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PubMed1980

Reconstruction of alveolar jaw bone. An experimental and clinical study of immediate and preformed autologous bone grafts in combination with osseointegrated implants.

In edentulousness, which cannot be adequately compensated for by a denture but causes considerable oral dysfunction, the treatment of choice is a bridge construction on osseointegrated titanium fixtures. In those cases, where the quantity or quality of the alveolar ridge--as a consequence of progressing resorption--does not provide enough bone tissue for lasting implant anchorage, restoration of jaw bone anatomy is required. In attempts to evaluate the best material and method for bone reconstruction in these cases, experimental and clinical studies on various grafting procedures were performed. The immediate, autologous cancellous bone and marrow graft was not found to provide volume restitution to the required extent because of rapid graft resorption. The biomechanical capacities of the jaw bone were, however, restored to such a degree that fixtures could be integrated and permanent bridge stability achieved in 13 out of 18 cases. In order to avoid resorptive derangement of the anatomy of the reconstructed alveolar region a modified transplantation technique was developed. In an experimental study in dogs a procedure of preformation of autologous composite bone grafts containing integrated titanium implants was designed. The results indicated that this procedure could provide graft persistance together with implant stability. Clinical applications of this reconstructive procedure showed that preformed grafts containing incorporated implants from the proximal tibial metaphysis could be used to restore jaw bone anatomy and that the implants remained integrated within the transplanted, remodelled bone, providing permanent support for bridge constructions.

Adult↗
PubMed1987

Long term results in cleft and palate repair with modified periosteal flap technique.

The authors describe their multidisciplinary approach to cleft lip and palate repair. The preoperative treatment is performed only in a few selected cases. The lip is operated on at 3 months of age with a periosteal flap, slightly modifying Skoog's technique. The cleft palate is closed at 18 months (Langenbeck method). The orthodontic treatment is undertaken at 6 or 7 years. 45 cases are periodically investigated (casts, masks, X-ray, cephalograms, records, films). Our follow-up covers a range of 9 years. Results are satisfactory.

Alveoloplasty↗
PubMed1992

The early gingivoalveoloplasty. Preliminary results.

To try and achieve good alveolar structure without the need for later bone grafting, we have carried out secondary gingivoalveoloplasties in 19 consecutive patients with cleft lip and palate at a mean age of 36 months (range 19-68). The lip and soft palate had been repaired at a mean age of 6 months. Preliminary results suggest that simultaneous closure of the hard palate and reconstruction of the alveolomaxillary cleft results in good formation of new bone and good or reasonable alveolar structure, so obviating the necessity for bone grafting at the age of 9-10 years. Long term follow up is needed to confirm these results.

Age Factors↗
PubMedDate not supplied

Placement of endosseous implants into bone-grafted alveolar clefts: assessment of bone bridge after autogenous particulate cancellous bone and marrow graft.

The objective of this study was to evaluate the bone quantity of alveoli grafted with autogenous particulate cancellous bone and marrow for implant placement in patients with alveolar clefts. Bone height, bone width, and interdental alveolar crest level were evaluated using computed tomography and periapical radiographs. The grafted alveoli underwent resorption 3-dimensionally, and the interdental alveolar crest level also decreased. The latter seemed to be the critical factor for implant surgery, as almost half of the grafted alveoli required another bone graft within 24 months after the original bone graft to increase the interdental alveolar crest level for endosseous implant placement. These data suggest that alveoli grafted with particulate cancellous bone and marrow are suitable for implant placement, but that the loss of width and height of the bone bridge must also be considered.

Adolescent↗
PubMedDate not supplied

Current periodontal plastic procedures around teeth and dental implants.

Periodontal plastic procedures are performed to prevent or correct anatomical, developmental, traumatic or plaque-induced defects of the gingiva, alveolar mucosa or bone. The majority of these procedures are performed in combination with restorative and/or orthodontic therapy, with the primary goal of enhancing esthetics. In this review, some of the more prominent techniques currently available to address mucogingival deficiencies, including pedicle grafts, free soft tissue grafts and combination grafts, are illustrated. In addition, potential complications associated with periodontal plastic procedures will be discussed.

Alveolar Bone Loss↗
PubMed1999

[Evaluation of the biocompatibility of grafts for bone defects].

BACKGROUND: This paper examines a new material composed of polylactic and polyglycolic acids mixed with destrane easy to handle in bone defect reconstruction in periodontology and implantology: its name is fisiograft. METHODS: According to the European directives, fisiograft was checked for some biological tests selected for its specific use. In particular, tests of cytotoxicity, genotoxicity, sensitization and implantation in rabbit's femurs were carried out. RESULTS: The results show that the composite material is not cytotoxic when it is in direct and indirect contact with murine fibroblasts. It is not genotoxic and not allergenic. The implantation in rabbit, already after 30 days, shows that around the material there is a rapid bone growth and the material is reabsorbing. The degradation is suitable for its clinical use. CONCLUSIONS: Fisiograft showed to be biocompatible, easy to handle and its degradation kinetics in bone is appropriate.

Alveolar Ridge Augmentation↗
PubMed1999

[The facial artery-buccinator musculo-mucosal flap for reconstruction of the palate].

Since may 1999, 5 facial artery musculo-mucosal (FAMM) flaps have been used for mucosal reconstruction of the top of the mouth. The FAMM flap, first described by Pribaz in 1993 is a modification of the naso-labial cutaneous flap. The flap can be inferiorly based on the facial vessels (orthograde flow) or superiorly based (retrograde flow). It can easily reconstruct palate, alveolus and soft palate defects. The are of rotation has its pivot point inferiorly at the retromolar trigone, superiorly at the gingival labial sulcus. The FAMM flap has been used for 2 palatal fistula after facial blast injuries and 1 secondary cleft palate surgery. For the cleft palate surgery an Lefort 1 osteotomy with iliac crest graft was associated. All the flap but one survive with primary healing. One partial necrosis was noted but spontaneously healed secondarily. The FAMM flap is a reliable flap for mucosal reconstructions of the top of the mouth. The flap dissection is easy and the donor site morbidity is low.

Adolescent↗
PubMed1976

Principles in periodontal osseous resection.

In the clinical treatment of periodontal disease, the therapist should set definite goals so that he will know what to expect in a completed case. The goal of surgical intervention is certainly the elimination of the periodontal pocket. This is an obtainable objective. The therapist must understand normal periodontal morphology, thin margins, cone-shaped interdental papillae, and the interdental grooves blending into a harmonious periodontium. With this knowledge, he can surgically alter the tissue to achieve the desired architectural result. Restoration of the structures to healthy, maintainable contours is the ultimate success of his efforts. In many cases, osseous resection provides a mode of treatment that is predictable. It has become a basic procedure in periodontal therapy after more than 25 years of widespread clinical use by a large number of therapists.

Alveolectomy↗
PubMed1976

Osseous surgery--how much need we compromise?

It is essential that the execution and results of osseous surgery be carefully analyzed. Perhaps the two most compelling reasons are (1) that we should understand the effects on tooth mobility and their implications for complex restorative dentistry, and (2) to facilitate the accurate assessment of postoperative "success," bearing in mind not only improvement of the environment, but also increased chances of survival for the operated teeth. We have discussed the effects of osseous surgery on tooth mobility. In the light of recent information, a more accurate assessment of the need for splinting can be made. There has always been some controversy about osseous recontouring. Of late, there has been a particular resurgence of scepticism as to the efficacy of osseous resective procedures compared with more conservative forms of therapy. Scientific investigation demands the doubting mind and the analytical approach in order to establish the truth or fallacy of current ideas. This approach is essential to the continued existence of periodontics as a clinical science. These investigations should be based on a full understanding of the therapeutic measures being investigated, as it is misleading to assess the results of a procedure when that procedure is either not used to its full advantage or inappropriately used. It is hoped that these comments will be helpful in deciding whether definitive osseous correction in a given case is desirable or possible, in terms of both bone removal and permanent splinting. The author also hopes that this article has served to enhance the possibilities of more complete osseous correction when indicated, in order to achieve minimal pocket depths, and to permit proper comparison with other modes of periodontal therapy. It is, however, crucial to realize that whatever modality of therapy utilized, it is merely one phase in the treatment spectrum. Maintaining a stable state for the patient over many years is the ultimate goal, beside which any given technical procedure pales in significance. Periodontal therapy is an ongoing process in which patient recall plays a central role.

Alveolectomy↗