Pterygomaxillary implants: a graftless solution to deficient maxillary bone.

Edentulism is one of the common dental problems in the aging population. Implant therapy has emerged as one the valid and effective solutions to this problem. However in the maxilla, posterior part presents with several anatomic obstacles in the form of bone quality, quantity, size of maxillary antrum and poor accessibility. There are various options like sinus lift with graft and pterygomaxillary implant options available. Option like ptergomaxillary implants requires lot of skill of technic sensitivity and skill of the surgeon and also is proven to be statistically superior. Case reports of pterygomaxillary implants for both partially edentulous and fully edentulous conditions are hereby described in the article.

Rehabilitation of partial maxillectomy defect with implant retained hollow bulb obturator prosthesis: a case report.

Tissue integrated oral implants have initiated a new perspective in oral rehabilitation of tumor patients who have had undergone surgical resection procedure. The present case demonstrated a simple and predictable approach to rehabilitate a patient who had partial maxillectomy using dental implants. The use of an implant in conjunction with hollow bulb obturator shared remarkable improvement in retention and stability of the existing complete denture prosthesis.

The value of transmandibular approach to total maxillectomy in the management of T3-T4 carcinoma of the maxillary sinus.

Surgical excision of the maxilla either as a primary procedure or after radiotherapy continues to play an important role in the management of carcinoma of the maxillary sinus. A majority of these cancers are seen in T3-T4 stage. Recurrence at the infratemporal fossa has been recognized as a major cause of failure. Although the importance of inclusion of the pterygopalatine fossa in the field of excision has been recognized, there is no uniform approach for en bloc removal of the pterygopalatine fossa. Transmandibular approach has been described for purpose and practiced at the Bangalore Institute of Oncology for the past 8 years with success. This paper presents the technique used, its benefits and the results obtained.

Antral balloon sinus elevation and grafting prior to dental implant placement: review of 34 cases.

PURPOSE: The objective of this study was to assess the antral balloon technique for sinus elevation followed by bone graft and implant placement. MATERIALS AND METHODS: A total of 34 patients with atrophic edentulous posterior maxillary ridges underwent antral balloon sinus elevation followed by bone grafting (autogenous bone retrieved from the chin mixed with platelet-rich plasma) and implant placement. RESULTS: The population consisted of 26 male and 8 female patients with a mean age of 42 years (range, 33 to 56 years). Successful sinus membrane balloon elevation was performed in all 34 patients, and 62 implants were placed. A membrane tear in one patient was managed intraoperatively by placement of a collagen membrane. Two implants failed within 6 months, and the survival rate of the other 60 implants was 100% after 3 years of follow-up. The mean inflated balloon volume was 1.96 mL and the mean elevated sinus height by balloon was 11.6 mm. An average bone gain of 7.5 mm (range, 5.2 to 10.5 mm) was observed. CONCLUSIONS: This case series demonstrates the feasibility of antral balloon sinus membrane elevation followed by bone augmentation and implant placement. This technique offers optimal assurance for membrane safety, and it is less invasive than the routine lateral window technique, safe, and associated with less postoperative bleeding and discomfort. This method is predictable, easy to learn, and associated with low complication rates. However, large comparative studies with other techniques are required.

Effect of hyperbaric oxygen on bone healing after enucleation of mandibular cysts: a modified case control study.

INTRODUCTION: Mandibular cysts may require enucleation, resulting in large cavities compromising mandibular strength and functions. We investigated the effects of hyperbaric oxygen therapy (HBOT) on healing after enucleation of mandibular cysts. PATIENTS AND METHODS: Fourteen healthy individuals in whom no modifiers of wound healing were present received a median of 20 post-operative HBOT. The rate of filling of the defect was derived from the number of pixels in the residual cavity after transformation of the area of the lesion in orthopantomograms taken immediately after surgery and at six months postoperatively. Modifications in bone density, detected on panoramic radiographs, were defined through a gray scale of 256 tonalities. The radiolucency of a healthy tooth was used as a reference to control for differences between radiographs taken at different times in the same patient. Both the rate of filling and changes in bone density were compared with corresponding data from a previous study of 27 healthy subjects who healed spontaneously without HBOT. RESULTS: At six months postoperatively, the HBO-treated group showed 55 ± 9% reduction in the size of the residual cavity and 55 ± 17% increase in bone density compared to immediate postoperative values. Corresponding values in the control study were 12 ± 4% and 37 ± 23%, respectively. These differences were significant (t = -16.95; P = 1.21E-11 [x 10-11] for the reduction in cavity size and t = -2.39; P = 0.029 for bone density). CONCLUSIONS: HBOT merits a place as a useful adjunct in the surgical management of defects of the mandible.