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Journal of Indian Prosthodontic Society 2021Surgical resection of the lower jaw due to the presence of a benign or malignant tumor is the most frequent cause of mandibular deviation. Location and extent of the...
Surgical resection of the lower jaw due to the presence of a benign or malignant tumor is the most frequent cause of mandibular deviation. Location and extent of the tumor decide the surgical modality of mandibulectomy to be performed. The clinician must wait for an adequate span of time for completion of the healing and acceptance of the osseous graft before considering a definitive prosthesis. During the inceptive healing period, prosthodontic intervention is of utmost priority for preventing the mandibular deviation. A corrective appliance termed "guide flange prosthesis (GFP)" is indicated to limit this clinical manifestation. The basic intention of rehabilitation is to train the mandibular muscles and to re-establish an acceptable occlusal relationship so that the patient can adequately control the opening and closing movements. This case series describes early prosthodontic management of three patients who had undergone hemimandibulectomy, with different techniques of fabrication of a GFP. The three techniques described consist of two conventional methods of fabrication while the third technique is a new innovative approach.
Topics: Humans; Malocclusion; Mandible; Mandibular Osteotomy; Mandibular Prosthesis; Mandibular Prosthesis Implantation
PubMed: 33938873
DOI: 10.4103/jips.jips_12_21 -
Journal of Prosthodontics : Official... Feb 2021To evaluate implant and prosthetic survival rates of full-arch rehabilitations retained by three implants in patients with edentulous mandibles. (Review)
Review
PURPOSE
To evaluate implant and prosthetic survival rates of full-arch rehabilitations retained by three implants in patients with edentulous mandibles.
MATERIALS AND METHODS
This systematic review was developed following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement. The focused question was: Are fixed mandibular 3-implant retained prostheses safe and predicable for full-arch mandibular prostheses? The Medline/PubMed and Cochrane Library databases were used to conduct the systematic search for clinical trials on fixed mandibular 3-implant retained prostheses published between 1999 and 2020. Only English-language studies that presented information on implant and prosthetic survival were included.
RESULTS
A total of 302 studies were identified, of which 13 addressed the inclusion criteria. Additionally, 574 participants were included in these studies. As reported, 73 (4.57%) of 1596 implants failed, with a survival rate of 95.43%. In addition, the mean survival rate of the presented prostheses was 89.66%. The mean marginal bone loss was 1.09 mm.
CONCLUSION
Within the limitations of the present review, implant and prosthetic survival rates of fixed mandibular 3-implant retained prostheses were similar to those of full-arch mandibular prostheses retained by four or more implants. Further research exploring the topic is necessary.
Topics: Dental Implants; Dental Prosthesis, Implant-Supported; Dental Restoration Failure; Follow-Up Studies; Humans; Mandible; Mandibular Prosthesis
PubMed: 32893938
DOI: 10.1111/jopr.13253 -
Plastic and Reconstructive Surgery Sep 2000Porous polyethylene implants are available that are designed to augment the mandibular ramus and body. They can be used to increase the bigonial distance in patients...
Porous polyethylene implants are available that are designed to augment the mandibular ramus and body. They can be used to increase the bigonial distance in patients with normal mandibular anatomy who desire an increase in lower facial width. When used in combination with extended chin implants, they can camouflage the skeletal contour inadequacies associated with class II mandibular deficiency. The implants are placed through intraoral incisions and fixed with titanium screws. In a clinical experience with 11 patients over 6 years, this technique has proven to be safe and effective.
Topics: Adult; Female; Humans; Male; Mandible; Mandibular Prosthesis Implantation; Middle Aged; Polyethylene; Plastic Surgery Procedures
PubMed: 10987481
DOI: 10.1097/00006534-200009030-00030 -
The Journal of Prosthetic Dentistry Mar 2021Prosthetic complications have been frequently reported in implant-supported complete-arch prosthesis. Prosthetic restorations designed with an all-on-four treatment...
STATEMENT OF PROBLEM
Prosthetic complications have been frequently reported in implant-supported complete-arch prosthesis. Prosthetic restorations designed with an all-on-four treatment concept and fabricated from zirconia ceramic may be used to overcome these problems.
PURPOSE
The purpose of this biomechanical study was to evaluate the effects of cantilever length and inclination of implant on the stress distribution in bone tissue, implant, and a monolithic zirconia ceramic-lithium disilicate glass-ceramic superstructure for all-on-four prosthesis.
MATERIAL AND METHODS
All-on-four mandibular prosthesis fabricated from a zirconia and lithium disilicate glass-ceramic (LDGC) superstructure was designed with cantilever lengths of either 5 mm or 9 mm and posterior implants with a distal tilt of either 15 or 30 degrees. Stresses were evaluated with a simulated application of a static load of 600 N.
RESULTS
Increasing implant inclination from 15 to 30 degrees led to a decrease in maximum principal stress (MaxPS) values of approximately 4 to 7 MPa in cortical bone around all implants except the right anterior implant in the designs with short cantilevers and an increase in MaxPS values (approximately 3 to 19 MPa) in the same places in the designs with the long cantilevers. Increasing cantilever length from 5 to 9 mm resulted in an increase in minimum principal stress (MinPS) values of approximately 3 to 13 MPa in the cortical bone surrounding all posterior implants. In the designs with the long cantilever, MaxPS values increased approximately 3 to 4 MPa in spongy bone adjacent to the right posterior implant. An increase in cantilever length also led to higher vMS values at the first and second implant grooves in the right posterior implant in the design with the 15-degree implant tilt. An increase in implant inclination in the design with the short cantilever resulted in lower vMS values at the apex and all grooves of the left posterior implant, whereas in the design with the long cantilever, an increase in implant inclination resulted in lower stress values in the first and second grooves of the same implant. An increase in implant inclination led to in an increase in vMS values in the core structure.
CONCLUSIONS
In zirconia ceramic restorations by using an all-on-four design with an LDGC superstructure, short cantilevers may be preferable because they result in a more favorable distribution of stress than long cantilevers. An increase in implant angulation from 15 to 30 degrees decreased MaxPS values in cortical bone.
Topics: Dental Implants; Dental Prosthesis Design; Dental Prosthesis, Implant-Supported; Dental Stress Analysis; Finite Element Analysis; Mandibular Prosthesis; Stress, Mechanical; Zirconium
PubMed: 32893017
DOI: 10.1016/j.prosdent.2020.05.027 -
Atlas of the Oral and Maxillofacial... Sep 2022
Review
Topics: Facial Bones; Humans; Joint Prosthesis; Mandibular Prosthesis; Temporomandibular Joint; Tissue Engineering
PubMed: 36116883
DOI: 10.1016/j.cxom.2022.06.003 -
Journal of the American Veterinary... Apr 2017CASE DESCRIPTION A 12-year-old neutered male domestic shorthair cat had been treated for a mass arising from the lingual aspect of the caudal right mandibular body....
CASE DESCRIPTION A 12-year-old neutered male domestic shorthair cat had been treated for a mass arising from the lingual aspect of the caudal right mandibular body. Cytoreductive surgery of the mass had been performed twice over a 2-year period, but the mass recurred following both surgeries. The mass was diagnosed as an osteosarcoma, and the cat was referred for further evaluation and treatment. CLINICAL FINDINGS Clinical findings were unremarkable, except for a 2-cm-diameter mass arising from the lingual aspect of the right mandible and mild anemia and lymphopenia. Pre- and postcontrast CT scans of the head, neck, and thorax were performed, revealing that the osteosarcoma was confined to the caudal right mandibular body, with no evidence of lymph node or pulmonary metastasis. TREATMENT AND OUTCOME The stereolithographic files of the CT scan of the head were sent for computer-aided design and manufacture of a customized 3-D-printed titanium prosthesis. Segmental mandibulectomy was performed, and the mandibular defect was reconstructed in a single stage with the 3-D-printed titanium prosthesis. The cat had 1 minor postoperative complication but had no signs of eating difficulties at any point after surgery. The cat was alive and disease free 14 months postoperatively. CLINICAL RELEVANCE Reconstruction of the mandible of a cat following mandibulectomy was possible with computer-aided design and manufacture of a customized 3-D-printed titanium prosthesis. Cats have a high rate of complications following mandibulectomy, and these initial findings suggested that mandibular reconstruction may reduce the risk of these complications and result in a better functional outcome.
Topics: Animals; Cat Diseases; Cats; Diagnosis, Differential; Male; Mandibular Neoplasms; Mandibular Prosthesis Implantation; Osteosarcoma; Titanium; Tomography, X-Ray Computed
PubMed: 28358629
DOI: 10.2460/javma.250.8.900 -
Aesthetic Plastic Surgery 1992A new type of implant designed to increase the angle of the mandible in three dimensions is described. Made of silicone and shaped like a saddle, this implant makes the...
A new type of implant designed to increase the angle of the mandible in three dimensions is described. Made of silicone and shaped like a saddle, this implant makes the technique of implantation relatively simple, and its versatility makes it a desirable addition to the tools for skeletal framework reconstruction of the face. The satisfaction rate has been high and the complications easy to manage. The surgical technique consists of an intraoral incision and the development of a subperiosteal pocket at the mandibular angle area, often performed under local anesthesia.
Topics: Adult; Humans; Male; Mandibular Prosthesis; Surgery, Plastic
PubMed: 1414661
DOI: 10.1007/BF01570699 -
Journal of Oral and Maxillofacial... Jun 2019Reconstruction of mandibular substance loss by a free flap is a widely used technique. This technique suffers from several disadvantages, including the presence of a...
Reconstruction of mandibular substance loss by a free flap is a widely used technique. This technique suffers from several disadvantages, including the presence of a second intervention site and a substantial frequency of complications. We have undertaken a custom-made 3-dimensional reconstruction (using computer-aided design and manufacturing) with prosthetic dental rehabilitation and esthetic improvement by lipomodeling of the face. A 50-year-old woman presented with a massive recurrence of an ameloblastoma of the right hemimandible. A cervical approach was used to resect the mandible well away from the tumor site. In light of her refusal to undergo reconstruction by a fibula free flap, reconstruction was performed using a custom-made porous titanium device with dental prosthetic rehabilitation, followed by lipomodeling of the face. The reconstruction was achieved without the occurrence of any complications. The implant-supported prosthetic dental implantation and the lipofilling resulted in functionally and esthetically satisfactory outcomes. Three-dimensional mandibular reconstruction with a custom-made porous titanium device and lipofilling yielded satisfactory results. Fitting of the dental prosthesis was undertaken at an early stage as it did not require osseointegration, although there was a need to overcome difficulties linked with the seal and the stability of the dental prosthesis and titanium support. The duration of patient follow-up was 18 months.
Topics: Bone Transplantation; Dental Implants; Dental Prosthesis, Implant-Supported; Esthetics, Dental; Female; Humans; Mandible; Mandibular Neoplasms; Mandibular Prosthesis; Mandibular Reconstruction; Middle Aged; Neoplasm Recurrence, Local; Porosity; Titanium
PubMed: 30689966
DOI: 10.1016/j.joms.2018.12.026 -
BioMed Research International 2018The purpose of this study was to evaluate and compare the effect of three mandibular full-arch superstructures on the peri-implant bone stress distribution during...
PURPOSE
The purpose of this study was to evaluate and compare the effect of three mandibular full-arch superstructures on the peri-implant bone stress distribution during mandibular flexure caused by mid-opening (27 mm) and protrusion mandibular movements.
MATERIALS AND METHODS
Three-dimensional finite element models were created simulating six osseointegrated implants in the jawbone. One model simulated a 1-piece framework and the other simulated 2-piece and 3-piece frameworks. Muscle forces with definite direction and magnitude were exerted over areas of attachment to simulate multiple force vectors of masticatory muscles during mandibular protrusion and opening.
RESULTS
During the movement of 27.5 mm jaw opening, the 1-piece and 3-piece superstructures showed the lowest values of bone stress around the mesial implants, gradually increasing towards the distal position. During the protrusion movement, bone stress increased compared to opening for any implant situation and for a divided or undivided framework. The 3-piece framework showed the highest values of peri-implant bone stress, regardless of the implant situation.
CONCLUSIONS
The undivided framework provides the best biomechanical environment during mandibular protrusion and opening. Protrusion movement increases the peri-implant bone stress. The most mesial implants have the lowest biomechanical risk.
Topics: Biomechanical Phenomena; Computer Simulation; Finite Element Analysis; Humans; Mandible; Mandibular Prosthesis; Models, Biological; Prosthesis Design; Stress, Mechanical
PubMed: 29805978
DOI: 10.1155/2018/8241313 -
Revue de Stomatologie Et de Chirurgie... 1994The authors report on 40 cases using acrylic-metal prosthesis after ablative cancer surgery and compare them with the literature. The long-term complications (prosthesis... (Comparative Study)
Comparative Study Review
The authors report on 40 cases using acrylic-metal prosthesis after ablative cancer surgery and compare them with the literature. The long-term complications (prosthesis extrusion or infection) are important, but the short-term follow-up (3 months) is more than 80% of success, any material used. The prosthesis keep a physiological position to the mandible, against scar sequelae. The use of soft tissue closure without post-operative radiotherapy increase the success of a simple-used and low-priced device of mandibular reconstruction.
Topics: Acrylic Resins; Adult; Aged; Aged, 80 and over; Carcinoma; Chromium Alloys; Combined Modality Therapy; Female; Follow-Up Studies; Humans; Male; Mandibular Neoplasms; Mandibular Prosthesis; Middle Aged; Prosthesis Design; Prosthesis Failure; Prosthesis-Related Infections; Retrospective Studies; Surgical Flaps
PubMed: 8029633
DOI: No ID Found