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Results for “Maxillofacial Prosthesis Implantation”

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At least 19 recordsLinked to original sources
PubMed2002

Diagnostic and prognostic value of 99mTc-tetrofosmin scintigraphy in maxillofacial flaps.

In oro-maxillofacial malignancies, new therapeutic approaches are placing changing demands on the diverse diagnostic modalities. In contradistinction to mandibular reconstruction of former years, the transplants (microvascular anastomosed pedicled flaps, "flaps") now consist of one or more arteries feeding a soft tissue component attached to a piece of bone suitably fitted to fill the defect. We addressed the diagnostic value of technetium-99m tetrofosmin scintigraphy in differentiating between viability and non-viability of the soft tissue portion of flaps in the immediate postoperative assessment. A total of 60 patients who had received flaps for reconstruction of the mandible after partial resection were investigated with (99m)Tc-tetrofosmin 3-5 days after surgery. Scintigraphy consisted of (a) radionuclide angiography, (b) static planar imaging in four projections starting at 10 min post injection, and (c) single-photon emission tomography (SPET) performed immediately after the planar imaging. Normal perfusion associated with no defects throughout the soft tissue portion of the transplant was observed in 46/60 patients. This scintigraphic pattern was identical to viability and normal postoperative follow-up. Hypoperfusion and small defects on planar and SPET images indicated viability and uncomplicated postoperative healing in 6/60 patients, but non-viability/inadequate healing of the flap in 4/60 patients. Absence of perfusion combined with a large defect on static planar and SPET images definitively showed the non-viability of the flap (4/60 patients). It is concluded that (99m)Tc-tetrofosmin scintigraphy is a sensitive diagnostic tool for the immediate postoperative assessment of the viability and the adequacy of implantation of the soft tissue portion of flaps. Therefore tetrofosmin scintigraphy is an important modality in order (a) to define the optimal therapeutic regimen in the immediate postoperative period and (b) to provide better prognosis.

Adult↗
PubMed1999

Usefulness of dental implants in maxillofacial reconstruction.

Fabricating maxillofacial prosthesis can be challenging. Placement of implants can have a dramatic effect on the stability and retention of the prosthesis in patients. This article provides clinical retrospective analysis of osseointegrated implants used for maxillofacial reconstruction. Patient charts and radiographs were reviewed to determine implant status, stability of prosthesis, and masticatory and speech function. Of the 104 implants placed, there were 4 implant failures. The overall survival rate for implants in this patient population was 96.1%. The stability of maxillofacial prostheses demonstrated significant improvement after anchorage to implants. Implant-borne maxillofacial prostheses are better stabilized and retained than non-implant-borne prostheses, providing an improved quality of life to patients requiring prosthesis rehabilitation of maxillofacial defects.

Adult↗
PubMed2004

[Implant prosthesis rehabilitation after maxillofacial injuries--case report].

The dental and oral rehabilitation of patients with severe trauma that involves the oral cavity is demanding and challenging. Recently, advanced surgical techniques and innovations in oral implantology led to more sophisticated treatment modalities that may better fulfill the patients needs in special situations. Young people rather often suffer from accidents--at school and during leisure activities--in a period of their life that has a great impact on their physical, mental and personal development. Thus, the wish for a quick functional and esthetical rehabilitation contrasts with the complex clinical situation and the compromised oral conditions. All persons involved in the rehabilitation process--including the patient--must seek for the best solution that takes into account treatment time, invasivity of procedures and patients morbidity. Further, it is also observed that insurances very much stress the reduction of cost and the simplicity of treatment. This will also influence the treatment planning and the sequence of the procedures as shown by the following case.

Accidental Falls↗
PubMed1994

Implant prosthodontic procedures for a completely edentulous patient with cleft palate.

Prosthodontic treatment of the edentulous cleft palate patient presents the dentist with numerous challenges for achieving a satisfactory result for the patient. A technique is described for prosthodontic rehabilitation of a completely edentulous cleft palate patient using bone augmentation procedures, root-form dental implants, and a removable maxillofacial prosthesis. Dental implants may improve prosthesis retention, stability, and occlusal function when used in carefully selected cases.

Adult↗
PubMed1995

[Maxillofacial prosthesis fixed on endosseous implants. Apropos of 15 cases].

In the light of 15 cases of craniofacial defects due to trauma of carcinomas, the authors propose a new approach of the indications for craniofacial prostheses. Progress in materials (silicons) and treatments of maxillo-facial defects (titanium implants) have renewed the interest in maxillo-facial prostheses in maxillo-facial surgery. The advantages and disadvantages of classical methods of prosthesis fixation (on glasses or adhesives) and modern techniques of extra-oral implants (Swedish) are cause of the recent interest for prostheses in plastic surgery. New implants (German) and easier techniques induce a growing interest for extra-oral implants.

Head and Neck Neoplasms↗
PubMed2006

The clinical application of a new synthetic bone grafting material in oral and maxillofacial surgery.

A novel bone formation material based on hydroxyapatite-xerogel is presented. With the use of the innovative sol-gel technology this material is produced in the low-temperature range by the addition of silicon dioxide; in its structure it mimics to a great extent the natural bone matrix. This results in high osteoconductivity and an osteoprotective effect as well as in complete biodegradation corresponding to bone formation in the course of natural bone remodelling. Two case reports are presented.

Adult↗
PubMedDate not supplied

A study of 25 zygomatic dental implants with 11 to 49 months' follow-up after loading.

PURPOSE: The purpose of this study was to evaluate indications, surgical problems, complications, and treatment outcomes related to the placement of zygomatic implants. A second aim was to determine any prosthetic difficulties and complications. MATERIALS AND METHODS: Twenty-five zygomatic implants were placed in 13 patients between April 1999 and December 2001. The patient age range was between 49 and 73 years, with a mean age of 59 years. All patients showed severe resorption of alveolar bone in the maxilla. All but 2 patients were smokers. Two patients had a history of cleft palate surgery, and 2 patients were known to be bruxers. Standard recommended surgical protocol was followed, and treatment was performed under general anesthesia. After abutment surgery, 9 patients received bar-retained overdentures, and 4 patients received fixed prostheses. RESULTS: No implants were lost, and few surgical complications were experienced. The follow-up period was 11 to 49 months. DISCUSSION: Although surgical problems precipitated by difficult anatomy in cleft patients and a patient with reduced interarch access were experienced, the results were favorable. Fabricating a functional and esthetic prosthesis can be a challenge. CONCLUSION: Zygomatic implants provide a treatment option for patients with severe maxillary resorption, defects, or situations where previous implant treatment has failed. In this experience, treatment with zygomatic implants was a predictable method with few complications, even in a group of patients that would not be considered ideal for implant treatment.

Aged↗
PubMed2004

Systematic review of the evidence supporting intra-oral maxillofacial prosthodontic care.

The literature on maxillofacial prosthodontics may be considered to be dominated by articles describing case reports or case series. Prospective, well-controlled clinical trials are scarce owing to the inherent difficulty of performing such trials in patients suffering from oral cancer. The aim of this study was to perform a systematic review of the literature relating to intra-oral maxillofacial prosthodontics based on the principles of evidence-based dentistry. A detailed report of the findings is presented and critically assessed and a discussion of the outcome in respect to the various confounding factors is carried out. Finally, suggestions for future research in the field of maxillofacial prosthodontics are made.

Dental Implantation↗
PubMedDate not supplied

Rehabilitation of severely resorbed maxillae with zygomatic implants: an evaluation of implant stability, tissue conditions, and patients' opinion before and after treatment.

PURPOSE: The aim of the present study was to describe experiences of 11 consecutively treated patients who received zygomatic implants. Patient results were assessed through clinical and radiographic evaluations of tissue conditions, including resonance frequency analysis (RFA). MATERIALS AND METHODS: Eleven patients were treated with implant-retained fixed prostheses. A total of 64 implants were placed, 22 of which were placed in the zygoma. Fixed prostheses were removed to allow clinical and radiographic evaluations at a follow-up visit 18 to 46 months following implant placement. RFA was performed on all implants. A visual analog scale was used to assess patient satisfaction before and after treatment. RESULTS: All patients received implant-supported prostheses. All zygomatic implants demonstrated clinical signs of osseointegration. One anterior implant was lost during follow-up. Mean ISQ values for the zygomatic and anterior implants were 65.9 (range, 42 to 100) and 61.5 (range, 48 to 71), respectively. Twenty-four implants showed moderate inflammation, with 3 exhibiting severe inflammation. Most anterior implants (75.6%) showed a marginal bone recession of 1 thread or less. Four zygomatic implants showed bone loss of 4 to 5 threads, and 5 zygomatic implants exhibited no marginal bone support. Patients described significant improvement in chewing ability and esthetics but did not describe changes in speech. DISCUSSION: The use of zygomatic implants can help the clinician avoid the need for bone grafting and reduce morbidity. In addition, it can shorten the treatment time considerably. CONCLUSION: This preliminary report demonstrates that zygomatic implants can provide posterior support to fixed prostheses in patients who lack bone volume to place conventional implants without encroaching upon the maxillary sinus.

Adult↗
PubMed1997

Effects of implant anchorage on midface prostheses.

STATEMENT OF PROBLEM: Acquired midface defects may produce functional and psychologic impairments that adversely effects a patient's quality of life. Conventional prostheses may lack adequate retention and stability, diminishing the patient's confidence that the prosthesis will remain in place during routine activities. PURPOSE: The experience with and patient response to endosseous implants in prosthetic restoration of midface defects is presented in this study. MATERIAL AND METHODS: Five patients in age from 36 to 88 years were treated with 19 titanium endosseous root-form implants to provide retention and stability for prostheses. Patients responded to a questionnaire rating overall use, effectiveness, and satisfaction of their prosthesis, before and after the use of implants. RESULTS: All 19 implants were judged to be osseointegrated at abutment connection. Of the 17 implants used prosthetically, 14 (82%) remained osseointegrated and 3 (18%) failed. Analysis of the questionnaire tends to indicate an improvement of the quality of life for the patients with an implant-retained prosthesis.

Activities of Daily Living↗
PubMed1997

[The management of extra-oral implants. Anachronisms and paradoxes].

Used in France for ten years and in Sweden since 1977. Extra-Oral Implants (EOI) represent one of the new therapeutic approach of facial defects treatment by maxillo-facial prostheses fixed on implants and of some transmission deafnesses. Audiologic applications are free of charges for the patient but not the prosthetic applications; the authors note this paradox and some other anachronisms. Finally the authors wonder why Extra-Oral implantology is a "correct" science and why Intra-Oral Implantology remains absent from the Administrative texts as if it was a sort of doubtful therapy without scientific principles.

Aged↗
PubMed2003

Comparison of maxillary implant-supported prosthesis in irradiated and non-irradiated patients.

In order to investigate the influence of radiation therapy after the treatment of maxillary implant-supported prostheses, 27 patients received a total of 131 implants in maxilla after oral cancer treatment and/or reconstructive surgery. Among them, 25 received maxillary implant-supported prostheses. The cumulative survival rates of implants and prostheses were evaluated by the product-limit-estimates method according to Kaplan-Meier. The cumulative survival rate of implants and prostheses in irradiated patients was compared with that in non-irradiated patients by statistical Log-rank test. The results showed that 112 implants were observed after implant loading. The implants cumulative survival rate was approximately 65% for overall patients. The cumulative prosthesis successful rate was approximately 88% for all 25 patients. Log-rank test analysis revealed that there was a significant difference in cumulative implants survival rates between non-irradiated and irradiated maxillary bone (P < 0.01). It was concluded that the implants and prostheses in irradiated patients have significantly lower survival rates than in non-irradiated patients.

Aged↗
PubMed2000

Nonmetallic fixation in elective maxillofacial surgery.

Resorbable fixation technology offers several benefits, including easily cut and shaped plates, strong and predictable resorption qualities, and improved patient acceptance and expectations. Moreover, resorbable fixation implants can be completely reabsorbed into the body, eliminating the need for subsequent removal. This article describes the use of this innovative technology in orthognathic surgery, including preoperative and postoperative patient needs, intraoperative patient care, and potential complications.

Absorbable Implants↗
PubMed2001

Prosthodontic guidelines for surgical reconstruction of the maxilla: a classification system of defects.

Surgical reconstruction of maxillectomy defects has been described as an alternative to prosthetic rehabilitation to close the oral cavity. Advancements in microvascular surgical techniques require comprehensive treatment planning guidelines for functional rehabilitation. This retrospective study evaluated acquired maxillectomy defects after surgical reconstruction and/or prosthodontic rehabilitation in an attempt to establish surgical and prosthodontic guidelines that could be organized into a classification system. Forty-seven consecutive patient treatments of palatomaxillary reconstruction at a single facility, The Mount Sinai Medical Center (New York, N.Y.), were reviewed. All patients were rehabilitated with a tissue-borne obturator, a local advancement flap, a fasciocutaneous free flap, or a vascularized bone-containing free flap. Palatomaxillary defects were divided into 3 major classes and 2 subclasses. The aim of this defect-oriented classification system was to organize and define the complex nature of the restorative decision-making process for the maxillectomy patient.

Bone Transplantation↗