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Clinical Oral Implants Research Nov 2016The aim of this randomized clinical trial was to analyse and compare the volumetric changes after ridge preservation procedures using two different biomaterials and to... (Comparative Study)
Comparative Study Randomized Controlled Trial
OBJECTIVES
The aim of this randomized clinical trial was to analyse and compare the volumetric changes after ridge preservation procedures using two different biomaterials and to evaluate associations between outcome variables and pristine three-dimensional aspects of the ridges.
MATERIALS AND METHODS
Twenty-eight patients subjected to single-tooth alveolar ridge preservation were enrolled in the present multicentre, single-blind, prospective and randomized clinical trial. Fourteen sites were randomly allocated to each experimental group. The experimental sites were grafted with pre-hydrated collagenated cortico-cancellous porcine bone (coll group) or with a cortical porcine bone (cort group) and a collagen membrane; a secondary soft tissue healing was obtained for all experimental sites. Plaster casts were scanned (preoperative, at 1 and 3 months postoperative). Analysis of volumes and areas was performed, and all measured variables were statistically compared.
RESULTS
Intragroup analyses at 3 months revealed that when examining changes related to three-dimensional features of remodelling patterns (volume, surfaces, height and shape), the two biomaterials showed similar behaviours with a minor loss in volume and ridge surface. Intergroup analysis at 3-month survey revealed that volume resorption of the coll group (244 mm ) was significantly lower (P = 0.0140) than that of the cort group (349 mm ). The reduction for basal surface appeared significantly different between the two groups at 1-month survey only (P = 0.0137), while the final basal surface reduction was 4.9 and 12.2 mm for coll and cort group, respectively. The superior surface reduction was 40.8 mm for coll and 50.7 mm for cort group, with no significant difference between the two groups.
CONCLUSION
At the 3rd month analysis, coll group showed a significantly lower reduction of ridge volume and a significantly smaller shrinkage of the basal area when compared to the cort group; moreover, the coll group experienced a smaller superior surface shrinkage when compared to the cort group, even though no significance was evaluated.
Topics: Adult; Aged; Alveolar Ridge Augmentation; Animals; Bone Remodeling; Bone Transplantation; Collagen; Cone-Beam Computed Tomography; Female; Heterografts; Humans; Male; Middle Aged; Prospective Studies; Single-Blind Method; Swine; Tooth Socket
PubMed: 25727443
DOI: 10.1111/clr.12572 -
The Cleft Palate-craniofacial Journal :... Nov 2016
Topics: Alveolar Process; Alveoloplasty; Bone Transplantation; Cleft Lip; Cleft Palate; Humans
PubMed: 26575962
DOI: 10.1597/15-091 -
Journal of Plastic, Reconstructive &... Nov 2016Few studies have examined the long-term outcomes of gingivoperiosteoplasty at the age of permanent canine eruption. The success rates of gingivoperiosteoplasty vary...
Few studies have examined the long-term outcomes of gingivoperiosteoplasty at the age of permanent canine eruption. The success rates of gingivoperiosteoplasty vary significantly depending on the surgeon because of the difficulty of the surgical technique. Therefore, the authors utilized a simplified gingivoperiosteoplasty technique by inserting one or two large, triangular-shaped mucoperiosteal flaps on the opposite side in a tongue-in-groove or interdigitation fashion. The purpose of this study was to evaluate the long-term outcomes of this simplified gingivoperiosteoplasty technique at the age of permanent canine eruption. Forty nonsyndromic cleft lip and palate patients who had undergone simplified gingivoperiosteoplasty were retrospectively reviewed. Canine eruption and the bone formation rate of the interalveolar septum using the Bergland method and a modified Long et al. method were evaluated. A total of 55 alveolar cleft sites were treated. Simplified gingivoperiosteoplasty was performed at a mean age of 13.4 months, and the mean age at the time of follow-up was 14.3 years. The overall success rate of simplified gingivoperiosteoplasty was 50.90%. With regard to cleft types, clefts of the primary palate and unilateral alveolar clefts showed a significantly higher success rate than clefts of the primary and secondary palates and bilateral alveolar clefts, respectively. Our gingivoperiosteoplasty technique is a simple surgical procedure and is performed at 12 months of age, at which time the cleft alveolus has grown sufficiently, to ensure the success of the delicate surgical technique. Therefore, we could obtain favorable outcomes.
Topics: Alveoloplasty; Cleft Palate; Female; Follow-Up Studies; Gingivoplasty; Humans; Infant; Male; Periosteum; Plastic Surgery Procedures; Retrospective Studies; Treatment Outcome
PubMed: 27667546
DOI: 10.1016/j.bjps.2016.08.003 -
Journal of Plastic, Reconstructive &... Nov 2016Optimal timing for cleft lip rhinoplasty is controversial. Definitive rhinoplasty is deferred until facial skeletal growth is completed. Intermediate rhinoplasty is... (Comparative Study)
Comparative Study
BACKGROUND
Optimal timing for cleft lip rhinoplasty is controversial. Definitive rhinoplasty is deferred until facial skeletal growth is completed. Intermediate rhinoplasty is performed after stabilization of the grafted alveolar bone, because the grafted bone tends to be absorbed over several months postoperatively, distorting the nasal profile. Here, we report our experience with simultaneous rhinoplasty during alveolar bone grafting for indicated patients, describe our surgical technique that ensures long-term bone graft survival, and report graft take rates and nasal profile changes.
METHODS
This retrospective chart review included a total of 54 patients; 44 underwent alveolar bone grafting only, and 10 underwent simultaneous cleft lip rhinoplasty. All surgeries were conducted with a judicious mucosal incision for tensionless wound closure. Bone graft take was evaluated with dental radiographs by the Bergland classification. Further, nasal aesthetic outcome was evaluated with medical photographs, based on nostril height and width and alar base width.
RESULTS
In total, 96.3% of clefts showed graft success with Type I (66.7%) or Type II (27.8%) classifications; only 3.7% of clefts showed unfavorable results classified as Type III, and no clefts showed Type IV failure. The nasal shape was flatter with a decreased nostril height and increased nostril width after alveolar bone grafting, while nostril height was increased and nostril width was decreased in patients who underwent simultaneous rhinoplasty.
CONCLUSION
With surgical techniques ensuring alveolar bone graft survival, simultaneous cleft lip rhinoplasty can result in nasal aesthetic improvement for patients with severe nasal deformities, decreasing the number of operations.
Topics: Adolescent; Alveolar Bone Grafting; Alveoloplasty; Bone Transplantation; Child; Cleft Lip; Female; Humans; Male; Photogrammetry; Retrospective Studies; Rhinoplasty; Surgical Flaps; Time Factors; Treatment Outcome
PubMed: 27502020
DOI: 10.1016/j.bjps.2016.07.011 -
The Journal of Oral Implantology Oct 2016The aim of this study is to present a method, using 3 computer-aided design/computer-aided manufacturing (CAD/CAM) surgical guides, to accurately obtain the desired bone...
The aim of this study is to present a method, using 3 computer-aided design/computer-aided manufacturing (CAD/CAM) surgical guides, to accurately obtain the desired bone reduction followed by immediate implant placements and loading for patients diagnosed with terminal dentition. Patients who had bone reduction, implants placed, and immediate loading using Anatomage Invivo 5 CAD/CAM surgical guides between the period 2013 and 2015 were evaluated retrospectively. Patients diagnosed with terminal dentition and treated using the "3-guide technique" were identified. Pre- and postsurgical images were superimposed to evaluate deviations of the bone reduction and deviations at the crest, apex, and angle of implants placed. Twenty-six implants placed in 5 patients were included in this study. The overall deviation means measured for bone reduction was 1.98 mm. The overall deviation means measured for implant placement at the crest, apex, and angle were 1.43 mm, 1.90 mm, and 4.14°, respectively. The CAD/CAM surgical guide fabrication is an emerging tool that may facilitate the surgical process and aid in safe and predictable execution of bone reduction and immediate implant placement. Using 3 CAD/CAM surgical guides, a method is presented to obtain the desired bone reduction followed by immediate implant placement and loading for patients diagnosed with terminal dentition. This method may improve guide stability for patients with terminal dentition undergoing complete implant-supported treatment by taking advantage of the teeth to be extracted.
Topics: Computer-Aided Design; Dental Implantation, Endosseous; Dentition; Humans; Surgery, Computer-Assisted; Tooth
PubMed: 27276111
DOI: 10.1563/aaid-joi-D-16-00016 -
Dentistry Today Apr 2016
Topics: Alveoloplasty; Bicuspid; Biocompatible Materials; Cost-Benefit Analysis; Dental Caries; Dental Implantation, Endosseous; Dental Implants; Durapatite; Follow-Up Studies; Guided Tissue Regeneration, Periodontal; Humans; Osteogenesis; Patient Care Planning; Tooth Extraction; Tooth Socket
PubMed: 27244995
DOI: No ID Found -
The Journal of Prosthetic Dentistry Sep 2016The use of computer-aided engineering (CAE) and computer-aided design and computer-aided manufacturing (CAD-CAM) technology to fabricate complete dentures was introduced...
The use of computer-aided engineering (CAE) and computer-aided design and computer-aided manufacturing (CAD-CAM) technology to fabricate complete dentures was introduced in 2011. Clinical procedures for digital immediate dentures can be identical to those for conventional immediate dentures and can be simplified by leaving all remaining dentition until the time of extraction and denture placement. Through the digital process, a single digital design and a definitive digital record are created which can be used to fabricate the immediate digital denture and surgical reduction guide for alveoloplasty. Digital immediate dentures can be relined using the same process as for conventional dentures. The definitive digital dentures can be fabricated with a reline impression and new centric relation record, using the existing digital immediate denture without additional clinical procedures. Providing patients with digital immediate dentures is a viable trend.
Topics: Computer-Aided Design; Dental Impression Technique; Denture Design; Denture, Complete; Female; Humans; Middle Aged; Radiography, Panoramic
PubMed: 27061629
DOI: 10.1016/j.prosdent.2016.01.010 -
The Cleft Palate-craniofacial Journal :... May 2017The defect volume measured on computed tomography (CT) for secondary bone graft (SBG) is well correlated to the actual amount of particulate cancellous bone and marrow...
OBJECTIVE
The defect volume measured on computed tomography (CT) for secondary bone graft (SBG) is well correlated to the actual amount of particulate cancellous bone and marrow (PCBM) transplanted in unilateral cleft lip and palate (UCLP) patients. However, the validity of such measurements have not been completely verified due to lack of evaluation of treatment results. The objective of this study was to propose an estimation method by CT based on the data of successfully treated patients. For this purpose, the association was initially verified between the weight of transplanted PCBM and the defect volume measured on CT using the results of successfully treated patients.
METHODS
Treatment results were evaluated 1 year after SBG by intraoral radiography in 50 UCLP patients. For the patients with good results, the correlation was investigated between the defect volume on CT and the transplanted PCBM weight, and a method was proposed based on PCBM density, calculated as PCBM weight divided by defect volume on CT.
RESULTS
In successfully treated patients showing level 3 or 4 alveolar resorption, a strong correlation (r = .87) was found between the volume on CT and the PCBM weight. Level 4 results were observed in 22 of 23 (95.7%) patients who had calculated PCBM densities of more than 6 g/cm.
CONCLUSIONS
Volume estimation on preoperative CT was confirmed to have sufficient validity. The weight of PCBM transplanted should be greater than the defect volume on CT multiplied by 6.
Topics: Adolescent; Alveoloplasty; Bone Marrow; Bone Transplantation; Cancellous Bone; Child; Cleft Lip; Cleft Palate; Female; Humans; Male; Tomography, X-Ray Computed; Treatment Outcome
PubMed: 27043653
DOI: 10.1597/15-193 -
The Cleft Palate-craniofacial Journal :... May 2017To report the surgical outcomes of secondary alveolar bone grafting with premaxillary osteotomy in a single surgeon cohort of complete bilateral cleft lip and palate...
OBJECTIVE
To report the surgical outcomes of secondary alveolar bone grafting with premaxillary osteotomy in a single surgeon cohort of complete bilateral cleft lip and palate patients.
DESIGN
Retrospective review of 44 consecutive patients using hospital notes and radiographs.
SETTING
Single specialist cleft lip and palate center, UK.
PATIENTS
Consecutive patients with complete bilateral cleft lip and palate who were being treated with secondary alveolar bone grafting incorporating premaxillary osteotomy.
OUTCOME MEASURES
Assessment of success of bone graft by Kindelan score; canine eruption; closure of fistulae and assessment of morbidity.
RESULTS
Between January 6, 2000, and August 8, 2013, 44 patients with complete BCLP underwent secondary ABG with a premaxillary osteotomy as a one-stage procedure. The mean follow-up was 7.3 years (range 1.4 to 14.6). Eighty-five percent of ABGs were successful (a Kindelan score of 1 or 2), and canine eruption was 89%. Failure of the ABG occurred in 7%. Fistulae recurrence rate was 11%, all of which were asymptomatic. No premaxillae were devitalized.
CONCLUSION
Incorporating a premaxillary osteotomy into the secondary ABG surgical protocol can be a safe technique that gives excellent surgical exposure for fistula repair.
Topics: Alveolar Bone Grafting; Alveoloplasty; Child; Cleft Lip; Cleft Palate; Female; Humans; Length of Stay; Male; Maxilla; Osteotomy; Retrospective Studies; Treatment Outcome; United Kingdom
PubMed: 27031266
DOI: 10.1597/15-162 -
Annali Italiani Di Chirurgia 2016Bone grafting of the alveolus has become an essential part of the contemporary surgical management of the oral cleft. The aim of this retrospective study was to evaluate...
PURPOSE
Bone grafting of the alveolus has become an essential part of the contemporary surgical management of the oral cleft. The aim of this retrospective study was to evaluate the results of bone grafting in association with PRP (plateletrich plasma) to enhance osteogenesis and osteointegration.
PATIENTS AND METHODS
The study included 16 patients, aged between 9 and 11, affected with unilateral residual alveolar clefts, who underwent bone grafting using secondary alveoplasty. The eight patients belonging to the control group were administered autologous bone graft alone while the study group, consisting of 8 patients, underwent autologous bone grafting in association with PRP. All patients had pre and post surgery orthodontic treatment. The statistical analyses included Student's t test, 2 test and Kaplan-Meir time to event analysis. The p-value was considered significant if p<0.05. All statistical analyses were performed using SAS Software release 9.3 (SAS Institute, Cary, Nc).
RESULTS
The control group (M 50%, mean age 10.2±2.3) underwent simple autologous bone graft while the study group (M 62.5%, mean age 9.9±2.2) was treated with a combination of autologous bone and PRP. No statistically significant differences were found between the two groups as regards age, gender and labial-palatal cleft clinical characteristics. 6, 12, 24 month follow-ups were performed by means of clinical and radiographic investigations. None of the study group developed oronasal fistulas or experienced bone height, bone bridging and bone quality loss; only two patients developed mild periodontal problems. The study group was able to undergo a significantly (p<0.001) earlier and shorter orthodontic treatment.
CONCLUSIONS
In our experience, the use of PRP enhances the quality of osteoplasty, accelerates "creeping substitution" and bone healing and favours earlier orthodontic treatment.
KEY WORDS
Alveolar cleft, Bone grafting, Palate, Platelet-rich plasma.
Topics: Alveolar Bone Grafting; Alveolar Process; Alveoloplasty; Child; Cleft Palate; Combined Modality Therapy; Female; Humans; Ilium; Male; Orthodontics, Corrective; Platelet-Rich Plasma; Retrospective Studies; Time Factors; Transplantation, Autologous; Treatment Outcome
PubMed: 27026208
DOI: No ID Found