Patient- and clinician-reported outcomes for the additively manufactured sub-periosteal jaw implant (AMSJI) in the maxilla: a prospective multicentre one-year follow-up study.

The clinical outcomes of maxillary rehabilitation with the additively manufactured sub-periosteal jaw implant (AMSJI; CADskills BV) were evaluated in edentulous patients with a Cawood-Howell atrophy classification ≥5 in all regions of the maxilla. Fifteen consecutive patients were included in the study and followed up for 1 year. They were interviewed using a survey protocol and were examined clinically and radiographically preoperatively (T0) and at 1 (T1), 6 (T2), and 12 (T3) months after permanent upper prosthesis placement. The patients reported an increased oral health-related quality of life. The overall mean Oral Health Impact Profile-14 score at T0 was 17.20 (standard deviation (SD) 6.42). When results at T0 were compared to those at T1 (mean 8.93, SD 5.30), a statistically significant difference was seen (P = 0.001). At T3, the mean value was 5.80 (SD 4.18). Compared to T0, there was also a statistically significant difference at T3 (P = 0.001). General satisfaction based on the numerical rating scale was a mean 49.93 at T1, which was less than patient expectation prior to treatment at T0 (52.13). A higher overall value was seen at T3 (53.20) when compared to T0. Within the constraints of the short follow-up, the AMSJI appears to be a promising tool for patients with extreme jaw atrophy. The high patient expectations were met without complications.

Flaplessly placed 2.4-mm mini-implants for maxillary overdentures: a prospective multicentre clinical cohort study.

Studies on flaplessly placed, one-piece mini dental implants (MDIs) supporting overdentures in the maxilla are scarce. This prospective multicenter cohort study evaluated the outcomes (over 2 years) of five to six MDIs placed in the maxilla for overdentures. Study patients were ≥50 years old, with an edentulous maxilla and dentate/fixed prosthesis in the mandible. Dentures were provisionalized with the final connection at 6 months. Implant/prosthetic survival was evaluated, and postoperative discomfort and patient satisfaction were assessed (rating scale). Of 185 MDIs placed in 31 patients, 32 failed in 16 patients (17.3%); 22/83 in female patients and 10/102 in male patients. Kaplan-Meier analysis showed survival percentages of 86.3% (6 months), 84.0% (1year), and 82.3% (2 years). Two patients lost five or six MDIs resulting in two prosthetic failures (6.5%). Implant loss was significantly affected by sex, but not by smoking or location. The worst treatment combination was a torque value >25N·cm with an antagonist implant overdenture. The mean pain score was 4.1±2.8 on day 1 and 1.1±1.7 on day 7. The mean final satisfaction score was 8.6±1.7. The majority (96%) of the patients would recommend this treatment. Despite higher MDI failure in the maxilla compared to the mandible, prosthetic survival was acceptable and patient satisfaction was high, suggesting this to be a valuable treatment alternative.

Otodental syndrome. A case report.

A 12-year-old boy with characteristic findings of otodental syndrome is presented. Abnormalities of deciduous and permanent dentition included bulbous canines, globe-shaped posterior teeth and agenesis of maxillary premolars. High-frequency sensorineural hearing loss was demonstrated, and results of genetic studies indicated an autosomal dominant trait. This patient presented previously unreported findings, including generalized macrodontia, delayed mineralization of the mandibular premolars, and supplementary permanent maxillary canines.

Diagnosis and treatment of vascular lesions of the lip.

Many vascular lesions involve the lip. We present the clinical and imaging findings of vascular lesions, including haemangiomas and vascular malformations. We review the changing role of surgery and other treatments in the management of each type of lesion. Haemangiomas are treated surgically only when lip function is substantially impaired. Superselective embolisation is the treatment of choice for arteriovenous malformations, whereas capillary-venous malformations are best treated by operation together with intralesional injection of fibrosing agents. Capillary malformations are usually treated with laser.

[Atypical histiocytic granuloma]. / Atypisch histiocytair granuloom.

This report deals with a case of atypical histiocytic granuloma in a male patient of 65 years old. The white ulcerative lesion was located in the upper labial mucosa. No bleeding or pain was observed on palpation. A complete spontaneous healing was observed within two weeks. On histologic examination an excess of atypical cells with multiple mitotic configurations was seen. These cells were histiocytes (this was substantiated by the use of a specific histochemical colour method (KP1-CD 68)). The authors emphasize the difficult clinical differential diagnosis with a traumatic eosinophilic granuloma. Also the other ulcerative lesions, including spinocellular epithelioma, of the oral mucosa must be considered. Only biopsy will differentiate between these entities.

[CO2 laser sterilization in periradicular surgery: a clinical follow-up study]. / Stérilisation au laser CO2 en chirurgie périradiculaire: une étude clinique de suivi.

Periradicular surgery combined with final laser sterilisation was performed on 62 teeth of 50 patients by 3 trained oral surgeons, according to a well defined treatment protocol. It concerned a 5 Watt continuous wave CO2-laser. After a follow-up period ranging from 6 to 17 months all patients were recalled. 28 patients (56%) or 33 teeth (53%) could be evaluated. The successrate was determined by a questionnaire, a standard clinical examination and an X-ray evaluation. Complete surgical healing was found in 59% of the teeth and incomplete healing in 23%. Uncertain healing and unsatisfactory healing were observed in respectively 11% and 7% of the teeth. Better healing results were found in elements with one endodontic canal (67% complete healing) and when endododontic treatment was combined with the intervention (71% complete healing). Comparison of the results of the present study with comparable studies without laser sterilisation, showed however no statistical significant improvement.

[CO2 laser sterilization in periradicular surgery: a clinical follow-up study]. / Stérilisation au laser CO2 en chirurgie périradiculaire: une étude clinique de suivi.

Periradicular surgery combined with final laser sterilisation was performed on 62 teeth of 50 patients by 3 trained oral surgeons, according to a well defined treatment protocol. It concerned a 5 Watt continuous wave CO2-laser. After a follow-up period ranging from 6 to 17 months all patients were recalled. 28 patients (56%) or 33 teeth (53%) could be evaluated. The success rate was determined by a questionnaire, a standard clinical examination and an X-ray evaluation. Complete surgical healing was found in 59% of the teeth and incomplete healing in 23%. Uncertain healing and unsatisfactory healing were observed in respectively 11% and 7% of the teeth. Better healing results were found in elements with one endodontic canal (67% complete healing) and when endodontic treatment was combined with the intervention (71% complete healing). Comparison of the results of the present study with comparable studies without laser sterilisation, showed however no statistical significant improvement.

Clinical examination of the T.M.J. interobserver reliability.

A clinical study was performed on 18 healthy persons, chosen at random and without major T.M.J. complaints, by 4 different examiners (2 physiotherapists and 2 oral and maxillo-facial surgeons). The main goal was to examine the interobserver reliability of the different clinical examination methods commonly used in the department of Oral and Maxillo-Facial surgery and physiotherapy. The clinical examination consisted of bilateral palpation of the active movements of the T.M.J., evaluation of the passive movements and evaluation by specific manual distraction and compression tests. Statistical processing was performed with a Pearson correlation coefficient. The critical positive value for a good correlation was never reached. Although evaluation of 5 subjects with minor complaints, shows a low tendency of positive correlation. Therefore, interobserver reliability for the examination of the T.M.J. seems to be fictive in an at random sample. Examination of pathologic cases may be more concordant.