Ulrich Joos

University of Münster | WWU · maxillo-facial surgery

Cleft lip and palate (CLP) as a dislocation malformation confronts parents with a malformation of their child that could not be more central and visible: the face. In addition to the stigmatizing appearance, however, in cases of a CLP, food intake, physiological breathing, speech and hearing are also affected. In this paper, the principles of morph...

Physiological processes in facial development show that cleft lip and palate (CLP) malformations are not defect malformations but dislocation malformations. The consideration of these processes and their integration into an operative concept significantly improve the growth of the midface and nose in CLP malformations and outcomes. An understanding...

The conventional surgical procedures for the closure of cleft-lip and palate are based on proven plastic-surgical procedures from tumour surgery or traumatology. These flap surgeries take little account of the fact that the treatment of such malformations takes place during the time of a child's increased growth and is known to lead to pronounced s...

E-learning programmes have become established in postgraduate oral medical education and training. Internet and literature researches show a variety of good concepts that provide an attractive alternative to face-to-face training. What is missing is an overall concept in which continuing education and training are offered in bundled form in various...

The classical treatment of craniosynostosis is based on the fundamental work by Tessier. However, developmental aspects suggest modified osteotomy lines like fronto orbito nasal advancement combined with a modified midfacial distraction. This also makes it possible to take assess the different distances of the anterior displacement of the individua...

Physiologische Abläufe in der Gesichtsentwicklung zeigen, dass es sich bei Lippen‑, Kiefer-, und Gaumenfehlbildungen (LKG-Fehlbildungen) nicht um Defektfehlbildungen, sondern um Dislokationsfehlbildungen handelt. Die Berücksichtigung dieser Abläufe und deren Integration in ein operatives Konzept verbessern deutlich das Wachstum von Mittelgesicht un...

Biomedical science, especially biomaterials, is an expanding field in medicine. Universities are being challenged to gain the best students for a later academic career. Pre-university assessment of pupils has become crucial to reach this aim. Blended learning is an emerging paradigm for science education even though it has not yet been rigorously a...

Purpose: Missing teeth are a major problem in cleft patients, who require specialized prosthetic management, including dental implants. The aim of this review was to investigate the optimal date for implant insertion in patients born with cleft lip and palate after bone grafting and to assess the long-term prognosis of the inserted dental implants...

Background. Recently, government and medical practitioners have shown considerable interest in the discipline of evidence-based medicine. Literature research and results. In this study, we investigated the literature concerning treatment concepts in cleft surgery according to criteria of evidence-based medicine. Over the last decade 996 articles on...

Velopharyngeal insufficiency (VPI) can be caused by a variety of disorders. The most common cause of VPI is the association with cleft palate. The aim of this study was to evaluate the effectiveness of different surgical techniques for cleft palate patients with VPI: 1) velopharyngoplasty with an inferiorly based posterior pharyngeal flap (VPP post...

The present paper describes the structure, realization and evaluation of a blended-learning course on Smart Materials on the basis of the materials science study course for pupils talented and interested in natural science and engineering.

Background Model surgery is an integral part of the planning procedure in orthognathic surgery. Most concepts comprise cutting the dental cast off its socket. The standardized spacer plates of the KD-MMS provide for a non-destructive, reversible and reproducible means of maxillary and/or mandibular plaster cast separation. Methods In the course of...

Background. Comparative studies of different forms of osteosynthesis require that biomechanical and biological criteria be observed. The conditions in experimental studies should be as close as possible to the in vivo situation. The aim of our study was to develop a fracture model that would allow determination of the micromovements in the gap tiss...

Introduction Due to increasing use of disease modifying antirheumatic drugs (DMARDs) as first line therapy in rheumatic diseases, dental and maxillofacial practitioner should be aware of drug related adverse events. Especially effects on bone-metabolism and its cells are discussed controversially. Therefore we investigate the in vitro effect of sho...

Background We describe a procedure for diagnosis and planning for orthognatic surgery based on international standards. A special 2D planning based on lateral cephalograms (Axis Orbital Marker Lines System) realize a transmission to the SAM 2P articulator (3D) by means of the Axis Orbital Plane. Methods Former intraoperative measurement of the ave...

Recent developments and results in the field of mechanical bone stimulation have made it possible to define limits between physiological and non-physiological transmission of strength to the bone. Now it is necessary to investigate the different geometries of dental implants regarding biomechanical reliability. The aim of this study was to examine...

Biomechanische Untersuchungen des Unterkiefers erweisen sich aufgrund seiner komplexen anatomischen Struktur als schwierig. Voraussetzung für eine korrekte rechnerische Rekonstruktion des biomechanischen Verhaltens sind die Herstellung eines geometrisch individuellen Modells sowie die Bestimmung der knochenspezifischen Materialparameter. Ziel unser...

Introduction. The aim of this paper was to evaluate cephalometrically the nasopharyngeal development of patients with complete unilateral cleft lip and palate. Influencing factors were evaluated and cleft to noncleft subjects were compared to each other. Material and Methods. The lateral cephalograms of 66 patients with complete cleft lip and palat...

Introduction. The objective of this investigation was to evaluate the reliability and validity of the NasalView system as a screening tool for hypernasality within the scope of a routine diagnostic procedure in cleft lip and palate patients. Material and Methods. In a collective of 95 patients with cleft and lip palate ranging from 4 to 25 years of...

Head and neck cancer patients are prone to nutritional problems, partly due to the location and size of the disease, due to significant comorbidity and also often therapeutic intervention. Excessive weight loss after surgery reduces further the patients' physical resistibility and increases the complication rate for adjuvant radiation and or chemot...

Melnick-Needles Syndrome (MNS) is a congenital syndrome associated with severe architectural disorder of the skeletal system that can cause significant effects on the craniofacial skeleton including poor aesthetics, impaired speech and masticatory problems. The authors report a case of a female patient who experienced masticatory constraint, hinder...

Zusammenfassung Geschildert wird der Fall eines 58-jährigen Patienten mit progredienter Hypästhesie im Bereich von N. lingualis und N. alveolaris inferior links. Diagnostik und Bildgebung ergaben ein monophasisches Synovialsarkom des pterygomandibulären und infratemporalen Raums mit Destruktion von Unterkiefer und Schädelbasis. Einer neoadjuvanten...

Bone repair is a subject of intensive investigation in reconstructive surgery (for review, see [1]). Current approaches in skeletal reconstructive surgery use biomaterials, autografts or allografts, although restrictions on all these techniques exist. These restrictions include donor site morbidity and donor shortage for autografts [2], immunologic...

In this chapter, biomaterials used as bone-substitutes in alveolar/maxillofacial reconstruction are presented and their properties described.

Orthognathic surgery is associated with side effects including severe postoperative swelling, pain, neurological dysfunction and trismus. The beneficial effects of localised cold treatment on postoperative swelling have been described. Topographical considerations make it difficult to quantify facial swelling. A new and promising method to measure...

Current approaches in bone regeneration combine osteoconductive scaffolds with bioactive cytokines like BMP or VEGF. The idea of our in-vitro trial was to apply VEGF165 in gradient concentrations to an equine collagen carrier and to study pharmacological and morphological characteristics of the complex in a circulation model. Release kinetics of VE...

Tissue engineering and regenerative medicine strategies have gained increased attention in dental implantology, since dental implantology faces new challenges in clinical dentistry. Whereas conventional implant placement and implant loading protocols under ideal anatomical and biological conditions seem to be clinically solved, engineering and rege...

The aim of this retrospective analysis was to evaluate patient and tumor characteristics and treatment results and prognostic factors for patients with craniofacial osteosarcoma (CFOS). The COSS database was searched for patients with previously untreated, histologically confirmed craniofacial osteosarcoma with at least one follow-up examination. I...

Intermediate filaments are involved in cell migration and intracellular signal transduction pathways. In a variety of organs, the expression of distinct intermediary filaments are further associated with distinct steps of malignant transformation. In this study, we seeked to define the cytokeratin (Ck) expression pattern in oral leukoplakia and ora...

Treatments to correct skeletal deformities in patients with hemimandibular hyperplasia differ, particularly about the age at which the operation is done and the operation itself. To some extent, the differences can be attributed to the unknown biological basis of disease. The aim of the present study was to evaluate clinically the outcome of a rati...

Cyclin-dependent kinases (CDKs) and cyclin-dependent kinase inhibitors (CDKIs), such as p21 and p27, exert a direct control on the cell cycle. p21 and p27 are negative regulators of cyclin-dependent kinases and in this function they are negative check-point regulators of the cell cycle. We therefore aimed to evaluate p21 and p27 expression in oral...

Soft tissue sarcomas in the head and neck region are rare and often present a difficult differential diagnosis. The aim of our presentation is to point out the complexity of the diagnosis, treatment and follow up. An eighty-seven year old female patient was referred to our unit with a fast growing brownish lump on the face. Four months beforehand,...

In the PubMed accessible literature, information on the characteristics of interdisciplinary orthodontic and surgical treatment of patients with Apert syndrome is rare. The aim of the present article is threefold: (1) to show the spectrum of the phenotype, in order (2) to elucidate the scope of hindrances to orthodontic treatment, and (3) to demons...

Cleft surgery in infants includes special risks due to the kind of the malformation. These risks can be attributed in part to the age and the weight of the patient. Whereas a lot of studies investigated the long-term facial outcome of cleft surgery depending on the age at operation, less is known about the complications arising during a cleft surge...

The aim of this study was to analyse cleft patients for hypernasality following velopharyngoplasty. 95 subjects (43 females, 52 males) with cleft lip, alveolus and palate (4 - 25 years old) were analysed. Forty-three patients were treated according to the current protocol of the Cleft Palate/Craniofacial Malformations Centre of the Department of Cr...

To describe options and indications for different surgical reconstruction techniques after resection of large skin tumours on the scalp taking into account an interdisciplinary approach of cranio-maxillofacial surgeon, dermatologist, and neurosurgeon, and to evaluate complications and postoperative outcome. From a total of 39 patients with large sk...

Osseointegration of implants is crucial for the long-term success of oral implants. Mineralization of the bone's extracellular matrix as the ultimate step of a mature bone formation is closely related to implant osseointegration. Osteogenesis at oral implants is a complex process, driven by cellular and acellular phenomena. The biological process o...

Heat or auto-cured acrylic resins are materials that are commonly used in splint construction. Newly developed light-cured resins hold promise in view of the altered characteristics of the material. The aim of this study was to evaluate how far light-curing resin-based splints can be used in orthognathic surgery. Over a period of 1 year, 141 orthog...

Melanotic neuroectodermal tumor of infancy (MNTI) is a rare, distinctive neoplasm of early infancy with rapid expansile growth and a high rate of recurrences. Most commonly the lesion affects the maxilla of infants during the first year of life, but it may also occur in the mandible, skull, brain, epididymis, and other rare locations. The origin of...

The clinical behavior of central giant cell granuloma (CGCG) of the jaws is variable and difficult to predict. Clinical data and follow-up information of 26 patients with CGCG were analyzed. Histologic features were correlated with the clinical course of the disease. In 16 patients the CGCGs were asymptomatic; 10 lesions presented with aggressive g...

Surgery in malignant melanoma of the external ear often leads to substantial defects where reconstruction poses a difficult challenge. We describe an option of a one-step ear reconstruction after subtotal ear resection in malignant melanoma surgery. In a patient with a high-risk melanoma of the helical rim, a wide local excision was performed. Beca...

During the last years, implant dentistry has seen an dramatic increase as a treatment option in oral rehabilitation. This is based to a large extent on scientific advances and clinical improvements in implantology. The extension of indications has broadened the opportunities to rehabilitate patients that were formerly considered to possess restrict...

Initial stability of the implant is, in effect, one of the fundamental criteria for obtaining long-term osseointegration. Achieving implant stability depends on the implant-bone relation, the surgical technique and on the microscopic and macroscopic morphology of the implant used. A newly designed parabolic screw-type dental implant system was test...

Intermediary filaments are involved in cell motility and cancer progression. In a variety of organs, the expression of distinct intermediary filaments are associated with patient prognosis. In this study, we seeked to define the prognostic potential of cytokeratin and vimentin expression patterns in squamous cell carcinomas (SCC's) of the oral cavi...

Reduction of the expression of catenin is a crucial step in the pathogenesis, progression and prognosis of many epithelial cancers including squamous cell carcinomas (SCCs). Catenin expression in oral carcinomas was evaluated in relation to clinico-pathological features in order to determine its value as a prognostic marker. Eighty-five patients wi...

Der Osseointegrationsprozess von dentalen Implantaten hängt von der Gewebereaktion an der Implantatgrenzschicht ab. Deren Art und Kinetik werden entscheidend durch das Verhalten von Osteoblasten, die den dynamischen Prozess der Knochenbildung steuern, gegenüber der Oberflächenstruktur beeinflusst. Ziel dieser Studie war es, die Knochenzellreaktione...

Ein großes und oftmals ungelöstes Problem in der Kieferorthopädie ist es, ausgeübte Kräfte zu kompensieren. Dieses erfolgte bisher über Verblockung von Zähnen oder durch extraorale Fixierungen. Es war nicht möglich, einzelne Zahnsegmente zu verschieben, ohne im Abstützungssegment ebenfalls eine Verschiebung vorzunehmen. Die Zahl erwachsener Patient...

Aggressive fibromatosis (AF) involving bones of the head is rare and surgery is often complicated by a high recurrence rate. Interdisciplinary treatment is of the utmost importance to avoid extensive, mutilating resection. Two cases emphasize the difficulties in the management. A 67-year-old woman was referred to our unit with a blepharochalasis of...

Background Aggressive fibromatosis (AF) involving bones of the head is rare and surgery is often complicated by a high recurrence rate. Interdisciplinary treatment is of the utmost importance to avoid extensive, mutilating resection. Two cases emphasize the difficulties in the management. Case reports A 67-year-old woman was referred to our unit wi...

The influence of the osteotome technique on the interface reaction of cylinder implants (SLA, ITI) was compared with the interface reaction of conventional implant insertion in an animal model. A total of 64 implants were placed in the cranial and caudal tibia of 8 Göttinger minipigs. The implant site was prepared either by a conventional technique...

The delivery of an adequate amount of blood to the tissue capillaries for normal functioning of the organ is the primary purpose of the vascular system. Preserving the viability of the soft tissue segment depends on the soft tissue incision being properly designed in order to prevent impairment of the circulation. A knowledge of the course of the v...

Although the bone's capability of dental implant osseointegration has clinically been utilised as early as in the Gallo-Roman population, the specific mechanisms for the emergence and maintenance of peri-implant bone under functional load have not been identified. Here we show that under immediate loading of specially designed dental implants with...

Various conservative methods for treatment of labial swelling in patients with cheilitis granulomatosa have been attempted, often with only moderate success and sometimes with persistent disfiguring lip swelling. Severe macrocheilia can produce an unaesthetic facial deformity associated with functional disturbances. In patients with persistent macr...

The aim of this study was to investigate the influence of controlled release of recombinant human vascular endothelial growth factor (rhVEGF(165)) on angiogenesis and osteogenesis in a mandibular defect model. A total of 56 rabbits were operated and bicortical holes were placed at the lower border of the mandible. The defects were filled with type-...

Besides the color of the teeth the color of the alveolar gingiva plays a crucial role in esthetic rehabilitation in dento-alveolar treatment. Whereas nowadays the color of the teeth can be determined exactly and individually, the specific influence of the red color of the gingiva on treatment has not been assessed yet. The aim of this study was to...

Hypoxia-inducible factor 1 (HIF-1) is a transcription factor, which plays a central role in biologic processes under hypoxic conditions, especially concerning tumour angiogenesis. HIF-1alpha is the relevant, oxygen-dependent subunit and its overexpression has been associated with a poor prognosis in a variety of malignant tumours. Therefore, HIF-1a...

There is an ongoing controversy about indications for prophylactic removal of third molars. The purpose of this retrospective study was to clarify the risk of preservation of lower third molars. In a 5-year period, 316 patients were registered who had received in-patient treatment for deep abscess formation, cyst formation or mandibular angle fract...

This study was designed to evaluate prognostic parameters for respiratory failure after major oropharyngeal resections in head and neck cancer surgery, focusing on a score system to identify patients requiring an elective tracheotomy and to avoid tracheotomy under emergency conditions. One hundred and fifty-two out of 928 patients with oropharyngea...

Besides its immunoregulatory effects, interleukin-4 (IL-4) has growth inhibitory activity on cells from human solid tumors, and IL-4 receptors are present on tumor cells including cells from head and neck squamous cell carcinomas. We have conducted a phase I/II trial in patients with oral squamous cell carcinomas of T(4), N(+) (1 exception) stage t...

Mechanische Einflüsse sind bekannte Größen für das Knochenremodelling an der Knochen-Implantat-Grenzfläche. Es besteh