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PubMed1988

[Surgical protocol of velo-palatal and labio-nasal clefts].

Based on a series of 52 cases of velopalatine and labionarinal clefts treated according to the same principle of therapeutic chronology, the authors define their recent surgical protocol for the primary repair of these clefts. Satisfactory functional repair of the tongue and platysma muscles of the face determine the good anatomical results and, in particular, the development of the maxilla together with the results on speech and middle ear pathology. Pathophysiological elements argue in favour of staphylorrhaphy as the first operative stage in unilateral labiovelopalatine clefts associated, at the same time, with cheilorhinoplasty; passive orthodontia is generally performed until the secondary palatoplasty. The surgical repair technique is closely related to this therapeutic timing in terms of the muscular and periosteal detachments.

Adolescent↗
PubMedDate not supplied

[Periodontal osseous surgery: osteoplasty and osteotomy].

Elimination of the periodontal pocket is a prime objective of periodontal therapy. Normally the gingiva is consistent with the underlying bone, and aberration in gingival form can be corrected by gingivectomy or gingivoplasty if the gingiva is supported by good bony architecture. If periodontitis has caused marginal irregularities or septal deformities the complete elimination of the periodontal pocket is done by osteoplasty or osteoectomy. The Authors through a review of the literature have examined these surgical techniques.

Alveolar Process↗
PubMed1988

Use of mucogingival surgical procedures to enhance esthetics.

The procedures outlined herein deal primarily with improving esthetics. The importance of esthetics in periodontics is most apparent in patients with a high lip line. Current mucogingival procedures provide the surgeon with the capability to have a major role in the total treatment of complex restorative cases. Periodontal considerations must be included as an integral part of esthetic dentistry. A complete examination of the patient must include a thorough periodontal evaluation. In addition to the usual detection of periodontal pockets and inflammation indicative of periodontal disease, the examination should include a thorough mucogingival evaluation for detection of the following: (1) inadequate keratinized gingiva; (2) gingival recession; (3) excessive gingival display; (4) insufficient clinical crown length; (5) asymmetric gingival margins; (6) flat marginal contour; (7) improper gingival margin relationships; (8) lack of harmony of gingival margins with the lip line; and (9) alveolar ridge deficiencies. Mucogingival surgical procedures should be performed after control of all etiologic factors and in concert with the restorative therapy so that the surgery can produce the most desirable esthetic result. It must be understood that the location and contour of the gingival margin and its relationship to adjacent margins are as important to the final esthetic result as the location, form, and relationship of the incisal margins of the anterior teeth. Attention to the total dental display as framed by the smile, with appropriate mucogingival analysis and treatment, is necessary to achieve the most satisfying esthetic results.

Alveoloplasty↗
PubMed1977

Preprosthetic bone graft augmentation with allogeneic bone: a preliminary report.

Allogeneic bone biologically interacts with host tissues at a graft site. Addition of autogenous cancellous bone and marrow to allogeneic bone enhances the osteogenic activity of the graft. These observations have been confirmed by noninvasive, quantitative radionuclide methods. The process of freeze-drying greatly reduces and, from the standpoint of clinical significance, essentially eliminates the antigenicity of allogeneic bone. Judged by the results of 14 cases that are under continuous follow-up, allogeneic bone graft augmentation of the denture-bearing area is a possible alternative to autogenous grafting. The process of obtaining and preparing the blanked bone for surgery is reasonable although some questions remain, such as the desirable length of time for tissue reconstitution and the need for culturing or adding antibiotics to the reconstitution solution, or both. It appears that the addition of autogenous cancellous bone and marrow is desirable in most instances unless the dimension of the area to be augmented is quite small or an iliac osteotomy is precluded for medical reasons. The occurrence of complications such as infection and dehiscence during the postoperative course is similar to that in patients with autogenous grafts. Dehiscence can be expected although it appears that if the graft has been supplemented with autogenous cancellous marrow the incidence and extent are dminished. It should be emphasized that dehiscence does not signify failure of the graft-allogeneic bone is not sloughed in toto after being exposed to the oral cavity. Secondary soft tissue procedures can be used in patients with allogeneic grafts; additional cases with long-term follow-up are still needed to establish this method.

Adult↗
PubMed1977

Preprosthetic surgery.

Several of the abnormal conditions existing in the edentulous patient can be corrected surgically, prior to construction of dentures, to enable the patient to function more successfully following prosthetic restoration. The more common problems have been discussed which often require surgical correction. In some instances, articulated diagnostic models of the patient's mouth show that surgery can be avoided, or when surgery is necessary, these models help identify the exact locations of the tissue to be corrected. Alveolectomy has been presented with an eye toward conservatism since this procedure affects the quality of denture foundation and therefore denture stability. Alveolectomy should be performed only when there is a definite indication for the procedure. Correction of soft tissue abnormalities can substantially improve the patient's ability to function with dentures and solve many of the adjustment problems which confront the dentist. It is often better to correct the soft tissue abnormality rather than to circumvent the problem with an inferior prosthetic restoration. Since the introduction of resilient acrylics and tissue conditioning materials, the patient need no longer suffer the discomfort of denture withdrawal after surgery. Electrosurgery has emerged as a successful method of correcting many soft tissue abnormalities. Vestibuloplasty is receiving much emphasis as a possible treatment for atrophic ridges in which there is still enough alveolar bone from which to extend a sulcus. These sulcus extension procedures may offer some help in the future regarding the problem of resorbed ridges, but presently, more research is necessary before widespread use is recommended.

Alveoloplasty↗