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At least 145 records · Page 8Linked to original sources

Use of hydroxylapatite for the augmentation of deficient alveolar ridges.

Investigations were undertaken to evaluate nonresorbable, particulate ceramic hydroxylapatite (durapatite) for augmentation of deficient alveolar ridges. One hundred and fifteen augmentations in both jaws were reported for 110 patients over a 33-month postoperative period. Subjective and objective data show that the implant was successful for all classes of ridges augmented; height, bulk, contour, and ridge form generally improved, and soft tissue overlying the augmented ridges was firm and immobile. Impressions for dentures were usually obtained four to six weeks after surgery, and the dentures were more stable, retentive, and esthetically pleasing than the preoperative prostheses and required fewer relinings. Other than transiently altered sensations resulting from mental nerve manipulation during surgery, patients had few complications. No infection or bone resorption beneath the implant was observed throughout these studies. It was concluded that hydroxylapatite particles placed through a subperiosteal tunnel offer a highly successful method of ridge augmentation and eliminate the most serious problems associated with the use of autogenous or banked bone, namely, morbidity, risk, costliness, and poor results.

Adult↗

A technique for osseous restoration of deficient edentulous maxillary ridges.

A technique for maxillary bone grafting to augment the atrophic ridge is presented, and the results from 15 cases followed from three to ten years are briefly described. Loss of postoperative ridge height ranged from 10-20% in this sample. It appears that the tendencies to postoperative resorption that occur when autogenous particulate cancellous bone grafts are employed to restore atrophic mandibles are not operative in the maxilla.

Alveolar Process↗

Composite graft for mandibular alveolar ridge augmentation: a preliminary report.

Augmentation of atrophic mandibles with a composite graft system consisting of allogeneic freeze-dried rib, autogenous cancellous bone and marrow, and hydroxylapatite is reported. The six patients subjected to this procedure tolerated the surgery well and showed marked improvement in dental function, with maintenance of 78% of the augmented height one year later and 67% of the height at two years.

Adult↗

Particulate allogeneic bone grafts into maxillary alveolar clefts in humans: a preliminary report.

The purpose of this study was to determine the ability of particulate allogeneic bone graft to adequately bridge unilateral maxillary alveolar clefts in humans. Twenty patients with unilateral alveolar clefts and oronasal fistula underwent alveolar cleft grafting with a clinically appropriate amount of particulate allogeneic bone. The grafted cleft area was followed radiographically for three to six months postsurgery. Although it was difficult to quantitate, it was both clinically and radiographically apparent at three months that bone bridging and filling of the cleft had occurred in 100% of the cases. From this study, it appears that allogeneic bone is a viable alternative for repairing alveolar clefts and that its use has a significant benefit to the patient by eliminating the morbidity of a second operative site.

Adolescent↗

Accuracy of cephalometric prediction in orthognathic surgery.

The reliability of predicting the results of orthodontic surgical treatment was analysed. The sample consisted of 30 patients treated with one of the following six types of surgery: mandibular anterior alveolar surgery; maxillary anterior alveolar surgery; mandibular setback surgery; mandibular advancement surgery; Le Fort I surgery; and a combination of Le Fort I and mandibular setback surgery. Comparisons of tracings of the initial cephalometric radiographs, the prediction tracing and the six-month follow-up film showed great variation in the results both within and between the surgical subgroups. Generally, it was easier to predict the treatment results of alveolar segmental osteotomies, especially in the mandible, than of operations in which the whole mandible was repositioned. The results from Le Fort I surgery with or without a concomitant mandibular setback showed the greatest difference between the predicted and the actual outcome. The postoperative vertical dimension appeared to be particularly hard to predict. Explanations for these discrepancies are offered and possibilities for improvements suggested. It is concluded that prediction tracings are still of value despite the poor accuracy in some cases.

Adolescent↗

The stability of Le Fort I maxillary osteotomies in patients with simultaneous alveolar cleft bone grafts.

A retrospective study was performed on 20 patients who had been treated with Le Fort I maxillary osteotomies and simultaneous alveolar cleft bone grafts. The age range was 11 to 23 years, and there were 11 males and nine females. Changes in both anterior-posterior (A-P) and vertical direction were investigated using preoperative, immediate postoperative, and long-term postoperative lateral cephalometric radiographs. The results indicated little change between the immediate postoperative and long-term postoperative position of the maxilla in an A-P dimension, but in a vertical direction there was a great tendency for relapse.

Adolescent↗

Long-term results after secondary bone grafting of alveolar clefts.

The aim of this study was longitudinally to evaluate the treatment results after secondary bone grafting in 224 cleft patients with an observation period of more than four years. The patients were divided into three groups according to age and eruption stage of the canine at the time of surgery. Group A included 94 patients with a mean age of 10 years, operated before eruption of the canine; group B included 72 patients with a mean age of 13.1 years operated after eruption of the canine; and group C included 58 patients operated after the age of 16 years (mean age, 20.4 years). The evaluation of the treatment results included longitudinal comparison of marginal bone level, periodontal status on cleft-related teeth, dental status in the bone grafted region, esthetical and functional properties of the reconstructed alveolar process, as well as the influence on growth of the maxilla. The marginal bone level was found to be significantly higher among unilateral cleft lip and palate (UCLP) and bilateral cleft lip and palate (BCLP) patients in the youngest groups as compared to the other groups. The number of UCLP and BCLP patients who could be treated without bridgework was significantly higher in the youngest age group than in the other groups, as were the esthetic and functional properties of the reconstructed alveolar process. External root resorption occurred in 17 patients in groups B and C. No influence of the procedure on sagittal growth of the maxilla could be demonstrated, whereas the anterior facial height was reduced.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗

Compartment syndrome following oral and maxillofacial surgery.

Compartment syndrome must be included in the differential diagnosis in any patient who complains of pain or neuromuscular deficit in an extremity. The etiology, differential diagnosis, clinical features, and treatment of compartment syndrome are reviewed to assist in proper diagnosis and management. Although the exact etiology in this case will never be ascertained, delay in diagnosis and treatment resulted in a neuromuscular deficit. It is therefore imperative that proper patient positioning during the perioperative period be closely monitored to avoid this complication.

Adult↗

Closure of alveolar clefts with corticocancellous block grafts and marrow: a retrospective study.

A surgical technique is presented for maxillary alveolar cleft repair that includes a contoured iliac crest corticocancellous block graft and marrow packing, along with closure by a Y-vestibular mucosal advancement flap. A retrospective study of graft survival in 48 cleft sites showed a 94% success rate with no complications; the remaining 6% of the cases showed minor complications.

Adolescent↗

Effect of calcium phosphate ceramic implants on tooth eruption.

This study evaluated the effects of calcium phosphate ceramics, hydroxylapatite, and tricalcium phosphate implants on tooth eruption and development. Forty kittens, three to four months of age, had their primary right second and third mandibular premolars extracted and the sockets packed with either hydroxylapatite, tricalcium phosphate, autogenous cancellous marrow, or nothing. The results of this study indicated that the use of a nonresorbable hydroxylapatite for grafting resulted in impediment of tooth eruption and distortion of crown development. This was in contrast to the tricalcium phosphate, which had minimal effect on tooth eruption and development.

Alveolar Process↗

Reconstruction of the severely atrophic edentulous mandible by means of autogenous bone grafts and simultaneous placement of osseointegrated implants.

A method of reconstructing the severely atrophic mandible that simultaneously provides additional strength and the ability to house osseointegrated implants is presented. The performance of the procedure from an external approach minimizes the possibility of oral contamination and, therefore, infection. The procedure has been performed on 10 patients, with a longest follow-up of 3 years. A 93% success rate has been achieved, and bone resorption at the implant sites has thus far been negligible. Prosthetic rehabilitation has been done in 9 of the 10 cases; 3 have been tissue-supported prostheses, and 6 have been completely implant-supported prostheses.

Adult↗