Highly crystalline MP-1 hydroxylapatite coating. Part II: In vivo performance on endosseous root implants in dogs.

The in vivo integration strength and degree of bone apposition were compared for oral endosseous implants with different plasma-sprayed hydroxylapatite (HA) coatings. Pullout strength measurements and histological analysis were used to compare two different commercially available coating from the same manufacturer. One coating does not receive a post-plasma-spray treatment and contains about 75% crystalline HA. The other coating is treated with the MP-1 process, a pressurized hydrothermal post-plasma-spray process, which increases the coating composition to approximately 95% crystalline HA without changing the coating's adhesive or cohesive strength. Comparisons were made in dogs after healing times of 3 and 15 weeks in the mandible. No significant differences were found in either case between the two coatings. Two different methods were used to determine the degree of bone apposition at 15 weeks. Both methods confirmed that the MP-1 process does not affect the osseointegration rate of plasma-sprayed HA coatings. Qualitative histology data suggest that the treated coating is more stable than the control coating, especially in cases of direct soft tissue attachment to the implant. The present data suggest that extensive dissolution of calcium phosphate components into surrounding tissue is not a necessary precursor for direct apposition of bone to HA-coated implants.

Management priorities and treatment strategies for medical emergencies in the dental office.

The importance of prioritization in the management of the emergency dental patient cannot be overemphasized. Each dentists' ability to recognize and deal with emergencies depends on the dentists' education, the training of the staff, and the available equipment. This article helps the dentist prioritize the management of medical emergencies by examining preventive protocol and treatment options, as well as preparation and training strategies.

Longitudinal report on hydroxyapatite-coated implants and advanced surgical techniques in a private practice.

An oral and maxillofacial surgery practice placed and evaluated 690 hydroxyapatite-coated dental implants from 1985 to 1993. Many implants were placed in patients with compromised conditions, such as lack of bone height or width. Advanced surgical procedures were used. Factors that were considered in assessing the success of the implants included anatomic position, sex of the patient, and length of the implant. The study showed that although shorter implants were more likely to fail than longer implants, the cumulative survival rate up to 88 months was 96.5%.

Cranial arteritis mimicking odontogenic pain: report of case.

A 65-year-old patient treated for pain of apparent odontogenic origin did not respond to appropriate dental treatment. While the signs and symptoms mimicked a dental problem, further diagnostic evaluation determined the "culprit"--cranial arteritis. Proper treatment immediately after diagnosis is advised as the complications of cranial arteritis can include the rapid onset of blindness.

Benign mesenchymoma of the palate: report of a case.

A case of benign mesenchymoma of the hard palate is presented. The lesion was completely excised and the tumor margins were shown to be free of disease. Within 4 months a second noncontiguous lesion arose of the opposite side of the palate and was also removed. Whether this represented a distinctly new lesion or possibly one which was seeded through previous diagnostic efforts was difficult to ascertain. Follow-up for more than 2 years has not revealed any further evidence of neoplasia.

Costochondral grafting in condylar replacement and mandibular reconstruction.

Thirty costochondral grafts in 22 patients were retrospectively studied with a mean follow-up of five (range, 2 to 11) years. The functional results, esthetics, and incidence of complications in these patients were determined. A discussion of these findings as well as the surgical technique is included. The results confirm previous studies and indicate that free costochondral grafting is a successful and physiologically sound method for reconstruction of portions of the mandible and its temporal articulation.

Complicated orbital fractures.

A method for the clinical evaluation of patients with orbital and midfacial fractures is presented. Pertinent anatomic relations, classification of fractures, and significant associated injuries are reviewed. Principles of treatment are offered.