Ridge maintenance by root submergence.
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Alveolar bone graft augmentation has returned successful prosthetic denture function to patients with deficient alveolar ridges who were beyond the scope of treatment by preprosthetic soft tissue surgical procedures alone. The results of a 30.7-month mean postoperative follow-up of 15 patients with panoramic radiographs were recorded. Emphasis was placed on evaluation by functional improvement rather than on radiographic interpretation. Ideal results were not obtained in all instances; however, in the majority of cases, the patient benefitted by improved prosthetic function.
A modified technique for alveolar sulcus extension was developed from the classic procedure of extending the oral sulcus with epithelium. The ease of surgical manipulation sharply reduces postoperative morbidity and offers highly satisfactory functional results.
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The healing of an extraction wound is taken as starting-point, and complications and their avoidance are discussed insofar as they affect the shape of the alveolar process. Surgical methods of treating cysts and other tumours are reviewed, and it is shown how these may be carried out with little damage to the form of the denture-base. Every dentist should bear in mind subsequent prosthetic care whenever undertaking surgery of the oral cavity.
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Effective management of furcation regions affected by periodontal destruction includes accurate assessment of etiologic factors, careful diagnosis of furcation involvement, and an appropriate plan of therapy. Many forms of therapy have been advocated; most have been designed to allow adequate professional and personal removal of plaque from the furcation. All types of traditional therapy have disadvantages that must be carefully considered by the therapist and the patient. Newer treatment modalities attempt to regenerate periodontal attachment in the furcation. The techniques do not have sufficient controlled documentation at this time to warrant unqualified support, but they appear to be biologically feasible and hold considerable clinical promise. At this time, guidelines for management of a periodontally involved furcation region must stress application of the simplest therapy that is likely to provide clinical stability. Longitudinal data from carefully controlled clinical trials comparing therapy techniques are needed to refine our clinical judgment.
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