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PubMed1998

[Glassman palatine expansion. Experiences with mono- and bimaxillary dysgnathia operations].

The median palatine suture has long been regarded as having the greatest resistance to dilatation of the maxilla. In 1984 Glassman [3] presented a conservative-surgical method of division of the palatineal suture in which only the lateral and anterior support of the maxilla is debilitated surgically. An orthodontic apparatus cemented in place preoperatively is already used intraoperatively for dilatation of the maxilla. In the period from 1991 to 1997, 16 patients with a leptomaxilla and various dysnathic findings have been operated on at our clinic by the method described by Glassman. Sometimes the maxilla was dilated intraoperatively using the apparatus cemented in place by the method of Derichsweiler and dilatation was continued post-operatively until the described result was achieved. After successful dilatation of the maxilla and a stabilizing phase, a mono- or bimaxillary operation was performed. The use of this method led to the desired result in 15 patients. Dilatation of the maxilla was objectivized by determining the pre- and postoperative width of the anterior and posterior dental arch using models and X-ray of the occlusal overlay of the maxilla. In one patient who was operated on at the age of 38 years, a fracture of the alveolar process of the maxilla occurred unilaterally due to the completed ossification of the median palatine suture. The method of surgically aided dilatation of the maxilla at the level of Le Fort I plane is suitable for patients up to the age of 30. In older patients, the median palatine suture should be transsected as well.

Adult↗
PubMed1984

Morphologic analysis of upper lip area following maxillary osteotomy via the tunneling approach.

Preservation of favorable upper lip morphology is a critical factor in assessing the success of maxillary osteotomy surgery. Unesthetic postsurgical lips often appear thin and tight, with the vermilion border shortened and rolled inward. Clinical observation of patients who had undergone total maxillary alveolar process osteotomies by means of vertical buccal incisions and a tunneling approach suggests that presurgical lip morphology is minimally changed. This study investigates the presence and degree of change in upper lip morphology following this technique. Pre- and postoperative cephalometric radiographs of ten patients were compared by superimposition of acetate tracings on cranial base landmarks. Cross-sectional lip area was calculated by compensating polar planimetry presurgically and at four intervals following intervention: 1 to 3 days, 1 to 3.5 months, 6 to 9 months, and more than 10 months. Analysis showed the cross-sectional upper lip area, compared to the presurgical baseline, to be as follows: Immediately following surgery, the area increased by a mean of 27.8% (range, 15.0% to 36.9%; SE = 4.72). At 1 to 3.5 months postsurgery, the increase was reduced to 3.3% (range, 0 to 7.7%; SE = 0.82). At 6 to 9 months, lip area remained minimally increased, at + 0.78% (range, -5.0% to 7.6%; SE = 1.68). At 10 months or longer, the mean increase from preoperative values was 0.61% (range, -6% to 6.4%; SE = 1.38). The results of this study indicate that the upper lip cross-sectional area returns to its presurgical value at 6 months following surgery and remains constant at subsequent measurements. The performance of maxillary surgery with this flap design appears to preserve presurgical lip morphology.

Adult↗
PubMed1979

Immediate dental root implants from synthetic dense calcium hydroxylapatite.

In this article, root implants implanted directly after extraction of the natural teeth were described. The root implants were made of densely sintered or hot-pressed calcium hydroxylapatite (CHA). The significance of using such implants as a method of preserving the bulk of the alveolar ridge and as possible anchoring sites for a post and core for fixed partial dentures was discussed.

Alveolar Process↗
PubMed1981

Increased occlusal vertical dimension in adult monkeys.

Splints which opened the vertical dimensions on all posterior teeth in five rhesus monkeys were studied over a period of 3 to 36 months. Findings were as follows: 1. The increased vertical dimension of occlusion did not have a pathologic effect on the TMJs. 2. The posterior teeth attached to the splint and the teeth opposing the splint were intruded into the alveolar processes. 3. The nonoccluding incisor teeth extruded, but the epithelial attachment remained close to the cementoenamel junction. 4. The vertical dimension as measured between the markers in the bones of the mandible and maxillae gradually returned toward the pretreatment vertical dimension, although complete closure to this position was not accomplished during the time period of the experiment. 5. The relationship between the epithelial attachment and the cementoenamel junction remained undisturbed by the experiment. 6. After completion of growth, there appeared to be a definite tendency for rebound to the normal pretreatment vertical dimension following increase of the vertical dimension. This was recorded by measurable movements of the teeth.

Animals↗
PubMed1989

Surgical and prosthodontic residual ridge reconstruction with hydroxyapatite.

The ultimate goal of a ridge augmentation procedure is to form a bearing surface for the denture that will provide stability, retention, and support. Residual ridge reconstruction with an implanted material must be based on an understanding of the variations of ridge atrophy. A problem-oriented classification describes the different forms of residual ridges. This classification of similar types of resorbed residual ridges can be used to establish a rational plan of treatment. The proper placement of hydroxyapatite is critical to obtain the desired reconstructed residual ridge. In the mandible, a lingualized placement of the alloplast is suggested. Careful use of an anatomic matrix to support and contain the hydroxyapatite particles eliminates the need for a splint. The surgical stage includes vestibuloplasty and skin grafting to provide the patient with an increased denture-bearing surface. The ridge created in the form of a comma posteriorly enhances retention and stability. The broad residual ridge with an improved interarch relation also enhances the support and provides a better foundation for balanced occlusion.

Alveolar Process↗
PubMed1993

Cast titanium implants for localized ridge defects: a clinical report.

A technique that allows the correction of alveolar ridge defects with titanium implants and pin stabilization is described. The use of titanium pins has improved the intimacy of contact of the implant with the bone, which simplifies implant placement and enhances implant stabilization.

Adult↗
PubMed1976

Florid osseous dysplasia. A clinical-pathologic study of thirty-four cases.

Thirty-four patients with florid osseous dysplasia were studied. The majority were asymptomatic Negro women: Seventeen biopsy-proven simple bone cysts were found in affected quadrants of fourteen patients. Radiographs displayed a spectrum of sclerotic and ground-glass opacities limited to alveolar processes but not to root apices. Biopsy material was studied in all cases, and biochemical analyses of serum and cyst fluid were performed on some patients. Test results and skeletal radiographs indicate that the disease is limited to the jaws. Patients have remained asymptomatic with little alteration of radiographic patterns. Three cysts failed to heal following treatment, others filled with radiographically abnormal tissue. Chronic osteomyelitis may infrequently complicate the disease. These cases appear to represent the most exuberant manifestation of this reactive fibro-osseous jaw disease.

Adult↗
PubMed1985

Ridge form in preprosthetic surgery.

In preprosthetic surgery there is a need for improved methods of diagnosis that are based on the recognition of the anatomy of the deficient residual ridge. These methods enable the surgeon to direct his attention to obtaining the ideal ridge form for denture construction. To this end, characteristics and patterns of resorption as well as a cephalometric method of assessment are presented. A problem-oriented classification of deficient residual ridges will also permit the clinician to select the most effective method of treatment.

Alveolar Process↗
PubMed1988

Ridge reconstruction with hydroxylapatite. Part 2. Ridge reconstruction based on residual anatomic structure.

The second part of this article shows how the problems of atrophy and resorption of the residual ridge can be corrected with hydroxylapatite to obtain ideal ridge form and maximal prosthetic rehabilitation. The high degree of efficiency of the system is based on a thorough knowledge of the anatomic structures involved, on the use of the cephalogram as a guide, on the correction of adverse intermaxillary relationships and on the recourse to a staging of procedures when required.

Alveolar Process↗
PubMed1989

Collagen/hydroxylapatite implant for augmenting deficient alveolar ridges: a 24-month clinical and histologic summary.

A new alveolar ridge augmentation material composed of purified fibrillar collagen (PFC) and particulate hydroxylapatite (HA) (Alveoform Biograft, Collagen Corp., Palo Alto, Calif.) was evaluated in the treatment of 77 edentulous patients in a multicenter study. All patients had mandibular augmentation; 22 also had maxillary implant augmentation. Mean ridge height was 15.4 mm before surgery. Twenty-four-month data showed a mean ridge augmentation of 4.1 mm. Prosthodontists rated the ridge firmness "good" to "excellent" in 96.6% of patients after 2 years. All adverse effects with the exception of some residual paresthesia/dysesthesia resolved spontaneously within 24 months. Bone-graft interface samples were examined histologically in five patients 1 year after mandibular ridge augmentation. No evidence of PFC was found, and the HA particles were surrounded by dense, fibrous, host-connective tissue or trabeculae of woven and lamellar bone. Assessment of PFC/HA-augmented ridges at 24 months showed clinically and histologically significant results.

Alveolar Process↗
PubMed1990

Histologic evaluation of the bone/graft interface after mandibular augmentation with hydroxylapatite/purified fibrillar collagen composite implants.

Samples of the bone/graft interface were evaluated histologically in five patients 1 year after mandibular ridge augmentation with a composite of hydroxylapatite particles in a matrix of purified fibrillar collagen (HA/PFC). The resulting defects were refilled with HA/PFC after the biopsy specimens were obtained. Histologic examination of the specimens yielded no evidence of purified fibrillar collagen. Hydroxylapatite particles were surrounded by dense fibrous host connective tissue, trabeculae of woven and lamellar bone, or both. HA/PFC was found to be biocompatible with human tissue and receptive to direct bone apposition on the hydroxylapatite particles.

Aged↗
PubMed1990

Triple bone labeling of canine mandibles.

Fluorescence microscopy was used for evaluation of new bone formation in 16 canine mandibles augmented with hydroxylapatite (HA) granules. Three fluorochromes were injected at different time intervals during therapeutic radiation treatment. Oxytetracycline, DCAF, and alizarin-complexone were given intravenously to mark the bone level at these times, respectively. Oxytetracycline, which defined the baseline of bone at implantation of HA, was detectable in 42% of animals that were irradiated and in no animal of the nonirradiated control group. The marker DCAF, designating levels of bone at the start of radiation, was demonstrated in 92% of irradiated animals, and in 75% of animals in the control group. The uptake of alizarin-complexone determined the level of bone found at the end of irradiation. This marker was demonstrated in 50% of the dogs irradiated and in 75% of the control dogs. Bony trabeculae were found between and at the surface of the HA granules. New generation of bone directly on the HA granule and in the surrounding haversian systems as part of normal bone turnover was demonstrated to take place more than 5 months after implantation of HA.

Alveolar Bone Loss↗
PubMed1987

Maxillofacial and dental soccer injuries in Finland.

Between 1979 and 1982 there were 8640 accidents to registered soccer players in Finland. Of these, 552 (6.4%) affected the maxillofacial and dental regions. Medical records were located relating to 537 of these cases (97%). There were a total of 843 injuries, of which 681 (80.8%) affected the teeth or alveolar processes, and 95 (11.2%) were fractures of the lower or middle third of the facial skeleton. The most common cause of the accidents (in 86.4% of cases) was contact with another player. The mean cost of maxillofacial and dental injuries was over twice as high as the mean cost relating to all soccer injuries. The need for the use of mouthguards by soccer players to protect against such injuries is discussed.

Adolescent↗
PubMed1989

Experimental fractures of the mandibular body of sheep and dogs. A new technique.

In order to create artificial fractures in animals resembling those which occur naturally, a new technique for fracture production was developed. Using a specially designed clamp, artificial fractures were produced in the mandibular body of seven sheep and 12 dogs. Radiographical analysis of the effects of the clamp on the mandibular body showed simple, single vertical fractures in the buccal cortex, inferior border and the alveolar process comparable to those which occur naturally. Using the technique described it was possible, in all cases, to carry out treatment with the use of 4-hole poly(L-lactide) plates and screws.

Animals↗
PubMed1990

Alveolar ridge augmentation using a new design of inflatable tissue expander: surgical technique and preliminary results.

Ridge augmentation with particulate hydroxyapatite (HA) is compromised by the propensity for the HA particles to disseminate throughout any surgically created space within the tissues. Several techniques designed to overcome this problem have been described, including the use of inflatable tissue expanders. Some of the residual problems related to this technique are attributable to aspects of expander design and surgical technique. This paper which describes a new design of tissue expander which is completely submerged in use, also describes in detail the surgical technique associated with it. Preliminary results are discussed.

Alveolar Process↗