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Ridge mapping for determination of alveolar ridge width.

Ridge mapping is a measurement procedure to ensure that the diameter of an endosseous screw implant does not exceed the dimensions of available bone. The long-term success of implants is a prime aim. To achieve this, it is essential for the initial evaluation of the dimensions of the resorbing alveolar process to be absolutely accurate. Ideally, an implant should be covered by at least 1 mm of bone on all sides. The major problem is estimating the thickness of bone, since the mucosal contour can mask the actual dimension of the alveolar ridge. Use of ridge mapping with the Wilson Bone Caliper makes possible a reliable evaluation procedure at the initial stage of treatment planning.

Alveolar Process↗

Effect of experimental diabetes on mandible growth in rats.

The aim of the present work was to assess the effects of experimental diabetes on mandible growth in rats. Experimental diabetes was induced in rats, aged 26 d, by a single dose of 100 mg/kg b.w. of Streptozotocin (STZ). Thirty-one d post STZ or vehicle injection, the animals were killed. Mandibles were resected to determine Mandibular Skeletal Units dimensions (MSU) and overall mandible growth. Statistical analysis of results revealed, for STZ treated animals as compared to the control group: 1) a decrease in b.w.; 2) an increase in food intake; 3) an increase in glucemia (200%); 4) normal hemoglobin, creatinine and plasma urea values; 5) a reduction in growth of symphyseal (9%), coronoid (16%), and alveolar (13%) heights, condyloid (11%), angular (8%), and base (3%) lengths, and condyloid width (8%). Mandibular length (4%), height (8%) and length of base (6%) were significantly lower in diabetic animals as compared to the control group. No significant differences in length of symphyseal process, alveolar length and height of base were found between groups. Rats on a restricted diet, resulting in a decreased b.w., and the control group exhibited similar mandibular dimensions. These data show that STZ-induced diabetes reduces mandibular growth, resulting in some deformity of the structure.

Alveolar Process↗

Cryosurgery and OK 432 in the treatment of malignant melanoma.

We used concomitant therapy that consisted of cryosurgery and injection of OK 432 (a hemolytic streptococcal preparation) in the treatment of a giant malignant melanoma that primarily arose from the hard palate to the alveolar process in a 69-year-old man. The tumor consequently disappeared completely. One and a half years later, there are no signs of relapse.

Aged↗

[The choice of the optimal plan for treating dystopia of individual teeth combined with arch defects of the maxilla].

Treatment of patients requires cooperation of an orthodontist and prosthesis-maker as early as during treatment planning. An adequate clinical situation of treatment can be chosen only after preliminary modeling and prediction of results using dismountable diagnostic models of the jaws and computer simulation of the graphic scheme of the teeth position and transposition, described in this paper. Two-staged orthodontic and orthopedic treatment is needed for patients with early removed teeth and delayed prostheses, congenital cleft alveolar process and palate, and lack of two lateral incisors. However, for 25% of patient lacking two lateral incisors, orthodontic treatment alone is sufficient.

Adolescent↗

Embryonic development of the mandibular canal.

On the basis of examination of 50 fetal mandibles, development of the mandibular canal is described. The development of the foramen mandibulae, foramen mentale, the lingula, the alveolar process, and the morphological changes in the mandible due to the effect of the development of the mandibular canal are discussed. The anatomical conditions examined may also have clinical implications.

Alveolar Process↗

Can the location of tooth agenesis and the location of initial bone loss seen in juvenile periodontitis be explained by neural developmental fields in the jaws?

Recent studies on prenatal innervation of the jaws have shown that three separate main innervation paths, constituting three bilateral neural developmental fields (incisor field, canine/premolar field, molar field) exist in each jaw. In this communication the sequences in which the fields are innervated are indicated. These correspond to the sequences of formation of teeth and jawbone. The normal pattern of tooth agenesis is closely related to the neural fields, as the region within a single field were innervation occurs last is always the area most often affected by tooth agenesis. The initial manifestations of juvenile periodontitis also appear at the sites within the different fields where innervation occurs last. It is suggested that the pubertal growth of the alveolar process does not occur in these regions due to deficient innervation, and that the infection in juvenile periodontitis might be secondary to this regional lack of bone apposition.

Aggressive Periodontitis↗

Accuracy of clinical and radiological classification of the jawbone anatomy for implantation--a survey of 374 patients.

The aim of this study was to investigate the anatomical features of edentulous jaw dental segments (eJDS) in order to offer the most reliable clinical and radiological classification of such segments in planning for implant treatment. A total of 374 patients, 156 men and 218 women, participated in the investigation. The mean age of the patients was 46 years (SD 12.7), ranging between 17 and 73 years. The eJDS were estimated by means of orthopantomogram, computerized tomography, and intraorally with special ridge-mapping callipers for measurement of alveolar process width. A total of 792 screw-shaped and 1-stage Osteofix Dental Implant System (Oulu, Finland) implants were inserted. Dental segments were divided according to the results of the commonly accepted eJDS assessments into 3 clinical-anatomical types. Type I indicated insignificant or no atrophy of eJDS (232 patients with 476 implant sites; 60.1% of the total number). Type II indicated mild to moderate vertical or horizontal atrophy of eJDS (100 patients with 222 sites; 28% of the total number). Type III indicated significant vertical or horizontal atrophy of eJDS (42 patients with 94 sites; 11.9% of the total number). The accuracy of the clinical and radiological classification was adjudged to have been 95.8%. By the process of establishing clinical and radiological classification of the jawbone segments, more reliability was anticipated regarding the insertion of implants both in maxillae and mandibles.

Adolescent↗

[Development of the mandible and its vascularization in human fetuses in light of morphologic, microangiographic and gnathometric studies].

Studies were carried out on 75 mandibles of human fetuses from the 4 to 9th month of fetal life. There were 31 female and 44 male fetuses. The material came from the Institute of Normal Anatomy--Pomeranian Medical Academy. Investigations consisted in filling the external carotid artery and its branches with Micropag. After filling the arteries, the head of the fetus was isolated and fixed in formalin solution in concentration--1.11 mol/dm3 for the period of 3 weeks. Next the mandibles with articular capsule were excised, soft tissue removed and cut at the site of symphysis. Some of the mandibles were decalcified in the solution of nitric acid in concentration--1.16 mol/dm3 for the period of two weeks. All the mandibles were X-rayed employing Unipan 401 equipped with a micro focus X-ray tube for structural examinations. Radiogram photo copies were equipped with a micro focus X-ray tube for structural examinations. Radiogram photo copies were made by the positive method to obtain additional blow up. The decalcified mandibles were X-rayed again. In order to perform a thorough study of vascularization, the decalcified mandibles were cut into specimens (transverse longitudinal axis) about 500 microns thick, thereafter structural pictures were taken--enlarged 9, 11, 17, 22 and 25 times. The decalcified mandibles were exploited to prepare histological specimens in longitudinal cross-section (along the longitudinal axis of mandible). Further observations referred to the growth of mandibles in the particular age groups. Therefore antropometric measurements were made on X-ray pictures and their results were subjected to statistical analysis (Fig. 1-2). The results of studies (Fig. 3-7) proved that in the radiological photo of human fetuses from 4 to 9th month of fetal life; morphological elements characteristic of extrafetal mandibles were found, (such as: body, angle, ramus, mentum, coronoid process, condylar process, alevoluses and teeth buds). The bone structure of mandible showed trabecular structure with clearly seen borders. The structure of condylar process was of isosceles triangle with different trabecular structure. With age and texture of the triangle shriveled. Vascularization of the body of the mandible with alveolar process derived mainly from the inferior alveolar artery. The condylar process was supplied with rich vascular rete derived from arteries of temporomandibular joint. The coronoid process was vascularized by the adjacent arteries. The condylar process stroma formed cartilaginous model surrounded by trabeculae osseae cuff resembled, by the look and structure, the epiphysis of long bones. The analysis of measurement of the fetal mandibles proved that both halves of the fetal mandible revealed statistic identity. The comparison of the results of mandible measurement in both sexes did not show any significant differences. The mandible parameters presented slow, successive and constant growth month after month, and the greatest dynamics of growth in all mandible parameters was present, however, in the 7th month of fetal life a growth inhibition was observed. The gonial angle was constant, its mean value -148 degrees.

Angiography↗

Incidence of dentoalveolar injuries in hospital emergency room patients.

A retrospective survey over one year of a hospital emergency room population, seen at an oral and maxillofacial surgery clinic, found 271 patients (4.6% of the total population) with dentoalveolar injuries. A very large number of injuries occurred to children between the ages of 0 and 5 years (42.1%), and there was a significant number of injured patients in the adult population (19.1%). The ratio of male to female was 1.9:1. The leading cause of injury was falls (59.8%). The largest number of injuries was seen during summer. The diagnoses were lateral luxation (27.3%), concussion (17.3%), exarticulation (14.3%), tooth fracture (12.5%), intrusive luxation (11.1%), fracture of alveolar process (7.4%), extrusive luxation (3.7%), and cases with more than one diagnosis (6.3%). Most of the involved teeth were maxillary central incisors, in both dentitions.

Adolescent↗

The problem of dentoalveolar ankylosis and subsequent replacement resorption in the growing patient.

Dentoalveolar ankylosis is a serious complication following injuries of the periodontal membrane in severe dental trauma such as avulsion and intrusion. The condition is a fusion of the alveolar bone with the tooth. The consequences of this condition are progressive resorption of the root with replacement by bone (replacement resorption) and arrested growth of the alveolar process in the growing patient. This article will present an overview of dentoalveolar ankylosis and replacement resorption and its problems, treatment options and prognosis, especially focusing on the growing patient.

Adult↗

Relining extension-base removable partial dentures.

Modern prosthodontic therapy must continue to address the inevitable consequence of tooth loss--that is, alveolar process atrophy. The use of removable partial dentures (RPDs) to treat partial edentia must rely, in part, on support from the ever-deteriorating edentulous ridges. Extension-base RPDs are particularly affected as the tissue-base relationship changes over time after extraction of the natural teeth. This article reviews the concept of observed changes in the residual edentulous alveolar ridge and conventional procedures used to compensate for this bone loss. Finally, a practical procedure is presented which uses convenient and accurate materials that can be readily incorporated into the modern dental practice.

Aged↗

[Primary malignant melanoma of the oral cavity: a case report and review].

The oral cavity is a rare location for the development of primary malignant melanoma. Two cases of malignant melanoma of the superior alveolar process are described. The necessity of an early recognition and of clarification concerning the differential diagnosis of oral pigmentation as well as the treatment are discussed, together with a review of the literature.

Adult↗

Tissue reactions towards titanium implants inserted in growing jaws. A histological study in the pig.

In this investigation, the tissue reactions towards titanium implants inserted in growing jaws of pigs were studied by means of histology. At the age of 12 weeks, 5 test pigs each received 4 Brånemark System titanium implants (fixtures). The fixtures were inserted immediately after extraction of the mesial root of the second deciduous premolar (P2) and the deciduous canine (C) on one side of the mandible and the mesial root of the first deciduous premolar (P1) on the other side. The fourth implant was placed after extraction of the deciduous lateral incisor (L) on one side in the upper jaw. Furthermore, 1 pig in which no extractions or fixture installations were performed served as a control. All pigs were followed for 165 days with clinical, radiographic and biometric examinations, the results of which have been previously presented. In this study, 10-microns-thick ground sections were produced for histology after the jaws had been fixed by immersion in formalin and further processed and embedded in plastic resin. Six of the fixtures originally inserted were lost during the experimental period, and the remaining implants were found to be involved with mineralized bone to varying degrees. Regarding the fixture-to-teeth relationship, it was found that, in the premolar region of the lower jaw, the teeth were positioned superior to and buccally angulated in relation to the fixtures. In the upper jaw, the implants were positioned below the adjacent teeth but centrally in the alveolar process. Tooth germs adjacent to the fixture had a displaced eruption path, buccally or lingually to the fixture. If the bud developed in close contact with the fixture, a changed morphology of the germ could be observed.

Alveolar Process↗

Facial injuries sustained during sports and games.

This study is an investigation into the number and type of facial injuries due to sports and games, because no detailed information on these dental misfortunes could be found in the literature. The group investigated consisted of 319 patients, treated at the Department of Oral and Maxillo-Facial Surgery, Nijmegen in the period January 1, 1971-December 31, 1978. Facial injuries were classified into different types of fractures according to site as also were further series of associated injuries. Males were shown to be more prone to facial injuries than females (2.4:1). In the age group 15-40 years, males proved to be more prone to such injuries than the age group under 15 years. The major part of the injuries is due to fractures of the alveolar process and/or luxation of teeth (59.6%), the zygomatic bone and arch (24.2%) and the mandible (15.3%). Fractures of the maxilla and the nose were rarely seen.

Adolescent↗

Wound healing of endosteal vitreous carbon implants in dogs.

Endosteal vitreous carbon implants are biocompatible and were well-tolerated by the alveolar process of dogs but were not accepted by the gingival margin and the mucosa. A continuous gingival recession with 2 to 3 mm sulcus depth was not similar to that around adjacent natural teeth. There was no epithelial attachment around the neck of vitreous carbon implants, and there was very little or no resistance to probing. The feasibility of using vitreous carbon as it presently exists for the maintenance and preservation of alveolar bone is unfavorable and should be revised. Endosteal vitreous carbon implants require more intense laboratory and clinical studies. Therefore, the practical value of the vitreous carbon implant is questionable, and further investigations are needed before vitreous carbon can be declared acceptable in clinical dental practice.

Alveolar Process↗

[Periodontal tissue status in shortening of the interalveolar distance].

A total of 186 patients aged 40 to 65 with short interalveolar distance were treated. 65.5% of them developed pathological changes in the marginal periodontal tissues (inflammation, periodontal and osseous pouches, resorption of bone tissue of the maxillary alveolar process). Patients with involvement of the marginal periodontal tissue were treated by therapeutic, surgical, and orthodontic methods. Good results were attained in 95.1% of patients.

Adult↗

Nonporous hydroxylapatite in the repair of alveolar clefts in a primate model: clinical and histologic findings.

Twelve adult Rhesus monkeys with surgically created alveolar clefts (ACs) underwent repair that used nonporous hydroxylapatite (NPHA) granules on one side and autogenous particulate bone in the contralateral defect. Clinical and radiographic evaluations at 1, 2, 3, 6, and 12 months postoperatively disclosed some displacement of granules initially, but this stabilized by 2 months. Three of 12 sites repaired with NPHA and four of 12 sites repaired with bone dehisced; however, all of these healed by 2 months. No untoward inflammatory or resorptive changes were observed beyond 3 months. The repaired alveolar processes were similar in bulk and contour in sites grafted with NPHA and with bone. Histologically, giant cells were noted at 3 months, but the number decreased at 6 months and remained at that level up to 12 months. The NPHA granules were embedded in mature fibrous connective tissue with osseous ingrowth evident in eight of the 12 defects. It was concluded that NPHA granules are an acceptable implant material for repair of residual alveolar clefts in which erupting teeth and orthodontic movements are not factors.

Alveolar Process↗