-
Minerva Dental and Oral Science Dec 2022Subperiosteal implants were introduced in the last century. Poor clinical results led those implants to be progressively abandoned. Recently, several Authors suggested a...
Subperiosteal implants were introduced in the last century. Poor clinical results led those implants to be progressively abandoned. Recently, several Authors suggested a revival of subperiosteal implants as an alternative to regenerative procedures. The purpose of this study was to describe the clinical application of custom-made additively manufactured subperiosteal implant for fixed prosthetic rehabilitation of edentulous maxilla. Plaster models of the upper and the lower arch were scanned, as well as the mock-up. Digital Imaging and Communications in Medicine data obtained from cone beam computed tomography were processed through the thresholding procedure. The design of the subperiosteal implant was drawn on the stereolithographic model and scanned. Once the digital project of the subperiosteal implant was completed, it was sent to additive manufacturing. After the surgery, the patient was strictly monitored for up to 2 years. The outcomes were assessed based on the incurrence of biological and mechanical complications, postoperative complications, and implant survival. The patient did not suffer from postoperative complications. Neither biological nor mechanical complications occurred during the follow-up period. At the end of the study, the implant was still in function. Custom-made subperiosteal implants could be considered as an alternative to regenerative procedures for the rehabilitation of severe bone atrophy. Further studies are needed in the future to confirm the positive outcome.
Topics: Humans; Dental Implants; Dental Implantation, Endosseous; Mouth, Edentulous; Maxilla; Atrophy
PubMed: 36345834
DOI: 10.23736/S2724-6329.22.04640-X -
BMC Oral Health Apr 2022This prospective randomized clinical trial aimed to evaluate the immediate and short-term skeletal, dentoalveolar, and periodontal effects of rapid palatal expansion... (Randomized Controlled Trial)
Randomized Controlled Trial
Skeletal and alveolar changes in conventional rapid palatal expansion (RPE) and miniscrew-assisted RPE (MARPE): a prospective randomized clinical trial using low-dose CBCT.
BACKGROUND
This prospective randomized clinical trial aimed to evaluate the immediate and short-term skeletal, dentoalveolar, and periodontal effects of rapid palatal expansion (RPE) and miniscrew-assisted RPE (MARPE) in adolescent and young adult patients.
METHODS
This study followed a two-arm, parallel, randomized clinical trial design that recruited patients with transverse maxillary deficiency in a 1:1 allocation ratio. Forty patients (14 men and 26 women) requiring maxillary expansion were randomly allocated to the RPE (n = 20, age = 14.0 ± 4.5) or MARPE (n = 20, age = 14.1 ± 4.2) groups. The assignment was performed via computer-generated block randomization, with a block size of four. Upon identical (35 turns) amount of expansion, low-dose cone-beam computed tomography images were taken before treatment (T0), immediately after expansion (T1), and after a 3-month consolidation period (T2). The primary outcome of this study comprised the assessment of midpalatal suture separation. Secondary outcomes included, skeletal, dentoalveolar, and periodontal measurements, which were performed at each time point.
RESULTS
The frequency of midpalatal suture separation was 90% (18/20) and 95% (19/20) for the RPE and MARPE groups, respectively. A greater increase in nasal width in the molar region (M-NW) and greater palatine foramen (GPF) was observed immediately after the expansion (T1-T0) and consolidation periods (T2-T0) in the MARPE group compared to the RPE group (P < 0.05). The MARPE and RPE groups showed similar dentoalveolar changes except for the maxillary width (PM-MW, M-MW). The MARPE group presented greater bilateral first premolar (PM-MW) and molar (M-MW) maxillary width in relation to the RPE group (P < 0.05). Through the expansion and consolidation periods (T2-T0), lesser buccal displacement of the anchor teeth was observed in the MARPE group (PM-BBPT, PM-PBPT, M-BBPT [mesial and distal roots], and M-PBPT)( P < 0.05).
CONCLUSIONS
Midpalatal suture separation was observed in 90% and 95% of patients in the RPE and MARPE groups, respectively. Both RPE and MARPE groups exhibited significant triangular basal bone expansion and skeletal relapse during consolidation. Under identical amounts of expansion, the MARPE group showed lower decrease in the skeletal, dentoalveolar and periodontal variables after consolidation. The reinforcement of RPE with miniscrews contributes to the maintenance of the basal bone during consolidation period. Trial registration WHO Institutional Clinical Trials Registry Platform (IRB No. KCT0006871 / Registration date 27/12/2021).
Topics: Adolescent; Child; Cone-Beam Computed Tomography; Female; Humans; Male; Maxilla; Neoplasm Recurrence, Local; Palatal Expansion Technique; Palate; Prospective Studies; Spiral Cone-Beam Computed Tomography; Young Adult
PubMed: 35395801
DOI: 10.1186/s12903-022-02138-w -
Journal of Clinical Periodontology Feb 2021To compare marginal bone level changes around immediately placed and immediately provisionalized implants with immediately placed and delayed provisionalized implants in... (Randomized Controlled Trial)
Randomized Controlled Trial
AIM
To compare marginal bone level changes around immediately placed and immediately provisionalized implants with immediately placed and delayed provisionalized implants in the aesthetic region after five years of function.
MATERIALS AND METHODS
Forty patients with a failing tooth in the maxillary anterior region were randomly assigned immediate implant placement with immediate (Group A: n = 20) or delayed (Group B: n = 20) provisionalization. Definitive crown placement occurred three months after provisionalization. The primary outcomes were changes in marginal bone level. In addition, survival rates, buccal bone thickness, soft peri-implant tissues, aesthetics and patient-reported outcomes were assessed.
RESULTS
After 5 years, the mean mesial and distal marginal bone level changes were 0.71 ± 0.68 mm and 0.71 ± 0.71 mm, respectively, in group A and 0.49 ± 0.52 mm and 0.54 ± 0.64 mm, respectively, in group B; the difference between the groups was not significant (p = .305 and p = .477, respectively). Implant and restoration survivals were 100%. No clinically relevant differences in buccal bone thickness or in mid-facial peri-implant mucosal level, aesthetic and patient outcomes were observed.
CONCLUSIONS
The mean marginal bone level changes following immediate implant placement and provisionalization were comparable with immediate implant placement and delayed provisionalization. (www.isrctn.com: ISRCTN57251089 and www.trialregister.nl: NL8255).
Topics: Dental Implantation, Endosseous; Dental Implants, Single-Tooth; Esthetics, Dental; Humans; Immediate Dental Implant Loading; Maxilla; Treatment Outcome
PubMed: 33141935
DOI: 10.1111/jcpe.13398 -
Dental Press Journal of Orthodontics Feb 2017Maxillary transverse deficiency is a highly prevalent malocclusion present in all age groups, from primary to permanent dentition. If not treated on time, it can...
INTRODUCTION
Maxillary transverse deficiency is a highly prevalent malocclusion present in all age groups, from primary to permanent dentition. If not treated on time, it can aggravate and evolve to a more complex malocclusion, hindering facial growth and development. Aside from the occlusal consequences, the deficiency can bring about serious respiratory problems as well, due to the consequent nasal constriction usually associated. In growing patients, this condition can be easily handled with a conventional rapid palatal expansion. However, mature patients are frequently subjected to a more invasive procedure, the surgically-assisted rapid palatal expansion (SARPE). More recently, researches have demonstrated that it is possible to expand the maxilla in grown patients without performing osteotomies, but using microimplants anchorage instead. This novel technique is called microimplant-assisted rapid palatal expansion (MARPE).
OBJECTIVE
The aim of the present article was to demonstrate and discuss a MARPE technique developed by Dr. Won Moon and colleagues at University of California - Los Angeles (UCLA).
METHODS
All laboratory and clinical steps needed for its correct execution are thoroughly described. For better comprehension, a mature patient case is reported, detailing all the treatment progress and results obtained.
CONCLUSION
It was concluded that the demonstrated technique could be an interesting alternative to SARPE in the majority of non-growing patients with maxillary transverse deficiency. The present patient showed important occlusal and respiratory benefits following the procedure, without requiring any surgical intervention.
Topics: Cone-Beam Computed Tomography; Female; Humans; Malocclusion; Mandible; Maxilla; Orthodontic Appliance Design; Orthodontic Appliances; Palatal Expansion Technique; Young Adult
PubMed: 28444019
DOI: 10.1590/2177-6709.22.1.110-125.sar -
Indian Journal of Cancer 2015
Topics: Adult; Fibrosarcoma; Humans; Male; Maxilla; Myosarcoma
PubMed: 26905113
DOI: 10.4103/0019-509X.176688 -
International Journal of Implant... Nov 2023Implant-supported immediately loaded fixed full-arch rehabilitation via All-on-four treatment yields good long-term results for both the maxilla and the mandible....
The All-on-four concept for fixed full-arch rehabilitation of the edentulous maxilla and mandible: a longitudinal study in Japanese patients with 3-17-year follow-up and analysis of risk factors for survival rate.
PURPOSE
Implant-supported immediately loaded fixed full-arch rehabilitation via All-on-four treatment yields good long-term results for both the maxilla and the mandible. However, the risk factors affecting long-term implant survival are unknown, and the long-term prognosis of All-on-four concept procedures in Japanese individuals has not been elucidated. We aimed to determine the cumulative implant survival rate after 3-17-year follow-up and identify the associated risk factors.
METHODS
We analysed 561 cases (307 maxillae, 254 mandibles) with 2364 implants (1324 maxillae, 1040 mandibles) that received All-on-four treatment. We investigated the cumulative implant- and patient-level survival rates and various risk factors for implant failure. Statistical analysis was performed using the log-rank test for differences in Kaplan-Meier curves, univariate analysis using the Chi-square test, and multivariate analysis for risk factors affecting the survival rate.
RESULTS
The cumulative survival rate was 94.4% by patient level and 97.4% by implant level for the maxilla, and 96.7% by patient level and 98.9% by implant for the mandible, with up to 17 years of follow-up. The maxillary survival rate at the implant level was significantly lower (p < 0.05). Furthermore, the maxillary survival rate within 24 months was significantly lower at the implant level (p < 0.01). Multivariate analysis revealed that the maxilla was the most significant risk factor (p < 0.01).
CONCLUSIONS
All-on-four treatment yielded high long-term survival rates in Japanese patients. However, the maxilla showed a significantly lower cumulative survival rate than the mandible, while early failure was significantly higher. Furthermore, the maxilla was a significant risk factor influencing the survival rate.
Topics: Humans; Maxilla; Survival Rate; Longitudinal Studies; East Asian People; Follow-Up Studies; Mandible; Mouth, Edentulous; Risk Factors
PubMed: 37938479
DOI: 10.1186/s40729-023-00511-0 -
Frontiers in Endocrinology 2020The masticatory system is a complex and highly organized group of structures, including craniofacial bones (maxillae and mandible), muscles, teeth, joints, and... (Review)
Review
The masticatory system is a complex and highly organized group of structures, including craniofacial bones (maxillae and mandible), muscles, teeth, joints, and neurovascular elements. While the musculoskeletal structures of the head and neck are known to have a different embryonic origin, morphology, biomechanical demands, and biochemical characteristics than the trunk and limbs, their particular molecular basis and cell biology have been much less explored. In the last decade, the concept of muscle-bone crosstalk has emerged, comprising both the loads generated during muscle contraction and a biochemical component through soluble molecules. Bone cells embedded in the mineralized tissue respond to the biomechanical input by releasing molecular factors that impact the homeostasis of the attaching skeletal muscle. In the same way, muscle-derived factors act as soluble signals that modulate the remodeling process of the underlying bones. This concept of muscle-bone crosstalk at a molecular level is particularly interesting in the mandible, due to its tight anatomical relationship with one of the biggest and strongest masticatory muscles, the masseter. However, despite the close physical and physiological interaction of both tissues for proper functioning, this topic has been poorly addressed. Here we present one of the most detailed reviews of the literature to date regarding the biomechanical and biochemical interaction between muscles and bones of the masticatory system, both during development and in physiological or pathological remodeling processes. Evidence related to how masticatory function shapes the craniofacial bones is discussed, and a proposal presented that the masticatory muscles and craniofacial bones serve as secretory tissues. We furthermore discuss our current findings of myokines-release from masseter muscle in physiological conditions, during functional adaptation or pathology, and their putative role as bone-modulators in the craniofacial system. Finally, we address the physiological implications of the crosstalk between muscles and bones in the masticatory system, analyzing pathologies or clinical procedures in which the alteration of one of them affects the homeostasis of the other. Unveiling the mechanisms of muscle-bone crosstalk in the masticatory system opens broad possibilities for understanding and treating temporomandibular disorders, which severely impair the quality of life, with a high cost for diagnosis and management.
Topics: Animals; Biomechanical Phenomena; Bone and Bones; Humans; Mandible; Masticatory Muscles; Maxilla; Stomatognathic System
PubMed: 33732211
DOI: 10.3389/fendo.2020.606947 -
Journal of Human Evolution Jul 2022Differences in morphology among modern humans and African apes are frequently used when assessing whether hominin fossils should be attributed to a single species or...
Differences in morphology among modern humans and African apes are frequently used when assessing whether hominin fossils should be attributed to a single species or represent evidence for taxic diversity. A good understanding of the degree and structure of the intergeneric, interspecific, and intraspecific variation, including aspects such as sexual dimorphism and age, are key in this context. Here we explore the variation and differences shown by the maxilla of extant hominines, as maxillary morphology is central in the diagnosis of several hominin taxa. Our sample includes adults of all currently recognized hominine species and subspecies, with a balanced species sex ratio. In addition, we compared the adults with a small sample of late juveniles. The morphology of the maxillae was captured using three-dimensional landmarks, and the size and shape were analyzed using geometric morphometric methods. Key observations are that 1) the maxillae of all extant hominine species and subspecies show statistically significant differences, but complete separation in shape is only seen at the genus level; 2) the degree of variation is not consistent between genera, with subspecies of Gorilla being more different from each other than are species of Pan; 3) the pattern of sexual shape dimorphism is different in Pan, Gorilla, and Homo, often showing opposite trends; and 4) differentiation between maxillary shapes is increased after adjustment for static intraspecific allometry. These results provide a taxonomically up-to-date comparative morphological framework to help interpret the hominin fossil record, and we discuss the practical implications in that context.
Topics: Animals; Fossils; Gorilla gorilla; Hominidae; Humans; Maxilla; Sex Characteristics
PubMed: 35617847
DOI: 10.1016/j.jhevol.2022.103210 -
Medicina Oral, Patologia Oral Y Cirugia... Sep 2014To critically review the evidence-based literature on immediate loading of implants with fixed full-arch prostheses in the maxilla to determine 1) currently recommended... (Review)
Review
OBJECTIVES
To critically review the evidence-based literature on immediate loading of implants with fixed full-arch prostheses in the maxilla to determine 1) currently recommended performance criteria and 2) the outcomes that can be expected with this procedure.
STUDY DESING
Studies from 2001 to 2011 on immediate loading with fixed full-arch maxillary prostheses were reviewed. Clinical series with at least 5 patients and 12 months of follow-up were included. Case reports, studies with missing data and repeatedly published studies were excluded. In each study the following was assessed: type of study, implant type, number of patients, number of implants, number of implants per patient, use of post-extraction implants, minimum implant length and diameter, type of prosthesis, time until loading, implant survival rate, prosthesis survival rate, marginal bone loss, complications and mean follow-up time. Criteria for patient selection, implant primary stability and bone regeneration were also studied.
RESULTS
Thirteen studies were included, reporting a total of 2484 immediately loaded implants in 365 patients. Currently accepted performance criteria regarding patient and implant selection, and surgical and prosthetic procedures were deduced from the reviewed articles. Implant survival rates went from 87.5% to 100%, prosthesis survival rates from 93.8% to 100% and radiographic marginal bone loss from 0.8 mm to 1.6 mm.No intraoperative complications and only minor prosthetic complications were reported.
CONCLUSIONS
The literature on immediate loading with fixed full-arch prostheses in the maxilla shows that a successful outcome can be expected if adequate criteria are used to evaluate the patient, choose the implant and perform the surgical and prosthetic treatment. Lack of homogeneity within studies limits the relevance of the conclusions that can be drawn, and more controlled randomized studies are necessary to enable comparison between the immediate and the conventional loading procedures.
Topics: Humans; Immediate Dental Implant Loading; Maxilla
PubMed: 24880445
DOI: 10.4317/medoral.19664 -
Journal of Clinical Sleep Medicine :... Dec 2021
Topics: Cephalometry; Humans; Maxilla; Sleep Apnea, Obstructive; Tooth
PubMed: 34398742
DOI: 10.5664/jcsm.9608