-
BMJ Case Reports May 2021Dyskeratosis congenita is a rare disease caused by telomerase dysfunction classically characterised by the triad: skin pigmentation, nail dystrophy and mucosal... (Review)
Review
Dyskeratosis congenita is a rare disease caused by telomerase dysfunction classically characterised by the triad: skin pigmentation, nail dystrophy and mucosal leukoplakia. Few cases are described in literature regarding patients with head and neck squamous cell carcinoma affected by dyskeratosis congenita, and the therapeutic decisions are not yet well defined. A review of the literature of the last 20 years (2001-2021) was performed, and it was analysed the case of a 38-year-old male patient affected by dyskeratosis congenita diagnosed with a squamous cell carcinoma of the inferior alveolar ridge, treated with surgery. The absence of complications and the good postoperative recovery of the patient comfort in saying that resection and reconstructive surgery can be safely performed. The occurrence of disseminated disease 6 months after the treatment warns about the extreme aggressiveness of the pathology, its often systemic nature and the necessity of a multidisciplinary approach as well as further studies.
Topics: Adult; Alveolar Process; Carcinoma, Squamous Cell; Dyskeratosis Congenita; Head and Neck Neoplasms; Humans; Leukoplakia; Male
PubMed: 33975847
DOI: 10.1136/bcr-2021-242459 -
PloS One 2021Bone quality is evaluated using bone density for qualitative classification, a characteristic that may be delicate to evaluate. Contemporary implantology that relies on... (Meta-Analysis)
Meta-Analysis
AIM
Bone quality is evaluated using bone density for qualitative classification, a characteristic that may be delicate to evaluate. Contemporary implantology that relies on modern measurement techniques, needs a more quantitative estimate of the bone quality.
MATERIALS AND METHODS
PubMed and EMBASE databases were searched with no time restriction. Clinical and radiographic studies reporting on alveolar ridge dimensions and its parameters in different areas of the dentate and edentulous jaws were included. A meta-analysis was performed using random effect models to report a combined mean for alveolar ridge and its parameters. Meta regression statistical tests were performed in order to identify differences in those outcome parameters.
RESULTS
30 studies were included. The majority of the selected studies (total of 27) used live human subjects and CBCT to analyze alveolar ridge dimensions and its parameters. Using the combined mean obtained from the meta-analysis, a typical portrait of the alveolar ridge was constructed, and a geometrically based quantitative bone classification proposed. The quantitative classification was found to match the existing qualitative classification.
CONCLUSION
A geometry-based analysis was constructed that yields valuable insights on the bone type based on its components and on the dynamics of the dentate / edentulous states.
Topics: Alveolar Process; Cone-Beam Computed Tomography; Humans; Jaw; Jaw, Edentulous; Mandible; Maxilla
PubMed: 34133463
DOI: 10.1371/journal.pone.0253283 -
TheScientificWorldJournal 2022Initial bone thickness has a substantial impact on the success of dental implant treatments. The objective of the current study was to analyze the thickness of the...
BACKGROUND
Initial bone thickness has a substantial impact on the success of dental implant treatments. The objective of the current study was to analyze the thickness of the buccal and alveolar bone at the central incisors using CBCT in relation to gender and side to determine the anatomical features and choose the best implant treatment option for minimizing the surgical complications.
METHODS
One hundred CBCT images were investigated (50 females and 50 males, aged 20 to 50 years old). The buccal bone thickness and alveolar bone thickness were evaluated for right and left sides of each subject at three sites; C: crest (3 mm); M: middle (6 mm); A: apical (9 mm) from the cementoenamel junction.
RESULTS
The mean thickness of buccal bone was less than 2 mm on the incisors according to side and gender. Buccal bone thickness revealed a statistically significant difference between right and left sides at the apical point in both females and males with values of ( ≤ 0.001) and (0.001), respectively. The buccal bone thickness displayed statistically significant differences between genders at all sites. The alveolar thickness demonstrated similar significant differences between genders except for the crest site.
CONCLUSIONS
Iraqi participants had about 1 mm buccal bone thickness at 3 mm apical from the CEJ in right and left central incisors with a progressive rise in bone thickness to be less than 2 mm at the apex. Alveolar bone also showed the same increase in bone thickness from crest to apex. Bone thickness was greater in males than females. The present study provided valuable CBCT data on bone thickness of the esthetic maxillary region as a preoperative analysis for establishing an immediate implant treatment plan with aesthetically pleasing long-term outcomes.
Topics: Adult; Alveolar Process; Cone-Beam Computed Tomography; Female; Humans; Incisor; Iraq; Male; Maxilla; Middle Aged; Young Adult
PubMed: 35185395
DOI: 10.1155/2022/7226998 -
Clinical and Experimental Dental... Jun 2022When teeth are lost, dental implants contribute to improved oral function and quality of life. Limitations in dental implant placement arising from poor bone anatomy may...
The long-term impact of alveolar ridge preservation with xenograft bone mineral on peri-implant health after 5 years in function: A retrospective cohort study of 108 patients assessed clinically and radiologically.
OBJECTIVES
When teeth are lost, dental implants contribute to improved oral function and quality of life. Limitations in dental implant placement arising from poor bone anatomy may be circumvented via alveolar ridge preservation (ARP). The aim is to evaluate the long-term impact of ARP on peri-implant health and the relationship with common risk indicators such as smoking and history of periodontitis.
MATERIALS AND METHODS
One hundred and eight patients were enrolled in this retrospective cohort study with 308 implants. Of these, ∼41% were placed in bone sites that had previously received ARP with deproteinized bovine bone mineral xenograft. Association between baseline variables: ARP, age, gender, number of implants per patient, anatomical site, smoking, and previous history of grade III/IV periodontitis, and outcome variables: mucositis, peri-implantitis, implant loss, full-mouth plaque score (FMPS), full-mouth bleeding score, and marginal bone loss (MBL) was evaluated using both univariate and multivariate models.
RESULTS
After 5 years, the overall survival rate was 93.7%. The occurrence of peri-implantitis was 21.3% and the extent of MBL was ~2.2 mm. Both peri-implantitis occurrence and MBL were comparable between ARP and ARP . Smoking is associated with higher FMPS and MBL.
CONCLUSIONS
The findings indicate that peri-implant health can be maintained around dental implants for up to 5 years in ARP sites using Bio-Oss®. Smoking is a major risk indicator for peri-implantitis, whereas the association between history of periodontitis and the risk of peri-implantitis, based on this specific, well-maintained cohort and the specific implants used, remains inconclusive.
Topics: Alveolar Bone Loss; Alveolar Process; Animals; Cattle; Cohort Studies; Dental Implants; Heterografts; Humans; Minerals; Peri-Implantitis; Periodontitis; Quality of Life; Retrospective Studies
PubMed: 35510846
DOI: 10.1002/cre2.583 -
The Angle Orthodontist Sep 2017To investigate the morphometric and histological alterations of the constricted alveolar ridge when affected by root thrusting with and without open-flap decortication.
OBJECTIVE
To investigate the morphometric and histological alterations of the constricted alveolar ridge when affected by root thrusting with and without open-flap decortication.
MATERIALS AND METHODS
Eight beagles were divided into three groups: C, control without root thrusting; R, root thrusting only; RD, root thrusting with alveolar decortication. The ridge constriction model was prepared in 16 mandibular quadrants after extraction of the third premolars. Reciprocal root thrusting of the second and fourth premolars was performed toward the constricted ridge for 10 weeks, having a moment of 900 g-mm. Open-flap decortication was conducted on the constricted bone surface in group RD. Micro-CT-based histomorphometric analysis and trichrome-staining-based tissue fractional analysis were performed to evaluate morphometric and microstructural changes on the ridge.
RESULTS
Group R revealed a higher percentage of bone volume (P < .001), lower bone mineral density (P < .01), and higher trabecular number (P < .001) than did group C, which was supported by a higher bone fraction woven to lamellar bone (P < .05) resulting from histologic fractional analysis. However, group RD showed no significant difference from group C.
CONCLUSIONS
Root thrusting toward the constricted ridge induced hypertrophic bone modeling with a high trabecular fraction on the ridge. However, combined open-flap decortication with root thrusting did not improve the volume or quality of the constricted ridge.
Topics: Alveolar Bone Loss; Alveolar Process; Animals; Bicuspid; Bone Density; Bone Regeneration; Bone Remodeling; Bone Resorption; Dogs; Male; Mandible; Models, Animal; Surgical Flaps; Tooth Extraction; Tooth Root; Tooth Socket; X-Ray Microtomography
PubMed: 28707951
DOI: 10.2319/030917-174.1 -
International Journal of Environmental... Feb 2021Edentulism and terminal dentition are still considered significant problems in the dental field, posing a great challenge for surgical and restorative solutions... (Review)
Review
Edentulism and terminal dentition are still considered significant problems in the dental field, posing a great challenge for surgical and restorative solutions especially with immediate loading protocols. When the implant placement is planned immediately after extraction with irregular bone topography or there is an un-leveled alveolar ridge topography for any other reason, bone reduction may be required to level the alveolar crest in order to create the desired bone architecture allowing for sufficient bone width for implant placement and to insure adequate inter-arch restorative space. Bone reduction protocols exist in analog and digitally planned methodologies, with or without surgical guides to achieve the desired bone level based upon the desired position of the implants with regard to the restorative outcome. The objective of this paper was to scrutinize the literature regarding the practice of bone reduction in conjunction with implant placement, and to review different types of bone reduction surgical guides. Results: The literature reveals different protocols that provide for bone reduction with a variety of bone reduction methods. The digitally-planned surgical guide based on Cone-Beam computerized tomography (CBCT) scan reconstructed data can improve accuracy, reduce surgical time, and deliver the desired bone level for the implant placement with fewer surgical and restorative complications. The clinician's choice is based on personal experience, training, and comfort with a specific guide type. Conclusions: Bone reduction, when required, is an indispensable step in the surgical procedure to attain suitable width of bone in anticipation of implant placement ideally determined by the desired tooth position and required restorative space based on material selection for the chosen framework design, i.e., hybrid, monolithic zirconia. Additionally, bone reduction and implant placement can be accomplished in the same surgical procedure, minimizing trauma and the need for two separate interventions.
Topics: Alveolar Process; Cone-Beam Computed Tomography; Prostheses and Implants; Surgery, Computer-Assisted; Tooth
PubMed: 33673563
DOI: 10.3390/ijerph18052341 -
BioMed Research International 2017The treatment of patients with atrophic ridge who need prosthetic rehabilitation is a common problem in oral and maxillofacial surgery. Among the various techniques...
The treatment of patients with atrophic ridge who need prosthetic rehabilitation is a common problem in oral and maxillofacial surgery. Among the various techniques introduced for the expansion of alveolar ridges with a horizontal bone deficit is the alveolar ridge split technique. The aim of this article is to give a description of some new tips that have been specifically designed for the treatment of atrophic ridges with transversal bone deficit. A two-step piezosurgical split technique is also described, based on specific osteotomies of the vestibular cortex and the use of a mandibular ramus graft as interpositional graft. A total of 15 patients were treated with the proposed new tips by our department. All the expanded areas were successful in providing an adequate width and height to insert implants according to the prosthetic plan and the proposed tips allowed obtaining the most from the alveolar ridge split technique and piezosurgery. These tips have made alveolar ridge split technique simple, safe, and effective for the treatment of horizontal and vertical bone defects. Furthermore the proposed piezosurgical split technique allows obtaining horizontal and vertical bone augmentation.
Topics: Adult; Alveolar Process; Alveolar Ridge Augmentation; Cortical Bone; Female; Humans; Male; Middle Aged; Osteotomy; Piezosurgery
PubMed: 28246596
DOI: 10.1155/2017/4530378 -
Medicine Jun 2018The purpose of this study was to evaluate the clinical and radiological outcomes of 2 piezosurgical split techniques performed in conjunction with the sinus lift.The... (Comparative Study)
Comparative Study Observational Study
The purpose of this study was to evaluate the clinical and radiological outcomes of 2 piezosurgical split techniques performed in conjunction with the sinus lift.The present retrospective study included 20 patients with edentulism of the posterior maxilla who had undergone the sinus lift and alveolar ridge split treatment separately or the sinus lift combined with the monoblock alveolar ridge split. Differences between these 2 techniques were analyzed.All the surrounding areas successfully produced an adequate bone volume for the insertion of implants. A clinical evaluation showed a mean vertical augmentation of 3.6 ± 0.4 mm in Group A and 3.2 ± 0.7 mm in Group B. With regards to the lateral augmentation, the clinical evaluation gives a mean gain of 5.2 ± 0.3 mm in Group A and 4.9 ± 0.5 mm in Group B. The mean vertical and horizontal bone augmentation recorded for both types of surgical procedures were comparable.The proposed surgical procedures enabled the tridimensional volume of the alveolar ridge to be recreated. This resulted in the creation of a natural contour of hard and soft tissues which enabled a functional and aesthetic rehabilitation of the edentulous posterior maxilla to be obtained.
Topics: Alveolar Process; Alveolar Ridge Augmentation; Female; Humans; Jaw, Edentulous; Male; Maxillary Sinus; Middle Aged; Retrospective Studies
PubMed: 29901597
DOI: 10.1097/MD.0000000000011029 -
Journal of Periodontology Jun 2022There is limited information on the need for bone augmentation in the context of delayed implant placement whether alveolar ridge preservation (ARP) is previously...
BACKGROUND
There is limited information on the need for bone augmentation in the context of delayed implant placement whether alveolar ridge preservation (ARP) is previously performed or not. The primary aim of this retrospective cohort study was to evaluate the efficacy of ARP therapy after tooth extraction compared with unassisted socket healing (USH) in reducing the need for ancillary bone augmentation before or at the time of implant placement.
METHODS
Adult subjects that underwent non-molar single tooth extraction with or without simultaneous ARP therapy were included in this study. Cone beam computed tomography scans obtained before tooth extraction and after a variable healing period were used to record the baseline facial bone thickness and to virtually plan implant placement according to a standard method. A logistic regression model was used to evaluate the effect of facial alveolar bone thickness upon tooth extraction and baseline therapy (USH or ARP) on the need for additional bone augmentation, adjusting for several covariates (i.e., age, sex, baseline KMW, and tooth type).
RESULTS
One hundred and forty subjects that were equally distributed between both baseline therapy groups constituted the study population. Implant placement was deemed virtually feasible in all study sites. Simultaneous bone augmentation was considered necessary in 60% and 11.4% of the sites in the USH and ARP group, respectively. Most of these sites (64.2% in the USH group and 87.5% in the ARP group) exhibited a thin facial bone phenotype (<1 mm) at baseline. Logistic regression revealed that the odds of not needing ancillary bone augmentation were 17.8 times higher in sites that received ARP therapy. Furthermore, the need for additional bone augmentation was reduced 7.7 times for every 1 mm increase in facial bone thickness, regardless of baseline therapy.
CONCLUSIONS
Based on a digital analysis, ARP therapy, compared with USH, and thick facial alveolar bone largely reduce the need for ancillary bone augmentation at the time of implant placement in non-molar sites.
Topics: Adult; Alveolar Bone Loss; Alveolar Process; Alveolar Ridge Augmentation; Cone-Beam Computed Tomography; Female; Humans; Male; Retrospective Studies; Tooth Extraction; Tooth Socket
PubMed: 35289400
DOI: 10.1002/JPER.22-0030 -
Clinical Interventions in Aging 2017The morphology of the alveolar process determines the retention and stability of prosthetic restorations, thereby determining the result of the therapy. Considering that...
OBJECTIVES
The morphology of the alveolar process determines the retention and stability of prosthetic restorations, thereby determining the result of the therapy. Considering that the edentulous jaws may be affected by the atrophy process, it was hypothesized that the morphology of the alveolar process of the maxilla may be dependent on the anterior facial height and anatomy of the mandible.
SUBJECTS AND METHODS
Twenty-five healthy edentulous Caucasian individuals were randomly chosen. Each subject underwent a lateral cephalogram before and after prosthetic rehabilitation. During exposition, newly made prostheses were placed in the patient's mouth. Teeth remained in maximal intercuspidation. Morphological parameters were evaluated according to the Ricketts, McNamara, and Tallgren's method.
RESULTS
An inversely proportional association was observed between patient age and the distal part of the maxilla. A statistically significant connection was noted between the vertical dimension of alveolar ridge and anterior total and lower facial height conditioned by prosthetic rehabilitation.
CONCLUSION
The height of the lateral part of the alveolar ridge of the maxilla remains in connection with the anterior total and lower facial height obtained in the course of prosthetic rehabilitation. The vertical dimension of the alveolar ridge of the maxilla seems to be in close relationship with the morphology of the lower jaw.
Topics: Adult; Alveolar Process; Atrophy; Cephalometry; Dental Arch; Face; Female; Humans; Male; Mandible; Maxilla; Middle Aged; Mouth, Edentulous; Vertical Dimension
PubMed: 28979109
DOI: 10.2147/CIA.S140791