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J Prosthet Dent ; 2021 Jan 13.
Artículo en Inglés | MEDLINE | ID: mdl-33454116


An oral prosthesis can help maintain a sense of normalcy by preserving psychosocial and physiologic function in the aftermath of a maxillary resection. Rehabilitating the resulting defect in a timely manner requires strategic choices in treatment sequencing and prosthetic design. This clinical report describes the process of fabricating a series of removable and implant-retained prostheses to minimize a patient's time without the restoration of critical craniofacial structures.

J Prosthodont ; 29(8): 725-729, 2020 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-32794594


Amyloidosis of the tongue can result in significant and irreversible alterations of tooth position and function due to prolonged application of imbalanced force on the teeth by the enlarged tongue. Due to the rarity of this oral form of systemic disease, little has been elucidated on management of the resulting impaired oral function. While surgery can address the size of the tongue, it carries significant morbidities, enlargement can recur, and does not address adverse tooth positioning. Prosthetic rehabilitation can more aptly restore oral function but it also needs to be tailored based on the patient's expectations and goals as well as biologic and mechanical parameters of treatment. This report discusses an effective and noninvasive application of a tooth-supported, removable prosthesis with an onlay occlusal design to restore occlusion, speech, and esthetics in a patient with tongue-based amyloidosis.

Amiloidosis , Estética Dental , Enfermedades de la Lengua , Amiloidosis/complicaciones , Oclusión Dental , Humanos , Lengua/cirugía
Quintessence Int ; 51(6): 464-472, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32368764


Squamous cell carcinomas arising from keratocystic odontogentic tumors are a rare phenomenon in head and neck cancer, accounting for only 1.45% of oral squamous cell carcinomas, and are classified as primary intraosseous carninomas. This cancer is locally aggressive, has a high potential for recurrence, and requires radical resection and subsequent rehabilitation. This case report describes a patient diagnosed with this uncommon tumor who was treated by dental specialists at Mayo Clinic. During convalescence, orthodontic changes to the maxillary dental archform were observed secondary to alterations in the soft tissue equilibrium following mandibulectomy and reconstruction with a microvascular fibula free flap. This highlights the need for treatment plan adaptability, the role of orthodontists in maintenance or treatment of pre-resection archforms, and the interdisciplinary nature necessary in managing the complex oncologic, functional, and esthetic needs in patients undergoing treatment for head and neck cancer.

Colgajos Tisulares Libres , Neoplasias de la Boca , Procedimientos Quirúrgicos Reconstructivos , Peroné , Humanos , Recurrencia Local de Neoplasia
J Oral Maxillofac Surg ; 78(2): 287.e1-287.e12, 2020 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-31730759


PURPOSE: The purpose of this investigation was to evaluate diagnostic agreement in anterior-posterior (AP) categorization of the maxilla and mandible between a skeletal-landmark analysis and a facial-landmark analysis for treatment planning of orthognathic surgery and orthodontics. MATERIALS AND METHODS: This retrospective, consecutive case series of adult patients who presented to the Mayo Clinic orthodontic department compared maxillary and mandibular AP diagnoses. Steiner's analysis of the sella-nasion-A point angle and sella-nasion-B point angle was used for a skeletal-landmark diagnosis. Element II of Andrews' 6 elements of orofacial harmony was used for a facial-landmark diagnosis. Both diagnoses were categorized as either deficient, optimal, or excessive for each jaw. Categorization of the skeletal landmark was determined by normative data, whereas the facial landmark provides a customized categorization unique to each individual. RESULTS: Weighted κ statistics were completed to test agreement between the categories determined by the skeletal and facial landmarks. The maxilla showed poor agreement, and the mandible showed slight agreement. CONCLUSIONS: No agreement was found for AP categorization of the maxilla and mandible between skeletal-landmark and facial-landmark analyses. Most mandibles were diagnosed as retrognathic by the facial landmark, whereas most were diagnosed as optimal by the skeletal landmark. When the 2 landmarks disagreed, the facial landmark defined the optimal position farther anterior. The landmark chosen for diagnosis will impact the optimal jaw position and can affect orthognathic and orthodontic outcomes.

Maloclusión de Angle Clase III , Ortodoncia , Cirugía Ortognática , Procedimientos Quirúrgicos Ortognáticos , Adulto , Cefalometría , Humanos , Mandíbula , Maxilar , Estudios Retrospectivos