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The Angle Orthodontist Apr 1998It is now possible to use the orthodontic extrusion of periodontally compromised teeth to facilitate the development of a future implant site in an area where the amount...
It is now possible to use the orthodontic extrusion of periodontally compromised teeth to facilitate the development of a future implant site in an area where the amount of bone in the inciso-apical dimension would otherwise have been inadequate. The purpose of this case report was to analyze the hard and soft tissue changes when forced eruption is used for implant site development.
Topics: Adult; Alveolar Bone Loss; Alveolar Process; Alveoloplasty; Bone Transplantation; Combined Modality Therapy; Dental Implantation, Endosseous; Dental Implants; Humans; Incisor; Male; Malocclusion, Angle Class II; Maxilla; Membranes, Artificial; Periodontal Diseases; Polytetrafluoroethylene; Retrognathia; Tooth Extraction; Tooth Movement Techniques
PubMed: 9564429
DOI: 10.1043/0003-3219(1998)068<0179:CRFEAI>2.3.CO;2 -
Journal of Oral and Maxillofacial... Jul 1997Controversy still exists regarding the optimal timing and surgical technique for primary cleft lip and palate (CLP) repair, and treatment protocols vary considerably.... (Review)
Review
PURPOSE
Controversy still exists regarding the optimal timing and surgical technique for primary cleft lip and palate (CLP) repair, and treatment protocols vary considerably. This study reviews the literature on timing and technique for primary repair and reports on the outcome for a consecutive group of patients treated by a single surgical protocol at the Sunnyview Cleft Palate Clinic.
PATIENTS AND METHODS
Twenty-eight patients treated by a standardized clinical protocol from infancy through adolescence were evaluated with respect to the need for orthognathic surgery to correct jaw size discrepancy. For each patient, data was collected regarding type of cleft deformity, total number of surgical procedures from infancy, surgeon performing the primary repair, and the need or indication for orthognathic surgery.
RESULTS
Twenty-five percent of patients treated by this protocol required orthognathic surgery because of anteroposterior jaw size discrepancy. The number of prior operations was not a significant factor. The need for orthognathic surgery was seen in all types of CLP deformity. Different primary surgeons varied considerably in the percentage of their patients who ultimately required orthognathic surgery.
CONCLUSION
The results of this study parallel other larger cohort studies with respect to the percentage of patients requiring orthognathic surgery. The number of prior operations does not significantly affect the later need for orthognathic surgery.
Topics: Adolescent; Adult; Age Factors; Alveoloplasty; Child; Cleft Lip; Cleft Palate; Female; Growth Disorders; Humans; Male; Maxillofacial Development; Orthognathic Surgical Procedures; Osteotomy; Retrospective Studies
PubMed: 9216501
DOI: 10.1016/s0278-2391(97)90579-6 -
Journal of Oral and Maxillofacial... Mar 1997
Topics: Adult; Aged; Aged, 80 and over; Alveoloplasty; Clinical Protocols; Follow-Up Studies; Head and Neck Neoplasms; Humans; Hyperbaric Oxygenation; Jaw; Jaw Diseases; Male; Middle Aged; Osteoradionecrosis; Retrospective Studies; Surgical Wound Dehiscence; Tooth Extraction; Treatment Outcome
PubMed: 9054916
DOI: 10.1016/s0278-2391(97)90541-3 -
The Angle Orthodontist 1997This retrospective study was undertaken to describe and compare frontal craniofacial dimensions in alveolar-bone-grafted and nongrafted complete unilateral cleft lip and... (Comparative Study)
Comparative Study
This retrospective study was undertaken to describe and compare frontal craniofacial dimensions in alveolar-bone-grafted and nongrafted complete unilateral cleft lip and palate (CUCLP) patients and in noncleft subjects with normal occlusions and good facial balance. Clinical data were obtained from the files of the Hospital for Sick Children, Toronto. Patients were eligible for inclusion if they had posteroanterior cephalograms (PA) taken at adulthood and no congenital anomalies other than CUCLP. A total of 86 adult Caucasian CULCP patients were studied, including 58 who had not received grafts, 28 who had received secondary alveolar bone grafts, and, for comparison, 60 noncleft Caucasian adults. The PA cephalometric radiographs were traced, digitized, and measured. Analysis of variance (ANOVA) was used to test for among-groups differences in the means of the ratios, proportions, and angular measures. Tukey-Kramer HSD procedure was used to conduct post-hoc pairwise comparisons following significant (p < or = 0.05) F-ratios from ANOVA. Sexual dimorphism was a common finding, with males demonstrating greater facial width. Despite primary surgical repairs, the anterior nasal spine in the nongrafted CUCLP patients was deviated to the noncleft side, and the alar base was depressed on the cleft side. The maxillary incisors close to the cleft site were irregularly inclined, and this irregularity was more severe in the nongrafted CUCLP patients. The long-term effects of secondary alveolar bone grafting on transverse craniofacial growth appears to be minimal and limited to the immediate area of the cleft.
Topics: Adolescent; Adult; Alveoloplasty; Analysis of Variance; Bone Transplantation; Cephalometry; Cleft Lip; Cleft Palate; Face; Female; Humans; Image Processing, Computer-Assisted; Incisor; Male; Malocclusion; Maxilla; Maxillofacial Development; Nasal Bone; Nose; Retrospective Studies; Sex Characteristics
PubMed: 9347113
DOI: 10.1043/0003-3219(1997)067<0389:ARCOFF>2.3.CO;2 -
The Angle Orthodontist 1996Grafting of the alveolar ridge with autogenous bone is an integral stage of contemporary management of complete cleft lip and palate cases. Alveolar bone grafting... (Review)
Review
Grafting of the alveolar ridge with autogenous bone is an integral stage of contemporary management of complete cleft lip and palate cases. Alveolar bone grafting restores continuity of the dental arch, closes oronasal fistulae, supports the alar base, and facilitates spontaneous eruption of permanent teeth adjacent to the cleft. However, timing of the graft and the selection of materials have been topics of much debate in the literature. This article discusses an alternative donor site in cases where rehabilitation has passed the recommended time. Harvesting bone from the third molar regions allows not only the removal of impacted third molars during the same surgical procedure, but also eliminates the morbidity associated with additional surgical sites such as the ilium or mandibular symphysis. This report should not be interpreted as a recommendation for the use of this alternative site in cases where grafting is carried out within the optimal time period, which is usually in the mixed dentition stage. However, when grafting is necessary in young adults suffering from complete cleft lip and palate, the third molar region may provide another acceptable donor site.
Topics: Adolescent; Adult; Alveolectomy; Alveoloplasty; Bone Transplantation; Cleft Lip; Cleft Palate; Female; Humans; Lip; Molar, Third; Nose; Palate; Tooth Extraction; Tooth, Impacted
PubMed: 8678350
DOI: 10.1043/0003-3219(1996)066<0009:ADSFAB>2.3.CO;2 -
The Angle Orthodontist 1995This patient presented with a Class III malocclusion and an anterior crossbite. Although spaces were present distal to the mandibular canines, the alveolar ridges were...
This patient presented with a Class III malocclusion and an anterior crossbite. Although spaces were present distal to the mandibular canines, the alveolar ridges were greatly atrophied. New bone was acquired through guided tissue regeneration. The alveolar ridges were augmented, followed by successful orthodontic tooth movement and correction of the Class III relationship and the anterior crossbite.
Topics: Alveolar Process; Alveoloplasty; Atrophy; Cephalometry; Cuspid; Diastema; Female; Guided Tissue Regeneration, Periodontal; Humans; Malocclusion, Angle Class III; Patient Care Planning; Tooth Movement Techniques
PubMed: 8526288
DOI: 10.1043/0003-3219(1995)065<0307:CRR>2.0.CO;2 -
Journal of Periodontology Oct 1988Changes in the periodontal alveolar bone are often evaluated by comparing a series of radiographs taken over time. This investigation used a technique that allowed the...
Changes in the periodontal alveolar bone are often evaluated by comparing a series of radiographs taken over time. This investigation used a technique that allowed the image registration to be geometrically standardized each time a radiograph was taken. Radiographs of 24 patients from an ongoing double-blind, clinical study using metronidazole were obtained: (1) before any treatment, (2) at the completion of scaling and root planing and surgery (when performed) and (3) during the maintenance phase. One hundred six (106) paired comparisons were analyzed by subtraction radiography using a computerized system. Of these, 95 (89%) exhibited a minimal degree of geometric distortion and could be successfully substracted. Most areas (67%) showed no change in bone structure following periodontal treatment. Bone gain was noted in 12% of the sites examined, while bone loss was seen in 21% of the sites. This bone loss was statistically associated with sites that had received some form of surgical treatment.
Topics: Alveolar Process; Alveoloplasty; Bone Resorption; Dental Scaling; Equipment Design; Humans; Metronidazole; Periodontitis; Radiography; Subtraction Technique; Tooth Root
PubMed: 3054045
DOI: 10.1902/jop.1988.59.10.633 -
Journal of Periodontology Jun 1988The purpose of this study was to compare, longitudinally, the effectiveness of scaling and root planing, osseous surgery, and the modified Widman procedures. The study... (Comparative Study)
Comparative Study
The purpose of this study was to compare, longitudinally, the effectiveness of scaling and root planing, osseous surgery, and the modified Widman procedures. The study was carried out in a private practice setting. Sixteen adult patients with moderate to advanced adult periodontitis were treated with initial scaling and oral hygiene procedures. Posthygiene data were used for comparison of changes in probing depth, clinical attachment levels and gingival recession. The initial examination data were used to compare changes in plaque and gingival indices. Frequency distributions were used to compare changes that occurred at individual sites. At one year, plaque and gingival indices were significantly reduced when compared with the initial examination. At one year, shallow pockets (1-3 mm) were reduced when compared to posthygiene. Four- to six-millimeter pockets were significantly reduced by the three procedures. Osseous surgery and modified Widman had significantly greater pocket reduction when compared with scaling. For pockets greater than 7 mm, osseous surgery and the modified Widman had significantly greater reduction when compared with scaling. For pockets 1-3 mm at one year osseous surgery had significantly greater clinical attachment loss when compared with scaling. For 4-6 mm pockets at one year, the three procedures had slight gains in clinical attachment levels. The results were similar for pockets with greater than 7 mm. Interproximal soft tissue craters were measured for six postoperative weeks. Initially, the modified Widman had a higher percentage of soft tissue craters when compared with osseous surgery. At six weeks, however, there were no significant differences when the surgical procedures were compared. Recession was measured at each examination. Recession for 1-3 mm pockets at one year was greater for osseous surgery when compared with scaling and the modified Widman. Recession for 4-6 mm and greater than 7 pockets was greater for the surgical procedures than scaling. The results from this study indicate that with three-month maintenance recalls, both the modified Widman and osseous surgery are effective for pocket reduction, and each will produce a slight gain of clinical attachment over one year. Scaling was effective at maintaining attachment levels but was not as effective in reducing pocket depth.
Topics: Adult; Alveoloplasty; Dental Prophylaxis; Dental Scaling; Female; Gingival Recession; Humans; Longitudinal Studies; Male; Middle Aged; Periodontal Diseases; Periodontal Index; Periodontal Pocket; Surgical Flaps; Tooth Root
PubMed: 3292752
DOI: 10.1902/jop.1988.59.6.351 -
Annals of the Royal College of Surgeons... Jun 1973
Topics: Adult; Aged; Alveoloplasty; Bone Resorption; Denture Retention; Denture, Complete; Humans; Methods; Middle Aged; Surgery, Oral; Tooth Extraction
PubMed: 4578548
DOI: No ID Found