Immediate reconstruction of the resected mandibular arch.
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Contiguous cervical and deltopectoral flaps have several advantages in reconstruction of the head and neck after extirpation of cancer. The cervical skin provides an excellent color match for facial skin, and nonhair-bearing skin is available if lining of the oral cavity is required. The deltopectoral flap provides superior coverage for the carotid artery.
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The use of Proplast in the restoration of contour defects and for reconstruction of alveolar ridges is described. An evaluation of the results of treatment suggests it is a useful material for the restoration of facial contour, but that there is a significant risk of infection when the intra-oral approach is adopted.
The material presented in this paper is a preliminary report on the use of bone marrow grafting in the secondary closure of alveolar palatal defects in young children with mixed dentition. A group of patients is presented in whom successful closure of an alveolar fistula was achieved with improvement of the eruption pattern of the teeth adjacent to the cleft due to new bone formation that allowed early orthodontic alignment. The concept of the formation of a dynamic growing bone from bone marrow grafting is discussed.
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A common problem of the mylohyoid ridge in the resorbed edentulous mandible is discussed. A surgical technique that is simple, though efficient, is described for the elimination of the anomaly in the ambulant patient. A prosthetic technique is suggested for maximum advantage to be gained from the operation.
Tricalcium phosphate ceramic, with 50% porosity and 400 to 500 micrometer pore diameter, was used to augment the edentulous alveolar ridge of 10 adult mongrel dogs. The implants were evaluated histologically at different time intervals (7, 30, 90, 180, and 360 days). Preoperative and postoperative blood chemistry studies were also evaluated. The results showed that, other than for the expected acute nonspecific inflammatory response due to the surgery, the material was well tolerated by the tissues and was nontoxic. Bone and soft tissues grew into the pores, thereby creating an excellent biomechanical bond between the ceramic implant and surrounding structures. Preoperative and postoperative blood chemistry studies demonstrated no significant change.
A technique has been described which can augment concavities and irregularities in edentulous ridges where cosmetics are important. Using the combination of temporary acrylic resin restorations and connective tissue autografts, unattractive con-cavities and ridge irregularities can be corrected.
Two mongrel adult dogs were used in this study. The mandible was edentulated unilaterally and then augmented with porous tribasic calcium phosphate ceramic. To determine the effects of a denture over the augmented site, a unilateral distal-extension removable partial denture was constructed and inserted. At the end of the 6-month period, clinical evaluation revealed a healthy residual alveolar ridge tissue with no inflammatory reaction due to the implant. Histologic examination confirmed the clinical findings. There was no inflammation, bone and soft tissue grew into the pores, and no bone resorption occurred. It is concluded therefore that porous tribasic calcium phosphate ceramic is a potential material for residual alveolar ridge augmentation.