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Brazilian Oral Research 2022The purpose of this study was to evaluate the clinicodemographic characteristics and treatment protocol as prognostic factors in patients with oral squamous cell...
The purpose of this study was to evaluate the clinicodemographic characteristics and treatment protocol as prognostic factors in patients with oral squamous cell carcinoma (OSCC) of the hard palate, upper gingiva, and alveolar ridge (HPUGAR). This retrospective cohort study collected data of patients treated in two head and neck surgery departments in southern Brazil between 1999 and 2021. Information on clinicodemographic data, habits, site, size, clinical aspect, clinical staging, cervical metastasis, treatment, and survival was collected. Associations between independent variables and outcomes were assessed using Pearson's chi-square test and binary regression. Kaplan-Meier test was employed to compare the survival between the neck approaches. Forty-one patients were included; most were male (61%), with a mean age of 68.8 (± 13.9) years. The consumption of tobacco (p = 0.003) and alcohol (p = 0.02) was significantly higher in male than in female patients. The main clinical features observed in the study sample were lesions larger than 2 cm (48.7%), no cervical (90.2%), or distant metastasis (90.2%). Surgery alone was the main treatment approach (48.8%). The watch-and-wait strategy was adopted in 34 cases (83.0%), while elective neck dissection was applied in five (12.2%). Only two patients with cN0 disease (4.9%) presented with cervical metastasis at follow-up. Eight patients (12.2%) died of the disease. Clinicodemographic variables, habits, surgical margins, and histological subtype were not significantly associated with cervical metastasis or survival. Cervical metastasis (p = 0.004) was associated with poor survival. No difference was detected in survival between different neck approaches (p = 0.28). Cervical metastasis and local recurrence are negative prognostic factors for HPUGAR OSCC.
Topics: Humans; Male; Female; Aged; Carcinoma, Squamous Cell; Palate, Hard; Mouth Neoplasms; Retrospective Studies; Prognosis; Lymphatic Metastasis; Neoplasm Staging; Neoplasm Recurrence, Local; Survival Rate; Squamous Cell Carcinoma of Head and Neck; Alveolar Process; Head and Neck Neoplasms
PubMed: 36507745
DOI: 10.1590/1807-3107bor-2022.vol36.0058 -
BMC Oral Health Feb 2021The shrinkage of alveolar bone dimensions after tooth extraction is a well-known issue. This clinical phenomenon poses a challenge for clinicians aiming at...
BACKGROUND
The shrinkage of alveolar bone dimensions after tooth extraction is a well-known issue. This clinical phenomenon poses a challenge for clinicians aiming at implant-prosthetic treatment. BonMaker ATB is a novel autogenous bone grafting material, produced by the mechanical and chemical processing of natural teeth. This pilot case report aims at providing a clinical, radiographical, and histological evaluation of the safety and efficacy of Bonmaker ATB powder in the treatment of EDS class 3-4 postextraction sockets with alveolar ridge preservation.
METHODS
A total of 9 teeth were extracted from 5 patients. The extracted teeth were prepared immediately with the Bonmaker device. The extraction sockets were filled up with ATB powder. Six months after extraction, standardized intraoral x-rays and CBCT scans were performed. Re-entry was performed under local anaesthesia. Core biopsies were harvested for histological analysis and implants were placed.
RESULTS
Horizontal alveolar dimension loss occurred, even though ARP was performed, but the horizontal shrinkage was moderate. Vertical dimensions did not show loss of volume, but increased defect fill. Core biopsies showed ATB particles surrounded by newly formed bone and connective tissue. According to histomorphometric analysis, the harvested samples contained 56% of newly formed bone on average, and only a mean of 7% of non-remodelled ATB material was observed.
CONCLUSION
The preliminary clinical, radiographical, and histological results of Bonmaker autogenous tooth graft therapy indicate that ATB may be safely and successfully used as a grafting material for ARP. Optimal graft incorporation and histologically proven effective remodelling, as well as uneventful wound healing support the clinical application of ATB to minimize post-extraction hard tissue loss. Further research is needed to exploit the full potential of ATB and to evaluate the long-term peri-implant hard and soft tissue stability of ATB-treated post-extraction sites.
Topics: Alveolar Bone Loss; Alveolar Process; Alveolar Ridge Augmentation; Bone Transplantation; Humans; Minerals; Tooth Extraction; Tooth Socket
PubMed: 33573644
DOI: 10.1186/s12903-021-01429-y -
Alveolar ridge regeneration in two-wall-damaged extraction sockets of an in vivo experimental model.Clinical Oral Implants Research Aug 2021To determine the healing outcome following grafting with deproteinized porcine bone mineral (DPBM) with or without collagen membrane coverage in two-wall (both buccal...
AIM
To determine the healing outcome following grafting with deproteinized porcine bone mineral (DPBM) with or without collagen membrane coverage in two-wall (both buccal and lingual)-damaged extraction sockets.
MATERIALS AND METHODS
Distal roots of three mandibular premolars in six beagle dogs were extracted, and the whole buccal and lingual bony walls were surgically removed. Three treatment protocols were then applied according to the following group allocation: no graft (None), grafting DPBM (BG), and grafting DPBM with coverage by a collagen membrane (BG + M). Two observational periods (2 and 8 weeks) were used with the split-mouth design, and quantitative and qualitative analyses were performed by microcomputed tomography and histology.
RESULTS
The dimensions of the alveolar ridge at both grafted sites (BG and BG + M) remained similar to those of the pristine ridge in the histologic and radiographic analyses, whereas the ungrafted sites (None) collapsed both vertically and horizontally. Both grafting protocols produced substantial bony regeneration, but the addition of a covering membrane enhanced the proportion of mineralized tissue within the augmented area, and the BG + M group also showed a significantly larger area of regenerated ridge than the None group (p < .05).
CONCLUSIONS
Bone grafting with collagen membrane can maintain the alveolar ridge dimensions with substantial bone regeneration in a two-wall-damaged extraction socket.
Topics: Alveolar Bone Loss; Alveolar Process; Alveolar Ridge Augmentation; Animals; Dogs; Models, Theoretical; Swine; Tooth Extraction; Tooth Socket; X-Ray Microtomography
PubMed: 34101908
DOI: 10.1111/clr.13791 -
Clinical and Experimental Dental... Jun 2020The objective of the present study was to examine the influence of a combination material of a collagen cone and a collagen membrane on the healing process of extraction... (Randomized Controlled Trial)
Randomized Controlled Trial
OBJECTIVES
The objective of the present study was to examine the influence of a combination material of a collagen cone and a collagen membrane on the healing process of extraction sockets with regard to histological, histochemical, and immunohistochemical parameters.
MATERIALS AND METHODS
In a prospective randomized clinical study, 10 patients (test group) received a collagen combination material after tooth removal. The extraction sockets of 10 other patients (control group) were left to heal without further intervention. Eleven ±1 weeks after tooth extraction, histological biopsies were performed in both groups at the time of implant placement. Subsequently, the biopsies were evaluated semiquantitatively in terms of histological, histochemical, and immunohistochemical parameters for the identification of factors of bone metabolism and vascularization.
RESULTS
No significant difference between test and control group were found for any parameter. According to the descriptive data, the use of a collagen combination material seems to result in slightly higher values of the osteogenic Runt-related transcription factor 2 (Runx2) and vascularization.
CONCLUSION
The histological, histochemical, and immunohistochemical analysis of ARP with a collagen cone combined with a collagen membrane showed no significant differences in terms of bone metabolism and vascularization.
Topics: Adult; Aged; Alveolar Bone Loss; Alveolar Process; Alveolar Ridge Augmentation; Bone Regeneration; Collagen; Female; Humans; Male; Middle Aged; Organ Sparing Treatments; Prospective Studies; Tooth Extraction; Tooth Socket; Young Adult
PubMed: 31967736
DOI: 10.1002/cre2.279 -
Progress in Orthodontics Dec 2016The objective of this retrospective case-control study was to measure the maxillary lateral incisor root dimensions and quantify the labial and palatal bone in patients...
BACKGROUND
The objective of this retrospective case-control study was to measure the maxillary lateral incisor root dimensions and quantify the labial and palatal bone in patients with unilateral maxillary lateral incisor agenesis (MLIA) after orthodontic treatment and compare them to non-agenesis controls using cone beam computed tomography.
METHODS
The labiopalatal and mesiodistal root dimensions, mesiodistal coronal dimensions, and labiopalatal bone and alveolar ridge widths of the maxillary lateral incisor were assessed on posttreatment cone beam computed tomography scans of 15 patients (mean age 16.5 ± 3.4 years, 9 females and 6 males) with maxillary lateral incisor agenesis and 15 gender-matched patients (mean age 16.08 ± 3.23 years) with no dental agenesis or anterior Bolton discrepancy. The Mann-Whitney test was used to distinguish any differences in root width, crown width, or changes in labial or palatal bone width between the two groups.
RESULTS
The median labiopalatal root width was narrower in the MLIA group at the level of the cementoenamel junction (CEJ) to 8 mm apical of the CEJ compared to controls (p ≤ 0.009). The mesiodistal root width was significantly reduced in the MLIA group at the CEJ and at 4 mm apical to the CEJ. The labiopalatal alveolar ridge width was significantly decreased at 2 mm apical to the CEJ in MLIA group. The mesiodistal crown width was significantly smaller in the MLIA group at both the incisal edge and at the crown midpoint. The bone thickness was similar in both groups.
CONCLUSIONS
Coronal and root dimensions in patients with MLIA were reduced compared to controls. Alveolar ridge width was also reduced in patients with MLIA, although bone thickness was not different than controls.
Topics: Adolescent; Adult; Alveolar Process; Anodontia; Case-Control Studies; Child; Cone-Beam Computed Tomography; Female; Humans; Imaging, Three-Dimensional; Incisor; Male; Maxilla; Orthodontics, Corrective; Palate; Retrospective Studies; Statistics, Nonparametric; Tooth Cervix; Tooth Crown; Tooth Movement Techniques; Tooth Root; Young Adult
PubMed: 27641422
DOI: 10.1186/s40510-016-0144-y -
Clinical Oral Implants Research Sep 2023The aims of Working Group 1 were to address the role (i) of the buccolingual bone dimensions after implant placement in healed alveolar ridge sites on the occurrence of...
Group 1 ITI Consensus Report: The role of bone dimensions and soft tissue augmentation procedures on the stability of clinical, radiographic, and patient-reported outcomes of implant treatment.
OBJECTIVES
The aims of Working Group 1 were to address the role (i) of the buccolingual bone dimensions after implant placement in healed alveolar ridge sites on the occurrence of biologic and aesthetic complications, and (ii) of soft tissue augmentation (STA) on the stability of clinical, radiographic, and patient-related outcomes of implant treatments.
MATERIALS AND METHODS
Two systematic reviews were prepared in advance of the Consensus Conference and were discussed among the participants of Group 1. Consensus statements, clinical recommendations, recommendations for future research, and reflections on patient perspectives were based on structured group discussions until consensus was reached among the entire group of experts. The statements were then presented and accepted following further discussion and modifications as required by the plenary.
RESULTS
Dimensional changes of the alveolar ridge occurred after implant placement in healed sites, and a reduction in buccal bone wall thickness (BBW) of 0.3 to 1.8 mm was observed. In healed sites with a BBW of <1.5 mm after implant placement, increased vertical bone loss, and less favorable clinical and radiographic outcomes were demonstrated. Implants with buccal dehiscence defects undergoing simultaneous guided bone regeneration, showed less vertical bone loss, and more favorable clinical and radiographic outcomes, compared to non-augmented dehiscence defects during initial healing. At healthy single implant sites, probing depths, bleeding and plaque scores, and interproximal bone levels evaluated at 1 year, remained stable for up to 5 years, with or without STA. When single implant sites were augmented with connective tissue grafts, either for soft tissue phenotype modification or buccal soft tissue dehiscence, stable levels of the soft tissue margin, and stable or even increased soft tissue thickness and/or width of keratinized mucosa could be observed from 1 to 5 years. In contrast, non-augmented sites were more prone to show apical migration of the soft tissue margin in the long-term. Favorable aesthetic and patient-reported outcomes after STA were documented to be stable from 1 to 5 years.
CONCLUSIONS
It is concluded that dimensional changes of the alveolar ridge occur after implant placement in healed sites and that sites with a thin BBW after implant placement are prone to exhibit less favorable clinical and radiographic outcomes. In addition, it is concluded that STA can provide stable clinical, radiographic, aesthetic, and patient-reported outcomes in the medium and long-term.
Topics: Humans; Dental Implants; Dental Implantation, Endosseous; Alveolar Process; Mucous Membrane; Patient Reported Outcome Measures; Alveolar Ridge Augmentation; Treatment Outcome
PubMed: 37750519
DOI: 10.1111/clr.14154 -
Ultrasound in Obstetrics & Gynecology :... Nov 2010The aim of this study was to assess conventional two-dimensional (2D) ultrasound enhanced with a three-dimensional (3D) ultrasound technique, the 'reverse-face' view...
OBJECTIVE
The aim of this study was to assess conventional two-dimensional (2D) ultrasound enhanced with a three-dimensional (3D) ultrasound technique, the 'reverse-face' view (3D-RF) in prenatal evaluation of the involvement of the lips, alveolar ridge and secondary palate in suspected isolated orofacial clefting.
METHODS
One hundred and twenty-four cases of suspected orofacial clefting diagnosed by a routine 2D ultrasound scan were referred for specialist ultrasound at 20-34 weeks' gestation for a detailed assessment of the lips and palate using both 2D and 3D ultrasound. For the 3D examination the lips and alveolar ridges were examined both in profile and in the frontal plane. The palate was then assessed in the reverse coronal view by rotating the face through 180° on the vertical axis to produce the 3D-RF view. Antenatal diagnoses were compared with postnatal findings. Left and right lip and alveolar ridge defects were counted separately according to the Kernohan 'striped Y' classification.
RESULTS
Of 124 patients, 110 had isolated facial clefts and were available for follow-up; in 10, 3D-RF views were not successfully obtained, leaving 100 cases for assessment. The sensitivity of the 2D enhanced with 3D-RF technique for the diagnosis of cleft of the lip was 116/122 (95%), false-positive rate (FPR) 7.7%; for alveolar ridge was 87/103 (84.5%), FPR 7.2%; and for hard palate was 61/68 (89.7%), FPR 15.6%.
CONCLUSION
The data reported represent the largest series of orofacial abnormalities diagnosed by 2D ultrasound and enhanced with 3D imaging to refine the detection of clefts of the hard palate. The technique is feasible in 90% of patients in whom almost 90% have a correct classification of clefts of the lip, alveolar ridge and palate.
Topics: Alveolar Process; Cleft Lip; Cleft Palate; Female; Fetal Diseases; Humans; Image Processing, Computer-Assisted; Imaging, Three-Dimensional; Pregnancy; Ultrasonography, Prenatal
PubMed: 20617510
DOI: 10.1002/uog.7739 -
PeerJ 2023Anastomosis between posterior superior alveolar artery and infraorbital artery can go through bony canal in the lateral wall of the maxilla. This artery is called...
PURPOSE
Anastomosis between posterior superior alveolar artery and infraorbital artery can go through bony canal in the lateral wall of the maxilla. This artery is called alveolar antral artery. It can complicate lateral sinus lift procedure by bleeding and hemosinus formation or bone graft wash out. The artery can also go in soft tissues where is not visible on cone beam computed tomography. In previous studies, the relation of this artery to sinus floor or alveolar process was measured. These structures are highly unstable during lifetime and after tooth loss. The aim of this study is to study presence and relations of bony canal in the lateral maxillary wall, to characterize the group of patients which is more likely to have bone canal in the lateral maxilla. The aim and the novelty of this study is the describing of the relationship of the bony canal to the more stable structure of hard palate and describing the relation of presence of bony canal on width of maxillary sinus, and to facilitate the prediction of presence of the alveolar antral artery.
MATERIALS
The cone beam computed tomography scans of the patients (251 in number) of the university hospital were examined for presence of alveolar antral artery (148 was fulfilled inclusion criteria), patient were characterized by gender, age, and sinus type (wide, average, narrow). The diameter of the bony canal and its relation to the level of sinus floor and hard palate were measured.
RESULTS
The cone beam computed tomography scans of 148 patients, out of it 55 man (37,2%) and 93 women (62,8%). Bony canal containing alveolar anastomosis was found in 69 cases (57,0%). Presence of the bony canal in the lateral wall of maxillae showed statistical probability depending on age with = 0, 064 according to Mann-Whitney test. The older patients have more likely the bony canal. The presence of the alveolar antral artery was found more likely in the wide sinuses. The hard palate level can serve as a prediction point of alveolar antral artery only in first molar and second premolar region. In accordance with previous studies the width of bony canal is significantly higher in group of man ( = 0, 015). There was found a correlation between smaller distance of bony canal from sinus floor in the presence of teeth ( = 0, 067). After tooth loss the distance between sinus floor and bony canal increases, but the distance of bony canal to hard palate level stays constant. This can be explained hypothetically so that periodontal ligaments and root surface acts as a barrier for sinus pneumatization.
CONCLUSION
Lateral sinus lifting in some cases can be unenviable, the knowledge about alveolar antral artery anatomy can reduce the risk of arterial bleeding. The cone-beam computed tomography is a routine examination prior to augmentation surgery and therefore the data obtained from it has an impact on clinical practice.
Topics: Male; Humans; Female; Sinus Floor Augmentation; Tooth Loss; Cone-Beam Computed Tomography; Arteries; Alveolar Process
PubMed: 38050605
DOI: 10.7717/peerj.16439 -
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 -
Journal of Oral and Maxillofacial... Mar 2021Leukocyte- and platelet-rich fibrin (L-PRF) has been used for alveolar ridge preservation (ARP) in postextraction tooth sockets. However, current reports have measured... (Randomized Controlled Trial)
Randomized Controlled Trial
PURPOSE
Leukocyte- and platelet-rich fibrin (L-PRF) has been used for alveolar ridge preservation (ARP) in postextraction tooth sockets. However, current reports have measured its effectiveness in linear measurements of 3-dimensional ridge preservation. The purpose of this study was to determine the effectiveness of the use of L-PRF filling versus natural clot blood healing in ARP according to the clinical, radiographic, and volumetric measurements of postextraction tooth sockets.
MATERIALS AND METHODS
A split-mouth randomized clinical trial was designed. Healthy patients who needed bilateral extraction of upper third molars were selected. After the tooth extraction, the socket was filled and distributed randomly with L-PRF and the contralateral socket only with the blood clot. The dimensional change of soft tissue healing around the sockets, and the length, depth, and difference of bone formation were examined using standardized periapical radiographs. Volumetric measurement variation of the sockets was evaluated by 3-dimensional scanning of dental casts. Changes of all measures were analyzed at 7 days (initial) and 3 months (final) after the tooth extraction and compared between both groups (t test; P < .05).
RESULTS
Sixteen patients (aged 24.75 ± 3.53 years; 56.25% women) participated. Measurements of wound healing and the length, depth, and difference of bone formation were similar for both study groups at initial and final times. The calculation of initial-final volumetric socket variation was 15.45 ± 13.12 μL using L-PRF and 14.12 ± 11.23 μL using blood clot (P = .78).
CONCLUSIONS
L-PRF filling showed the same dimensional and volumetric behavior as normal blood clot healing in the ARP of postextraction tooth sockets. Future investigations will have to analyze the use of surgical models and digital instruments in ARP techniques.
Topics: Adult; Alveolar Process; Female; Humans; Leukocytes; Male; Mouth; Platelet-Rich Fibrin; Thrombosis; Tooth Extraction; Tooth Socket; Young Adult
PubMed: 33171113
DOI: 10.1016/j.joms.2020.10.006