-
Medicina Oral, Patologia Oral Y Cirugia... Jul 2010Cleft lip and palate is a congenital facial malformation with an established treatment protocol. Mixed dentition period is the best moment for correct maxillary bone...
OBJECTIVE
Cleft lip and palate is a congenital facial malformation with an established treatment protocol. Mixed dentition period is the best moment for correct maxillary bone defect with an alveoloplasty. The aim of this surgical procedure is to facilitate dental eruption, re-establish maxillary arch, close any oro-nasal communication, give support to nasal ala, and in some cases allow dental rehabilitation with osteointegrated implants.
STUDY DESIGN
Twenty cleft patients who underwent secondary alveoloplasty were included. In 10 of them autogenous bone graft were used and in other 10 autogenous bone and platelet-rich plasma (PRP) obtained from autogenous blood. Bone formation was compared by digital orthopantomography made on immediate post-operatory and 3 and 6 months after the surgery.
RESULTS
No significant differences were found between both therapeutic groups on bone regeneration.
CONCLUSION
We do not find justified the use of PRP for alveoloplasty in cleft patients' treatment protocol.
Topics: Alveoloplasty; Bone Regeneration; Bone Transplantation; Child; Cleft Lip; Cleft Palate; Combined Modality Therapy; Female; Humans; Male; Platelet-Rich Plasma
PubMed: 20038881
DOI: 10.4317/medoral.15.e619 -
Journal (Canadian Dental Association) 2008Alveolar atrophy following tooth extraction remains a challenge for future dental implant placement. Immediate implant placement and postextraction alveolar preservation...
Alveolar atrophy following tooth extraction remains a challenge for future dental implant placement. Immediate implant placement and postextraction alveolar preservation are 2 methods that are used to prevent significant postextraction bone loss. In this article, we report the management of a maxillary tooth extraction socket using an alveolar preservation technique involving placement of a cone of beta-tricalcium phosphate (beta -TCP) combined with type I collagen without the use of barrier membranes or flap surgery. Clinical examination revealed solid new bone formation 9 months after the procedure. At the time of implant placement, histomorphometric analysis of the biopsied bone showed that it contained 62.6% mineralized bone, 21.1% bone marrow and 16.3% residual beta -TCP graft. The healed bone was able to support subsequent dental implant placement and loading.
Topics: Adult; Alveolar Bone Loss; Alveoloplasty; Bicuspid; Biocompatible Materials; Bone Marrow; Bone Substitutes; Calcification, Physiologic; Calcium Phosphates; Collagen Type I; Dental Implantation, Endosseous; Follow-Up Studies; Humans; Male; Maxilla; Osteogenesis; Tooth Extraction; Tooth Socket
PubMed: 18644238
DOI: No ID Found -
American Journal of Veterinary Research May 2008To evaluate the biological behavior of a nonresorbable bone substitute (NRBS) in the alveoli of ponies, compared with tissue quality in naturally healing alveoli, after...
OBJECTIVE
To evaluate the biological behavior of a nonresorbable bone substitute (NRBS) in the alveoli of ponies, compared with tissue quality in naturally healing alveoli, after cheek tooth extraction.
ANIMALS
5 clinically normal ponies.
PROCEDURES
In each pony, both maxillary fourth premolars (Triadan 108/208) were repulsed bilaterally during anesthesia. One randomly chosen alveolus was filled with NRBS and isolated from the oral cavity by use of dental impression material and a spring-wire retention device. The other alveolus was occluded in its occlusal third portion with dental impression material. One year after surgery, cylindrical lateromedial biopsy specimens were collected from the apical, middle, and occlusal level of each alveolus. Biopsy samples were evaluated for bone mineral density and bone volume via micro-computed tomography; qualitative histologic characteristics were evaluated via light microscopy.
RESULTS
Bone mineral density and bone volume were greater in control alveoli, compared with NRBS-treated alveoli. Control alveoli were characterized by the presence of few mature bone trabeculae and wide spaces containing fat tissue and mesenchymal stroma. In treated alveoli, biocompatibility and osteoconductive properties of the NRBS were excellent; continuous bone formation and bone remodeling were also evident.
CONCLUSIONS AND CLINICAL RELEVANCE
Results indicated that the NRBS was integrated well in calcified alveolar tissues in ponies 1 year after maxillary cheek tooth extraction. Further research is necessary to establish the benefits of this NRBS in the development of a dental implant surgical technique in equids.
Topics: Alveolar Process; Alveoloplasty; Animals; Biopsy; Bone Density; Bone Remodeling; Bone Substitutes; Bone Transplantation; Dental Implantation, Endosseous; Histocytochemistry; Horses; Tomography, X-Ray Computed; Tooth Extraction
PubMed: 18447790
DOI: 10.2460/ajvr.69.5.604 -
The Angle Orthodontist Jul 2008To evaluate changes in the grafted bone after secondary alveolar bone graft (ABG) with iliac bone using 3-dimensional computed tomography (3D-CT).
OBJECTIVE
To evaluate changes in the grafted bone after secondary alveolar bone graft (ABG) with iliac bone using 3-dimensional computed tomography (3D-CT).
MATERIALS AND METHODS
The sample consisted of 10 patients with unilateral cleft lip and palate (UCLP) and 5 patients with unilateral cleft lip and alveolus (UCLA) (mean age = 10 years). 3D-CT data (Sensation 10, Siemens, Munchen, Germany), which was obtained 1 month before (T0), 3 months after (T1), and 12 months (T2) after ABG, were used to measure the height, labiolingual thickness (LLT), and volume of the grafted bone using V-Works 4.0 program (Cybermed Inc, Seoul, Korea). All of the UCLA patients showed the lingual process in the cleft area at T0, but the UCLP did not.
RESULTS
During T1-T2, there was a significant decrease in height of the upper part of the grafted bone; however, volumes of both the upper and lower parts were decreased. Unilateral cleft type and presence of ULI in the cleft area did not affect the change in height and volume of the grafted bone. The resorption amount (RA) was significantly larger in the lower part than in the upper part, while the resorption rate (RR) exhibited an opposite result. In addition, there was significantly more RA in the labial side in UCLA than UCLP (P < .05). There was no correlation between the initial cleft width and changes in height, LLT, and volume of the grafted bone.
CONCLUSION
Overpacking and/or excessive condensation of the grafted bone is not necessary in UCLA with the lingual process because of the greater chance of resorption on the labial side of the grafted bone.
Topics: Alveolar Process; Alveoloplasty; Bone Density; Bone Resorption; Bone Transplantation; Child; Cleft Lip; Cleft Palate; Female; Humans; Imaging, Three-Dimensional; Linear Models; Male; Prospective Studies; Statistics, Nonparametric; Tomography, X-Ray Computed; Treatment Outcome; Vertical Dimension
PubMed: 18302461
DOI: 10.2319/0003-3219(2008)078[0631:CIGSAB]2.0.CO;2 -
Annals of the Royal College of Surgeons... Nov 2005Birmingham Children's Hospital (BCH) is the centre for a regional comprehensive cleft service attempting to implement the national guidelines for minimum standards of...
INTRODUCTION
Birmingham Children's Hospital (BCH) is the centre for a regional comprehensive cleft service attempting to implement the national guidelines for minimum standards of care. A national audit of cleft management (CSAG) found that 58% of alveolar bone grafts were successful; published series suggest that success rates can be of the order of 95%. We present the results of an audit of alveolar bone grafting over a 33-month period, after implementation.
PATIENTS AND METHODS
A retrospective clinical process audit was taken from the hospital notes and an analysis of radiological outcome by Bergland score was obtained by two independent assessors.
RESULTS
The audit highlighted the difficulties of integrating the increased clinical workload. Other difficulties included poorly standardised pre- and postoperative occlusal radiography, inconsistent orthodontic management and a lack of prospective data collection. An 81% success rate for alveolar bone grafting compares favourably to the CSAG study. Of 82 patients, 68 had sufficient data for a retrospective review; 21 were our own patients and 47 were referred into the centralised service. The success of bone grafting as defined by CSAG (including Bergland scores) is based on only two-thirds of the patients as many have their orthodontic treatment managed in more distant units and radiographs are much harder to obtain. Bone grafting later than age 11 years, was true for 28% (6/21) of our BCH patients and 46% (22/47) for those referred to our service.
CONCLUSIONS
This audit demonstrates what has been achieved in a re-organised service in the context of Real Politik in the NHS and suggests the areas that require improvement.
Topics: Adolescent; Alveoloplasty; Bone Transplantation; Child; Child Health Services; Cleft Palate; Female; Humans; Male; Medical Audit; Practice Guidelines as Topic; Radiography; Retrospective Studies; Treatment Outcome
PubMed: 16263019
DOI: 10.1308/003588405X60605 -
Anesthesia Progress 2005An 11-year-old girl was scheduled for alveolar cleft bone grafting with an iliac bone under general anesthesia. Anesthesia was performed with 70% nitrous oxide, 30%...
An 11-year-old girl was scheduled for alveolar cleft bone grafting with an iliac bone under general anesthesia. Anesthesia was performed with 70% nitrous oxide, 30% oxygen, and propofol. On the first and second postoperative day, persistent hyperthermia was observed. Because the administration of diclofenac sodium had not been effective for the hyperthermia, dantrolene sodium was given. Her body temperature gradually dropped and returned to normal level on the fifth postoperative day. The hyperthermia in the present case might have been caused by a rapidly elevated muscle metabolism in response to pain and stress after the propofol anesthesia. The oral administration of dantrolene sodium successfully lowered the patient's high body temperature.
Topics: Alveolar Process; Alveoloplasty; Anti-Inflammatory Agents, Non-Steroidal; Body Temperature; Bone Transplantation; Child; Dantrolene; Diclofenac; Female; Humans; Malignant Hyperthermia; Muscle Relaxants, Central
PubMed: 15859445
DOI: 10.2344/0003-3006(2005)52[21:PHOUOT]2.0.CO;2 -
Australian Dental Journal Jun 2003The contemporary treatment of cleft lip and palate involves a sequence of surgical procedures and orthodontic management. Alveolar bone grafting (ABG) is usually...
BACKGROUND
The contemporary treatment of cleft lip and palate involves a sequence of surgical procedures and orthodontic management. Alveolar bone grafting (ABG) is usually undertaken after orthodontic expansion of the maxillary segments between the ages of eight and 12 years. Two of the important goals of alveolar bone grafting are the provision of bony support for the eruption of the canine and the closure of residual oro-nasal fistulae. The purpose of this study was to retrospectively evaluate the root development and eruption of the canine following ABG.
METHODS
Group 1: radiographic and clinical records of a sample of 19 cleft patients who underwent alveolar bone grafting procedures, performed between 1996 and 1999 were reviewed. Group 2: a random sample of 15 cleft patients attending for routine dental review were clinically examined. The age of patient, degree of root development and eruption status of the canine, and presence of oronasal fistulae pre and post alveolar bone grafting were evaluated.
RESULTS
Most cleft canines had continued root development and descended in the alveolus towards eruption following ABG. Four canine teeth (8 per cent) were impacted and required surgical exposure and orthodontic treatment following failure of eruption. Closure of anterior oro-nasal fistulae at the time of grafting was maintained post-operatively.
CONCLUSIONS
This study demonstrated that canine root development and eruption continued satisfactorily through grafted alveolar clefts in most cases and closure of anterior oro-nasal fistulae was achieved in all cases.
Topics: Adolescent; Age Factors; Alveoloplasty; Bone Transplantation; Child; Cleft Lip; Cleft Palate; Cuspid; Female; Humans; Incisor; Male; Nose Diseases; Odontogenesis; Oral Fistula; Respiratory Tract Fistula; Retrospective Studies; Tooth Eruption; Tooth Root; Tooth, Impacted
PubMed: 14649402
DOI: 10.1111/j.1834-7819.2003.tb00020.x -
Australian Dental Journal Mar 2003The use of implants has become a routine part of restorative dental treatment. The placement of implants requires a sufficient quantity of bone in which to place implant...
The use of implants has become a routine part of restorative dental treatment. The placement of implants requires a sufficient quantity of bone in which to place implant fixtures. Where such bone does not exist, a number of methods have been used to augment the affected area of the alveolar ridge. This case report describes the use of the relatively new distraction osteogenesis procedure to increase bone volume in a patient who required post-traumatic restoration of several missing teeth, as well as comprehensive orthodontic and orthognathic surgical treatment.
Topics: Adolescent; Alveoloplasty; Cuspid; Dental Implants; Follow-Up Studies; Humans; Incisor; Male; Malocclusion, Angle Class II; Mandible; Mandibular Condyle; Mandibular Fractures; Orthodontics, Corrective; Osteogenesis, Distraction; Patient Care Planning; Tooth Avulsion
PubMed: 14640161
DOI: 10.1111/j.1834-7819.2003.tb00012.x -
The Angle Orthodontist Apr 2000This paper emphasizes the important role that secondary bone grafting plays on the treatment of patients with alveolar clefts. The authors present a literature review... (Review)
Review
This paper emphasizes the important role that secondary bone grafting plays on the treatment of patients with alveolar clefts. The authors present a literature review and, based on panoramic radiographs, retrospectively and longitudinally analyze the behavior of permanent canines after completion of secondary bone grafting in 50 patients at the Hospital for Rehabilitation of Craniofacial Anomalies, University of São Paulo, Brazil. Twelve patients with unilateral cleft lip and alveolus and 38 patients with complete unilateral cleft lip and palate (n = 50) had undergone bone grafts to repair their residual alveolar clefts before the eruption of their permanent canines. These patients were observed over an average period of 3 years. In 94% of the sample (47 patients), the permanent canines presented intra-alveolar movement toward the oral cavity. In 72% of those 47 patients (36 patients), the permanent canines spontaneously erupted through the grafted area. In 6% of the 47 patients (3 patients), the permanent canines required orthodontic traction.
Topics: Adolescent; Alveolar Process; Alveoloplasty; Bone Transplantation; Child; Cleft Lip; Cleft Palate; Cuspid; Female; Humans; Male; Tooth Eruption
PubMed: 10833007
DOI: 10.1043/0003-3219(2000)070<0174:SBGAEO>2.0.CO;2 -
Journal (Canadian Dental Association) May 1999
Topics: Age Factors; Alveolar Process; Alveoloplasty; Bone Transplantation; Child, Preschool; Cleft Lip; Cleft Palate; Humans; Infant; Rhinoplasty
PubMed: 10380404
DOI: No ID Found