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At least 271 records · Page 15Linked to original sources
PubMed2003

Augmentation of the narrow traumatized anterior alveolar ridge to facilitate dental implant placement.

Traumatic tooth loss leads to alveolar resorption especially in sagittal direction. This can be due to avulsion of bone substance during the accident itself or due to resorption of the alveolar crest that takes place afterwards. Shortage of bone can prevent proper positioning of dental implants unless the volume of bone is increased before implantation. In the maxillary anterior area, this is also an esthetic problem. Several treatment modalities have been presented to augment the bone. This report reviews the latest literature on bone grafting, bone substitutes, guided bone regeneration, osteocompression and distraction which are potentially useful in the anterior maxilla. A special emphasis is paid to the versatility of using a crestal split osteotomy, by means of chisels and osteotomes to widen the narrow ridge. Three examples are illustrated showing onlay grafting, preservation of alveolar width with alloplastic coral material and lateral widening of a narrow maxillary alveolar ridge, using the crestal splitting technique.

Adult↗
PubMed1995

Case report RS: guided tissue regeneration precedes tooth movement and crossbite correction.

This patient presented with a Class III malocclusion and an anterior crossbite. Although spaces were present distal to the mandibular canines, the alveolar ridges were greatly atrophied. New bone was acquired through guided tissue regeneration. The alveolar ridges were augmented, followed by successful orthodontic tooth movement and correction of the Class III relationship and the anterior crossbite.

Alveolar Process↗
PubMed1996

Alternative donor site for alveolar bone grafting in adults with cleft lip and palate.

Grafting of the alveolar ridge with autogenous bone is an integral stage of contemporary management of complete cleft lip and palate cases. Alveolar bone grafting restores continuity of the dental arch, closes oronasal fistulae, supports the alar base, and facilitates spontaneous eruption of permanent teeth adjacent to the cleft. However, timing of the graft and the selection of materials have been topics of much debate in the literature. This article discusses an alternative donor site in cases where rehabilitation has passed the recommended time. Harvesting bone from the third molar regions allows not only the removal of impacted third molars during the same surgical procedure, but also eliminates the morbidity associated with additional surgical sites such as the ilium or mandibular symphysis. This report should not be interpreted as a recommendation for the use of this alternative site in cases where grafting is carried out within the optimal time period, which is usually in the mixed dentition stage. However, when grafting is necessary in young adults suffering from complete cleft lip and palate, the third molar region may provide another acceptable donor site.

Adolescent↗
PubMed1997

A retrospective comparison of frontal facial dimensions in alveolar-bone-grafted and nongrafted unilateral cleft lip and palate patients.

This retrospective study was undertaken to describe and compare frontal craniofacial dimensions in alveolar-bone-grafted and nongrafted complete unilateral cleft lip and palate (CUCLP) patients and in noncleft subjects with normal occlusions and good facial balance. Clinical data were obtained from the files of the Hospital for Sick Children, Toronto. Patients were eligible for inclusion if they had posteroanterior cephalograms (PA) taken at adulthood and no congenital anomalies other than CUCLP. A total of 86 adult Caucasian CULCP patients were studied, including 58 who had not received grafts, 28 who had received secondary alveolar bone grafts, and, for comparison, 60 noncleft Caucasian adults. The PA cephalometric radiographs were traced, digitized, and measured. Analysis of variance (ANOVA) was used to test for among-groups differences in the means of the ratios, proportions, and angular measures. Tukey-Kramer HSD procedure was used to conduct post-hoc pairwise comparisons following significant (p < or = 0.05) F-ratios from ANOVA. Sexual dimorphism was a common finding, with males demonstrating greater facial width. Despite primary surgical repairs, the anterior nasal spine in the nongrafted CUCLP patients was deviated to the noncleft side, and the alar base was depressed on the cleft side. The maxillary incisors close to the cleft site were irregularly inclined, and this irregularity was more severe in the nongrafted CUCLP patients. The long-term effects of secondary alveolar bone grafting on transverse craniofacial growth appears to be minimal and limited to the immediate area of the cleft.

Adolescent↗
PubMed1998

Case report: forced eruption and implant site development.

It is now possible to use the orthodontic extrusion of periodontally compromised teeth to facilitate the development of a future implant site in an area where the amount of bone in the inciso-apical dimension would otherwise have been inadequate. The purpose of this case report was to analyze the hard and soft tissue changes when forced eruption is used for implant site development.

Adult↗
PubMed2000

Secondary bone graft and eruption of the permanent canine in patients with alveolar clefts: literature review and case report.

This paper emphasizes the important role that secondary bone grafting plays on the treatment of patients with alveolar clefts. The authors present a literature review and, based on panoramic radiographs, retrospectively and longitudinally analyze the behavior of permanent canines after completion of secondary bone grafting in 50 patients at the Hospital for Rehabilitation of Craniofacial Anomalies, University of São Paulo, Brazil. Twelve patients with unilateral cleft lip and alveolus and 38 patients with complete unilateral cleft lip and palate (n = 50) had undergone bone grafts to repair their residual alveolar clefts before the eruption of their permanent canines. These patients were observed over an average period of 3 years. In 94% of the sample (47 patients), the permanent canines presented intra-alveolar movement toward the oral cavity. In 72% of those 47 patients (36 patients), the permanent canines spontaneously erupted through the grafted area. In 6% of the 47 patients (3 patients), the permanent canines required orthodontic traction.

Adolescent↗
PubMed2004

[Post-orthodontic rehabilitation of the sequellae of alveolar clefts: implantation or periodontal plastic surgery?].

Just as they do for many cranio-facial deformities, the treatment team begins the care of cleft palate patients early and continues treatment over a long period. Throughout the growth period, they perform well-timed interventions and re-evaluations according to the individual plan they have prepared. When growth is completed and the orthopedic and orthodontic corrections have contributed as much as possible to an esthetic and functional equilibrium, a final prosthetic replacement will frequently be required. When the correct edentulous space between the teeth on each side of the defect has been created, or maintained, practitioners can choose between two alternatives: implants or traditional fixed bridges. They should analyze any secondary anatomic discrepancies, severe or superficial, that may have developed, and prepare the best therapeutic pathway for a reconstruction of crestal gingival morphology by means of periodontal surgery.

Alveolar Process↗
PubMed2000

Prospective analysis of secondary alveolar bone grafting using computed tomography.

PURPOSE: This study radiographically evaluated the quantity and quality of secondary alveolar bone grafts from the anterior iliac crest to maxillary alveolar clefts in cleft lip and palate patients with the use of computed tomography. PATIENTS AND METHODS: A 1-year prospective study was conducted by using 14 unilateral and bilateral cleft lip and palate patients. Axial and coronal computed tomography (CT) scans were obtained during the immediate postoperative phase and at 1-year follow-up. RESULTS: This study showed that the average alveolar cleft requires a bone graft volume ranging from 0.9 to 3.6 cm3, with a mean volume of 2.10 cm3. The percentage of bone loss derived from the linear dimensional changes to the alveolar bone graft between the immediate postoperative and follow-up CT scans were as follows: 17.9% in maximal bone height, 29.9% in maximal anteroposterior bone width, and 13.7% in maximal transverse width. As compared with the linear measurements, the volumetric analysis showed a disproportional amount of volume loss equaling 43.7% and 42.5% in the coronal and axial studies, respectively. This showed a total average volume loss of 43.1% at approximately 1 year after the secondary alveolar cleft repair. However, as the canine tooth erupts through the bone graft, it can account for up to 53.4% of the total average volume loss. All 14 patients (17 clefts) showed bone bridging between the alveolar cleft radiographically, with good incorporation and maturation of the bone graft, and no recurrence of the oronasal fistula. CONCLUSION: The CT scan is a valuable radiographic imaging modality to assess and follow the clinical outcome of secondary alveolar bone grafting.

Adolescent↗
PubMed2001

Alveolar ridge augmentation by distraction osteogenesis.

Distraction osteogenesis is an alternative method for reconstructing atrophic alveolar bone. Fourteen patients underwent vertical alveolar distraction by the LEAD SYSTEM-Endosseous Alveolar Distraction System (Stryker Leibinger, Kalamazoo, MI). An alveolar segmental osteotomy was carried out and the vertical distraction device was mounted. In patients with an extensive alveolar defect, two distraction devices were placed in order to better control the vector of elongation in both bone edges. The distraction was started on the fourth postoperative day at a rate of 0.8 mm/day for 10-16 days, followed by a consolidation period of 60 days. Vertical distraction osteogenesis (VDO) was completed successfully in all patients with segment lengths in the range of 8 to 13 mm and with an average of 10.3 mm. Subsequently, the devices were removed and 23 threaded titanium dental implants were placed for osteointegration. Earlier mineralization in the vertically distracted area was seen radiographically during the consolidation period. In a follow up of 6-20 months after the distraction, 22 implants were successfully osteointegrated while one implant failed due to improper distracted segment stability. As a result of alveolar distraction, a segment of mature bone was transported vertically in order to lengthen the crest for better implant anchorage, either for aesthetic purposes or for functional prosthetic requirements. The main advantages of VDO are: (1) augmentation of alveolar bone height with new bone formation and simultaneous expansion of the soft tissues; (2) no bone harvesting is necessary; (3) the technique has a lower morbidity rate compared with conventional techniques; (4) it makes the insertion of longer dental implants feasible.

Adolescent↗
PubMed2002

Transport distraction osteogenesis following marginal resection of the mandible.

We performed sliding transport distraction osteogenesis (STDO) of an alveolar segment containing an unerupted third molar in the mandible of a 22-year-old man with a benign cementoblastoma. Marginal mandibulectomy including the tumour and the right mandibular second premolar and first and second molars was done. STDO was performed to horizontally reconstruct the alveolar ridge and to restore occlusion with the use of the third molar. After forward horizontal distraction of the alveolar segment, the third molar spontaneously erupted and was gradually moved to the position previously occupied by the second molar.

Adult↗