[Tooth extraction for alveolectomy].
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Alveolectomy↗
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Alveolectomy; modification of current technique.
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Humans↗
[Cases treated with external alveolectomy].
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Tooth Root↗
Surgical management of hard palate malignancies.
OBJECTIVE: A variety of surgical procedures can be used to treat malignancies of the hard palate and inferior maxilla. This study was designed to evaluate the efficacy of alveolectomy, palatectomy, and infrastructure maxillectomy in the treatment of cancers in these areas. METHODS AND MATERIAL: A retrospective review of 50 patients who underwent alveolectomy, palatectomy, or infrastructure maxillectomy from 1971 to 1997 was performed. The pathology of these lesions included squamous cell carcinoma (25), adenoid cystic carcinoma (11), adenocarcinoma (6), and others (8). RESULTS: The 5-year survival rate by Kaplan-Meier analysis for all lesions was 85%. The 5-year survival rate for squamous cell carcinoma was 76%, and that for adenoid cystic carcinoma was 90%. The 10-year survival rate for adenoid cystic carcinoma was 75%. There was minimal morbidity associated with these procedures. DISCUSSION: Alveolectomy, palatectomy, and infrastructure maxillectomy are the procedures of choice for lesions in the region of the hard palate. The differences between these surgical techniques are presented, and indications, contraindications, and results for each technique are discussed.
Adenocarcinoma↗
Preprosthetic surgery.
Several of the abnormal conditions existing in the edentulous patient can be corrected surgically, prior to construction of dentures, to enable the patient to function more successfully following prosthetic restoration. The more common problems have been discussed which often require surgical correction. In some instances, articulated diagnostic models of the patient's mouth show that surgery can be avoided, or when surgery is necessary, these models help identify the exact locations of the tissue to be corrected. Alveolectomy has been presented with an eye toward conservatism since this procedure affects the quality of denture foundation and therefore denture stability. Alveolectomy should be performed only when there is a definite indication for the procedure. Correction of soft tissue abnormalities can substantially improve the patient's ability to function with dentures and solve many of the adjustment problems which confront the dentist. It is often better to correct the soft tissue abnormality rather than to circumvent the problem with an inferior prosthetic restoration. Since the introduction of resilient acrylics and tissue conditioning materials, the patient need no longer suffer the discomfort of denture withdrawal after surgery. Electrosurgery has emerged as a successful method of correcting many soft tissue abnormalities. Vestibuloplasty is receiving much emphasis as a possible treatment for atrophic ridges in which there is still enough alveolar bone from which to extend a sulcus. These sulcus extension procedures may offer some help in the future regarding the problem of resorbed ridges, but presently, more research is necessary before widespread use is recommended.
Alveoloplasty↗
Hyperbaric oxygen treatment of osteoradionecrosis of the mandible with repeated pathologic fracture. Report of a case.
Treatment of patients with osteoradionecrosis of the mandible with a pathologic fracture consists in almost all cases of a continuity resection of the mandible. This leads to functional and esthetic problems that can only be solved by often extensive surgery. In this case report we present a 38-year-old woman who developed osteoradionecrosis of the mandible with a pathologic fracture 1 1/2 years after combined surgical and radiation therapy of an adenocarcinoma of the right parotid gland. The patient had a subcondylar pathologic fracture together with osteolysis in the right mandibular body, normally an indication for partial resection of the mandible. Because of the absence of denuded bone, fistulation, and the poor quality of the surrounding soft tissues, a more conservative approach was chosen. Treatment consisted of hyperbaric oxygen and dental extractions with alveolectomy with the patient under local anesthesia. During follow-up, a second pathologic fracture occurred in the region of the right first and second molar. No additional treatment was given. Six and one-half years after the initial treatment and 5 1/2 years after the last fracture, the patient is free of complaints, the fractures have healed and both esthetic and functional results are good.
Adenocarcinoma↗
The effect of tramadol on dento-alveolar surgical pain.
The aim of the study was to assess the analgesic effect of tramadol in the relief of pain after dentoalveolar operations that involve the removal of bone and suturing. Four-hundred and fifty-two patients over the age of 18 years who were to undergo removal of impacted teeth (n = 362), removal of root (n = 79), or alveolectomy, enucleation of cysts, or removal of soft tissue (n = 11) under local anesthesia were studied. Patients were randomly allocated to receive tramadol 100 mg or 50 mg four times daily, or 50 mg twice daily, or placebo. Median pain scores on the day of operation in the three tramadol groups were similar (2 in each group, ranges 1-5, 1-4.8, and 1-5 respectively) and were all significantly lower than that in the placebo group (2.3 range 1-4.2). The median number of Paracetamol tablets taken by patients in the three tramadol groups was 2 (ranges 0-8, 0-12 and 0-8 respectively), and were all significantly less than in the placebo group (4, range 0-12). More patients given tramadol reported complete pain relief than the placebo group. The advantages of tramadol continued over the next 2 days. There were no serious or unexpected adverse effects. It is concluded that tramadol is an effective analgesic after dentoalveolar operations.
Acetaminophen↗
Porous hydroxyapatite as a bone graft substitute in alveolar ridge augmentation: a histometric study.
Following bilateral alveolectomy, the ridge form was restored in 10 dogs with blocks of porous HA matrix and bicortical iliac autografts. The specimens were retrieved after 11 to 17 months and undecalcified sections were prepared for microscopy and histometry. Within the HA implants, bone ingrowth extended throughout the pores. This bone appeared mature and well vascularized. The autografts united to the mandible. However bone ingrowth into the cancellous spaces of the grafts was minimal or absent. Measurement of implant and graft cross-sectional areas showed the maintenance of alveolar ridge form to be equally permanent for the 2 materials over the 1.5 year duration of the study. The implant specimens were composed of 43.1% HA matrix, 45.2% bone and 11.7% soft tissue. The HA matrix had a surface area averaging 9.3 mm2/mm3 that was 91.1% covered with bone ingrowth. Although this study supported the thesis that a porous HA matrix can function as a bone graft substitute, it is noted that the unyielding nature of the implant blocks, compared to granules, requires a solution to the challenge of long-term denture support without ulceration before it can be used with clinical confidence.
Alveolar Ridge Augmentation↗
Preliminary evaluation of hydroxyapatite cement as an augmentation device in the edentulous atrophic canine mandible.
OBJECTIVE: The purpose of this study was to answer the following two questions: (1) Can hydroxyapatite cement in combination with demineralized freeze dried bone feasibly augment the dimension of an atrophic edentulous canine mandible? (2) What is the histologic fate of an augmentation graft composed of hydroxyapatite cement and demineralized freeze dried bone placed on the surface of an atrophic edentulous canine mandible? STUDY DESIGN: Each of four mixed-breed canines (weighing 50 to 60 pounds) underwent bilateral mandibular dental extraction (canine to second molar) and radical alveolectomy. After 4 months of healing, a bilateral subperiosteal mandibular augmentation graft was put into place, with hydroxyapatite cement/demineralized freeze dried bone on the surface of one hemimandible and porous granular hydroxyapatite and demineralized freeze dried bone on the surface of the other hemimandible. The animals were killed after functioning on a soft diet for 9 months, and the grafted hemimandibles were harvested. RESULTS: Both hydroxyapatite cement and granular hydroxyapatite grafts appeared to augment the edentulous atrophic canine mandible. On histologic exam, the hydroxyapatite cement grafts showed osteoconduction and subperiosteal and endosteal osteonal bone formation, whereas the granular hydroxyapatite grafts showed only osteoconduction. Neither graft material showed chronic or acute inflammation. CONCLUSION: Hydroxyapatite cement can function feasibly as a mandibular augmentation device. The histologic fate of hydroxyapatite cement is different from that of granular hydroxyapatite. It has a fate comparable to autograft or allograft cortical bone grafts.
Alveolar Ridge Augmentation↗
Lingual approach for surgical extraction of the mandibular canine tooth in dogs and cats.
A lingual approach for surgical extraction of the mandibular canine tooth was developed based on anatomic observations of tissues and structures of the rostral mandible and lingual orientation of the mandibular canine tooth root. Measurements of the lingual and buccal aspects of the alveolus indicated similar quantities of bone required for alveolectomy to expose the tooth root. The surgical procedure was performed in 12 dogs and four cats with no complications reported during the follow-up period.
Alveolectomy↗
Osseointegrated fixture placement with simultaneous tooth extraction.
Three cases are presented that illustrate the potential for accelerating the healing phase with fixture-based treatment. Depending on the clinical circumstances, techniques may include radical alveolectomy, the use of fresh extraction sockets, and fixture placement in inter-radicular bone.
Adult↗
The immediate implant: a treatment alternative.
The safety and efficacy of placing endosseous implants into the anterior mandible at the time of dental extractions with appropriate radical alveolectomies ("immediate implants") is reported. The results were compared to a control group of patients. The success of the immediate group was 92.7%; that of the control group was 98.1%. The difference in success rates was not significant at the P less than .05 level.
Adult↗
[Periodontal considerations related to extractions].
During any tooth extraction, the dentist has to think about healing problems in order to maintain as much bone as possible afterwards. Careful and well done extractions using classical techniques allow maximum bone preservation in normal cases. At minima alveolectomy techniques are a guarantee against tremendous bone loss. After healing and before prosthetic rehabilitation, crests must be checked and, if necessary, corrected by one of the several available techniques.
Alveolar Ridge Augmentation↗
Vertical dimension and freeway space in implant prosthodontics: components of macroaesthetics.
The concept of prosthesis-directed implant-supported restorations in now fully recognized, increasing the importance of prosthodontics in the initial treatment planning. This article reviews the role of prosthodontics in planning and execution of the restoration, with focus on the vertical dimension and freeway space--the major components of macroaesthetics. The signs of ridge resorption and ridge extrusion are identified, and the methods of ridge correction are presented, including alveolectomy prior to fabrication of the prosthesis and the adjustment of the abutment height to the modified ridge.
Alveolectomy↗
Alveolar ridge augmentation in Macaca fascicularis using polysulfone with and without demineralized bone powder.
The purpose of this study was to test the soft tissue and bone response to the implantation of porous polysulfone (PPSF) with and without demineralized bone powder (DBP) for ridge augmentation in Macaca fascicularis. The mandibular molar teeth were extracted in five adult female monkeys, followed by massive alveolectomy. Five to eight months later, PPSF + DBP was inserted subperiosteally on the left side, while PPSF alone was inserted on the right side. The animals were killed 42, 60, and 90 days following implantation. Specimens were processed for light microscopy, scanning electron microscopy, tetracycline labeling, and histomorphometric measurement of new bone. The 42-day specimens of the PPSF + DBP and PPSF revealed penetration of fibrous tissue rich in fibroblasts and blood vessels into the pores of the PPSF. At 60 and 90 days, the PPSF side showed organized fibrous tissue, but bone grew only for a short distance into the implant. In contrast, the PPSF + DBP side showed large amounts of bone formation, and bone almost covered the implant. The qualitative results were confirmed by histomorphometric examination.
Alveolar Process↗
Fabrication of a surgical stent for bilateral tuberosity and mandibular alveolar reduction.
A technique for constructing a single surgical stent to direct bilateral preprosthetic maxillary tuberosity reductions and mandibular alveolectomies is presented. The stent is fabricated using unaltered articulated definitive casts. The stent allows the oral surgeon to replicate the desired vertical dimension of occlusion for a thorough assessment of the sufficiency of the surgical revisions. The situation illustrated is unique, in that preoperatively, the patient's maxillary tuberosities were situated inferior and medial to their ipsilateral retromolar pads.
Exostoses↗
An integrated approach to optimizing orofacial health, function, and esthetics: a 5-year retrospective study.
The restorative dentist treats patients with needs that often transcend dental disciplines. This dentist will be responsible for long-term dental maintenance and should logically oversee interdisciplinary reconstruction. This case report demonstrates an integrated treatment approach and 5-year retrospective study involving a patient with maxillary anterior excess, pronounced overjet, and advanced periodontitis. Extraction and radical alveolectomy with removable prosthesis is often considered in such cases; however, results are often less than optimum function, esthetics, and general oral health. In this case, a previously undescribed anterior maxillary rotating segmental ostectomy was integrated with restorative, periodontal, and removable full and partial denture procedures.
Combined Modality Therapy↗