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At least 991 records · Page 55Linked to original sources
PubMed2002

Maxillary anterior esthetic extractions with delayed single-stage implant placement.

As a result of the high predictability of dental implantology, successful osseointegration is no longer the primary challenge. Rather, esthetics has emerged as the primary challenge. Hard and soft tissue ridge augmentation, performed either in preparation for later implant placement or concurrently with implant placement, has been described in the literature for the esthetic zone. These procedures are still evolving. If, however, ridge collapse can be prevented or minimized after tooth extraction, more predictable outcomes with better esthetics can be accomplished, along with fewer surgical procedures. This article describes a technique for esthetic extraction, as well as delayed esthetic single-stage implant placement, in the maxillary anterior sextant.

Aged↗
PubMed2002

Distraction osteogenesis of basal mandibular bone for reconstruction of the alveolar ridge.

Alveolar distraction is being used increasingly for alveolar bone reconstruction in patients with severe mandibular defects. When there has been total loss of alveolar bone, distraction of the mandibular basal bone is necessary. Distraction osteogenesis is considerably more challenging in mandibular basal bone than in alveolar bone. The low level of the cut increases the technical difficulty and may result in a poor outcome. We describe three cases in which more than 10 mm of distraction of mandibular basal bone was required. Semirigid distraction devices were used to reconstruct the alveolar structures in each case.

Adult↗
PubMed2002

Ectodermal dysplasia with total anodontia: rehabilitation of a seven year old child.

Total anodontia in a paediatric patient is a difficult prosthetic problem. Upper and lower complete dentures were fabricated for a 7 year old patient with anodontia. The problems encountered on account of the age of the child, the absence of alveolar processes, the tooth size and acceptability of the dentures are discussed herein.

Anodontia↗
PubMed2002

[Autogenous bone versus beta-tricalcium phosphate graft alone for bilateral sinus elevations (2-3D CT, histologic and histomorphometric evaluations)].

INTRODUCTION: When the maxilla is edentulous and the alveolar process is extensively absorbed, a dental root can be implanted only after the implantation of bone or a bone-substitute. Only in this way can the subjective and objective negative features associated with a removable prosthesis be avoided. Many forms of bone-substitutes are known. Freely taken bone from the patient generally serves as the gold standard for the classification of bone-substitutes. AIMS: The aim of our work was to compare two materials (the patient's own bone and beta-tricalcium phosphate) in the same patient. METHODS: Ten patients were selected who for some reason did not want or could not wear a removable prosthesis. The maxilla was so atrophied that bone or bone-substitute implantation was necessary before the dental root could be implanted. The maxilla had to be elevated from inside (sinus elevation) and thickened from outside (onlay-plasty). Bone was taken in the usual manner from the hipbone. For the internal elevation, such autogenous bone was utilized on one side, and beta-tricalcium phosphate granulate on the other. The formation of new bone and the rate of bone formation were followed by clinical methods and by radiological, histological, and histomorphometric examinations. RESULTS: The implantation succeeded clinically in all ten patients: one year later they all received a fixed bridge. The radiological and histological examinations demonstrated good bone formation on both sides. As concerns the rate of formation of new bone, there was practically no difference after the implantation of autogenous bone or beta-tricalcium phosphate. CONCLUSIONS: This study has therefore provided further evidence that, when certain bone deficiencies are to be eliminated, the unpleasant phenomena accompanying the removal of the patient's own bone can be avoided through the use of new synthetic materials. Accordingly, when comparing the present results with the findings of other authors, beta-tricalcium phosphate may be considered a good graft material even without autogenous bone.

Biocompatible Materials↗
PubMed2003

Clinical and histologic evaluation of bone-replacement grafts in the treatment of localized alveolar ridge defects. Part 1: Mineralized freeze-dried bone allograft.

The purpose of this study was to evaluate the use of mineralized freeze-dried bone allograft (FDBA) in conjunction with a titanium-reinforced expanded polytetrafluoroethylene (TR e-PTFE) barrier in the treatment of localized alveolar ridge deficiencies prior to endosseous dental implant placement. Twelve patients (aged 23 to 65 years) requiring tooth replacement with ridge augmentation were recruited to participate in this study. During ridge augmentation surgery, measurements were made prior to grafting with FDBA plus a TR e-PTFE barrier. Six months later, ridge measurements were repeated, and suitability for implant placement was assessed. At each implant site, a biopsy was taken from the grafted site. The implants were placed and allowed to osseointegrate for 13 weeks prior to phase-two surgery. Clinical data analyzed were horizontal ridge width changes and vertical ridge height changes. Histologic evaluation revealed the formation of new bone and residual particles in each graft site at the time of implant placement Ten patients completed the study. The mean alveolar ridge width increased by 3.2 +/- 1.0 mm (P < .0005). Histomorphometric analysis revealed a range of new bone from 42.9% to 70.5%, with a mean of 47.6%. Graft particles remaining ranged from 29.5% to 57.1%, with a mean of 52.4%. The clinical and histologic findings of this study demonstrate that sites grafted with FDBA in conjunction with an e-PTFE barrier can provide a predictable way to augment deficient alveolar ridges prior to implant placement.

Adult↗
PubMed1998

Localized ridge augmentation with chin grafts and resorbable pins: case reports.

Six block grafts harvested from the mandibular symphysis were used to augment partially atrophied ridges. Three maxillary defects and three mandibular defects were treated in five patients. Autologous bone grafts from the chin were stabilized in the recipient sites with resorbable pins and no membranes were used over the grafts. Healing proceeded without complications. At 3 to 4 months the external cortical surface of the grafts progressively resorbed and the profiles of the pins protruded from underneath the buccal tissue that covered the augmented areas. However, the pins never perforated the tissue and they were resorbed macroscopically within 4 to 6 months. At 6 months the areas treated showed successful ridge augmentation and when exposed for stage 2 surgery, remnants of the pin holes on the external surface of the repaired defects were detected. Radiographic evaluation of the block grafts was performed at 3 and 6 months and histologic specimens were obtained at 6 months; the specimens demonstrated incomplete pin resorption and encapsulation. A severe foreign-body reaction was detected in one case. The presence of an acellular bone matrix in certain sections and a normal bone pattern with a cellular component in others was a consistant finding. ITI endosseous Implants were placed with excellent primary stability in all treated cases.

Absorbable Implants↗
PubMed2003

[Medico-genetic counselling and surgical correction of different forms of facial clefts in children].

In the paper, consideration is given to the necessity of a medicogenetic counselling of children with different forms of facial cleft as an important stage in the therapeutic policy permitting carrying out differential diagnosis with a syndromological approach, verifying the diagnose made, calculating a returned genetic risk for the family, and formulating a policy of administering prophylaxis of birth of a child with cleft lip, alveolar process, hard and soft palate. Special stress is laid on staging of surgical treatment of children presenting with the developmental defect under consideration, the need for colleagues in multiple disciplines, such as maxillofacial surgeon, orthodontist, logopedist, otolaryngologist, pediatrician, genetician, psychologist, which measures will, we believe, help in securing a successful rehabilitation and social adaptation of a child.

Child↗
PubMed2003

The use of bovine porous bone mineral in combination with collagen membrane or autologous fibrinogen/fibronectin system for ridge preservation following tooth extraction.

Preservation of the alveolar ridge following tooth extraction is desirable since it facilitates placement of endosseous implants and may improve the adverse esthetics often associated with fixed partial dentures. The purpose of this study was to compare the clinical effectiveness of bovine porous bone mineral (BPBM) used as a graft material combined with either guided tissue regeneration (GTR) or with the autologous fibrinogen/fibronectin system (AFFS) in preserving alveolar ridges following tooth extraction. Twenty-six patients who required extraction of two or more anterior or bicuspid teeth participated in a split-mouth design study. Following tooth extraction and elevation of a buccal full thickness flap, sockets were filled with bovine porous bone mineral which was then covered with either a collagen membrane or mixed and covered with an AFFS system. An acrylic stent served as a reference point for measurements. Primary flap closure was achieved in all surgical sites, and reentry surgery was performed at 6 months. Reentry surgery showed that BPBM/GTR sites presented with [1] significantly more internal socket bone fill (6.04 +/- 0.21 mm vs. 4.98 +/- 0.26 mm), [2] less, although not statistically significant, resorption of alveolar bone height (0.23 +/- 0.28 mm vs. 0.3 +/- 0.21 mm), and [3] significantly less horizontal resorption of the alveolar bony ridge as compared to BPBM/AFFS (1.06 +/- 0.28 mm vs. 2.60 +/- 0.25 mm). This study suggests that treatment of extraction sockets with a combination of bovine porous bone mineral and guided tissue regeneration is of slightly more benefit in preserving alveolar ridge dimensions following tooth extraction than treatment with a combination of bovine porous bone mineral and the autologous fibrinogen/fibronectin system.

Adult↗
PubMed2003

Morphology of third molar teeth with incompletely formed apices on the basis of panoramic radiograms.

Third molar teeth are causative factors of many oral pathologies. Lower third molars are the most often retained teeth and the origin of considerable pain. The aim of the study is a presentation of the morphology of third molars with incompletely formed apices on the basis of panoramic radiograms. The material comprised routine panoramic radiograms taken in the years 1996-2000. In the cases where third molars with incompletely formed apices were found, there was determined the location of the teeth in the alveolar process. The angle between occlusal plane and tooth axis was measured, which allowed determination of angularity of the teeth. Retromolar space width ratio was also calculated as a prognostic radiographic feature on which an estimation of future eruption of mandibular third molars could be based. In retained teeth the reasons for impaction, such as incorrect angularity, insufficient retromolar space, presence of pathological lesions impeding eruption, were analysed. Panoramic radiograms proved useful in diagnostics of morphology of third molars with incompletely formed apices.

Adolescent↗
PubMedDate not supplied

Electromyographic analysis of the upper and lower fascicles of the orbicular oris muscle, in edentulous patients, before and after complete denture implantation.

The orbicular oris muscle, including its upper and lower fascicles, the alveolar processes and dental arches, constitute a complex morpho-functional system, located in the lower third of the face, which is very important for the clinical determination of the occlusal vertical dimension. Any alteration of this system, as in the case of edentulous patients, might produce esthetic problems and alterations in the muscular tonicity. This study was aimed to evaluate the electromyographic behaviour of that musculature in patients while pronouncing the syllables PAH, BAH, MAH, SAH, FAH, VAH, MEE, and the word MISSISSIPPI. Edentulous patients were submitted to electromyographic tests under two clinical conditions: before and after the implantation of complete dentures. A K6-I EMG Light Channel Surface Electromyograph was utilized (Myo-tronics Co. Seattle, WA, USA). The Analysis of Variance, with 3 sources of variation (Syllables, Muscles and Clinical Conditions) and 12 repetitions, indicated statistically significant differences in the pronunciation of the different syllables. For the Muscles factor, the analysis revealed higher electromyographic readings in the lower fascicle of the orbicular oris muscle, as compared with those of the upper fascicle. The comparison among the Clinical Conditions indicated higher electromyographic values for the edentulous condition (i.e., before complete denture implantation), as compared to those recorded after denture implantation.

Dental Implantation↗
PubMedDate not supplied

[The determination of human mandibular deformations by using optical holography].

A scheme of holographic investigation in counter-current bundles was used to study mandibular deformations in functional exercise. He-Ne laser LGN-215, generating was used as a source of light. To record the holographic interferograms, high-resolution plates of the PFG-03 type were employed, fixed directly on the object. The findings evidence that in contractions of the anterior and posterior masticatory muscles the mandible is exposed to deformation in the horizontal and frontal planes, most marked near the teeth and alveolar process. The deformation near the angle is more marked than in the chin area.

Biomechanical Phenomena↗
PubMed2003

Use of HTR synthetic bone grafts in conjunction with immediate dental implants.

Immediate placement of dental implants in fresh extraction sockets is associated with remaining voids around the implants and often a partial dehiscence or thinning of the facial alveolar plate. Nine patients had Bioplant HTR synthetic bone used as a ridge preservation/augmentation material in conjunction with immediate placement of 10 implants. Hard tissue replacement (HTR) was used to fill the remaining socket void and enhance the facial ridge width, and the wound closed as completely as possible. Dental implants were uncovered at approximately 6 months. Measurements taken of the internal socket width and total ridge width at the implant placement and uncovering showed the mean internal socket width was maintained (7.2 mm vs 6.9 mm), and the total ridge width exhibited a mean change from 9.6 mm to 8.8 mm. Of the 10 implant sites, 7 showed a net increase, 2 no change, and 1 a decrease in overall ridge width. All 10 implants were restored for at least 6 months. These clinical results suggest that HTR is a useful adjunct in the placement of immediate dental implants for the preservation of ridge width and provides a good base for functional and esthetic prosthetic reconstruction.

Adolescent↗
PubMed2004

Treatment options of untreatable traumatized anterior maxillary teeth for future use of dental implantation.

The anterior maxilla is the most traumatized region during childhood. Posttraumatic complications occasionally lead to tooth loss as well as the need for future implants. Unfortunately, it is contraindicated to place dental implants during childhood. A waiting period of approximately 8 to 10 years before completion of growth is required. For this patient to become a candidate for future dental implants, it is necessary to ensure the continuous growth and to preserve the dimensions of the alveolar process until growth has ceased from time of injury until joint maturation. To achieve these goals, it is essential to coordinate the treatment sequence at the time of trauma. After loss of a traumatized anterior permanent maxillary incisor in young adults, treatment options are limited: orthodontic closure of the gap and reshaping the adjacent teeth, or tooth extraction and maintaining the gap with a temporary restoration. Orthodontic space closure has limited indications and requires prosthetic restoration of at least 2 teeth. Extraction and temporary restoration will usually lead to bone augmentation before implantation. Other possible treatment options include orthodontic extrusion of the root remnant (in cases of untreatable root fracture or complicated crown-root fracture) and a temporary crown to serve the patient until the completion of growth and development, autogenous tooth transplantation, intentional extraction and immediate tooth replantation, distraction osteogenesis, and decoronation. Because general rules do not apply, individual treatment plans are necessary.

Adult↗
PubMed1992

[Severe atrophy of the alveolar ridge in edentulous patients. Combined treatment using bone grafts and screw implants].

In cases of advanced alveolar ridge atrophy, when the bone available for endosseous implants is not sufficient, endosseous implants are combined with augmentation of the alveolar ridge by means of autologous bone transplants. Depending on the type of atrophy found, the authors use three different surgical procedures: onlay technique, sandwich technique and alveolar extension technique. In all cases functional loading of the implants was performed by way of an entirely implant-supported bridgework. Results to date indicate that initial postoperative resorption is followed by a virtual standstill once the implants have been loaded.

Alveolar Process↗
PubMedDate not supplied

Osteotome-mediated sinus floor elevation: a clinical report.

PURPOSE: It was the aim of the present study to clinically evaluate the success of osteotome-mediated sinus floor elevation (OMSFE) using autogenous and xenogenic bone and a variety of screw-type implants. MATERIALS AND METHODS: From August 1995 to February 2003, 276 OMSFE procedures with simultaneous implant placement were completed in 167 patients. RESULTS: The mean residual bone height (RBH) of the alveolar ridge was 7.1 mm (range 3 to 10 mm). The mean increase in height of the implant sites using osteotome techniques was 3.8 mm (range 2 to 7 mm). Of the 276 implants placed, 240 had been loaded for an average of 27.9 months (range 1 to 84 months). There were a total of 18 failures: Ten implants failed to integrate, 3 implants were lost within the first 18 months of loading, 1 implant fractured after 3 years in function, and 4 implants demonstrated excessive bone loss. The overall survival rate was 93.5%. When only sites with an RBH of 4 mm or less were considered, the survival rate dropped to 73.3%. Small tears in the schneiderian membrane were clinically assessed at 13 sites, for a detectable perforation rate of 4.7%. DISCUSSION: The primary determinant in implant survival with OMSFE procedures was the height of the residual alveolar ridge. Implant design, graft material, and the method of sinus floor infracture (direct or bone-cushioned) exerted minimal influence on survival outcome; however, factors such as edentulism, osteoporosis, and an overdenture prosthesis were shown to negatively influence postloading survival of implants placed in areas of limited RBH. CONCLUSION: OMSFE procedures can be used predictably for implant placement at sites with moderate vertical deficiencies in the posterior maxilla.

Adult↗
PubMedDate not supplied

Use of horizontal alveolar distraction osteogenesis for implant placement in a narrow alveolar ridge: a case report.

Although alveolar distraction is a promising method for ridge augmentation involving the atrophic maxilla or mandible for implant placement, techniques of horizontal and oblique alveolar distraction for expanding a narrow alveolar ridge have not been established. A case of horizontal alveolar distraction for implant placement using a titanium mesh plate and a distraction screw is reported. Horizontal alveolar distraction was performed on a patient with an extremely atrophic alveolar ridge in the anterior mandibular region. Two transport segments using horizontal osteotomies were prepared, and 2 horizontal alveolar distraction devices were inserted. After a 7-day waiting period, the devices were activated and alveolar widening was performed labially (0.225 mm twice a day for 14 consecutive days). Three months after consolidation, the distraction devices were removed. The distracted areas were completely filled with newly formed solid bone tissue. Two months after the device was removed, 4 endosseous implants were placed and an implant-supported definitive prosthesis was placed. This method of horizontal alveolar distraction appears to be clinically useful for the placement of implants in atrophic or knife-edged alveolar ridges.

Alveolar Process↗