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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 -
BMJ Case Reports Jan 2013Alveolar bone exostoses (ABE), also known as a buttress bone formation, are not uncommon to the literature. Although, exostoses in response to the trauma from occlusion...
Alveolar bone exostoses (ABE), also known as a buttress bone formation, are not uncommon to the literature. Although, exostoses in response to the trauma from occlusion are a popular concept proposed more than 45 years ago, still the aetiological factors behind this development are unclear. Various risks and complications associated with orthodontic implants have been published, but buttress bone formation subsequent to this procedure has not been reported till date. This article describes a case of ABE, subsequent to the placement of orthodontic mini implants, where after careful evaluation, resective osseous surgery was performed.
Topics: Adolescent; Alveolar Process; Alveoloplasty; Bone Screws; Exostoses; Female; Humans; Jaw Diseases; Orthodontic Anchorage Procedures
PubMed: 23355580
DOI: 10.1136/bcr-2012-007951 -
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 -
Clinical Oral Investigations Aug 2011The objective of this study is to compare dental arch relationship following one-stage and three-stage surgical protocols of unilateral cleft lip and palate. Dental... (Comparative Study)
Comparative Study
The objective of this study is to compare dental arch relationship following one-stage and three-stage surgical protocols of unilateral cleft lip and palate. Dental casts of 61 children (mean age, 11.2 years; SD, 1.7), consecutively treated in one center with one-stage closure of the complete cleft at 9.2 months (SD, 2.0), were compared with a sample of 97 patients (mean age, 8.7 years; SD, 0.9), consecutively treated with a three-stage protocol including delayed hard palate closure in another center. The dental casts were assigned random numbers to blind their origin. Four raters graded dental arch relationship and palatal morphology using the EUROCRAN index. The strength of agreement of rating was assessed with kappa statistics. Independent t tests were run to compare the EUROCRAN scores between one-stage and three-stage samples, and Fisher's exact tests were performed to evaluate differences of distribution of the EUROCRAN grades. The intra- and inter-rater agreement was moderate to very good. Dental arch relationship in the one-stage sample was less favorable than in three-stage group (mean scores, 2.58 and 1.97 for one-stage and three-stage samples, respectively; p < 0.000). Palatal morphology in the one-stage sample was more favorable than in the three-stage group (mean scores, 1.79 and 1.96 for one-stage and three-stage samples, respectively; p = 0.047). The dental arch relationship following one-stage repair was less favorable than the outcome of three-stage repair. The palatal morphology following one-stage repair, however, was more favorable than the outcome of three-stage repair.
Topics: Age Factors; Alveoloplasty; Bone Transplantation; Cephalometry; Child; Cleft Lip; Cleft Palate; Dental Arch; Female; Humans; Lip; Male; Malocclusion; Oral Surgical Procedures; Orthodontic Appliances, Removable; Palatal Muscles; Palatal Obturators; Palate, Hard; Palate, Soft; Plastic Surgery Procedures; Surgical Flaps; Treatment Outcome; Vomer
PubMed: 20473537
DOI: 10.1007/s00784-010-0420-z -
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 -
The Journal of Clinical Pediatric... 2010Various methods have been described for the primary surgical reconstruction of the unilateral cleft lip and palate deformity (UCLP) in infants. There have been several...
BACKGROUND
Various methods have been described for the primary surgical reconstruction of the unilateral cleft lip and palate deformity (UCLP) in infants. There have been several attempts at restoring the normal anatomy of the nose at the time of lip repair in the affected individuals with varying degrees of success. Presurgical nasoalveolar molding (PNAM) is a presurgical infant orthopedic procedure that attempts to target the nasal deformity leading to a more esthetic surgical repair.
OBJECTIVE
At our center we aimed to use PNAM to help in providing the surgical team with a better foundation for an easier and more esthetic single stage repair at the level of nose in addition to the lip and alveolus.
METHOD
The infant nasal cartilages are amenable to correction in the first few weeks of life when they retain their plasticity. Three infants with complete unilateral cleft lip palate (CUCLP) were operated upon after a course of PNAM. No nasal stents were use after repair to retain the results.
RESULTS
PNAM reduced the extent of the cleft deformity and improved the anatomic relationship between the affected structures. Postoperative recovery was uneventful. Subjective evaluation immediate post surgery and at the time of palate repair reveals adequate nasolabial esthetics. Long-term results of PNAM assisted repair are to be ascertained.
CONCLUSIONS
The use of PNAM enables in reducing the severity of the deformity the surgical team has to tackle thereby enabling in a better and esthetic primary repair.
Topics: Alveolar Process; Alveoloplasty; Cleft Lip; Cleft Palate; Humans; Infant; Infant, Newborn; Lip; Male; Nasal Cartilages; Nose; Orthopedic Procedures; Palatal Obturators; Preoperative Care; Plastic Surgery Procedures; Stents; Surgical Flaps
PubMed: 20578667
DOI: 10.17796/jcpd.34.3.7r7615h422235773 -
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 -
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 -
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 -
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