The contribution of imaging and digitised data to mandibular reconstruction and implant stabilised occlusal rehabilitation: a case report.
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Different methods are recommended for the surgical reconstruction of the resected mandible. The advantages for implant stabilised prostheses in restoring the occlusion are recognised but few papers provide adequate data to identify the successful outcome of treatment. The literature is reviewed and the advantages of imaging together with the use of digitised data is highlighted by a case requiring rehabilitation with enhanced planning methods. (+info)
The reasons for extraction of permanent teeth in Scotland: a 15-year follow-up study.
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AIMS: Although Scotland has the highest proportion of edentulous adults in the UK, the frequency of edentulousness has fallen by 21% during the last 20 years. This study, carried out in 1999, was designed to establish whether the reasons for tooth loss have also changed since 1984 when they were last determined. METHODS: The Scottish Dental Practice Board provided the names of every fourth dentist on its list among which 425 general dental practitioners were identified. They were asked to record permanent tooth extractions for 1 week, specifying the age, sex and dental attendance of patients who underwent extractions and the reasons for these extractions. 352 dentists took part: a response rate of 82.8%. RESULTS: The study confirmed that there has been a reduction in the number of extractions between 1984 and 1999: there were 25% fewer teeth extracted per patient and 30% fewer per dentist per week. From 0-20 years of age, orthodontics has replaced caries as the commonest reason for extraction and in all age groups over 20 years, caries has become the commonest reason in contrast to 1984 when periodontal disease was the principal reason in patients over 40 years old. CONCLUSIONS: Caries and its sequelae remain the most important cause of tooth loss throughout adult life in Scotland and, therefore, caries prevention and maintenance of restorations are of great importance at all ages. (+info)
Implant rehabilitation of the atrophic upper jaw: a review of the literature since 1999.
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The severely resorbed maxilla presents serious limitations for conventional implant placement. As a result, different techniques have been developed in the last two decades, with variable results. The most significant approaches comprise the placement of implants in anatomical abutments, elevation of the sinus floor, and reconstructive surgery with bone grafting. The present study reviews the most important articles on the management of the atrophic upper jaw published in the literature since 1999. (+info)
Preprosthetic and implantological surgery in patients with severe maxillary atrophy.
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AIMS: To evaluate the success of the osseointegration of dental implants in patients with severe maxillary atrophy after sinus lift augmentation and onlay graft surgery with autologous bone grafts. DESIGN: A descriptive and analytic study of 27 patients with severe maxillary atrophy and partial or total edentulism, after 4 years follow-up. All cases underwent to autologous bone graft sinus lift augmentation with or without onlay grafts in the anterior maxillae. After this, reconstruction with osseointegrated implants was performed. RESULTS: After the follow-up period, 89.1% of implants were osseointegrated and loaded. Anterior iliac crest bone graft provides good results with respect to implant osseointegration. The achievement of two surgical procedures for bone grafts surgery and implants surgery, separated 2 or more months, provides better results for osseointegration in comparison to a sole surgical procedure (p<0.01). CONCLUSIONS: Implants survival predictability is greater when a second surgical procedure is performed, once bone grafts have experimented an appropriate consolidation. The use of onlay graft and sinus lift augmentation techniques is useful in the resolution of complex problems such as the severe maxillary atrophy. (+info)
Compressive osteotomes for expansion and maxilla sinus floor lifting.
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AIM: The aim of this article is to assess the efficiency of the technique for the posterior alveolar expansion and elevation of the upper maxillary alveolar ridge through the use of compressive osteotomes (Quirurgical Bontempi, Espana) which have been specifically designed for Osseotite NT and Osseotite NT Certain of 3i implants (Implants Innovations, USA). MATERIALS AND METHODS: 24 adult patients (16 female and 12 male), who were selected according to Albrektsson's inclusion and exclusion criteria, took part in the study. All the patients presented bone deficiency in the width and height of the upper maxilla. 48 Osseotite implants were performed (four Osseotite Standard; six Osseotite NT; 38 NT Certain (3i, Implants Innovations, CA, USA)). Implant diameters were 4 mm in 44 cases and 5 mm in 4 cases with lengths varying between 11.5 (n = 4) and 13 mm (n = 44). The alveolar ridges of the 24 patients had initial widths from 1.5 mm to 5 mm and heights between 5 and 13 mm. RESULTS: The data obtained were analysed using the SPSS 11.0 program. In the 48 areas treated with immediate implants, an increase in bone height of 6.75 mm -/+ 1.25 mm was achieved. In the case of the alveolar expansion for the 48 implants, the average was 3.2 mm -/+ 0.15 mm. CONCLUSIONS: The technique for alveolar expansion and elevation of the upper maxilla with compressive osseotomes can lead to a 100% success rate after a 9-month follow-up of the implants and insertion of prostheses. It is a highly predictable surgical procedure which allows implants to be performed at the same time as surgery, thus reducing the number of such interventions while recovering aesthetic and functional losses in the patient. (+info)
Fat embolism following posterior iliac graft harvest for jaw reconstruction: managing the complications of major surgery.
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Oral and maxillofacial surgeons offer their patients a wide variety of surgical options that may be classified as major or minor surgery. Complications are part of surgery, but major surgery may lead to life-threatening complications that must be managed by the surgical team. Obtaining iliac graft tissue during oral and maxillofacial reconstruction carries the risk of rare but serious complications, such as deep vein thrombosis and fat embolism syndrome. In this paper we describe the latter postoperative complication experienced by a patient undergoing an otherwise routine major oral and maxillofacial reconstructive procedure. A discussion of the factors that stimulate fat embolism during or following surgical procedures is intended to help surgeons prevent this complication. (+info)
Reconstructive periodontal therapy with simultaneous ridge augmentation. A clinical and histological case series report.
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