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[Application of prosthetic replacement for bilateral maxillectomy defect].

A 59-year-old woman with large hard palate cancer underwent surgical resection. We constructed a maxillary prosthesis to be connected to the patient's mandibular denture. Bilateral maxillectomy resulted in total loss of the hard palate and bilateral alveolar and partial loss of the soft palate. A obturator prosthesis was prepared beforehand to fit the surgical cavity. The patient recovered functional speech and swallowing at a relatively early stage, achieving satisfactory cosmetic results.

Carcinoma, Squamous Cell↗

Principles of treatment for temporomandibular joint ankylosis.

An understanding of the growth and development of the temporomandibular joint (TMJ) is necessary for successful treatment of TMJ ankylosis. The concept of a growth center in the condyle is probably misleading; instead, the soft tissues of the orofacial region seem to provide the primary growth forces. As a result of this concept, methods of treatment should be reexamined.

Adolescent↗

Dislocation of the condyle into the middle cranial fossa.

Surgical intervention by a preauricular approach appears to be the preferred treatment in this rare injury. It does not appear necessary or wise to disimpact the condyle as it presents more of a surgical risk and its presence in the cranial fossa seems to pose no neurological problems. The use of an interposing medium, placed after the teeth are secured in occlusion, appears to be definitely indicated to prevent ankylosis and, hopefully, to eliminate deviation of the mandible. A carved piece of Silastic, designed to conform to the recontoured roof of the glenoid fossa, has produced excellent results in cases of ankylosis; it served well in this case. Silastic has the advantages of being easy to carve, it may be attached to the rim of the fossa, and it is extremely nonirritating; it eventually becomes encased in a fibrous capsule.

Humans↗

Fixture placement posterior to the mental foramen with transpositioning of the inferior alveolar nerve.

The results of 10 fixture placement operations with transpositioning of the inferior alveolar nerve are presented. Nerve transpositioning increased the operating time, but with experience this time should be reduced. Neurosensory dysfunction of the inferior alveolar nerve was found in 7 of 10 operated sites 1 week after surgery. Six months postoperatively, altered sensation was still present in 2 patients. Nerve function was normal in all patients 1 year postoperatively. The stability of fixtures was satisfactory throughout the examination period and the procedure should prove useful in treatment of the resorbed mandible posterior to the mental foramina.

Alveolar Bone Loss↗

[Immediate loading of dental implants in partialful edentulous and edentulous jaws].

OBJECTIVE: To investigate the clinical feasibility and technical characteristics of immediate loading and to access the short-term clinical results of treatment. METHODS: This study included 3 completely edentulous patients and 24 patients who were partially edentulous from March 1999 to December 2003. 21 implants were immediately loaded and provided support for mandibular overdenture for 3 fully edentulous patients. 30 implants were placed in 21 partially edentulous patients and implants were immediate loaded in edentulous mandibular providing support for fixed provisional prosthesis within 6 months. Then, metal-ceramic crowns were completed. All patients were followed up by 1, 3, 6, 12 months and the patients were checked every 12 months. RESULTS: A total of 42 implants were loaded immediately. From March 1999 to December 2003, no implants were lost during follow-up (range 3 to 49 months, mean of 28 months). No infections, nerve or sinus damage or other sequelae occurred. No implants exhibited peri-implant radiolucencies. Moreover, immediate loading seems to increase the ossification of the alveolar bone around endosseous implants. Patients were satisfied with the treatment. CONCLUSIONS: The data and the experience described in this study indicate that immediate loading with restorations using appropriate surgical and restorative techniques can predicate the completely edentulous and partially edentulous mandible in some cases. Further study is needed to determine the long-term result of immediately loaded implants.

Adult↗

Management of pediatric mandibular fractures.

The incidence of mandibular fractures is rare in the pediatric population when compared to adults. Although the basic principles for management are the same as for the adult, certain anatomical features of the pediatric mandible warrant special attention. Problems such as mixed dentition, unerupted teeth, and ongoing growth in the mandible require careful diagnosis and planning in deciding on the proper treatment.

Child↗

[The anatomy of the maxillary and mandibular retromolar area. Effect on complete dentures. 1. The retrotuberosity space].

Located at the border between vestibule and palatine area, the retrotuberosity space plays a major role in full dentures, as it involves the lateral portion of the posterior palatine joint. The arrangement of the pterygo-maxillary complex determines the morphology of this space and its use in full prosthesis. In most cases, the pterygo-mandibular ligament originates at a distance of the tuberosity, leaving a small mucosal fold, posterior to the tuberosity. This element, often mistaken with the origin of the ligament, should neither be released at the prosthetic border, nor be considered as a negative index. On the contrary, the presence of compressible submucosal glandular tissue, could be used when the posterior joint is prepared.

Alveolar Process↗