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1.
J Int Med Res ; 49(6): 3000605211021037, 2021 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-34098781

RESUMEN

A 7-year 10-month-old boy was evaluated for mouth breathing and snoring habits. Examination revealed soft convex tissues, maxillary protrusion, mandibular retrusion, and a class II sagittal osteofascial pattern. The patient failed a water holding test. He was clinically diagnosed with skeletal class II malocclusion caused by mouth breathing. Under interceptive guidance of occlusion (iGo), the malocclusion improved with fixed maxillary expansion using functional appliances and interventional treatment of mouth breathing by lip closure exercises. These treatments enabled the patient to gradually return to nasal breathing and guided him to develop physiological occlusion for a coordinated jaw-to-jaw relation. At the 5-year 2-month post-correction follow-up visit (at the age of 13 years), the patient had stable occlusion, a coordinated osteofascial pattern, and normal dentition, periodontium, and temporomandibular joints.


Asunto(s)
Maloclusión Clase II de Angle , Maloclusión , Adolescente , Cefalometría , Niño , Humanos , Lactante , Masculino , Maloclusión Clase II de Angle/diagnóstico por imagen , Maloclusión Clase II de Angle/terapia , Maxilar/diagnóstico por imagen , Maxilar/cirugía , Respiración por la Boca/etiología
2.
Int J Oral Maxillofac Implants ; 36(3): e51-e62, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-34115067

RESUMEN

PURPOSE: Clinical cases have shown that pterygoid implants are a successful alternative solution for the rehabilitation of atrophic posterior maxillae; however, little research on the biomechanical behavior has been produced. This study created 3D models of pterygoid implant-supported prostheses and compared the stress and strain distributions in the pterygoid implants and surrounding bone using finite element analysis. MATERIALS AND METHODS: Three-dimensional models of a standardized human skull, pterygoid implants, and conventional dental implants were created using Simpleware, based on microcomputed tomography (micro-CT) and CBCT images. Six constructs with varying implant positions and numbers were designed to simulate various clinical scenarios for patients with complete maxillary edentulism. Finite element volume meshes were created and exported to ABAQUS, where the modulus of elasticity and Poisson ratio were assigned for each respective structure. Two load scenarios were simulated with conditions as follows: (1) 150-N axial loading; and (2) 150-N axial loading with simultaneous 50-N lateral loading. Then, the Von Mises stress and maximum principle strain distributions for all models were collected, analyzed, and compared. RESULTS: The maximum stress and strain in the pterygoid implants and surrounding bone under both loading scenarios were found in model 4, which had two pterygoid implants and two anterior implants, at the implant-abutment connection and crestal bone of the premolar region, respectively. The stress and strain in the pterygoid implants for all constructs analyzed were at values within the limit of material strength. Additionally, the stress and strain in the surrounding bone for all constructs analyzed were at values within the bone resorption threshold. The maximum stress in the surrounding bone for all models with pterygoid implants was lower than the stress in the control model, which contained no pterygoid implants. CONCLUSION: Pterygoid implants decreased the stress and strain level in the surrounding bone for all cases studied. Additional concern should be placed on the crestal bone of the premolar region and the implant-abutment connections of the pterygoid implants, since these locations had the highest recorded values.


Asunto(s)
Implantes Dentales , Maxilar , Fenómenos Biomecánicos , Prótesis Dental de Soporte Implantado , Análisis del Estrés Dental , Análisis de Elementos Finitos , Humanos , Maxilar/diagnóstico por imagen , Maxilar/cirugía , Estrés Mecánico , Microtomografía por Rayos X
3.
Int J Oral Maxillofac Implants ; 36(3): 503-519, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-34115065

RESUMEN

PURPOSE: To review the evidence from the clinical outcomes of immediately loaded implants with fixed prostheses in edentulous maxillae. MATERIALS AND METHODS: An electronic search was performed in PubMed/MEDLINE, Embase, and Cochrane to identify studies investigating the outcome of implants subjected to immediate loading with fixed dental prostheses in edentulous maxillae. Only clinical studies with more than 10 patients and a mean follow-up time of more than 12 months were included. Meta-analysis was utilized to compare the clinical outcomes between immediately loaded implants and conventionally loaded implants. For immediately loaded implants, a cumulative implant survival rate (ISR) was weighted by the duration of follow-up and number of implants. The weighted marginal bone loss (MBL) was also assessed. RESULTS: A total of 33 studies (16 retrospective studies and 17 prospective studies) were included, which involved 2,635 patients and 12,480 implants. Meta-analysis did not reveal a significant difference of ISR or MBL between the two loading groups. For immediately loaded implants, the weighted cumulative ISR was 95.53% (median: 97.50%) with a mean follow-up of 46.07 months (SD: 30.92). Fourteen studies reported on the MBL of implants, and the mean MBL was 1.19 mm (SD: 0.88) with a mean period of 57.70 months (SD: 32.56). The results should be interpreted with caution due to the lack of randomized controlled trials (RCTs) and the heterogeneity of the data. CONCLUSION: Despite the lack of RCTs, immediate implant loading with a fixed prosthesis in the edentulous maxilla seems to be a reliable treatment alternative with a high ISR, when appropriate inclusion/exclusion criteria are followed.


Asunto(s)
Implantes Dentales , Carga Inmediata del Implante Dental , Arcada Edéntula , Implantación Dental Endoósea , Prótesis Dental de Soporte Implantado , Fracaso de la Restauración Dental , Estudios de Seguimiento , Humanos , Arcada Edéntula/cirugía , Maxilar/cirugía , Resultado del Tratamiento
4.
Artículo en Inglés | MEDLINE | ID: mdl-34076633

RESUMEN

During bone augmentation procedures, primary wound healing determines the bone augmentation result. After a crestal incision in the maxilla, the palatal flap might not be an adequate length to correctly couple to the vestibular flap and to seal the wound with horizontal mattress and single sutures. Due to the histologic structure made of dense connective tissue, the palatal flap eversion is impossible, negatively impacting the wound seal and primary healing. This case report describes the effectiveness and efficacy of an incision design to improve palatal flap management during bone augmentation procedures in the maxilla. Indeed, palatal flap verticalization is achieved. The incision line is proportionally shifted on the vestibular side, based on the defect anatomy, to obtain a palatal flap length extending at least 4 mm coronal to the bone graft level prior to wound closure. The described approach simplifies the optimal adaptation of the inner faces of the palatal and vestibular flaps, reducing the risk of nonprimary wound healing.


Asunto(s)
Maxilar , Colgajos Quirúrgicos , Trasplante Óseo , Humanos , Maxilar/diagnóstico por imagen , Maxilar/cirugía , Paladar (Hueso) , Suturas
5.
Artículo en Inglés | MEDLINE | ID: mdl-34076636

RESUMEN

Implant-supported restorations have proven to be a predictable option for replacing missing teeth. In cases of inadequate bone quantity, the bone volume can be increased by bone augmentation procedures. Several factors can affect bone regeneration, including the morphology of the defect at the implant site. A defect surrounded by bony walls (an intraosseous defect) is known to yield a highly successful regeneration. The purpose of this retrospective case series study was to present a new step-by-step surgical procedure known as the Custom Alveolar Ridge-Splitting (CARS) technique for maxillary anterior ridge augmentation. This technique creates an intraosseous defect while splitting and augmenting an atrophic ridge. Sixteen consecutive cases were treated with the CARS procedure. All implants were restored and followed for 12 to 24 months after loading, and all cases were effectively treated with successful implant placement. According to this retrospective study, the CARS procedure is simple, successful, and predictable and may be used as a surgical option for horizontal alveolar ridge augmentation in the anterior maxilla.


Asunto(s)
Aumento de la Cresta Alveolar , Maxilar , Proceso Alveolar/cirugía , Trasplante Óseo , Implantación Dental Endoósea , Humanos , Maxilar/cirugía , Estudios Retrospectivos
6.
Artículo en Inglés | MEDLINE | ID: mdl-34076642

RESUMEN

The aim of this retrospective study was to evaluate the long-term performance of the supercritical CO2 (Supercrit, BIOBank) viral-inactivated bone allografts in maxillary sinus augmentation. Thirty-four consecutive patients underwent 50 maxillary sinus augmentation procedures, and 103 implants were placed. At a mean of 8.8 years after graft surgery, 95 implants were well osseointegrated and functioning. Eight implants failed, and the overall implant survival rate at 10 years was 92.2%. The marginal bone loss averaged 1.2 ± 1.3 mm. Within the limitations of this study, the supercritical CO2 viral-inactivated bone allograft is a valuable bone graft material, achieving long-term satisfying outcomes when used alone.


Asunto(s)
Implantes Dentales , Elevación del Piso del Seno Maxilar , Trasplante Óseo , Dióxido de Carbono , Implantación Dental Endoósea , Fracaso de la Restauración Dental , Humanos , Maxilar/cirugía , Seno Maxilar/diagnóstico por imagen , Seno Maxilar/cirugía , Estudios Retrospectivos
7.
Int J Periodontics Restorative Dent ; 41(3): e103-e112, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-34076644

RESUMEN

Clinical evidence suggests using lateral and vertical ridge preservation procedures to make dental implant placement possible. This study evaluates and compares the radiographic and volumetric changes following ridge preservation procedures using either mineralized plasmatic matrix grafts (MPM) or bone grafts alone (non-MPM) in the existing crestal ridges of sockets in maxillary and mandibular regions using CBCT scans. Healthy volunteers (n = 26) were recruited and randomized into MPM and non-MPM groups (n = 13 patients per group). Ridge preservation (RP) was performed in sockets after extraction. Preoperative baseline vertical measurements (V1) were made from the existing highest level of the socket crestal ridges to a reference point in an apicocoronal direction. Similarly, baseline horizontal measurements (H1) were made in a buccolingual direction on CBCT scans. The measurements were repeated after 3 months (V2 and H2) and 6 months (V3 and H3) using the same reference points. Difference between V3 and V1 as well as H3 and H1 was used to assess the gains in height and width of the sockets after RP. No significant difference was found in the initial baseline V1 and H1 values in MPM and non-MPM groups. Median (Mdn) V2 and H2 scores were significantly different between MPM (Mdn = 18.91) and non-MPM groups (Mdn = 27.81) after 3 months of RP (U = 37, z = -6.302, P < .001.) However, after 6 months of treatment, V3 and H3 scores were significantly different between the MPM (Mdn = 27.19) and the non-MPM group (Mdn = 37.81). MPM can be used as a valuable and predictable technique in obtaining bone fill in the maxillary and mandibular sockets with residual crestal ridges deemed necessary for RP in implant therapy.


Asunto(s)
Pérdida de Hueso Alveolar , Aumento de la Cresta Alveolar , Trasplante Óseo , Humanos , Maxilar/diagnóstico por imagen , Maxilar/cirugía , Extracción Dental , Alveolo Dental/diagnóstico por imagen , Alveolo Dental/cirugía
8.
Int J Periodontics Restorative Dent ; 41(3): e121-e128, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-34076648

RESUMEN

The posterior maxilla has traditionally presented a challenge for successful placement of dental implants due to a combination of poor bone quality, ridge atrophy, and pneumatization of the sinus floor following tooth extraction. However, with the successful and predictable surgical outcomes reported in the literature, more clinicians and patients are choosing an implant-supported restoration in the edentulous posterior maxilla. Consequently, sinus elevation and augmentation have gained more popularity. Extensive research has been conducted on types of bone graft materials and implants, less-invasive techniques to perform sinus augmentation, and timing for implant placement for sinus grafting. Despite the predictability of the techniques and biomaterials employed in sinus grafting procedures, intra- and postoperative complications are common. Much of the current literature discusses the local risk factors related to sinus augmentation, with few studies focusing on the patient-related risk factors. The purpose of this review is to identify, evaluate, and discuss the possible management of patient-related risk factors to allow for more predictable maxillary sinus floor augmentation outcomes.


Asunto(s)
Aumento de la Cresta Alveolar , Implantes Dentales , Elevación del Piso del Seno Maxilar , Trasplante Óseo , Implantación Dental Endoósea , Fracaso de la Restauración Dental , Humanos , Maxilar/cirugía , Seno Maxilar/diagnóstico por imagen , Seno Maxilar/cirugía , Factores de Riesgo
9.
Compend Contin Educ Dent ; 42(6): F1-F11, 2021 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-34077670

RESUMEN

Ten keys for successful esthetic-zone single immediate implants encapsulate in an evidence-based manner the treatment planning and replacement of single hopeless teeth in the maxillary anterior sextant. These include two treatment-planning, five surgical, and three prosthetic keys, which, collectively, aim to minimize soft- and hard-tissue complications for an optimal esthetic implant restoration. The Straightforward, Advanced, and Complex (SAC) classification is designed to aid clinicians in the treatment planning of dental implant cases. As per this classification, cases are stratified by the degree of surgical and restorative risk and complexity for both the surgical and prosthetic phases of treatment. A technique-sensitive and skill-demanding task, the replacement of multiple adjacent teeth in the esthetic zone poses significant challenges for clinicians and is considered a complex SAC procedure surgically and restoratively. This article presents a case report on the replacement of multiple adjacent teeth in the esthetic zone, demonstrating the use of 10 key principles to achieve an optimal esthetic outcome.


Asunto(s)
Implantes Dentales de Diente Único , Implantes Dentales , Implantación Dental Endoósea , Estética Dental , Humanos , Maxilar/cirugía
10.
Shanghai Kou Qiang Yi Xue ; 30(2): 196-200, 2021 Apr.
Artículo en Chino | MEDLINE | ID: mdl-34109362

RESUMEN

PURPOSE: The aim of this study was to analyze the feasibility of zygomatic implant quad approach in patients with tooth agenesis. METHODS: Based on the data from cone-beam CT (CBCT), twenty one patients with tooth agenesis who were planned to receive zygomatic implant quad approach were enrolled. The radiographic bone-to-implant contact (rBIC) of each zygomatic implant placed virtually in patients' zygomatic segment was measured. SPSS 25.0 software package was used for statistical analysis. RESULTS: Twenty patients' plans of zygomatic implant quad approach were completed (12 men and 8 women). A total of 80 zygomatic implants were placed virtually and the average rBIC of zygomatic segment was (13.85±3.29) mm. The rBIC values of 40 mesial zygomatic implants and 40 distal zygomatic implants were (13.80±3.74) mm and (13.90±2.81) mm, respectively(P>0.05). The average rBIC in male of 24 mesial zygomatic implants and 24 distal zygomatic implants were(14.21±4.08) mm and(14.31±3.18) mm, respectively, slightly higher than those in female of 16 mesial zygomatic implants and 16 distal zygomatic implants, which were (13.18±3.18) mm and (13.29±2.10) mm, respectively. There was no significant difference between the two groups (P>0.05). The average rBIC of 15 extra sinus zygomatic implants, 46 against sinus lateral wall zygomatic implants and 19 intra-sinus zygomatic implants were (16.27±2.95), (13.87±3.10) and (11.88±2.78) mm, respectively. There was significant difference between the extra sinus zygomatic implants and the other two(P<0.05). CONCLUSIONS: It is feasible to plan zygomatic implant quad approach for patients with tooth agenesis. Zygomatic implants can get adequate rBIC in zygomatic segment and to provide sufficient support and retention of the superstructure.


Asunto(s)
Implantes Dentales , Cigoma , Tomografía Computarizada de Haz Cónico , Implantación Dental Endoósea , Prótesis Dental de Soporte Implantado , Estudios de Factibilidad , Femenino , Humanos , Masculino , Maxilar/cirugía , Cigoma/diagnóstico por imagen , Cigoma/cirugía
11.
Shanghai Kou Qiang Yi Xue ; 30(2): 214-218, 2021 Apr.
Artículo en Chino | MEDLINE | ID: mdl-34109366

RESUMEN

PURPOSE: To investigate the 5-year survival and complication rates of implants placed in grafted sinuses with different surgical approaches and analyze the causes for failure. METHODS: This study retrospectively observed the prognosis of patients who underwent maxillary sinus augmentation by means of lateral window technique(LWT) or transalveolar osteotomy technique (TOT) and simultaneously installed implants performed, in Hefei Stomatological Hospital. The primary predictor variables were surgical approaches, including LWT and TOT. The primary outcome measurement was the 5-year implant survival rate, complication rates and failure causes. Potential confounders included diabetes, age at surgery, gender, smoking habit, oral hygiene, tooth position, length and diameter of implants and type of prosthesis. Chi-square test and logistic regression analysis were performed with SPSS 21.0 software package. RESULTS: Fifty-nine patients (31 males and 28 females), installed with 93 implants, with a mean age of (61.3±10.1) years old, were enrolled. Over (5±1.2) years of follow-up, five implants failed, with a total survival rate of 94.6%. In detail, there were 3 failed implants in the LWT group and 2 failed implants in the TOT group, for a survival rate of 85.7% and 97.2%, respectively. Chi-square test showed that smoking habit (P=0.010), oral hygiene(P=0.037) as well as operative approach(P=0.040) were significantly associated with the final survival rates, multivariate logistic regression analysis displayed that smoking habit (OR=0.030, 95%CI: 0.002-0.493, P=0.014) was still associated with the finial survival rates. Surgical approach(P=0.025) was markedly related to causes for the failed implants. Of which, three (100%) failed implants in the LWT group was due to poor osseointegration and implant mobility 3 months after sinus augmentation, and 2(100%) in the TOT group was because of persistent peri-implantitis and loss of the graft or alveolar bone 4 years after sinus augmentation. Smoking habit was also significantly relevant to complication rates(P=0.014), and the occurrence incidence of controllable peri-implantitis in patient having a smoking habit was relatively higher, accounting for 6.8%(6/88), compared with patients without smoking habit. Significant relationship between surgical approaches and implant complications was not observed(P=0.051). CONCLUSIONS: Different surgical approaches for maxillary sinus augmentation do not significantly correlate with implant survival rates and implant complications. However, surgical approach is markedly related to the causes of failed implants. Smoking will lead to a decreased implant survival rate and controllable peri-implantitis.


Asunto(s)
Implantes Dentales , Elevación del Piso del Seno Maxilar , Anciano , Implantación Dental Endoósea , Fracaso de la Restauración Dental , Femenino , Estudios de Seguimiento , Humanos , Masculino , Maxilar/cirugía , Seno Maxilar/cirugía , Persona de Mediana Edad , Estudios Retrospectivos , Elevación del Piso del Seno Maxilar/efectos adversos , Resultado del Tratamiento
12.
Shanghai Kou Qiang Yi Xue ; 30(2): 219-224, 2021 Apr.
Artículo en Chino | MEDLINE | ID: mdl-34109367

RESUMEN

PURPOSE: To use three-dimensional reconstruction measurement, preoperative diagnosis, surgical design, surgical simulation, guide plate production, navigation verification and effect evaluation of orthognathic surgery assisted by digital technology, in order to explore more scientific and reasonable programs and procedures of orthognathic surgery. METHODS: Twenty-five patients with congenital dental and maxillofacial deformity were selected as the experimental subjects, craniofacial spiral CT was conducted before surgery and CT data were imported into Mimics 20.0 software to establish a 3D head digital model. The bone landmarks in three-dimensional reconstruction digital model were selected, measured, analyzed and diagnosed, and the design of the surgical plan and the production of the guide plates were performed. Surgical navigation system was used to confirm the maxillary position, verify the bone retention and guide precise bone grinding during operation. Craniofacial spiral CT was conducted 1 week after surgery for postoperative validation of the surgical design protocol. Statistical analysis was performed using SPSS 24.0 software package. RESULTS: All 25 patients were operated according to the digital orthognathic surgery design and procedure.There were no significant differences in X, Y and Z three-dimensional directions in 10 actual landmarks between the postoperative actual head model and the preoperative predictive head model(P>0.05). CONCLUSIONS: Orthognathic surgery assisted by digital technology has the advantages of precision and minimal invasiveness.


Asunto(s)
Cirugía Ortognática , Procedimientos Quirúrgicos Ortognáticos , Cirugía Asistida por Computador , Tecnología Digital , Humanos , Imagenología Tridimensional , Maxilar/diagnóstico por imagen , Maxilar/cirugía , Tomografía Computarizada Espiral
13.
BMC Oral Health ; 21(1): 252, 2021 05 12.
Artículo en Inglés | MEDLINE | ID: mdl-33980213

RESUMEN

PURPOSE: To assess the clinical and radiographic success rate of microsurgical endodontic treatment of upper molar teeth in relationship with the maxillary sinus, with 12 months follow-up. METHODS: Patients treated with microsurgical endodontic treatment of upper molar teeth in the period between 2017 and 2019 were recruited from two dental clinics according to specific selection criteria. The outcomes were determined based on clinical and radiographic results taken three, six and 12 months post-operatively, compared with those taken immediately before and after surgery. Clinical and radiographic outcomes were recorded. The distance between the most apical part of the root and of the lesion to the maxillary sinus was measured on CBCT images before the surgery. Patient-related outcomes were recorded. RESULTS: Out of 35 patients evaluated, 21 were selected according with the selection criteria for a total of 27 roots and 29 canals treated. After 12 months, 18 patients showed a complete healing whereas three demonstrated incomplete healing. Consequently, the success rate in this study was 85.7% after one year. In 28.5% (6 patients) there was a perforation of the Schneiderian membrane that didn't seem to affect the outcome. All patients kept the molar one year later. The pain level decreased significantly over the time during the first week after surgery. CONCLUSION: Microsurgical Endodontic treatment of the upper molar teeth should be considered a valid and predictable treatment option even in case of Schneiderian membrane perforation. Future clinical studies with a larger sample size are needed to compare the results obtained.


Asunto(s)
Tomografía Computarizada de Haz Cónico , Seno Maxilar , Humanos , Maxilar/cirugía , Seno Maxilar/diagnóstico por imagen , Seno Maxilar/cirugía , Diente Molar/diagnóstico por imagen , Diente Molar/cirugía , Mucosa Nasal , Estudios Retrospectivos , Raíz del Diente
14.
Compend Contin Educ Dent ; 42(4): 158-162, 2021 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-33960801

RESUMEN

Over time, patients treated in developmental stages of implantology may need additional treatment,as teeth adjacent to implants may fail and require replacement themselves with new implants. Blending newer implant rehabilitations into a dentition with existing implant-supported restorations can be challenging. The use of implants with a subcrestal angle correction (SAC) enables predictable screw-retained anchorage of temporary and definitive restorations. An SAC implant often can be placed into the palatal bone of an extraction socket, along the incisal angle of the crown, allowing screw retention of the prosthesis. This case report demonstrates the use of both straight and SAC implants combined with hard- and soft-tissue augmentation and serial provisionalization to replace hopeless teeth adjacent to pre-existing implants and improve esthetics in the anterior maxilla.


Asunto(s)
Implantes Dentales de Diente Único , Implantes Dentales , Coronas , Implantación Dental Endoósea , Prótesis Dental de Soporte Implantado , Estética Dental , Humanos , Maxilar/cirugía , Resultado del Tratamiento
15.
Compend Contin Educ Dent ; 42(4): g1-g4, 2021 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-33961750

RESUMEN

Fixed prostheses offer various advantages over conventional removable devices for immediate restoration of a fractured tooth in the esthetic zone. In this case report, a fixed solution is employed through the use of a same-day provisional restoration attached to an immediately placed dental implant. Utilizing biologics and an implant system that allows for excellent primary stability, this treatment modality offers a predictable method for achieving immediate implant placement and provisionalization. The minimally invasive technique facilitates the development and maintenance of soft- and hard-tissue contours to enable an optimal result in the final restoration.


Asunto(s)
Implantes Dentales de Diente Único , Implantes Dentales , Carga Inmediata del Implante Dental , Implantación Dental Endoósea , Restauración Dental Provisional , Estética Dental , Humanos , Maxilar/cirugía , Satisfacción del Paciente , Resultado del Tratamiento
16.
Compend Contin Educ Dent ; 42(5): 220-226; quiz 228, 2021 May.
Artículo en Inglés | MEDLINE | ID: mdl-33980019

RESUMEN

In this study of orthodontic and surgical management of impacted maxillary canines, the current literature is reviewed and a decision tree is presented to assist clinicians in determining the optimal treatment based on available evidence. Impacted canines have a prevalence of 2% and are more common in females. Palatal impactions are present in around 75% of cases. These trends are observed worldwide with small variations in different populations. Diagnosis through clinical examination and conventional imaging can be complemented with cone-beam computed tomography imaging when necessary. Early intervention by extraction of deciduous canines is indicated when the canine is impacted in sectors 2 or 3 and has an angle of 20 to 30 degrees in relation to the vertical line. Other early management approaches involve rapid palatal expansion or distalization of posterior teeth, when possible. Surgical orthodontic treatment is required when early intervention is unsuccessful. For buccal impactions, the canine position relative to the mucogingival junction determines the choice of surgical procedure; for palatal impactions, the open surgical procedure seems to be preferred. In some situations, however, a closed eruption has precise indications. Use of efficient orthodontic mechanics reduces treatment complications and may be complemented with the use of nitinol piggybacks, swinging gates, modified transpalatal arches, and temporary anchorage devices. Frequent complications with impactions include canine ankylosis, root resorption of the neighboring lateral or central incisor, and gingival esthetic differences between the impacted canine and the contralateral canine upon treatment completion.


Asunto(s)
Resorción Radicular , Diente Impactado , Tomografía Computarizada de Haz Cónico , Diente Canino/diagnóstico por imagen , Diente Canino/cirugía , Estética Dental , Femenino , Humanos , Incisivo , Maxilar/cirugía , Técnica de Expansión Palatina , Diente Impactado/diagnóstico por imagen , Diente Impactado/cirugía
17.
Hua Xi Kou Qiang Yi Xue Za Zhi ; 39(3): 286-292, 2021 Jun 01.
Artículo en Inglés, Chino | MEDLINE | ID: mdl-34041877

RESUMEN

OBJECTIVES: This study aims to evaluate the short-term clinical outcomes and patient satisfaction of anterior and pterygoid implants in the rehabilitation of edentulous maxilla with posterior atrophy. METHODS: Given a minimum follow-up of 1 year, 25 patients with fixed maxillary rehabilitation over anterior and pterygoid implants were enrolled in this retrospective study. The implant survival rates, peri-implant soft tissue status (including probing depth, modified sulcus bleeding index, and plaque index), marginal bone loss, and patient satisfaction were measured. RESULTS: The survival rates for anterior and pterygoid implants at 1-year follow-up were 96.5% and 97.8%, respectively (P>0.05). No statistically significant difference in probing depth, modified sulcus bleeding index, and plaque index was observed between the two types of implants (P>0.05). The marginal bone losses of anterior implants were 0.62 mm± 0.44 mm (mesial) and 0.61 mm± 0.40 mm (distal), and those of pterygoid implants were 0.64 mm± 0.46 mm (mesial) and 0.68 mm± 0.41 mm (distal) mm. These results showed no statistical difference in mesial and distal sites (P>0.05). Patients indicated a high degree of satisfaction with the full-arch prostheses supported by anterior and pterygoid implants. CONCLUSIONS: For the edentulous maxilla with posterior atrophy, full-arch fixed prostheses supported by anterior and pterygoid implants has an acceptable short-term clinical outcome and excellent patient satisfaction. It may be considered as a predictable and feasible method for maxillary rehabilitation.


Asunto(s)
Implantes Dentales , Arcada Edéntula , Atrofia/patología , Implantación Dental Endoósea , Prótesis Dental de Soporte Implantado , Estudios de Seguimiento , Humanos , Arcada Edéntula/patología , Arcada Edéntula/cirugía , Maxilar/patología , Maxilar/cirugía , Estudios Retrospectivos , Resultado del Tratamiento
18.
Am J Orthod Dentofacial Orthop ; 159(6): 733-742, 2021 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-33931257

RESUMEN

INTRODUCTION: This study compared the skeletal and dental changes of microimplant assisted rapid palatal expansion (MARPE) with those produced by surgically assisted rapid maxillary expansion (SARPE) in postpeak adolescents and adults. METHODS: The sample comprised 17 patients (mean age, 26 ± 11 years) selected for the MARPE group and 15 (mean age, 28.5 ± 10.5 years) selected for the SARPE group. Cone-beam computed tomography scans taken just before and after the expansion were used to assess dental and skeletal changes and compare the changes between the groups. RESULTS: MARPE showed greater transversal skeletal changes in the midface and posterior and anterior maxillary base measurements. The transverse displacement of the alveolar process was greater but not significant for the SARPE group than the MARPE group. Regarding dental effects, the root distance measurements did not differ between the groups, but SARPE produced a significantly greater increase in intermolar and interpremolar distance and a greater buccal inclination of the alveolar process and supporting teeth than MARPE. CONCLUSIONS: The MARPE technique showed an increase in skeletal transverse maxillary expansion at the midface and basal bone compared with SARPE, especially at the posterior palatal region; however, no difference was found in the expansion of the alveolar process between the 2 methods. MARPE presented a more parallel expansion in both a coronal and axial view, whereas SARPE led to a V-shaped opening. The greater buccal inclination of the alveolar process and supporting teeth was observed in the SARPE group.


Asunto(s)
Técnica de Expansión Palatina , Diente , Adolescente , Adulto , Tomografía Computarizada de Haz Cónico , Humanos , Maxilar/diagnóstico por imagen , Maxilar/cirugía , Paladar (Hueso)/diagnóstico por imagen , Paladar (Hueso)/cirugía , Adulto Joven
19.
J Med Case Rep ; 15(1): 236, 2021 May 15.
Artículo en Inglés | MEDLINE | ID: mdl-33990229

RESUMEN

BACKGROUND: Implant-supported prosthetic treatment options are reliable for elderly edentulous patients with systemic health problems. These patients often need cost- and time-efficient solutions to avoid complications. However, it is a challenge for clinicians to treat these patients without surgical interventions, placement of additional implants, or the need to renew existing prostheses. CASE PRESENTATION: A 75-year-old medically compromised caucasian male patient using multiple medications was referred for prosthetic rehabilitation of his edentulous maxilla after several implant failures. Because the patient's health was compromised, further surgical interventions were ruled out and the treatment was centered on the use of the remaining implants by placing a fixed attachment system and altering the existing prosthesis. The stepwise management of the patient's situation through the use of a new attachment system and adjustment of existing prosthesis is described in the present case report. CONCLUSIONS: Although implant therapy is not always contraindicated for medically compromised patients, it is preferable not to perform extensive surgeries to avoid complications. This clinical report describes an alternative, safe option based on a novel fixed attachment system to salvage an existing maxillary implant-supported fixed complete dental prosthesis of a patient with systemic health problems.


Asunto(s)
Implantes Dentales , Prótesis Dental , Resinas Acrílicas , Anciano , Prótesis Dental de Soporte Implantado , Estudios de Seguimiento , Humanos , Masculino , Maxilar/cirugía , Prótesis e Implantes
20.
Dental Press J Orthod ; 26(2): e2119187, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-34008738

RESUMEN

INTRODUCTION: A side effect observed in cases treated with extractions is the instability of orthodontic space closure. OBJECTIVE: The aim of this study was to investigate the influence of gingival invagination, presence of third molars and facial pattern, on the stability of orthodontic space-closure in the maxillary arch. METHODS: Ninety-nine subjects (41 male and 58 female) with Class I malocclusion treated with four premolars extraction were evaluated. Extraction sites reopening and gingival invaginations were evaluated in scanned dental models in the posttreatment and 1-year posttreatment stages (mean age 16.1 years). Third molars presence was evaluated at 1-year posttreatment panoramic radiographs, and the facial pattern (SN.GoGn) was evaluated in the initial lateral headfilms. Multiple logistic regression analysis was used to estimate the influence of the aforementioned independent variables on the frequency of extraction space reopening. RESULTS: Space reopening was observed in 20.20% of the subjects 1-year post-debonding. Gingival invaginations were present in 25.73% of quadrants after debonding and in 22.80% 1-year posttreatment. The mean pre-treatment SN.GoGn was 35.64 degrees (SD=5.26). No significant influence was observed of the three independent variables on the instability of extraction site closure. CONCLUSIONS: The presence of gingival invaginations, third molars and facial growth pattern do not seem to influence maxillary extraction sites reopening.


Asunto(s)
Maloclusión Clase I de Angle , Extracción Dental , Adolescente , Diente Premolar/diagnóstico por imagen , Diente Premolar/cirugía , Femenino , Humanos , Masculino , Maloclusión Clase I de Angle/diagnóstico por imagen , Maloclusión Clase I de Angle/terapia , Maxilar/diagnóstico por imagen , Maxilar/cirugía , Cierre del Espacio Ortodóncico , Extracción Dental/efectos adversos
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