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[The effect of different vacuum therapy regimens on protein and mineral metabolism in periodontal tissues].

Radionuclide label was used to study the effects of various vacuum therapy schemes on the protein and mineral metabolism in periodontal tissues. Vacuum therapy was found to normalize Ca, P, and protein metabolism in spontaneous atrophy of the alveolar processes in white rats. Focal dosed vacuum was found the most effective. These data will be used to develop a complex of measures to prevent atrophies of the maxillary alveolar processes.

Alveolar Process↗

[s] and [sh] as a function of linguapalatal contact place and sibilant groove width.

Sibilant groove place and width were initially examined during [s] [s] in isolation and in CV and VC syllables. The [s] was found to be produced through a 6- to 8-mm-wide groove near the front of the alveolar ridge by one talker and near the back of the ridge by the other. [s] was produced through a 10- to 12-mm groove behind the posterior border of the alveolar ridge by both. In the second experiment three subjects used visual articulatory feedback to vary sibilant groove width and place systematically. One subject was able to do this with comparatively few retrials; one had difficulty with certain targeted grooves; one had difficulty with many targeted grooves. The noises generated were replayed to 14 listeners who labeled them as "s," "probably s," "probably sh," or "sh." They usually heard the sound as [s] when the grooves were narrow and near the front of the alveolar process, [s] when the groove was wider and behind the alveolar process. Noise through grooves that matched natural speech places and widths usually produced higher listener recognition scores. Exceptions were found when the subjects had unusual difficulty in achieving stipulated groove widths and places.

Adult↗

[Selected cases of oral mucosa carcinomas].

The clinical picture and methods of surgical treatment are described in three cases of oral carcinoma with different sites of origin (buccal mucosa, alveolar process mucosa of the maxilla, and mucosa of the mandibular alveolar process and oral floor). After a survey of the pertinent literature and in the light of the presented cases attention is called to the need for one-stage surgical reconstruction of the tissue defect and simultaneous or early prosthetic rehabilitation.

Aged↗

[The atrophic jaw from the dental surgeon's point of view].

A report on 3000 cases of jaw atrophy over a period of 20 years. These cases underwent surgery and the results were obtained on the basis of close collaboration between maxillofacial surgery and prosthetics. Certain deductions could be obtained from these numerous patients over a longe period of observation. It is now possible to separate wistful thinking from reality. Subperiosteal implants have, in spite of chronic infections, functioned over a period of 10 years and more. Enossal implants seem to do the same for partial prosthetics. Complete failure of either form of implant is to be expected in edentulous mouths. Loss of a subperiosteal or enossal implant generally leaves a condition requiring new surgical intervention. The methods of vestibuloplasty, tuberoplasty and lowering of the floor of the mouth have been generally successful, if proper indication, surgical technique and prosthetic rehabilitation are observed by competent professionals. In plastic surgery of the alveolar process the use of ribs has been successful in this clinic. Even though postoperative resorption may destroy 50% and more of the obtained height of the alveolar process, the results justify this kind of surgery. The obtained results suggest that the methods described have justified their due place in maxillofacial surgery, because they may be considered to be results at long term.

Aged↗

Congenital epulis in the newborn.

Neoplasms in the oral cavity are generally recognized during the routine examination of the newborn. Lesions arising on the alveolar processes of the jaws may interfere with nursing and respiration. This paper reviews the congenital epulis (CE) in the newborn. A case of CE arising on the maxillary alveolar process is reported. Due to the indication for removal of these benign tumours in the neonatal period they should be recognized as early as possible.

Alveolar Process↗

Postsurgical bone loss following root planing by ultrasonic and hard instruments.

The ultrasonic scaler is currently used to plane the roots in periodontal surgery. The purpose of this study was to provide experimental evidence in support of, or against, the use of the ultrasonic scaler for root planning in periodontal surgical procedures. A notch was made through the enamel of each canine of nine adult cats. Full thickness mucoperiosteal flaps were elevated on each canine. Using hand curettes, soft tissue tags were removed from each tooth. At the maxillary right canines and mandibular left canines the roots were planed using the ultrasonic scaler, while at the maxillary left canines and mandibular right canines the roots were planed using hand curettes. A caliper was used to measure the distance from the notch to the crest of the alveolar process at each tooth. The mucoperiosteal flaps were repositioned and secured with cyanoacrylate cement. Three months postoperatively all 36 sites were reoperated and the distance from the notch of each canine to the crest of its alveolar process was measured using the caliper. The same caliper was used for all sites and the same investigator made all the measurements. Analysis of the results showed that all canines lost alveolar bone as a result of the surgical procedure, however, there was no statistical significance between the amount of bone lost on the canines where root planing was carried out by the ultrasonic scaler and the canines where the roots were planed with hand curettes. These findings support the use of the ultrasonic scaler for the planing of roots following elevation of mucoperisteal flaps and confirm its value in the practice of periodontal surgical procedures.

Alveolar Process↗

Vertical alveolar ridge distraction with prosthetic treatable distractors: a clinical investigation.

Alveolar ridge distraction is a recent and promising technique for ridge augmentation. Since 1997, a new distraction system incorporating a distraction implant has been in use. It can be used for alveolar ridge distraction and is not removed from the alveolar ridge. Upon completion of the distraction, it remains in the alveolar process for later prosthetic treatment. Thirty-five patients were treated with distraction implants for the correction of alveolar ridge deficiency. In 10 patients with atrophy of the mandible or maxilla, 16 patients with severe defects of the alveolar process after trauma, and 9 patients with localized alveolar ridge defects after single tooth loss, alveolar ridge distraction was carried out with the aid of 62 distraction implants. The distraction implants were loaded by prosthetic superstructures 4 to 6 months after distraction. A clinical and radiologic follow-up was carried out. Periotest values were examined, and peri-implant bleeding and probing depth were registered prior to prosthetic treatment and 3, 6, and 9 months after implant loading. In 29 patients, distraction was carried out without complications or problems. Two distraction implants were lost. In 2 patients distraction was discontinued because of ankylosis of the distraction segment. In 1 patient the alveolar ridge was overcorrected, and another patient experienced a persisting hypoesthesia of the lip. For 5% of the implants, pathologic probing depth of more than 3 mm and sulcus bleeding were registered prior to prosthetic treatment. These observations decreased during the next 9 months. Periotest values were normal before the start of prosthetic treatment. There was a decrease in the Periotest values, thus an increase in implant stability, during the following 9 months. It was concluded that alveolar ridge distraction using distraction implants can be a successful technique for alveolar ridge augmentation with a low rate of complication. Acceptable esthetic and functional results can be achieved by this atraumatic technique of surgery and distraction.

Adolescent↗

[Activity of carbohydrate metabolism enzyme activity in normal and pathologic parodontal tissues].

The activity of hexokinase, glucose-6-phosphate dehydrogenase, pyruvate dehydrogenase, isocytrate dehydrogenase, alpha-ketoglutarate dehydrogenase and the ATR content in the alveolar process and gingiva of dogs are established to decrease considerably in experimental cholestasis, induced by ligation of the common bile duct. Incorporation of tissue proteins into the Krebs cycle through the reverse NAD-dependent malate dehydrogenase reaction is a compensatory reaction favouring an increase of the ATP amount in the alveolar process.

Alveolar Process↗

Repair of bilateral clefts of lip, alveolus and palate Part 2: Concomitant lip closure and columella lengthening after lip adhesion.

Lip repair and synchronous columella lengthening in bilateral clefts of the lip, alveolus and palate following lip adhesion according to the method outlined in Part 1 is described in this part of the paper. Together with lip and nose repair the gingivo-periosteoplasty can also be performed when the alveolar process is perfectly aligned and the greater and lesser segments abutt onto each other. Copyright 2001 European Association for Cranio-Maxillofacial Surgery.

Journal Article↗

Comparative study of secondary and late secondary bone-grafting in patients with residual cleft defects. Short-term evaluation.

This report is a comparative study of the treatment results after secondary and late secondary bone-grafting in cleft-palate patients with residual cleft in the alveolar process, operated with surgical technique as described by Krantz Simonsen. 293 bone-grafted cleft-palate patients are included in the study. Marginal bone-level, periodontal state of teeth adjacent to the cleft-region, recurrence of oro-nasal fistula together with possibility of total dental rehabilitation (i.e., morphology of alveolar process in cleft region and amount of attached gingiva) have been used for evaluation of the treatment results. The best results are seen in the youngest group of patients, and based on the results of the present study, bone-grafting is recommended immediately before eruption of the canine in the cleft-region.

Adolescent↗

The reproducibility and the validity of landmarks for the antero-inferior part of the maxilla in radiographic cephalometry.

Two possible landmarks, C1 and C2, were evaluated as alternatives to the A point (subspinale), in lateral radiographic cephalometry. The landmarks were determined on tracings of 25 straight lateral radiographs. Horizontal and vertical coordinates were recorded for C1 and C2, and also for point A, and the incisor edge and apex. The reproducibilities of the landmarks were determined by statistical analyses of the differences between landmark determinations on repeated tracings. Regression analyses were used to evaluate the validity of measurements on C1 and C2 in relation to corresponding measurements on the A point. In addition, the influences of upper incisor inclinations and of alveolar process inclinations on validity were investigated by regression analyses and analytical geometry, respectively. The reproducibility of all landmarks including C1 and C2 was high (correlation coefficients above 0.985). Both C1 and C2 were strongly correlated with point A (adjusted R2 values from 82 to 85 per cent). The inclination of the lingual aspect of the alveolar process may change from an alteration of the incisor inclination. When this happens, the positional change of C2 horizontally is smaller than the change of C1. Therefore, C2 appears to be the more valid landmark for horizontal measurements. The designation suggested for this landmark is C.

Alveolar Process↗

Blade implants: presurgical preparation procedures and radiographical analyses.

In dental implantology the selection of the implants, the design of the prosthetic appliance and the relationship between implant and occlusal antagonists are based on clinical evaluation, the study of mounted casts, as well as radiography. The simulated data from the articulator must be transferred to the oral cavity during surgery. The alveolar bone height is critical for treatment planning. Determination of the height of the alveolar process, the location of the alveolar nerve and the maxillary sinus may be based on measurements on radiographs or intra oral evaluation. A comparison study of the radiological analysis based on pantomography or free focus radiography, with actual measurements in the oral cavity was carried out in a patient. The results indicated major discrepancies between direct measurements on radiographs and those carried out clinically.

Alveolar Process↗

Three-dimensional interpretation of labiolingual bone width of the lower incisors. Part II.

For quantitative evaluation of the different imaging quality of cephalograms and computed tomography in the region of the lower incisors, the macroscopic and histological findings of specimens were compared with the corresponding radiological findings. After removal of the soft tissue from 11 mandibular dentate segments, 15 artificial bone defects of different dimensions were produced in the region of the lower incisors. In comparison with the microscopic jaw measurements, the mean labiolingual diameter of the frontal alveolar process of the single incisors was overestimated in the cephalograms by 0.3 to 1.2 mm. Most of the anatomical-radiological correlations of the cephalometric measurements was insignificant. Individual metric assessment of the labiolingual bone width or of the facial/lingual cortical bone plates or the identification of the artificial defects of lower incisors in the cephalograms were generally not possible. In the CT-images the mean labiolingual diameter of the frontal alveolar process of the single incisors was overestimated by 0.1 to 0.5 mm, but the correlations were highly significant. The facial/lingual cortical bone plates of the lower incisors were evaluated and measured in the CT-scans. Thirteen of 15 artificial bone defects (80%) were identified in the CT-scans. CT-scanning is the only imaging technique offering three-dimensional quantitative evaluation of the labiolingual alveolar bone width and the facial/lingual cortical bone plates.

Alveolar Process↗

Augmentation of the maxillary sinus floor with particulated mandible: a histologic and histomorphometric study.

This study presents the results of 10 consecutive patients treated with unilateral bone augmentation of the maxillary sinus floor using particulated mandible harvested from the symphysis. Endosseous titanium implants (Brånemark) were placed 6 months after the transplant procedure. Thirty self-tapping implants were placed with a mean follow-up period of 26 months (range 12 to 46 months). Bone biopsy specimens were obtained from the donor site and the residual alveolar process at the time of grafting. A second biopsy specimen was obtained from the grafted site after 6 months of healing (at time of implant placement), and a third biopsy specimen was obtained after 12 months of healing (at time of abutment placement). Histomorphometry was performed on microradiographs using a computerized image analysis system. The bone volume fraction at the donor site before particulation was 58% +/- 19%, and the volume fraction at the residual alveolar process was 45% +/- 15%. The mean volume fraction of bone in the grafted area increased from 40% +/- 12% after 6 months of healing to 48% +/- 10% after 12 months. Histology of the retrieved bone biopsy specimens revealed normal healing and bone maturation in all samples.

Adult↗

[Morphological study of periodontal tissues in the initial stage of periodontal disease. Part 1. Application of a morphological measurement and a system for evaluating the periodontal status].

The functional aberration of occlusion, based on the morphology of the alveolar process, causes chronic irritation of the periodontium in addition to the concomitant effect of other local environment factors. This investigation was designed to study the role of morphological characteristics in the periodontal disease process. The periodontal health of 22 subjects was recorded by clinical and roentgenological measurements of the loss of periodontal tissue. The criteria for this selection were no loss of or a crowding of adjoining teeth and no disharmony in occlusal contact. Morphological data were measured around the premolars and molars of lower jaws on the study models individuals, in bucco-lingual width of the alveolar bone in relationship to the width of the crown and the sagittal figure of the Spee curve etc. by using a three-dimensional analyzer. The subjects were categorized as Type II when the records indicated a ratio of the crown width/bone width of 1/1.2. Types I and III, depended on a greater and smaller ratio, respectively. Type W symbolized the alveolar process, of which the interproximal bone showed a considerable curvature mediodistally. Type F showed a flat pattern. The sagittal figure of the Spee curve was divided into four patterns: Pattern A or B, when the cusp of the canine and first premolar leveled over or on the occlusal plane; Pattern C, when the cusp of the canine leveled over and the first premolar under the occlusal plane, and Pattern D, when all cusps, canine, premolar and molar, were under the occlusal plane. The distance from the occlusal plane to the deepest point of the Spee curve was divided into four groups: Pattern a, when the distance was 0-1.0 mm, Pattern b, 1.1-2.0 mm, Pattern c, 2.1-3.0 mm and Pattern d, 3.1-4.0 mm. These results suggest that the morphological evaluation is a useful diagnostic indicators on a rational basis. The morphological characteristics might be related to the presence of periodontal disease and allowed to speculate the pathological changes in established stage, and also to the response to periodontal treatment in the initial stage of periodontal disease.

Alveolar Process↗

Mandibular bone grafts for reconstruction of alveolar clefts.

This study evaluated the effect of mandibular bone grafts for reconstruction of alveolar clefts. The study included 25 patients with cleft lip and alveolar process only and three patients with unilateral cleft lip and palate, with a median postoperative follow-up of 8 months (range, 6 to 17 months). The bone grafts were obtained from below the mandibular incisors and canines through an intraoral approach. The marginal bone level achieved was satisfactory in all cases evaluated by occlusal radiographs; the radiographs also demonstrated that the bone grafts were totally integrated after 6 months in all cases. The morphology of the reconstructed alveolar process was satisfactory in all cases evaluated and no periodontal complications were seen. The donor site appeared healed radiologically in all cases 6 months after surgery. The advantages gained by using a mandibular bone graft as compared to an iliac crest graft include reduced morbidity, reduced hospitalization time, reduced operating time, and avoidance of scarring at the donor site. The results of the present study demonstrate that the mandibular symphysis can be used as donor site for reconstruction of small alveolar clefts.

Adolescent↗