Bone regeneration after removal of a mandibular cyst and following prosthetic rehabilitation with implants. Case report.

This study shows the spontaneous bone regeneration after a Partch II surgical operation without using filling materials. The following functional and esthetic rehabilitation was made with overdenture on implants even in the recovery zone. A male patient, 59 years old, with a cystic lesion of 3.5 mm diameter in the mandibular bone was submitted to surgical enucleation of this neoformation. Postoperative radiological examinations, orthopantomography and TC DentaScan were performed to value the bone regeneration. Four implants of 10 mm diameter and 4.1 mm length were subsequently fixed in the mandibular bone and also in the regeneration area. Then, the rehabilitation of the patient with an overdenture on implants was possible. Radiographic controls after cystic enucleation showed a good recovery of the region occupied by the neoformation. The implants fixed proved to be solid and it was possible to carry out an overdenture on them. The cystectomy alone, performed with conservative technique, without subsequent filling of the remaining cavity with biointegrative materials, permitted bone regeneration also in a large remaining cavity. This regeneration was sufficient to guarantee the success of the subsequent overdenture on implants, and very good functional and esthetic results in a patient totally edentulous in the mandibular bone.

The "piercing technique". A new procedure in impacted lower third molar surgery. Analysis of 802 consecutive extractions.

AIM: Our objective is to rationalize the odontotomic phase during the extraction of lower third molars. This study also evaluated the side effects and complications after the piercing technique utilized for surgery. METHODS: A total of 802 consecutive extractions of impacted lower third molars class B and C of Pell and Gregory were performed by the same surgeon in 506 patients with the ''Piercing Technique''. The incidence of complications and side effects was evaluated at 10, 21, 30, 60, 90 and 180 days. RESULTS: None of the patients had sensory impairment of the lingual nerve, mandibular fractures, displacement of the tooth in soft tissues or intra and post-operative haemorrhage. CONCLUSIONS: The data suggest that the ''Piercing Technique'' is very safe, minimally invasive and easy to apply in impacted lower third molar surgery. This surgical procedure represents the first operative stage of odontotomy and permits us to have a point of dental reference, that makes odontectomy as similar as possible to the ideal that we have thought. With this technique it is possible to inject anaesthetic into the dental pulp in cases of hypersensibility. It is also possible to have a point for insertion of angular elevators by making piercings in the tooth.