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Clinics in Plastic Surgery Jul 2021Alveolar distraction osteogenesis (ADO) has been used for the reconstruction of atrophic alveolus for decades. The advantage of this technique is that it augments the... (Review)
Review
Alveolar distraction osteogenesis (ADO) has been used for the reconstruction of atrophic alveolus for decades. The advantage of this technique is that it augments the bone and soft tissues together, creating a better alveolar platform for subsequent surgeries and dental rehabilitation. It is especially useful in patients with large and/or complex alveolar clefts for which approximating the alveolar segments reduces the size of the bony cleft and associated fistula. Displacement of the transported segment is the most frequently encountered complication of ADO but can be managed by constructing case-specific distractors.
Topics: Adolescent; Alveolar Bone Grafting; Alveolar Process; Alveoloplasty; Cleft Palate; Humans; Male; Orthodontics, Corrective; Osteogenesis, Distraction; Young Adult
PubMed: 34051895
DOI: 10.1016/j.cps.2021.02.004 -
Journal of Maxillofacial and Oral... Sep 2022The conventional alveoloplasty approach which uses manual equipment results in more resorption of the underlying alveolar ridge that makes denture prosthesis unstable....
PURPOSE
The conventional alveoloplasty approach which uses manual equipment results in more resorption of the underlying alveolar ridge that makes denture prosthesis unstable. The goal of this study was to compare results of piezosurgery alveoloplasty to those of conventional alveoloplasty.
MATERIALS AND METHODS
This was an in-vivo comparative study consisting of ten edentulous individuals who needed alveoloplasty due to bilateral bony projection. On one side, a conventional alveoloplasty was performed with a bone rongeur and bone file, whereas the contralateral side was treated with a piezosurgery unit. The clinical parameters were analyzed using SPSS version 21 software including operating time, postoperative pain evaluation on day 3 and a healing on day 7.
RESULTS
There was a statistically significant difference between the two groups in terms of outcome variables such as operating time, pain and healing. The Conventional group has a lower mean of operating time, a higher mean rank of VAS and a lower mean rank of healing index compared to the piezosurgery group.
CONCLUSION
Piezosurgery alveoloplasty not only lowers postoperative patient discomfort but also preserves alveolar bone integrity by not disrupting soft and hard tissue architecture thus allowing faster tissue healing and easier prosthesis replacement in the future.
PubMed: 36274873
DOI: 10.1007/s12663-022-01716-3 -
Zhonghua Kou Qiang Yi Xue Za Zhi =... May 2023Implant-supported full-arch fixed prosthesis is hot in edentulous therapy currently. Appropriate contour of bone is the premise of good restoration outcome....
Implant-supported full-arch fixed prosthesis is hot in edentulous therapy currently. Appropriate contour of bone is the premise of good restoration outcome. Alveoloplasty is an important part during treatment procedure. Alveoloplasty can be used to obtain bone platform for implant insertion, create adequate prosthetic space, achieve good Aesthetic effect, and form appropriate soft tissue morphology. The design of alveoloplasty has evolved from traditional plaster models and cone beam CT to three-dimensional (3D) virtual patients. The surgical techniques of alveoloplasty have also undergone the evolution from free-hand to static guide or dynamic navigation. This article elaborates on the concept, purpose and significance of alveloplasty in implant supported full-arch fixed restoration, technology evolution and process to provide reference for clinical practice.
PubMed: 37082855
DOI: 10.3760/cma.j.cn112144-20221130-00599 -
Anales de Pediatria Sep 2020To compare the results of secondary alveoloplasty performed in one Hospital when osteosynthesis material was used and when the bone graft does not require this material,... (Comparative Study)
Comparative Study
OBJECTIVES
To compare the results of secondary alveoloplasty performed in one Hospital when osteosynthesis material was used and when the bone graft does not require this material, and relating them to factors such as gender and age.
MATERIAL AND METHODS
A retrospective study was conducted from the years 2014 to 2019 in this Hospital on the selected patients who met the inclusion criteria. Two periods of ages, period A: ages between 5-12 years (mixed secondary alveoloplasty) and period B: greater than 12 years (late secondary alveoloplasty). Autologous bone from the iliac crest or parietal calotte was used for the bone graft. The patients were divided into 2 groups: group I: patients with alveoloplasties that required osteosynthesis material. Group II: patients who did not require osteosynthesis material. Parameters evaluated: the success criteria for alveoloplasty were assessed according to the clinical parameters described by Precious. Alveoloplasty was successful if they met all the criteria of Precious in the year of intervention. Postoperative complications in both groups were evaluated. The statistical analysis was performed using the exact Fisher test for qualitative variables.
RESULTS
Alveoloplasty was successful in 89.4% of patients in group I, while it was 90.3% in group II. Alveoloplasty was successful in 87.5% of females compared to 91.17% of males. The intervention was a success in 91.48% of patients in group A, compared to 66.6% in group B. The osteosynthesis material in two patients of group I was not degraded in the annual assessment. There were no significant differences in any of the comparisons.
CONCLUSIONS
The use of osteosynthesis material does not alter the integration of the bone graft in patients that undergo alveoloplasty. Factors such as gender or age do not influence the results of the interventions.
Topics: Age Factors; Alveolar Process; Alveoloplasty; Bone Transplantation; Child; Child, Preschool; Cleft Lip; Cleft Palate; Female; Humans; Male; Retrospective Studies; Sex Factors
PubMed: 32094091
DOI: 10.1016/j.anpedi.2020.01.009 -
Journal of the Korean Association of... Feb 2020The need for proper wound closure is of paramount importance after any intra-oral surgery. Various wound closure techniques have been described in literature using...
OBJECTIVES
The need for proper wound closure is of paramount importance after any intra-oral surgery. Various wound closure techniques have been described in literature using traditional non-absorbable suture materials. These include like synthetic absorbable sutures, surgical staples and tissue adhesives. Cyanoacrylates are among the most commonly used biocompatible tissue adhesives. To evaluate and compare intraoral wound healing using 3-0 silk sutures and n-butyl-2-cyanoacrylate after alveoloplasty.
MATERIALS AND METHODS
A total of 20 patients requiring bilateral alveoloplasty in the same arch (upper or lower) were included in this study. Patients with any pre-existing pathology or systemic disease were excluded. After alveoloplasty was performed, the wound was closed using 3-0 braided silk sutures on one side, and using n-butyl-2-cyanoacrylate bio adhesive on the other side. Patients were evaluated based on the following parameters: time required to achieve wound closure; the incidence of immediate and postoperative hemostasis; the time to the use of the first rescue medication; the side where pain first arises; and the side where wound healing begins first.
RESULTS
Compared to 3-0 silk sutures, cyanoacrylate demonstrated better hemostatic properties, reduced operative time, reduced postoperative pain and better wound healing.
CONCLUSION
These data suggest that cyanoacrylate glue is an adequate alternative to conventional sutures to close the surgical wound after alveoloplasty, and better than are 3-0 silk sutures.
PubMed: 32158678
DOI: 10.5125/jkaoms.2020.46.1.28 -
International Journal of Oral and... Jan 2024This study aimed to evaluate the effectiveness of autologous platelet derivatives (APD), specifically platelet-rich plasma (PRP) or platelet-rich fibrin (PRF), combined... (Meta-Analysis)
Meta-Analysis Review
This study aimed to evaluate the effectiveness of autologous platelet derivatives (APD), specifically platelet-rich plasma (PRP) or platelet-rich fibrin (PRF), combined with autogenous iliac crest bone grafts in secondary alveoloplasty for patients with cleft lip and palate. Electronic databases, relevant journals, and reference lists of included studies were searched until July 2022. Best-evidence synthesis was performed to draw conclusions. After the search strategies, 12 randomized controlled trials were included that provided data on six outcomes: newly formed bone, mean bone loss in height and width, bone density, functionality, and postoperative complications. Two authors independently assessed the risk of bias, and the certainty of evidence was assessed using the GRADE approach. The pooled results suggest that there is uncertainty as to whether the combination of APDs with autogenous iliac crest bone grafts improves the percentage of newly formed bone, as the certainty of the evidence was assessed as very low. It may slightly improve the functionality of patients (with low certainty of the evidence) and probably slightly reduces the incidence of postoperative complications (with moderate certainty of evidence). Further randomized clinical trials with standardized methodologies are required to validate these findings.
Topics: Humans; Cleft Lip; Alveoloplasty; Cleft Palate; Bone Transplantation; Postoperative Complications
PubMed: 37730524
DOI: 10.1016/j.ijom.2023.08.008 -
Special Care in Dentistry : Official... Jan 2021The edentulous mandibular ridge and associated shallow vestibule are often seen as a challenge in the oral rehabilitation of patients. Dental implants can provide an... (Review)
Review
The versatile "lip switch" or transitional flap vestibuloplasty combined with alveoloplasty and implant placement to treat atrophic mandibles with inadequate vestibules and attached tissue: A case series and review of the literature.
INTRODUCTION/AIMS
The edentulous mandibular ridge and associated shallow vestibule are often seen as a challenge in the oral rehabilitation of patients. Dental implants can provide an improvement in mastication and patient satisfaction. The aim of this study is to utilize a preprosthetic mucosal flap combined with a repositional periosteal flap concomitant with an alveoloplasty and placement of endosteal implants as a single-stage procedure in the anterior mandible. This approach provides a valued alternative for dental rehabilitation in patients with poor masticatory efficiency using a conventional denture.
METHODS
Eight patients underwent the preprosthetic surgical plan in the oral surgery clinic of the dental school during a 1-year period. Age, sex, preoperative, and postoperative vestibular depth, as well as hard and soft tissue elements were measured (P < .05) at 4-6 months.
RESULTS
Mean age was 53 years ± 14.62 (N = 8). Anterior mandible height was 19 ± 4.8 mm. A significant difference was measured using a two-tailed Student's t-test between pre- and postoperative vestibular depths, respectively (3.9 mm vs 10.5 ± 0.96 mm; P < .01).
CONCLUSIONS
A lip switch vestibuloplasty combined with placement of two implants provide a one-stage procedure that is convenient, provides a shorter postoperative period, and can be financially affordable. Future research requires larger sampling to support this treatment as a standard of care.
Topics: Alveoloplasty; Dental Implantation, Endosseous; Dental Prosthesis, Implant-Supported; Humans; Infant; Jaw, Edentulous; Lip; Mandible; Middle Aged; Vestibuloplasty
PubMed: 33270928
DOI: 10.1111/scd.12546 -
Quintessence International (Berlin,... Nov 2023Patients taking antiresorptive medications in dental clinics are at risk of medication-related osteonecrosis of the jaw (MRONJ), which poses daily challenges for their...
OBJECTIVE
Patients taking antiresorptive medications in dental clinics are at risk of medication-related osteonecrosis of the jaw (MRONJ), which poses daily challenges for their clinicians. This paper aimed to summarize and revisit the three most recognized practice guidelines for the management and prevention of MRONJ, which were proposed by the American Association of Oral and Maxillofacial Surgeons (AAOMS), and presented by the Journal of Bone and Mineral Research (JBMR) and the Journal of Clinical Oncology (JCO). Results and case studies: The AAOMS position paper focused on risk stratification by different medications, management decision trees, risk factors, pathophysiology, and disease staging. The JBMR international consensus presented eight focused questions, which were addressed by systematic reviews. The JCO clinical practice guideline presented six clinical questions, and each concluded with practical recommendations. Practical information was summarized and converted into an adoptable patient care workflow for clinicians to follow and apply in daily practice. Three case studies presented were treated following these guidelines. Each patient underwent advanced surgeries including alveoloplasty, tooth extraction, implant placement, and particulate bone grafting. Some of the considerations not fully informed were discussed and illustrated in each step of the patient care workflow, which included specifics for risk communication, updates on the use of antibiotics, biomarkers, and drug holidays.
CONCLUSION AND PRACTICAL IMPLICATIONS
Structured risk communication with official informed consent documentation should be considered before initiating invasive treatments. Disease control phase with home care therapy should be provided prior to staged reconstructive therapy. Drug holidays and antibiotics coverage can be customized based on individual conditions and related procedures with interprofessional coordination.
Topics: Humans; Bisphosphonate-Associated Osteonecrosis of the Jaw; Workflow; Bone Density Conservation Agents; Patient Care; Anti-Bacterial Agents; Diphosphonates
PubMed: 37449761
DOI: 10.3290/j.qi.b4213007 -
Clinical Case Reports Oct 2020Various cases of introduction of air into soft tissues have been reported in the dental literature. Here, we report a rare case of localized sublingual emphysema after...
Various cases of introduction of air into soft tissues have been reported in the dental literature. Here, we report a rare case of localized sublingual emphysema after alveoloplasty. There was no facial involvement. The patient responded to treatment and recovered uneventfully.
PubMed: 33088550
DOI: 10.1002/ccr3.3106 -
Journal of the Korean Association of... Aug 2021Wound healing is an integral part of any surgical procedure. Appropriate wound closure is critical to any successful surgical procedure, especially intraoral procedures....
OBJECTIVES
Wound healing is an integral part of any surgical procedure. Appropriate wound closure is critical to any successful surgical procedure, especially intraoral procedures. Various factors aid in wound healing, both pharmacological and non-pharmacological. Dehydrated human amniotic/chorionic membrane (dHACM) is an emerging bioinert material that contains anti-inflammatory properties, angiogenetic properties, osteogenic potential, and various growth factors. The purpose of this study was to evaluate the efficacy of wound healing properties of dHACM in bilateral alveoloplasty patients.
MATERIALS AND METHODS
A prospective split-mouth study was conducted on 10 patients. Site A received sutures with dHACM and site B was sutured without dHACM. Wound healing was assessed with the Landry, Turnbull, and Howley Index.
RESULTS
Sites A and site B were compared. A <0.05 and a test value of 22 was obtained, indicating a statistical difference between the two sites.
CONCLUSION
Our study showed better healing with dHACM than without.
PubMed: 34462385
DOI: 10.5125/jkaoms.2021.47.4.279