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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... 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 -
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 -
The Journal of Craniofacial Surgery 2020The aim of this study was to analyze the newly formed bone volume (FV), 6 months after secondary alveoloplasty using iliac cancellous bone graft, with and without... (Randomized Controlled Trial)
Randomized Controlled Trial
The aim of this study was to analyze the newly formed bone volume (FV), 6 months after secondary alveoloplasty using iliac cancellous bone graft, with and without platelet-rich plasma (PRP). Forty patients with unilateral alveolar cleft were involved in this randomized, prospective, comparative study, with 20 patients each forming the control (group A) and PRP (group B) groups, respectively. The preoperative alveolar defect volume (DV) and the postoperative FV were automatically calculated by the computer-aided engineering software using the patients' pre and postsurgical computed tomography data. The volume of the actual bone graft (AV) was identical to the DV calculated before surgery. The bone formation ratio (BF%) was calculated as follows: BF% = (FV/AV) × 100%. The mean BF% was 42.54 ± 9.32% in group A and 46.97 ± 18.49% in group B. There was no statistically significant difference between the 2 groups for BF% (P > 0.05). The study presents a fast and accurate method for assessing the effect of PRP in alveolar grafting. However, the study found no conclusive evidence on the effect of PRP on bone growth.
Topics: Adolescent; Alveolar Bone Grafting; Alveoloplasty; Bone Transplantation; Child; Cleft Palate; Female; Humans; Imaging, Three-Dimensional; Male; Osteogenesis; Platelet-Rich Plasma; Prospective Studies; Tomography, X-Ray Computed
PubMed: 31934980
DOI: 10.1097/SCS.0000000000006256 -
The Journal of Oral Implantology Apr 2020The purpose of this case report is to present implant-retained maxillary and mandibular complete overdentures in a patient with Marfan syndrome. The patient initially... (Review)
Review
The purpose of this case report is to present implant-retained maxillary and mandibular complete overdentures in a patient with Marfan syndrome. The patient initially presented with generalized periodontitis (stage IV, grade C). Due to the progressive nature of periodontal disease, the patient elected to have implant-retained maxillary and mandibular complete dentures. Bilateral maxillary sinus augmentation was performed 6 months before full-mouth extraction, alveoloplasty, and immediate implant placement. Maxillary and mandibular immediate overdentures were delivered. After 4 months of healing, the final overdenture was fabricated. The patient was seen regularly throughout the healing process for peri-implant maintenance. Soft-tissue grafts were completed to increase the thickness of the mucosa around the implants. The patient has been followed for 2 years and is functioning well without major complications. For patients with Marfan syndrome, implant-retained prostheses are a viable treatment option in the presence of a failing dentition.
Topics: Dental Implants; Dental Prosthesis, Implant-Supported; Denture, Overlay; Humans; Mandible; Marfan Syndrome; Mouth Rehabilitation
PubMed: 31910068
DOI: 10.1563/aaid-joi-D-19-00151 -
Progress in Orthodontics Dec 2019Maxillary incisor protrusion is a prevalent dental deformity and is often treated by upper incisor intrusion and retraction. The mechanical loading triggers the...
BACKGROUND
Maxillary incisor protrusion is a prevalent dental deformity and is often treated by upper incisor intrusion and retraction. The mechanical loading triggers the resorption and apposition of the bone. Alveolar bone remodeling is expected to follow orthodontic tooth movement in a one-to-one relationship. However, in many cases, the outcomes are different. Alveolar bone might still remain thick causing lip protrusion and other aesthetic problems after treatment. Additional corrective procedures such as alveoloplasty. On the other hand, if the labial bone becomes too thin, periodontal problems like gingival recession might occur. The unpredictability of the treatment result and the risk of requiring corrective procedures pose significant challenges to both the providers and patients. The aim of this study is to determine factors that can help to predict the alveolar bone reaction before maxillary incisor intrusion and retraction.
METHODS
The cohort included 34 female patients (mean age 25.8 years) who were diagnosed with skeletal class II malocclusion with upper incisor protrusion. These patients underwent extraction and orthodontic treatment with upper incisor intrusion and retraction. Lateral cephalograms at pre-treatment and post-treatment were taken. Linear and angular measurements were analyzed to evaluate the alveolar bone changes based on initial conditions.
RESULTS
The study found that the relative change, calculated as change in alveolar bone thickness after treatment divided by the initial alveolar thickness, was inversely correlated with the initial thickness. There was a significant increase of labial alveolar bone thickness at 9-mm apical from cementoenamel junction (B3) (P < 0.05) but no statistically significant change in the thickness at other levels. In addition, the change in angulation between the incisor and alveolar bone was inversely correlated with several initial angulations: between the initial palatal plane and upper incisor angle, between the initial palatal plane and upper incisor labial surface angle, and between the initial palatal plane and bone labial surface angle. On the other hand, the change in labial bone thickness was neither significantly correlated with the initial thickness nor significantly correlated to the amount of retraction.
CONCLUSION
The unpredictability of alveolar bone remodeling after upper incisor intrusion and retraction poses significant challenges to treatment planning and patient experience. The study showed that the initial angulation between the incisor and alveolar bone is correlated with the change in angulation after treatment, the initial thickness of the alveolar bone was correlated with the relative change of the alveolar bone thickness (defined as change in thickness after treatment divided by its initial thickness), and the amount of intrusion was correlated with the alveolar bone thickness change at 9-mm apical from the cementoenamel junction after treatment. The results of the present study also revealed that the change in labial alveolar bone thickness was neither significantly correlated with the initial thickness nor significantly correlated to the amount of retraction.
Topics: Adult; Bone Remodeling; Cephalometry; Esthetics, Dental; Female; Humans; Incisor; Maxilla; Tooth Movement Techniques
PubMed: 31867679
DOI: 10.1186/s40510-019-0300-2 -
Journal of Plastic, Reconstructive &... Dec 2019
Topics: Alveolar Bone Grafting; Alveoloplasty; Bone Regeneration; Bone Transplantation; Child; Cleft Lip; Humans; Surgical Flaps
PubMed: 31582317
DOI: 10.1016/j.bjps.2019.09.001 -
Annales de Chirurgie Plastique Et... Nov 2019In the course of treatment of cleft lip and palates, the quality of primary cheilo-rhinoplasty is essential to limit aesthetic and functional complications. This is why...
In the course of treatment of cleft lip and palates, the quality of primary cheilo-rhinoplasty is essential to limit aesthetic and functional complications. This is why these primary reconstructions come under the domain of specialised centres with multidisciplinary teams. Unfortunately, residual imperfections often remain, especially in bilateral clefts, and secondary cheiloplasties represent for us a complex challenge. They aim at functional and aesthetic correction, and the choice of time is very random and depends largely on the psychological repercussions of the deformation in the child. It often occurs at the age of school entry and is combined with alveoloplasty. We then speak of alveolar transplantation with vestibulo and labio-plastie, the GPVP. Then we propose to combine all the resources of cosmetic surgery to improve the aesthetic and functional result of these children.
Topics: Cicatrix; Cleft Lip; Cleft Palate; Cosmetic Techniques; Humans; Lip; Plastic Surgery Procedures; Reoperation; Rhinoplasty
PubMed: 31492440
DOI: 10.1016/j.anplas.2019.07.008 -
Compendium of Continuing Education in... Jun 2019Extraction is commonly presented as a treatment alternative for restorable teeth, and patients are biased to choose it for a variety of reasons. However, without...
Extraction is commonly presented as a treatment alternative for restorable teeth, and patients are biased to choose it for a variety of reasons. However, without subsequent rehabilitation, patients' health, function, and esthetics could be compromised. This article explores problematic outcomes where extraction was offered as a treatment option when teeth were restorable; a case report example demonstrates this issue. The case involved a patient who was diagnosed with moderate to severe periodontitis and had severe attrition and lingual erosion on his maxillary teeth. Despite being given the option of full-mouth rehabilitation, ie, periodontal and restorative treatment, due to financial reasons the patient chose to have all maxillary teeth extracted and receive a maxillary denture. Respecting the patient's autonomy, the dental team performed surgical extraction of the maxillary teeth and an alveoloplasty and delivered an interim denture. The patient did not adapt well to the denture, and several postoperative issues transpired, which required unanticipated surgical procedures. Dissatisfied with the treatment, the patient continued to need dental appointments more than a year after the extractions, and his oral health, function, and esthetics have still not been restored. The dental community must educate patients regarding extraction being an irreversible, last-resource procedure, and mainly indicated only when teeth restoration is not possible. Presenting extraction together with more conservative options for restorable teeth may contribute to patients' misconceptions that it is a treatment alternative as good as any other.
Topics: Esthetics, Dental; Humans; Maxilla; Mouth Rehabilitation; Tooth Extraction
PubMed: 31166685
DOI: No ID Found -
Journal of the American Dental... Apr 2019Distinct, irregular, and hard nodular protuberances similar to the morphologic features of exostoses can occasionally be noted on the labial surface of the alveolar bone...
BACKGROUND
Distinct, irregular, and hard nodular protuberances similar to the morphologic features of exostoses can occasionally be noted on the labial surface of the alveolar bone after orthodontic retraction of anterior teeth in adults. These have long been believed to be exostoses developed in response to loading. However, specific characterization of this phenomenon has not been documented.
CASE DESCRIPTIONS
Three cases of patients displaying multiple irregular labial bony protuberances after retraction of anterior teeth are reported. These protuberances appeared during retraction and became more prominent with additional retraction. Serial clinical photographs, lateral cephalograms, digital models, and cone-beam computed tomography scans were evaluated. On the basis of 3-dimensional superimpositions of digital models and cone-beam computed tomographic scans, the irregular protuberances appear to be the result of differential alveolar bone modeling, with more resorption of bone covering the tooth root than that of interdental bone, and not of true bone overgrowth or deposition (that is, exostoses).
CONCLUSION AND PRACTICAL IMPLICATIONS
Orthodontic patients often seek treatment to improve occlusion as well as esthetics. Although this study shows that these protuberances are the result of differential modeling, they may still be perceived by patients as "outgrowths," which may cause concerns related to esthetics or comfort. Clinicians should note that these protuberances are a possible outcome when large amounts of bodily retraction and root movement of anterior teeth are planned. Patients who experience psychosocial problems with this phenomenon may be candidates for alveoloplasty.
Topics: Adult; Alveolar Process; Cone-Beam Computed Tomography; Humans; Maxilla; Tooth Movement Techniques
PubMed: 30922461
DOI: 10.1016/j.adaj.2018.12.029