PubMed · 4593428
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E Krüger. 1974-01-10. [Preprosthetic surgery].. https://pubmed.ncbi.nlm.nih.gov/4593428/
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KEEP EXPLORING
For closure of the cleft alveolus usually a choice between a bone graft from the chin or from the iliac crest is made. In the department of Oral and Maxillofacial Surgery of the University Hospital Groningen harvesting of bone from the iliac crest was performed with an open technique. From the results of an earlier study on the morbidity of this procedure until June 1997 it was found that in 26.1% of the cases a contour defect could be observed in the donor region. The mean width of the mature scar was 5.0 +/- 2.4 mm (range 1-10 mm). Especially these findings and the wish to further reduce postoperative pain led the University Hospital to start harvesting iliac crest bone grafts with a trephine in june 1997. In the period june 1997 through december 1999 iliac crest bone grafts were harvested in 28 cleft lip and palate patients (mean age 10.5 years; range 8-12 years) with this trephine technique. The scars were smaller in +/- 0.3 both length (mean 15 +/- 1.5 mm; range 11-24 mm) and width (mean 1.5 +/- 0.3 mm; range 1-3.5 mm). No contour defects and sensory loss occurred. Postoperative pain could adequately be relieved by local infiltration of the donor area with a 0.25% marcaïne solution and analgetics. On the first day post surgery all patients could be mobilised without problems. Based on these findings and recent literature it can be concluded that the use of the trephine is the method of choice for harvesting iliac crest bone in cleft lip and palate patients. Only when large amounts of bone, a bone block or a piece of cortical bone is needed, the open technique should be used.
STUDY: In this study 24 patients with tumours of the mandible, mandibular resection, neck dissection and reconstruction by microvascular iliac crest (13) or scapula transplants (11) were examined following implantological treatment. RESULTS: In all patients the implantological examination was performed on average two years and five months after implant insertion. This allowed for observation of periotest values, periimplant probing depth and sulcus bleeding (SBI). Furthermore, the loss of periimplant bone was registered radiologically. In both groups periotest values were normal. In the group with scapular transplants the mean periotest value was -3.2 and in the other group -0.8. Pathological probing depth was registered in both groups and sulcus bleeding was similar. The loss of periimplant crestal bone was similar in both groups, too. DISCUSSION: It can thus be concluded that perimimplant conditions were equal in both groups two years after implant loading. The stability of implants in scapula transplants was higher than in iliac crest transplants.
Bimaxillary protrusion and severe labioversion of anterior teeth complicate impression procedures and increase the difficulty in making esthetic predictions for the immediate complete denture patient. The presented technique, performed in reverse order of traditional methods, is accomplished in stages in which the anterior and nonessential posterior teeth are extracted and interim removable partial dentures placed. An opportunity is thus created to evaluate esthetics, phonetics, and anterior tooth function before extraction of the remaining dentition and delivery of immediate complete dentures. This technique facilitated the determination of the need for alveoplasty of the anterior maxilla.