Heiland

  Head & face medicine. 01/2011; 7:3.

  The influence of surgery on growth and stability after treatment in patients with cleft lip and palate are topics still under discussion. The aim of the present study was to investigate the influenceThe influence of surgery on growth and stability after treatment in patients with cleft lip and palate are topics still under discussion. The aim of the present study was to investigate the influence of early lip closure on the width of the alveolar cleft using dental casts. A total of 44 clefts were investigated using plaster casts, 30 unilateral and 7 bilateral clefts. All infants received a passive molding plate a few days after birth. The age at the time of closure of the lip was 2.1 month in average (range 1-6 months). Plaster casts were obtained at the following stages: shortly after birth, prior to lip closure, prior to soft palate closure. We determined the width of the alveolar cleft before lip closure and prior to soft palate closure measuring the alveolar cleft width from the most lateral point of the premaxilla/anterior segment to the most medial point of the smaller segment. After lip closure 15 clefts presented with a width of 0 mm, meaning that the mucosa of the segments was almost touching one another. 19 clefts showed a width of up to 2 mm and 10 clefts were still over 2 mm wide. This means a reduction of 0% in 5 clefts, of 1-50% in 6 clefts, of 51-99% in 19 clefts, and of 100% in 14 clefts. Early lip closure reduces alveolar cleft width. In most cases our aim of a remaining cleft width of 2 mm or less can be achieved. These are promising conditions for primary alveolar bone grafting to restore the dental bony arch.

• Metastases in odontogenic cysts: literature review and case presentation.

  Authors: Wolfgang Eichhorn, Manfred Wehrmann, Marco Blessmann, Philipp Pohlenz, Felix Blake, Rainer Schmelzle, Max Heiland

  Oral surgery, oral medicine, oral pathology, oral radiology, and endodontics. 04/2010; 109(4):582-6.

  Malignant tumors in the oral cavity are relatively rare. About 5% of all malignant growths in the body are localized in the oral cavity. The vast majority of oral malignancies are primary tumors withMalignant tumors in the oral cavity are relatively rare. About 5% of all malignant growths in the body are localized in the oral cavity. The vast majority of oral malignancies are primary tumors with squamous cell carcinoma being the most frequent and sarcomas occurring very seldom. Secondary tumors caused by hematogenous spread arising from a tumor localized elsewhere in the body are extremely rare. About 1% of all oral cancers are metastases to the jawbones and the surrounding soft tissues. Metastases to the jaws are mainly caused by malignant tumors of the breast, lung, kidney, bone, and colon. They occur in the late state of the disease and are regularly detected by staging examinations including scintigraphy. Even more rare are metastases into odontogenic cysts. Odontogenic cysts include dentigerous cysts, periapical or radicular cysts, and the keratocysts-nowadays declared as keratocystic odontogenic tumor. The incidence of odontogenic cysts is about 10% to 15% of all oral biopsies and therefore general dentists are frequently faced with these types of lesions. The aim of this study was to review the literature regarding metastasis into odontogenic cysts and to further highlight this rare entity with the help of a clinical case.

• Clinical follow-up examination of surgically treated fractures of the condylar process using the transparotid approach.

  Authors: Jan Klatt, Philipp Pohlenz, Marco Blessmann, Felix Blake, Wolfgang Eichhorn, Rainer Schmelzle, Max Heiland

  Journal of oral and maxillofacial surgery : official journal of the American Association of Oral and Maxillofacial Surgeons. 03/2010; 68(3):611-7.

  The surgical approaches for the open treatment of condylar process fractures have been controversial. In our study, we evaluated the morbidity of the transparotid approach during 2 years ofThe surgical approaches for the open treatment of condylar process fractures have been controversial. In our study, we evaluated the morbidity of the transparotid approach during 2 years of follow-up. A total of 48 patients with condylar process Class II and IV fractures according to classification of Spiessl and Schroll, were included in the present study. Of the 48 patients, 16 were female and 32 male. The patient age range was 16 to 79 years (average 36.52). All patients were treated using the transparotid approach, with rigid internal fixation using miniplates. Follow-up examinations were performed for a minimum of 6.5 months and a maximum of 25 months (average 12.16) after surgical treatment. At the follow-up examination, the patients completed the Mandibular Function Impairment Questionnaire, and the examiner completed the Helkimo index. X-rays taken before, directly after, and 6 months after surgery were compared. None of our patients had problems with wound healing; 2 patients developed a fistula of the parotid gland; and 4 patients developed palsy of the facial nerve that was completely reversible after 6 weeks. The results of the Mandibular Function Impairment Questionnaire and the Helkimo index revealed only a few subjective and objective problems after 6 months. The transparotid approach to condylar process fractures is most appropriate for strongly displaced Class II fractures. Especially for very old patients with dementia, for whom maxillomandibular fixation is contraindicated, this approach is very appropriate. Another benefit to this type of patient is the short operating time, with an average of 45 minutes.

• Primary osteoplasty using calvarian bone in patients with cleft lip, alveolus and palate.

  Authors: Wolfgang Eichhorn, Marco Blessmann, Philipp Pohlenz, Felix A S Blake, Gerd Gehrke, Rainer Schmelzle, Max Heiland

  Journal of cranio-maxillo-facial surgery : official publication of the European Association for Cranio-Maxillo-Facial Surgery. 09/2009;

  PURPOSE: The results of primary bone grafting in terms of initial cleft width, existence or absence of a lateral incisor and scar formation in the donor area are compared. METHODS: After primaryPURPOSE: The results of primary bone grafting in terms of initial cleft width, existence or absence of a lateral incisor and scar formation in the donor area are compared. METHODS: After primary osteoplasty with calvarian bone at an average age of 24 months (4-56 months) radiographic assessment was carried out in 31 patients with 40 alveolar clefts. The bone formation in the grafted area was assessed using dental radiographs taken at 66 months on average (13-114 months) after primary bone grafting. According to the Abyholm classification patients were assigned to 4 groups (indices I-IV) with indices I and II being rated as a success. RESULTS: We observed success (indices I and II) in 76% and poor results (index IV) in 14%. The causes for the poor results were an alveolar cleft width of 11-12mm in three cases, an extraction of a decayed deciduous tooth 17 months after bone grafting in one case and a traumatic transplant loss in another case. The non-existence of a lateral incisor and a broad cleft are related to poor results. CONCLUSION: Based on the results presented, primary bone grafting using calvarial bone seems to be a promising alternative in bridging narrow alveolar defects. This method allows early intervention at an age in which children do not recognize themselves as cleft patients. The preservation of the deciduous teeth is equally important regarding their functional stimulus for bone development.

• Conditioning of myocutaneous flaps.

  Authors: Wolfgang Eichhorn, Felix A S Blake, Philipp Pohlenz, Gerd Gehrke, Rainer Schmelzle, Max Heiland

  Journal of cranio-maxillo-facial surgery : official publication of the European Association for Cranio-Maxillo-Facial Surgery. 02/2009;

  PURPOSE: The improvement of the ischaemic tolerance of myocutaneous flaps is of clinical importance and hence the subject of numerous investigations. METHODS: In an attempt to increase the ischaemicPURPOSE: The improvement of the ischaemic tolerance of myocutaneous flaps is of clinical importance and hence the subject of numerous investigations. METHODS: In an attempt to increase the ischaemic tolerance, 20 myocutaneous flaps (rectus abdominis muscle) in pigs were elevated and perfused with various, established solutions prior to the onset of ischaemia. The flaps were elevated, utilizing the superior epigastric vessels as the pedicle. Ten flaps were flushed with the University of Wisconsin solution, five with the Euro-Collins solution and the last five with a Ringer-Lactate solution, prior to the 6h long, normothermic ischaemia. On the day of operation, the first, third, fifth, seventh and tenth postoperative day clincical examinations and thermography were performed as well as biopsies. Additionally, on the tenth postoperative day, the rate of necrosis was determined morphometrically as the average of three measurements. RESULTS: Ten days after surgery, the flaps pretreated with the University of Wisconsin solution displayed a vital surface area of 89%, the Euro-Collins solution 23% and the Ringer-Lactate solution 14%. Histologically, muscle tissue proved to be more susceptible to ischaemia than skin. CONCLUSION: Regarding the rectus abdominis flap in a pig model, the University of Wisconsin solution proved superior in the prevention of ischaemic injury compared with the Euro-Collins solution and Ringer Lactate. In accordance with the literature, muscle tissue proved to be more susceptible to ischaemia than skin in our study.

• Conditioning of myocutaneous flaps

  Authors: Wolfgang Eichhorn, Felix A.S. Blake, Philipp Pohlenz, Gerd Gehrke, Rainer Schmelzle, Max Heiland

  Journal of Cranio-Maxillofacial Surgery.

  PurposeThe improvement of the ischaemic tolerance of myocutaneous flaps is of clinical importance and hence the subject of numerous investigations.MethodsIn an attempt to increase the ischaemicPurposeThe improvement of the ischaemic tolerance of myocutaneous flaps is of clinical importance and hence the subject of numerous investigations.MethodsIn an attempt to increase the ischaemic tolerance, 20 myocutaneous flaps (rectus abdominis muscle) in pigs were elevated and perfused with various, established solutions prior to the onset of ischaemia. The flaps were elevated, utilizing the superior epigastric vessels as the pedicle. Ten flaps were flushed with the University of Wisconsin solution, five with the Euro-Collins solution and the last five with a Ringer-Lactate solution, prior to the 6 h long, normothermic ischaemia. On the day of operation, the first, third, fifth, seventh and tenth postoperative day clincical examinations and thermography were performed as well as biopsies. Additionally, on the tenth postoperative day, the rate of necrosis was determined morphometrically as the average of three measurements.ResultsTen days after surgery, the flaps pretreated with the University of Wisconsin solution displayed a vital surface area of 89%, the Euro-Collins solution 23% and the Ringer-Lactate solution 14%. Histologically, muscle tissue proved to be more susceptible to ischaemia than skin.ConclusionRegarding the rectus abdominis flap in a pig model, the University of Wisconsin solution proved superior in the prevention of ischaemic injury compared with the Euro-Collins solution and Ringer Lactate. In accordance with the literature, muscle tissue proved to be more susceptible to ischaemia than skin in our study.

• Primary osteoplasty using calvarian bone in patients with cleft lip, alveolus and palate

  Authors: Wolfgang Eichhorn, Marco Blessmann, Philipp Pohlenz, Felix A.S. Blake, Gerd Gehrke, Rainer Schmelzle, Max Heiland

  Journal of Cranio-Maxillofacial Surgery.

  PurposeThe results of primary bone grafting in terms of initial cleft width, existence or absence of a lateral incisor and scar formation in the donor area are compared.MethodsAfter primaryPurposeThe results of primary bone grafting in terms of initial cleft width, existence or absence of a lateral incisor and scar formation in the donor area are compared.MethodsAfter primary osteoplasty with calvarian bone at an average age of 24 months (4–56 months) radiographic assessment was carried out in 31 patients with 40 alveolar clefts. The bone formation in the grafted area was assessed using dental radiographs taken at 66 months on average (13–114 months) after primary bone grafting. According to the Abyholm classification patients were assigned to 4 groups (indices I–IV) with indices I and II being rated as a success.ResultsWe observed success (indices I and II) in 76% and poor results (index IV) in 14%. The causes for the poor results were an alveolar cleft width of 11–12 mm in three cases, an extraction of a decayed deciduous tooth 17 months after bone grafting in one case and a traumatic transplant loss in another case. The non-existence of a lateral incisor and a broad cleft are related to poor results.ConclusionBased on the results presented, primary bone grafting using calvarial bone seems to be a promising alternative in bridging narrow alveolar defects. This method allows early intervention at an age in which children do not recognize themselves as cleft patients. The preservation of the deciduous teeth is equally important regarding their functional stimulus for bone development.