Paul Stoelinga

Radboud University | RU · oral and maxillofacial surgery

Follow-up studies on odontogenic keratocysts have reported widely varying recurrence rates. This raises the question of how reliable these studies are and how the results should be interpreted. The aim of this study was to critically assess the information from all follow-up studies published since 2004 against a set of criteria to determine how th...

Introduction The aim of this study was to review the literature on extra-osseous odontogenic keratocysts, and to present the best possible approach to these lesions. Material and methods A comprehensive literature search was performed using the strategy: (keratocyst) and (soft tissue)). A total of 25 articles were included, 20 reported on extra-os...

The treatment of odontogenic keratocysts is reviewed in light of the aetiology and pathogenesis of these lesions. The role of the dental lamina and submucosal hamartias, as frequently seen in nevoid basal cell carcinoma syndrome, is discussed, and the implications for treatment are emphasized.

Introduction This meta-analysis provides reliable data on the prevalence of unicystic ameloblastomas (UA's) among solid/multicystic ameloblastomas (SMA's), as well the ratio of their presence in the maxilla and mandible and in the tooth-bearing area versus the posterior regions of the mandible, including the third molar region and ascending ramus....

Aim The odontogenic keratocyst (OKC) is a potentially aggressive odontogenic lesion and there is an ongoing debate regarding its biological behavior and classification. The present systematic review aims to assess the expression of the p53 protein in the odontogenic keratocyst in comparison to the dentigerous cyst and ameloblastoma. Materials and...

Giant Cell Tumors (GCTs) are rare benign neoplasms that typically occur at the epiphyses of long bones in the extremities. Very rare is the occurrence of those lesions in the skull, where they show a tendency for significant bone destruction and local recurrence. We present a case of a 36-year-old woman that presented with right pre-auricular swell...

A comprehensive literature review identified 10 reported cases of recurrent odontogenic keratocysts (OKCs) in bone grafts. Seven of them were sufficiently documented for further analysis. All except one of the patients had a long history of repeated recurrences. They were all approached via an extraoral route, avoiding a mucosal perforation, when t...

A technique is described to reconstruct the symphyseal part of the mandible after a segmental resection because of ameloblastoma, while special attention was paid to fix the digastric and genioglossal muscles, so as to allow for normal tongue function. Twenty-two patients were followed for an average period of 30 months and all of them had normal t...

Aim To gain insight in the actual ratio of recurrent odontogenic keratocysts (OKCs) occurring in the tooth‐bearing area as compared to the posterior region of the mandible in order to come up with reliable data to base upon a rational treatment policy. Material and Methods We searched MEDLINE, Web of Science, Scopus, Cochrane Library and Google Sc...

Purpose This study was conducted in order to gain insight in the actual ratio of odontogenic keratocysts occurring in the tooth-bearing area as compared to the posterior region of the jaws in order to come up with reliable data to base upon a rational treatment policy. Methods We searched MEDLINE, Web of Science, Scopus, and Cochrane databases for...

Purpose This study was conducted in order to determine whether marsupialization before definitive enucleation of nonsyndromic odontogenic keratocysts (OKCs) is capable of decreasing the recurrence rate more effectively than just enucleation. Methods We searched MEDLINE, Web of Science, Scopus, and Cochrane Library, until August 5th of 2017 for ori...

The persistent view in the literature is that the relative frequency of ameloblastomas is higher in the black population than in Caucasians. The aim of this study was to determine the relative frequency of all odontogenic tumours (OT) in a 100% black population and to compare our findings with those of previous studies. A prospective study was unde...

Changes in cross-sectional area (CSA), volume (indicating muscle strength), and direction of the masseter and medial pterygoid muscles after surgical mandibular advancement were measured, along with the rotation of the condyles after bilateral sagittal split osteotomies (BSSOs) to advance the mandible. Measurements were done on magnetic resonance i...

Simon van Creveld received both the MD and PhD degrees and had a multifaceted medical and scientific education at many hospitals and research institutes in the Netherlands, Germany, and the UK. He and his wife were the first to develop insulin for the Netherlands. His major interests were in hemophilia and hemorrhagic disorders, which accounted for...

The results of a retrospective study on 24 patients who underwent a Le Fort I osteotomy to improve the condition for implant insertion are presented. They all had an edentulous maxilla, Cawood and Howell class VI. Bone grafts were taken from the anterior or posterior iliac crest and implants were placed between 3 and 6 months after the osteotomy. T...

We present the preliminary results of a study involving a group of consecutive patients who underwent lower border onlay grafting, limited to the symphyseal area, in preparation for implant insertion. This technique allows for maximum-sized implants, followed by prosthetic rehabilitation. The main advantage of this method is the minimal risk of dam...

The results are reported of a clinical follow-up study on 32 selected but consecutive patients with mandibular ameloblastoma. They were all treated by a segmental resection and reconstructed, using two 2.3 mm reconstruction plates and an autogenous particulate bone graft, taken from the anterior iliac crest, and platelet rich plasma. Follow-up rang...

There are essentially six types of aggressive cysts of the jaws that require special attention, so as to avoid recurrence, or even worse, widespread disease. They include, botryoid cysts, cysts in which carcinoma's arise, glandular odontogenic cysts, calcifying cystic odontogenic tumour, previously called calcifying odontogenic cyst and unicystic a...

A previous report from the authors' department showed that a modified alar cinch suture combined with a muco-musculo-periosteal V-Y closure (mACVY) improves nasolabial mobility. To test if the improvements were equal to the range of nasolabial mobility in non-dysgnathic persons, a prospective study was carried out in 56 patients: 31 with mACVY, 25...

The present study provides an inventory of the number of fractures that occurred in conjunction with implant placement in edentulous patients in the Dutch population from 1980 to 2007 and estimates the incidence with which this might occur. The study also sought to define the factors that increase the risk of fracture. Questionnaires were sent to a...

The authors emphasize the primary healing of bone grafts as opposed to creeping substitution and its significance with regard to the use of bone grafts for pre-implant surgery. Various types of bone grafts are described, including particulate grafts and block grafts, taken either from the mandible or distant sites. The application of these grafts i...

The purpose of this study was to determine whether a modified alar cinch suture and V-Y closure (mACVY) have a beneficial effect on labial form after Le Fort I intrusion and advancement osteotomies and whether they result in excessive upward nasal tip rotation. Both are possible effects compared with simple closing sutures (SCS). A prospective stud...

Surface modification of titanium alloy implants to enhance soft tissue adherence is important to minimize soft tissue dehiscence. This study aimed to confirm if a dual acid etched "Osseotite®" titanium surface contributes to soft tissue adherence in muscle. It also aims to explore if a radio frequency magnetron sputtered hydroxyapatite (HA)/bioglas...

The aim of this study was to evaluate the effects of standardized platelet-rich plasma (PRP) concentrates from 10 human donors on cellular behavior. The standardized PRPs used were fivefold average and fivefold maximum baseline values in whole blood. Both these standardized PRPs were characterized by determining platelet numbers and subsequently gr...

The purpose of this retrospective study was to evaluate a group of 20 patients who underwent a reconstruction of the mandible by use of free bone grafts and platelet-rich plasma (PRP). In a period of 8 years, 20 patients underwent a reconstruction of the mandible, by use of preshaped 2.3-mm titanium plates, autogenous cortical bone plates, autogeno...

To assess, using cone-beam computed tomography and histologic examination, whether the fixation of a condyle-ascending ramus mandibular modular endoprosthesis results in a physiologic condylar replacement in Macaca fascicularis. The right condyle and ascending ramus were resected in 8 adult monkeys and replaced with a modular endoprosthesis, fixed...

To assess whether the fixation of a condyle-ascending ramus mandibular modular endoprosthesis, using bone cement, will result in stress-related bone resorption in the Macaca fascicularis. The right condyle and ascending ramus were resected in 8 adult monkeys and replaced by a modular endoprosthesis, fixed with polymethylmethacrylate bone cement (Pa...

Platelet-rich plasma (PRP), containing various growth factors, may speed up wound and bone healing. Using osteoconductive alloplastic materials in reconstructive surgery, the amount of autogenous bone needed can be reduced. The purpose of this experiment was to study the effect of PRP on a mixture of autogenous bone and deproteinized bovine bone mi...

The present study presents the microcomputed tomographic and histologic evaluation of the peri-implant tissues of a modular endoprosthesis used to replace the condyle and ascending ramus in Macaca fascicularis. The right condyle and ascending ramus were resected in 8 adult monkeys and replaced by a modular endoprosthesis, fixed with polymethylmetha...

COLLOSS E, an equine extracellular matrix product containing native transforming growth factor beta1 and several bone morphogenetic proteins, has shown osteoinductive properties in ectopic sites. This study was set up to examine its properties in an orthotoptic site in conjunction with a beta-tricalciumphosphate (beta-TCP) scaffolding material. Thi...

In this study, the suitability of mineralized collagen, as a carrier for the native bone morphogenetic protein containing product COLLOSS(®)E, was evaluated in a rat subcutaneous implantation model. Tubular-shaped scaffolds were made from mineralized collagen and were left empty (controls), filled with 40 mg COLLOSS(®)E, or filled with a mixture of...

The results on 32 consecutive patients, who underwent bone grafting prior to implant surgery, are presented. The grafts were taken from the horizontal part of the mandible, including the full height of the buccal cortico-cancellous plate and were used to reconstruct alveolar defects or to augment sinus floors. 3-5 months postoperatively, 99 implant...

To evaluate the feasibility of replacing the condyle and ascending ramus with a novel modular endoprosthesis in Macaca fascicularis. Eight male adult monkeys (Macaca fascicularis) were used in this study. The right condyle and ascending ramus posterior to the lower second molar were resected. An endoprosthesis consisting of 2 modules was inserted t...

Complications and failures are unavoidable in dentoalveolar surgery, but can be reduced if treatment is carried out in the proper manner. Yet, one has to accept a certain percentage of complications and failures and the patient should be informed about that prior to surgery. Complications become reproachable when insufficient diagnostic procedures...

The aim of this study was to assess the release of metal elements from a Ti6Al4V modular endoprosthesis for mandibular reconstruction. Ten monkeys were included, seven of the animals had an endoprosthesis inserted and three served as controls. Mucosa, regional lymph nodes and distant organs, were assessed after the implant had been in place for 12...

Adverse effects on the soft tissues after Le Fort I osteotomies include: broadening of the alar base, loss of vermilion show of the upper lip and down sloping of the commissures. In theory, an alar cinch suture combined with a muco-musculo-periosteal V-Y closure (ACVY) should improve not only the nasal width, but would also improve the dynamics of...

In this study, the growth factors in COLLOSSE were analyzed, using ELISA tests, mass spectrometry, western blotting, and a 24-day cell culture experiment using osteoblast-like cells. The results of the ELISA testing, mass spectrometry, and western blotting all confirmed that TGF-beta1 was the main growth factor in COLLOSSE at 55 ng/mg. The results...

Destruction of bone by tumour is caused by osteoclasts rather than by tumour cells directly. Tumour cells of invasive oral squamous cell carcinomas (SCC) release osteoclast-related cytokines and cytokines activate osteoclasts. The purpose of this study was to investigate the possibility of predicting mandibular invasion by SCC by analysis of the ex...

In irradiated bone, a method assessing vascularity of intended implant recipient bone would be of clinical significance in preventing early implant loss and in reducing the risk of osteoradionecrosis due to surgical oral implant insertion. At present, assessing bone vascularity clinically, using laser Doppler flowmetry (LDF), seems to be realistic....

This paper presents the results of an animal experiment, in which a modular endoprosthesis is tested to replace a resected part of the mandible. The prostheses were fixed with polymethacrylate (PMMA) cement into the medullar space of the stumps. Clinical, radiologic, micro-computed tomographic and histologic evaluations were made after 3 and 6 mont...

Doel van het vrijleggen van geretineerde of geïmpacteerde elementen is de doorbraak van zo’n element te bevorderen. In de meeste gevallen is de asrichting van het element enigszins afwijkend en is er een benige weerstand die de doorbraak verhindert. In sommige gevallen vindt het erupterende element een buurelement op zijn weg, of zelfs een overtall...

Na elke chirurgische ingreep treedt een lokale reactie op die wordt gekenmerkt door zwelling en pijn. Deze verschijnselen worden veroorzaakt door een traumatische ontstekingsreactie. De aard, omvang en vermoedelijk ook de tijdsduur van de ingreep bepalen in hoge mate de intensiteit van deze lokale reactie.

Perifere tumortjes die voor verwijdering in aanmerking komen in de algemene tandheelkundige praktijk, zijn fibromen, papillomen, epulides en kleine mucoke`les. In het algemeen zijn dit goed herkenbare afwijkingen waarbij het risico van een verkeerde diagnose gering is. Desalniettemin is een goede diagnostiek gewenst, die begint met een nauwkeurige...

In het algemeen zijn er drie situaties waarin men in de algemene praktijk geconfronteerd wordt met achtergebleven wortelresten.

Iedereen heeft een frenulum labii superioris en inferioris, maar er bestaan grote individuele verschillen met betrekking tot afmeting en het niveau van aanhechting. Een laag aangehecht en hypertrofisch frenulum labii superioris kan een rol spelen bij de persistentie van een centraal diasteem in de bovenkaak.

Complications and failures are unavoidable in dentoalveolar surgery, but can be reduced if treatment is carried out in the proper manner. Yet, one has to accept a certain percentage of complications and failures and the patient should be informed about that prior to surgery. Complications become reproachable when insufficient diagnostic procedures...

Verstandskiezen komen bij ongeveer 75% van de bevolking in boven- en onderkaak voor. Een patiënt kan er vier, drie, twee of een hebben en zelfs vierde molaren worden gezien. Tot voor kort werd ervan uitgegaan dat alle verstandskiezen een potentieel risico vormen en dat ze dus verwijderd dienen te worden. In 1979 werd door het National Institute of...

Een element dat niet doorbreekt in het te verwachten tijdsbestek, kan worden beschouwd als geretineerd of geïmpacteerd.

Het woord apexresectie is overgebleven uit het verleden, toen er nog onvoldoende inzicht bestond over de pathogenese van periapicale aandoeningen. In oude boeken over mond- en kaakchirurgie, zoals van Wassmund (1935) maar ook van Thoma (1963) en Archer (1966) wordt de nadruk nog gelegd op de resectie van ongeveer een derde deel van de wortel en ver...

Het spreekt vanzelf dat voor elke operatie goede en voor die ingreep geschikte instrumenten aanwezig moeten zijn. Het is aanbevelenswaardig een basisset samen te stellen van die instrumenten die vrijwel altijd nodig zijn (figuur 2.1).

De frequentie waarmee medische noodsituaties in de algemene tandheelkundige praktijk voorkomen, is niet zo groot. Uit een groot onderzoek onder tandartsen-algemeen practici in het Verenigd Koninkrijk bleek dat de prevalentie varieert van één geval per 3,6 tot 4,5 praktijkjaren. Gevallen met dodelijke afloop zijn extreem zeldzaam. Uit hetzelfde onde...

Vanaf de vroege kinderjaren staat de dentitie bloot aan traumata. Onderzoeken in Denemarken hebben uitgewezen dat in de melkdentitie bij 31 tot 40% van de jongens en 16 tot 20% van de meisjes een trauma heeft plaatsgevonden. Bij het permanente gebit variëren deze getallen van 12 tot 33% bij jongens en van 4 tot 19% bij meisjes. De meerderheid van d...

Chirurgische ingrepen gaan altijd, in meer of mindere mate, gepaard met enige zwelling, pijn, koorts en functiebeperkingen. Die zijn het gevolg van een normale weefselreactie die tot doel heeft de homeostase te handhaven en tevens de aanzet is voor de wondgenezing. Vanzelfsprekend neemt de kans op deze verschijnselen toe naarmate er bij de ingreep...

In veel tandheelkundige opleidingsklinieken in binnen- en buitenland wordt gebruikgemaakt van gezondheidsevaluatieformulieren, ook wel medisch-risicoregistrerende anamneselijst genoemd. Dat is op zich een goede manier om zich te oriënteren over de conditie van de patiënt, maar men moet zich wel realiseren dat vóór elke behandeling een actualisatie...

Exostosen van de processus alveolaris of torus mandibularis en palatinus hebben gewoonlijk geen klinische betekenis, tenzij de omvang zo groot wordt dat ze hinderlijk worden bij het eten of spreken. Dat laatste is vooral het geval bij een uitgesproken torus mandibularis, waarbij gemakkelijk voedselresten kunnen achterblijven onder de ondersnijding...

Prothese fibromen, flabby ridges en in mindere mate fibreuze tubera zijn een gevolg van voortschrijdende resorptie van de processus alveolaris en een slecht passende gebitsprothese.

Het doel van een chirurgische ingreep in de mond is in de meeste gevallen het verwijderen van weefsel of gebitselementen. Daarbij is het nodig een toegang te verkrijgen via een incisie van de bedekkende mucosa of het mucoperiost.

This review aimed to evaluate the level of evidence for bone augmentation preimplant surgery for atrophic jaws in studies which measure outcome. Medline, Embase, Cochrane library and online journal searches were performed with a defined search strategy and the abstracts screened against selection criteria. The resultant papers were sorted by study...

The use of a mandibular modular endoprosthesis after segmental resection of part of the body of the mandible was studied. This preliminary study was carried out on four pigs and four monkeys. The devices were made of a titanium alloy and were cemented in the prepared medullary spaces with polymethylmetacrylate cement. The prosthesis failed in one p...

Because the survival of endosseous implants in irradiated bone is lower than in non-irradiated bone, particularly if the irradiation dose exceeds 50Gy, a study was carried out to assess the irradiation dose in the anterior mandible, when intensity modulated radiation therapy (IMRT) is used. The hypothesis was that adequate IMRT planning in orophary...

A new syndrome is described, affecting four persons in one family; it includes multiple non-erupting teeth with cementum defects, hypoplasia of the alveolar process and the maxillo-zygomatical region, genua valga and ear deformities. An autosomal recessive trait could be ascertained.

Mandibular defects may result from trauma, inflammatory disease and benign or malignant tumours. Mastication, speech and facial aesthetics are often severely compromised without reconstruction. The goal of mandibular reconstruction is to restore facial form and function, implying repair of mandibular continuity and muscle attachments. There should...

The aim of this study was to determine the optimal combination of preoperative examination methods to predict mandibular invasion by squamous cell carcinoma of the oral cavity. Data were gathered prospectively but evaluated retrospectively. The preoperative results of clinical examination, conventional radiography, bone single photon emission compu...

The effect of platelet-rich plasma (PRP) on bone formation was investigated in a rabbit segmental radial defect model. The purpose of the study was to evaluate the bone inductive properties of PRP with titanium fiber mesh and autologous bone chips in a 15-mm rabbit radial defect model. Eighteen New Zealand white rabbits were divided into three grou...

The objective of this study was to determine the value of dynamic contrast-enhanced MRI (DCE-MRI) for the preoperative assessment of mandibular invasion in squamous cell carcinomas (SCC), adjacent or fixed to the mandible. DCE-MRI was performed with gadolinium diethylene triamine pentaacetic acid (Gd-DTPA). Data were obtained from 25 patients. From...

Skull defects usually create aesthetic and functional disturbances to the patient. These defects are currently reconstructed by using computer-aided design and manufacturing processes. Classification of skull defects becomes important in discussing the complexity of reconstruction in clinical practice or comparing clinical results in scientific art...

Primary implant stability is related to local bone density. After insertion of an implant, implant stability is subject to changes due to bone remodeling. In patients who have undergone radiotherapy in the head and neck region, implant stability is impaired because irradiation reduces bone vitality. The current study was designed to monitor and tes...

The aim of this retrospective, mixed longitudinal study was to assess the long-term outcome of early secondary closure and premaxilla osteotomy in 40 bilateral cleft lip and palate patients who underwent early secondary osteotomy of the premaxilla and bone grafting at the age of 8-12 years. Clinical and cephalometric evaluations of profile, lip rel...

A simple, modified method to evaluate changes in the nasolabial soft tissues after orthognathic surgery is presented. Eighteen healthy volunteers were photographed in a standardized manner with a 2-month interval. Pictures were taken with the soft tissues in repose and 'maximum closed mouth smile'. Discrepancies for repose and dynamic exc...

The purpose of this animal study was to confirm that laser Doppler flowmetry (LDF) is a reproducible method for the assessment of maxillary and mandibular alveolar bone vascularity and that there is less vascularity in irradiated mandibular and maxillary bone compared to nonirradiated bone. All maxillary and mandibular premolars and molars of 6 Göt...

Four round critical-size defects were made in the foreheads of 20 goats. The defects were filled with autogenous particulate cancellous bone, in which 1 ml of platelet-rich plasma (PRP) was added in two of the four defects of each goat. The goats were divided into four subgroups of five goats each, which were killed after 1, 2, 6 and 12 weeks. The...

The early effect of platelet-rich plasma (PRP) on bone regeneration in combination with dense biphasic hydroxyl apatite (HA)/beta-tricalcium phosphate (TCP) particles (ratio 60%/40%) was evaluated in rat cranial defects with a diameter of 6.2 mm. We hypothesize that PRP exerts its beneficial effect on bone regeneration within the first and second w...