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PubMedDate not supplied

[An experimental study of the mechanisms of damage of the periodontal tissues in thyrotoxicosis].

Morphologic studies of the periodontal tissue in rats have revealed that destruction of the maxillodental system in excess of thyroid hormones is explained by disordered mineral metabolism, resorbed osseous tissue of the alveolar process, energy shifts, and developed inflammatory process. Introduction of physiologically-based amounts of calcium, iodine, and fluorine in the animals' ration at the early stages of their development reduced the degree of the alveolar process osseous tissue resorption.

Animals↗
PubMed2000

Healing process after alveolar ridge distraction in sheep.

OBJECTIVE: Mandibular augmentation by distraction of the alveolar ridge has been in use for several years. Since 1996, a distraction device that remains in the alveolar ridge after distraction has been used by the Department of Oral and Maxillofacial Surgery of Graz University. The distraction device is transformed into a dental implant after the end of the distraction process and can later be used for prosthetic purposes. We aimed to show the application of the device in this animal experiment and to follow the osseous healing process. STUDY DESIGN: Two distraction implants were inserted into the mandibles of 8 sheep. Distraction of 0.5 mm per day was carried out for 8 days. Two sheep were killed 1, 2, 3, and 6 months after distraction, and the dissected mandibles were examined clinically, radiologically, and histologically. RESULTS: After the first month of distraction, only slight radiopacity of the distraction gap was found. This increased steadily up to the third month after distraction. The boundary between the distraction fragments and the gap disappeared gradually. Six months after distraction, a homogeneous fine-meshed spongiosa structure was found in the area of distraction. Histologic examination showed desmoid ossification in the distraction gap and a continued increase in osteoid. After 6 months, mature bone was found. Only in the center was the rebuilding process not complete. Six months after distraction, osseointegration of the implants was shown in the region of the screw thread and distraction cylinder. CONCLUSIONS: The healing process corresponded to that found in long bones, but showed only desmal ossification. Osseous integration of the distraction implants was found 6 months after distraction, although the implants were stable 3 months after distraction.

Alveolar Ridge Augmentation↗
PubMed1997

A case of desmoplastic ameloblastoma of the maxilla.

A case of desmoplastic ameloblastoma of the maxilla is presented. The tumor showed characteristic radiographical and histological features. Radiographically, the tumor showed a mixed radiolucent-radiopaque lesion occupying the left maxillary sinus with undefined borders in the alveolar process. Histopathologically, the tumor was characterized by abundant, densely collagenous stroma with small nests and strands of odontogenic epithelium and bone tissues. Findings during operation suggested that the tumor arising in the alveolar process had grown upwards and almost displaced the left maxillary sinus. Complete resection is recommended for this variant because of the possibility of tumor infiltration into the surrounding bone marrow spaces.

Aged↗
PubMed1996

Diffuse sclerosing osteomyelitis and florid osseous dysplasia.

The literature on diffuse sclerosing osteomyelitis of the mandible has included at least two groups of lesions: (1) those from which bacterial infectious agents are rarely isolated (chronic-tendoperiostitis); and (2) those from which bacteria are readily isolated (true diffuse sclerosing osteomyelitis). The latter should be distinguished from secondarily infected florid osseous dysplasia. In this article the features of 16 patients with sclerotic jawbone lesions associated with symptoms of infection are analyzed. Eleven patients showed a large area of sclerosis of the mandible that was not restricted to the alveolar process and was surrounding an infectious focus. The histologic pattern revealed a deposition of reactive bone. These lesions are considered to represent true diffuse sclerosing osteomyelitis. The remaining five patients showed sclerotic lesions restricted to the alveolar process in one or more quadrants of the jaws. Apart from inflammation and reactive changes, histologic pattern revealed a fibroblastic stroma with bone and cementum-like structures that are formed by metaplasia. These lesions are considered to represent secondarily infected florid osseous dysplasia.

Adolescent↗
PubMedDate not supplied

[Functionally sparing surgery in locally spread malignant maxillary tumors and the use of local chemotherapy].

53 patients underwent functionally sparing operations which imply electrosurgical maxillectomy with alveolar process and hard palate left intact as well as eyeball preserving resections. At termination of the surgical intervention cyanoacrylate glue compounds incorporating cytostatics bleomycin or carminomycin were applied to the walls of the postoperative cavity. Maxillary alveolar process and hard palate were preserved when the tumor arose from maxillary posterior superior segments, ethmoidal labyrinth and upper nasal cavity. In orbital direction of the tumor spread the eyeball was spared when the lesion was confined to orbital wall and if intraorbital fat was uninvolved. 3-year survival after the above operations made up 60.4%. The method is believed oncologically effective and functionally, cosmetically sparing.

Antibiotics, Antineoplastic↗
PubMed1997

Orthodontic retraction into recent and healed extraction sites. A histologic study.

The aim of this experimental study was to assess the advantages of an early or delayed treatment start after tooth extraction on the basis of hard-tissue findings (density, maturity, osteodynamics) and of soft-tissue responses at the extraction site. Following bilateral extraction of the second incisors, reciprocal space closure was initiated in 3 foxhounds (age: 3.5 years): group 1 (6 teeth) 12 weeks after extraction, group 2 (6 teeth) immediately after extraction. After an 8-week bodily tooth movement period and a 2-month retention period, evaluation was undertaken on the basis of clinical/radiologic and histologic criteria (sequential polychromatic bone marking, light microscopy). Histologic analysis yielded the following findings in group 1 (delayed tooth movement): low bone density at the extraction site with more mature lamellar bone, pronounced horizontal atrophy of the alveolar process with periosteal bone apposition in direction of tooth movement, increased tendency towards gingival invagination. The findings in group 2 were characterized by: higher bone density with less maturity (bundle bone) at the extraction site, broader alveolar process, reduced tendency towards gingival invagination. No qualitative difference between the 2 groups was found with respect to root resorption. The histologic findings therefore indicate that orthodontic retraction into extraction sites should be initiated at an early stage.

Animals↗
PubMedDate not supplied

An atypical esthesioneuroblastoma of the inferior nasal cavity and maxillary sinus: report of a case.

Esthesioneuroblastoma is a rare malignant tumor of the nasal cavity that originates from the olfactory epithelium. In this paper a very rare clinical presentation of this tumor is described. The tumor originated from the maxillary sinus and alveolar process, and was independent of the olfactory region. The patient was a 14-year-old girl presenting with facial swelling and nasal obstruction. Paranasal computed tomography showed a mass filling the right nasal cavity, infiltrating the alveolar process, eroding the anterior wall of the maxilla and invading the subcutaneous tissues of the cheek. Fine-needle aspiration and incisional biopsies identified an esthesioneuroblastoma. After neoadjuvant chemotherapy, we performed a right subtotal and left inferior maxillectomy and reconstructed the maxillary defect with a permanent obturator. At 2 years' follow-up the patient is free of recurrence.

Adolescent↗
PubMed2002

[Evaluation of the usefulness of vascularized bone grafts for surgical reconstruction of the face].

The process of healing of vascularised bone grafts was examined clinically and the use of vascularised bone grafts in face reconstruction surgery was assessed basing on author's experience with the surgical technique, availability of graft recipient and donor sites and final outcome. Patients enrolled in this study were treated at the Department of Maxillofacial Surgery, Pomeranian Academy of Medicine in Szczecin, for cancer, injuries, developmental anomalies and atrophic changes. In each case it was necessary to restore facial bone structures of functional and aesthetic importance, including: floor of the orbital cavity, alveolar process of maxilla, palate, malar bone and mandible (Tab. 2). Reconstruction was done mostly with parietal bone grafts pedicled on temporal fascia and muscle, coronoid process of the mandible pedicled on temporal muscle, and lower part of the diaphysis of mandible pedicled on masseter and pterygoid muscles. In some cases, reconstruction material consisted of a rib on greater pectoral muscle, clavicle on sternocleidomastoid muscle and scapular bone crest pedicled on trapezius muscle. Free microvascular flaps with some elements of fibula and radius were used in two patients for the reconstruction of mandible and soft tissues. In total, 41 vascularised grafts were performed in 40 patients. Graft healing was examined clinically and usefulness of this technique for face reconstruction surgery was assessed basing on author's experience with the preparation technique, intraoperative complications and extent of trauma to donor sites. The results of healing of specific grafts are enclosed in Table 1. The surgical technique for graft preparation and its transfer into the recipient site varied from case to case. The most difficult and effortful approach was with free bone grafts transferred from remote sites by means of a microsurgical technique (group V). Despite the complexity of the reconstruction method, no intraoperative complications occurred in the course of preparation of the radial and fibular bone grafts. In group IV, the most difficult grafts included those taken from ribs, clavicle and scapular bone. Parietal bone grafts were much less troublesome (subgroups Ia and Ib) although associated with the largest number of intraoperative complications. The easiest preparation method applied to the grafting of coronoid process and lower part of the body of mandible (group II and III). Clinical evaluation of vascularised bone grafts confirmed without reservations the value of this approach in face reconstruction surgery. However, the extent to which individual graft types proved to be usable varied. The most valuable ones included parietal bone grafts pedicled on temporal muscle and fascia used for restoring upper and central facial structures and the coronoid process of mandible pedicled on temporal muscle used for reconstructing the floor of the orbital cavity and alveolar process of the maxilla. Rib grafts pedicled on pectoral muscle were of limited use. The same applies to grafts from the lower part of the body of mandible pedicled on masseter and pterygoid muscles occasionally used for restoring the mental part of mandible. Grafts from remote sites (fibula, radius) should be used only when other reconstruction methods are unavailable.

Bone Transplantation↗
PubMed2004

Autotransplantation of immature third molars into edentulous and atrophied jaw sections.

The aim of the present study was to assess the results after transplantation of 85 immature third molars. Recipient site conditions varied and different surgical techniques were used. The long-term results after preparation of a new alveolus, splitting osteotomy of the alveolar process or use of free bone autografts were compared with the results after transplantation into a fresh extraction site (control group). Transplantations into prepared sockets showed equal results to the control group (94% respectively). Transplantations in connection with free bone autografts (84%) or after splitting osteotomy of the alveolar process (63%) showed poorer success rates, the differences between the latter and the control group being statistically significant. A possible correlation to revascularization disturbances of the pulp due to an insufficiency of the recipient site or to postoperative infection is suspected. The results show that transplantation of immature third molars is a safe, useful procedure when appropriate conditions of the recipient site are present. Where the alveolus is atrophic, a splitting osteotomy should be performed only in exceptional cases and preference should be given to alternative methods such as primary bone augmentation or bone-regenerative procedures.

Adolescent↗
PubMedDate not supplied

Remodeling of devitalized bone threatens periosteal margin integrity of endosseous titanium implants with threaded or smooth surfaces: indications for provisional loading and axially directed occlusion.

Microradiographic analysis of endosseous implants in dogs revealed similar patterns of healing and remodeling of the alveolar process adjacent to both types of implants. However, substantial differences were noted in bone morphology both at the periosteal margin and within the cervical half of the interface. The grooves of the threaded implant were filled with relatively immature composite bone. In contrast, the smooth cylindrical implant was bordered by a dense cortex of relatively avascular bone except for a 1 mm at the periosteal margin that was remodeled and vital. For both types of implants, areas of apparently nonvital, hypermineralized bone were remodeling near the interface and in subperiosteal areas of the alveolar process. The integrity of the periosteal margin may be threatened by undermining remodeling of adjacent bone during the late healing period. The cervical (alveolar) crest and particularly the periosteal margin of the interface are high stress bearing areas. If overloaded, these areas are subject to "cervical cratering," a common prelude to implant failure. The results of this study suggest that axially directed occlusion and a progressive loading scheme are indicated.

Bone and Bones↗
PubMedDate not supplied

[The effect of local exposure to Mg and heat on the biosynthesis of sulfur-containing compounds in the oral tissues].

Local Mg electrophoresis was shown to considerably increase the radiolabeled sulphate contents in an application area: gums, mandibular alveolar processes, lower incisors and molars roots. In areas far beyond the phoresis sites (femoral epiphyses and diaphyses) label incorporation was not affected. Mg-free galvanization had no effect on sulphate incorporation into the mineralized tissues. Heating up to 50 C substantially increased the S radioactivity in alveolar processes, molar and incisor roots. Simultaneous heating with Mg electrophoresis produced an additive effect.

Animals↗
PubMed2004

Locally applied isosorbide decreases bone resorption in experimental periodontitis in rats.

BACKGROUND: The role of nitric oxide (NO) on bone metabolism is controversial, since it can either stimulate bone formation or resorption. We investigated the effect of local administration of the NO donor isosorbide in an experimental periodontal disease model. METHODS: Wistar rats were subjected to a ligature placement around the cervix of the right second upper molar and were sacrificed after 11 days. Alveolar bone loss was measured in one quadrant as the sum of the distances between the cuspid tip and the alveolar bone along the axis of each molar root, which was subtracted from the contralateral side, used as unligated control. The semiquantitative histopathological scale of the periodontium was based on cell infiltration and alveolar bone and cementum integrity. Groups were treated with a gel containing 1% or 5% isosorbide applied to the vestibular side of the molar gingiva 1 hour before the placement of the ligature and then twice daily until sacrifice. Controls included one group subjected to periodontitis and no treatment (NT) and another that received the gel containing just the vehicle (V). RESULTS: The application of the vehicle gel produced an increase of the alveolar bone resorption, without altering the inflammatory changes, compared to the NT group. The 5% isosorbide produced a significant reduction of the alveolar bone resorption, compared to V and NT. This reduction was confirmed by histological analysis, showing less inflammatory cell infiltration and preservation of the cementum and the alveolar process. CONCLUSION: Local application of isosorbide reduces alveolar bone resorption in experimental periodontal disease in rats, suggesting a local anti-inflammatory effect of isosorbide.

Alveolar Bone Loss↗
PubMed2000

Case challenge. Chronic maxillary inflammation.

A 30-year old male was referred by a dental practitioner to the Department of Oral Radiology at the University of Lund, Sweden, for a radiological evaluation of chronic symptoms of inflammation on the right side of the maxilla. According to the patient, at age 12 he had surgery to remove a non-erupted maxillary right second premolar. Postoperatively, a draining sinus tract appeared on the buccal aspect of the alveolar process. Thirteen years later, at age 25, surgery was again performed and the sinus tract reappeared. Intermittent discharge of exudate from the sinus tract occurred since the second surgery. Clinical and radiological examinations were conducted prior to a third surgery. The clinical examination revealed pus draining from the tract located on the buccal aspect of the alveolar process between the right maxillary first molar and first premolar. The radiological examination included periapical radiographs of the right maxillary first premolar and canine, a panoramic radiograph, and frontal tomograms of the maxillary right premolar area.

Adult↗
PubMed1990

Herpes simplex virus and intraoral ulcers in immunocompromised patients with haematologic malignancies.

Possible factors predisposing to the development of intraoral ulcers in immunocompromised patients with haematologic malignancies were investigated. Among 46 patients undergoing antineoplastic treatment, 18 developed an intraoral ulcer during the prospective study. Patients with or without ulcers were comparable with respect to underlying disease, presence of teeth, the qualitative composition of the aerobic and facultatively anaerobic oral microflora, herpes simplex virus (HSV) titer positivity, a past history of herpes labialis, leukocyte and thrombocyte counts, and duration of fever. Viral cultures from saliva revealed an association between the presence of HSV in saliva and the presence of intraoral ulcers. HSV was not isolated from the saliva of any patient without ulcers. Viral cultures from the ulcers revealed growth of HSV in 11 (61%) of the 18 patients with ulcers. HSV-positive ulcers were located more often on the alveolar process than elsewhere in the oral cavity. Ulcers on the lateral borders of the tongue and on the buccal mucosa were found only in dentate patients. Development of intraoral ulcers was not associated with an increase of the HSV titer in serum in any patient. It is concluded that some intraoral ulcers, especially when located on the alveolar process, are associated with and probably caused by HSV, while mechanical trauma during mastication seems likely to be involved in the pathogenesis of ulcers elsewhere in the oral cavity.

Adult↗
PubMed1985

Traction, prenatal development, and the labioseptopremaxillary region.

Twenty-nine human fetuses ranging in age from 8 to 22 weeks were coronally sectioned for gross light microscope analysis of the labioseptopremaxillary region. In "normal" fetuses from 8 to 15 weeks, the septopremaxillary ligament was present. The horizontal and oblique fibers of the orbicularis oris muscle were poorly developed initially and increased in density with age. The anterior nasal spine and the alveolar process of the maxillae were present and in the same coronal plane. From 15 to 22 weeks, the horizontal and oblique fibers were well developed and inserted into the perichondrium of both alar and nasal cartilages. The septopremaxillary ligament was thus obliterated or more difficult to define, and the anterior nasal spine was located anterior to the alveolar process. In the cleft fetuses from 8 to 15 weeks, the nasal septum was absent or horizontally rotated. No septopremaxillary ligament or orbicularis oris fibers were noted, and the anterior nasal spine was not distinguishable. From weeks 15 to 20, the fibers of the orbicularis oris muscle were poorly differentiated, inserting asymmetrically into the perichondrium of the lateral alar cartilage on the noncleft side, the septopremaxillary ligament was absent, and the anterior nasal spine and the premaxillae were in the same coronal plane. These results suggest that the midfacial deficiencies seen in some cleft patients might have an origin in prenatal dysmorphology.

Cleft Palate↗
PubMed1985

Secondary bonegrafting in unilateral cleft lip palate patients: indications and treatment procedure.

A consecutive series of 62 complete unilateral cleft lip and palate patients were investigated with respect to indication for a secondary bone grafting. 2 major indications for secondary bone grafting were established. One was a symptomatic oro-nasal fistula, the other one being a bony defect in the alveolar process, which could impair orthodontic treatment and prosthodontic rehabilitation in the cleft area. The average age for bonegrafting was 12 years. After surgery, fistula-related discomfort was eliminated and speech disorders were drastically reduced. Orthodontic uprighting of teeth and correction of mid-line deviations indicated in 50% of the patients were facilitated. In 10% of the cases with extensive defects in the alveolar process, the graft enhanced the possibility for later prosthodontic treatment. Secondarily, periodontal conditions improved. When bonegrafting was performed before canine eruption, total dental rehabilitation by orthodontic treatment was often sufficient, thus decreasing the need for later prosthodontic restoration of the cleft area. Patients who had surgery after eruption of the cleft side canine exhibited more complications. The optimal treatment sequence therefore appears to be transversal expansion of the maxilla in the late mixed dentition, followed by bone grafting. Maxillary expansion must be retained until final orthodontic and prosthodontic treatment is carried out.

Adolescent↗
PubMed2000

Transgenically ectopic expression of Bmp4 to the Msx1 mutant dental mesenchyme restores downstream gene expression but represses Shh and Bmp2 in the enamel knot of wild type tooth germ.

Bmp4 is a downstream gene of Msx1 in early mouse tooth development. In this study, we introduced the Msx1-Bmp4 transgenic allele to the Msx1 mutants in which tooth development is arrested at the bud stage in an effort of rescuing Msx1 mutant tooth phenotype in vivo. Ectopic expression of a Bmp4 transgene driven by the mouse Msx1promoter in the dental mesenchyme restored the expression of Lef-1 and Dlx2 but neither Fgf3 nor syndecan-1 in the Msx1 mutant molar tooth germ. The mutant phenotype of molar but not incisor could be partially rescued to progress to the cap stage. The Msx1-Bmp4 transgene was also able to rescue the alveolar processes and the neonatal lethality of the Msx1 mutants. In contrast, overexpression of Bmp4 in the wild type molar mesenchyme down-regulated Shh and Bmp2 expression in the enamel knot, the putative signaling center for tooth patterning, but did not produce a tooth phenotype. These results indicate that Bmp4 can bypass Msx1 function to partially rescue molar tooth development in vivo, and to support alveolar process formation. Expression of Shh and Bmp2 in the enamel knot may not represent critical signals for tooth patterning.

Alleles↗
PubMed1993

Cephalometric study on the influence of vertical traction of teeth on maxillofacial bones in young dogs.

The influence of one-sided vertical traction of teeth on maxillofacial bones was investigated using cephalometric radiographs and tetracycline-labeling in young dogs. On the frontal view of the dry skull, traction resulted in a downward distortional deformity of the maxilla including the nasal floor. Cephalometry of radiographs revealed a downward displacement of the upper premolar and incisor teeth, medial maxillary region, and alveolar process of molar, canine and incisor on the right side, where traction was applied. Displacement was from 2.2 +/- 0.4 (mean +/- S.D.) mm at P3 to 0.8 +/- 0.2 mm at I1. In the control group without traction, it was 0.0 +/- 0.0 at P3 and 0.2 +/- 0.1 at I1. Tetracycline-labeling disclosed, in the frontal cut surface of maxillofacial bones at P3, that traction affected not only the periodontal tissue and alveolar processes, but also the neighboring bones and midpalatal suture. The ratio of the labeled area in the bone, measured using an image analyzer in 6 sectors of the cut surface, was 1.2 +/- 0.3% in the left upper sector to 13.0 +/- 4.3% in the right lower sector. In the control group, it was 1.2 +/- 0.4% in the left upper and 4.8 +/- 1.1% in the right lower sector. In conclusion, vertical traction of teeth induces a vertical deformation of the maxilla.

Animals↗