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1.
J Oral Implantol ; 46(3): 235-243, 2020 Jun 01.
Artículo en Inglés | MEDLINE | ID: mdl-32582920

RESUMEN

No previously published studies have reported on the placement and restoration of dental implants in a patient diagnosed with sarcoidosis. Patients with sarcoidosis may develop periodontitis as a manifestation of systemic disease and are therefore at increased risk of tooth loss. These patients are likely to want fixed dental prostheses, which may need to be supported by dental implants. The case presented is that of a 31-year-old female patient presenting with a missing maxillary central incisor and a sarcoidal process affecting the anterior maxilla, which had severely compromised the periodontium of the adjacent lateral incisor. The patient was successfully rehabilitated with an implant-retained prosthesis following a staged horizontal and vertical bone augmentation procedure. At the 4-year review, the implant restoration performed well with stable peri-implant bone levels. We conclude that dental implant rehabilitation in patients with sarcoidosis may be a predictable treatment option, depending on disease stability and concurrent systemic therapy, but these patients will require additional maintenance because of the possibility of an increased risk of peri-implantitis. The effects of sarcoidosis and its management on the success of dental implants are discussed to aid treatment planning for such patients.


Asunto(s)
Implantes Dentales , Sarcoidosis , Adulto , Implantación Dental Endoósea , Diseño de Prótesis Dental , Prótesis Dental de Soporte Implantado , Fracaso de la Restauración Dental , Femenino , Humanos , Maxilar/cirugía , Resultado del Tratamiento
2.
Artículo en Inglés | MEDLINE | ID: mdl-32559033

RESUMEN

Immediate tooth replacement therapy (ITRT), ie, immediate implant placement and provisional restoration in postextraction sockets, has been shown to achieve favorable outcomes in reference to soft tissue stability and esthetics. However, avoiding socket perforation with uniaxial implants in the anterior maxilla can be challenging due to the inherent anatomy. Dual or co-axis subcrestal angle correction (SAC) implants have been developed to change the restorative angle of the clinical crown restoration subcrestally at the implant-abutment interface to enhance the incidence of screw-retained definitive restorations. An additional benefit of this macrodesign implant feature is variable platform switching (VPS) that increases soft tissue gap distance above the implant platform. The purpose of this prospective study on ITRT in maxillary anterior postextraction sockets was to investigate the effect of SAC with VPS (SAC/VPS) compared to conventional platform-switch-design implants (PS) relative to ridge dimension stability and peri-implant soft tissue thickness. A total of 29 patients had undergone ITRT and received either a PS or SAC/VPS implant; previously described measurements were made compared to the contralateral natural tooth sites. When the comparison of buccal soft tissue thickness was made, SAC/VPS showed a greater increase compared to PS (3.12 mm vs 2.39 mm, respectively) with statistical significance (P = .05). The increase was independent from periodontal phenotype. Therefore, SAC/VPS may increase peri-implant soft tissue thickness and help minimize recession following ITRT.


Asunto(s)
Implantes Dentales de Diente Único , Implantes Dentales , Carga Inmediata del Implante Dental , Humanos , Maxilar/cirugía , Estudios Prospectivos , Extracción Dental , Alveolo Dental/cirugía
3.
Compend Contin Educ Dent ; 41(6): 331-335, 2020 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-32551715

RESUMEN

This case series demonstrates internal maxillary sinus elevation and placement of 37 posterior implants in 34 private practice patients using sequential motorized expander burs exclusively to infracture the sinus border and embed bone graft material (allograft or xenograft) for vertical augmentation. With this technique, manual osteotome/malleting was completely avoided, improving surgical control and the patient experience. Sinus borders were lifted by a mean of 3.92 mm in ridges that had an average residual height of 7.52 mm. All implants achieved high insertion torque values (≥90 Ncm), obtained primary stability, and were successfully restored without complications. Anecdotally, the type of bone graft used did not appear to influence the outcome.


Asunto(s)
Implantes Dentales , Elevación del Piso del Seno Maxilar , Trasplante Óseo , Implantación Dental Endoósea , Humanos , Maxilar/cirugía , Seno Maxilar/cirugía , Osteotomía , Torque
4.
Codas ; 32(4): e20190152, 2020.
Artículo en Inglés, Portugués | MEDLINE | ID: mdl-32401996

RESUMEN

Purpose This study investigated the influence of the cleft type on the appearance of hypernasality after surgical maxillary advancement (MA). Methods Nasality was determined by measurement of nasalance (acoustic correlate of nasality) by nasometry. The study involved analysis of the nasalance scores of 17 individuals with isolated cleft palate (CP), 118 with unilateral cleft lip and palate (UCLP) and 69 with bilateral cleft lip and palate (BCLP), of both sexes, aged 18 to 28 years, after MA. Only individuals with normal nasalance scores indicating balanced resonance before MA were included in this study. Nasometry was performed 3 days before and 15 months after MA, on average. The proportion of patients who presented nasalance scores indicating hypernasality after surgery was calculated by the ANOVA test, and comparison among the different cleft types was evaluated by the chi-square test (p < 0.05). Results No significant difference was found in the proportions of individuals with hypernasality among the cleft types. Conclusion Nasometry showed that the appearance of hypernasality after MA in individuals with cleft palate with or without cleft lip occurred in similar proportions, regardless of the cleft type.


Asunto(s)
Labio Leporino/cirugía , Fisura del Paladar/cirugía , Procedimientos Quirúrgicos Ortognáticos/efectos adversos , Trastornos del Habla/etiología , Habla/fisiología , Insuficiencia Velofaríngea/etiología , Adolescente , Adulto , Labio Leporino/fisiopatología , Fisura del Paladar/fisiopatología , Femenino , Humanos , Masculino , Maxilar/cirugía , Osteotomía Le Fort/efectos adversos , Estudios Retrospectivos , Trastornos del Habla/fisiopatología , Medición de la Producción del Habla , Insuficiencia Velofaríngea/fisiopatología , Adulto Joven
5.
J Evid Based Dent Pract ; 20(1): 101410, 2020 03.
Artículo en Inglés | MEDLINE | ID: mdl-32381412

RESUMEN

ARTICLE TITLE AND BIBLIOGRAPHIC INFORMATION: Implants in the Posterior Maxilla: Open Sinus Lift Versus Conventional Implant Placement. A Systematic Review. Romero-Millán J, Alzcorbe-Vicente J, Peñarrocha-Diago M, Galindo-Moreno P, Canullo L, Peñarrocha-Oltra D. Int J Oral Maxillofac Implants 2019; 34(4):e65-e76. SOURCE OF FUNDING: Information not available. TYPE OF STUDY/DESIGN: Systematic review.


Asunto(s)
Implantes Dentales , Implantación Dental Endoósea , Fracaso de la Restauración Dental , Humanos , Maxilar/cirugía
6.
Cient. dent. (Ed. impr.) ; 17(1): 19-26, ene.-abr. 2020. ilus, graf
Artículo en Español | IBECS | ID: ibc-189745

RESUMEN

La pérdida ósea vertical en los sectores posteriores maxilares es un hecho frecuente tras la extracción dental. En muchas ocasiones para rehabilitar estas zonas podemos emplear técnicas de regeneración u optar por un abordaje más conservador con implantes cortos. En el presente caso clínico mostramos un caso rehabilitado bilateralmente con dos técnicas diferentes: elevación de seno y la inserción de implantes cortos, con un seguimiento de ocho años donde ambas técnicas han logrado resultados igualmente predecibles


Vertical bone loss in the posterior maxillary sectors is a frequent occurrence after tooth extraction. These areas can often be rehabilitated using regeneration techniques or by opting for a more conservative approach with short implants. The present clinical case shows bilateral rehabilitation with two different techniques: sinus lift and the insertion of short implants, with a follow-up of 8 years where both techniques have achieved equally predictable results


Asunto(s)
Humanos , Femenino , Persona de Mediana Edad , Atrofia , Maxilar/cirugía , Elevación del Piso del Seno Maxilar/métodos , Implantes Dentales , Maxilar/patología , Diente Molar/patología , Radiografía Panorámica
7.
Cient. dent. (Ed. impr.) ; 17(1): 35-40, ene.-abr. 2020. ilus
Artículo en Español | IBECS | ID: ibc-189747

RESUMEN

Los implantes dentales constituyen una alternativa predecible para la rehabilitación de los maxilares edéntulos, sin embargo, el éxito del tratamiento puede ver-se comprometido cuando existen graves atrofias maxilares. Para el tratamiento de estos casos complejos, se han desarrolla-do técnicas de regeneración ósea, entre las que destacan la regeneración ósea guiada y los injertos en bloque. Dentro de estos últimos, cabe destacar la técnica de Khoury. Se trata de un procedimiento indicado para regenerar defectos horizontales y verticales, mediante la obtención de finas láminas de hueso autógeno procedentes de la línea oblicua externa mandibular. Se presenta un caso clínico de un gran defecto mandibular reconstruido con la técnica de Khoury, secundario a un fracaso implantológico que además ocasionó patología nerviosa


Dental implants constitute a predictable alternative for the rehabilitation of edentulous jaws. However, the success of the treatment can be limited when severe atrophic alveolar ridges are present. For the treatment of these complex cases, several regeneration techniques have been developed, such as guided bone regeneration and block grafts. Within the last, it should be noted the Khoury technique. It is a procedure indicated for the regeneration of horizontal and vertical defects, through the obtention of autologous graft in form of thin plates, derived from mandibular external oblique line.A clinical case is presented, that consists in a great mandibular defect which was reconstructed by the Khoury technique. The defect was secondary to an implant failure, which was also related with nervous pathology


Asunto(s)
Humanos , Masculino , Anciano , Regeneración Ósea , Atrofia/cirugía , Hipoestesia/cirugía , Fracaso de la Restauración Dental , Maxilar/cirugía , Elevación del Piso del Seno Maxilar/métodos , Procedimientos Quirúrgicos Reconstructivos/métodos , Implantes Dentales , Resorción Ósea/patología , Boca Edéntula/cirugía
8.
J Biol Regul Homeost Agents ; 34(1 Suppl. 2): 13-17, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32270663

RESUMEN

Oral rehabilitation by means dental implants has high standards of success. Recently, a new type of two-pieces spiral implants has been introduced in the market. Since few reports focus of the efficacy of this medical device as a reliable tool for oral rehabilitation, here a retrospective study is reported. In the period June-December 2017 one hundred and two spiral fixtures were inserted, half in females and 51 in males. The median age was 56 ± 8 (min-max 36-73 years). Forty-eight implants were inserted in upper jawbone and 54 in mandible. Two implants were lost and thus survival rate (SVR) is 99.9%. Then peri-implant bone resorption was used to investigate the clinical success (success rate, SCR) over time. No implants have a crestal bone resorption greater than 1.5 mm in the first year follow up. No studied variable has an effect on clinical outcome. In conclusion the studied implants have high SCR and SVR so that they are good tools for oral rehabilitation.


Asunto(s)
Pérdida de Hueso Alveolar , Implantes Dentales , Mandíbula/cirugía , Maxilar/cirugía , Adulto , Anciano , Femenino , Humanos , Masculino , Persona de Mediana Edad , Estudios Retrospectivos , Resultado del Tratamiento
9.
J Biol Regul Homeost Agents ; 34(1 Suppl. 2): 25-29, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32270665

RESUMEN

It is generally accepted that maxilla has a less bone quality than mandible and this fact makes implant rehabilitation more complex. Recently a new type of spiral implants has been introduced in the global market. Since few reports are available a retrospective study was performed. A total of 48 two-piece spiral implants were inserted, 21in female and 27 in males. The median age was 58 ± 8. Implants replaced 10 incisors, 9 cuspids, 25 premolars and 4 molars. Implant' length was 10 mm, 11.5 mm and 13 mm in 13, 24, and 11 cases, respectively. Implant diameter was 3.3 mm, 3.75 mm and 4.2 mm in 25, 17 and 6 cases, respectively. One implant was lost, survival rate (SVR) = 97.91%. Then peri-implant bone resorption was used to investigate success rate (SCR). The mean bone resorption was 0.3 mm after an average period of 1 year follow up. In conclusion the implants studied are reliable devices for oral rehabilitation with a very high SCR and SVR.


Asunto(s)
Pérdida de Hueso Alveolar , Implantes Dentales , Maxilar/cirugía , Anciano , Femenino , Humanos , Masculino , Persona de Mediana Edad , Estudios Retrospectivos , Resultado del Tratamiento
10.
Expert Rev Med Devices ; 17(4): 345-356, 2020 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-32105159

RESUMEN

Introduction: Various prefabricated maxillofacial implants are used in the clinical routine for the surgical treatment of patients. In addition to these prefabricated implants, customized CAD/CAM implants become increasingly important for a more precise replacement of damaged anatomical structures. This paper reviews the design and manufacturing of patient-specific implants for the maxillofacial area.Areas covered: The contribution of this publication is to give a state-of-the-art overview in the usage of customized facial implants. Moreover, it provides future perspectives, including 3D printing technologies, for the manufacturing of patient-individual facial implants that are based on patient's data acquisitions, like Computed Tomography (CT) or Magnetic Resonance Imaging (MRI).Expert opinion: The main target of this review is to present various designing software and 3D manufacturing technologies that have been applied to fabricate facial implants. In doing so, different CAD designing software's are discussed, which are based on various methods and have been implemented and evaluated by researchers. Finally, recent 3D printing technologies that have been applied to manufacture patient-individual implants will be introduced and discussed.


Asunto(s)
Diseño Asistido por Computadora , Cara/cirugía , Maxilar/cirugía , Prótesis e Implantes , Diseño de Prótesis , Humanos , Impresión Tridimensional
11.
Niger J Clin Pract ; 23(2): 240-245, 2020 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-32031100

RESUMEN

Aims: Le Fort I (LI) osteotomy has been used for the correction of dento-facial deformities of the midface. The aim of this study was to determine the effects of advancement and impaction of the maxilla with LI osteotomy on the nasal cavity and septum. Patients and Methods: In this study, 40 adult patients, 23 females and 17 males (mean age 20.52 ± 4.4 years), who underwent single-piece LI advancement and impaction surgery combined with a bilateral sagittal split osteotomy (BSSO) were included. Posterior-anterior (PA) and lateral cephalometric radiographs taken before surgery (T0) and at least three months after surgery (T1) were evaluated. The superior and anterior movements of maxilla, changes of the nasal cavity, nasal septum and maxillo-mandibular parameter were measured on the cephalometric radiographs. Treatment changes were statistically analyzed using paired sample t-test, and Pearson correlation analysis was applied for the determination of the relationship between variables. Results: There was no statistically significant change in the deviation parameters (P > 0,05). However, a statistically significant decrease was found for left and right nasal cavity heights after LI osteotomy (P < 0.05). Furthermore, no significant correlation was found between septal deviation angle and extent of maxillary movement (P > 0.05). Positive correlation was found between nasal cavity width and amount of maxillary impaction. (P < 0.05). Conclusion: The influence of maxillary impaction with LI osteotomy on nasal septum deviation was not found significant but maxillary impaction with LI osteotomy significantly increased the nasal cavity width.


Asunto(s)
Mandíbula/cirugía , Maxilar/cirugía , Tabique Nasal/diagnóstico por imagen , Deformidades Adquiridas Nasales/etiología , Cirugía Ortognática/métodos , Osteotomía Le Fort/métodos , Complicaciones Posoperatorias , Adolescente , Femenino , Humanos , Masculino , Cavidad Nasal , Tabique Nasal/cirugía , Osteotomía Le Fort/efectos adversos , Estudios Retrospectivos , Tomografía Computarizada por Rayos X , Resultado del Tratamiento , Adulto Joven
12.
Int J Periodontics Restorative Dent ; 40(4): 539­547, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32045469

RESUMEN

Immediate tooth replacement therapy (ITRT) in the maxillary anterior sextant is an increasingly frequent treatment option sought by patients and performed by clinicians worldwide. Achieving long-term results that are predictable, stable, esthetic, and healthy is the ultimate goal. This trend also lends itself to minimally invasive surgery as well as defining the procedure to a singular surgical intervention. Preserving and augmenting hard and soft tissues at the time of immediate implant placement provides the best opportunity to achieve these goals. Incorporating an implant with a subcrestal angle correction [SAC] or biaxial feature facilitates screw-retention of both provisional and definitive restorations through the cingulum portion of the crown. Compared to uniaxial implants, these implants also feature an extended or variable platform switch [VPS] facially. Measurements of the peri-implant soft tissue thickness 2.0 mm apical to the facial free gingival margin were compared between two groups of 15 consecutively treated patients with different implant designs to evaluate the effect of SAC/VPS for ITRT. The null hypothesis was that there is no difference between uniaxial and biaxial implants with bone grafting and dermis allograft. These authors contend that using a combined hard and soft tissue grafting approach along with SAC/VPS biaxial implants has a synergistic effect on increasing peri-implant soft tissue thickness compared to uniaxial implants.


Asunto(s)
Implantes Dentales de Diente Único , Implantes Dentales , Aloinjertos , Trasplante Óseo , Implantación Dental Endoósea , Dermis , Humanos , Maxilar/cirugía , Estudios Retrospectivos , Resultado del Tratamiento
13.
Comput Methods Biomech Biomed Engin ; 23(7): 295-302, 2020 May.
Artículo en Inglés | MEDLINE | ID: mdl-31985276

RESUMEN

The objective of this study was to assess the biomechanical effects of different corticotomy designs used for orthodontic anterior retraction through finite element analysis. MATERIALS AND METHODS: A basic finite element model simulating retraction of anterior teeth was built reversely from CBCT films of an adult patient with protruded maxillary anterior teeth. Another thirteen FE models were created according to different corticotomy designs varied with site width and the extent of incision. The initial displacement, Von Mises stress and pressure stress of dento-alveolar structures was computerized and analyzed. RESULTS: Corticotomy can increase the initial displacement of anterior segment including teeth and surrounding alveolar bone, change the distribution of Von Mises stress in cancellous bone and the pressure stress in periodontal ligament of anterior teeth. When the incision was near the periphery of apical, the anterior segment showed the greatest displacement, the cancellous bone at either sockets or incision region showed the maximum stress. Bilateral incision combined with palatal incision showed approximate initial displacement and stress distribution with circumscribing incision. While the incision width increased, the biomechanical effects of corticotomy amplified. CONCLUSIONS: Varied corticotomy designs can change the biomechanical effects on dento-alveolar structures. The incision near the periphery of apical and bilateral incision combined with palatal incision may be the optimized design used for retraction of anterior teeth.


Asunto(s)
Análisis de Elementos Finitos , Técnicas de Movimiento Dental/métodos , Adulto , Fenómenos Biomecánicos , Humanos , Maxilar/cirugía , Ligamento Periodontal/cirugía , Estrés Mecánico , Diente/cirugía
14.
J Craniofac Surg ; 31(1): 130-133, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-31652212

RESUMEN

Authors tried to investigate the maxillomandibular morphology of Korean nationality with computerized tomography images and establish a series of cephalometric values which should be considered in orthognathic plastic surgery in Korea.The computerized tomography images of 200 patients were retrospectively reviewed with the computer workstation in Sanggye Paik Hospital, Inje University College of Medicine from 2016 to 2017.The mean distance between nasion to point A (NA) line and the maxillary central incisor was 5.07 cm. The mean distance from nasion to point B (NB) line to the mandibular central incisor was 7.11 cm. The mean angle between NA line and the long axis of the maxillary central incisor was 20.58 degree. The mean angle between NB line and the long axis of the mandibular central incisor was 26.47 degree. The mean angle between SN (sella to nasion) line and NA line was 83.18 degree. The mean angle between SN line and NB line was 78.83 degree. The mean angle between NA line and NB line was 4.35 degree. There were no any statistically significant differences between age groups. But there were statistically significant difference in the mean of angle between NB line and the long axis of the mandibular central incisor (P = 0.025, between sex groups) and in the mean of angle between NA line and the long axis of the maxillary central incisor between sex groups in the 51 to 60 age group (P = 0.045).The maxillomandibular profile of Korean adults was established which can be applied for orthognathic surgery of Korean patients.


Asunto(s)
Incisivo/diagnóstico por imagen , Maxilar/diagnóstico por imagen , Adulto , Anciano , Anciano de 80 o más Años , Cefalometría , Femenino , Humanos , Masculino , Maxilar/cirugía , Persona de Mediana Edad , Procedimientos Quirúrgicos Ortognáticos , Estudios Retrospectivos , Tomografía Computarizada por Rayos X , Adulto Joven
15.
Eur J Orthod ; 42(1): 24-29, 2020 Jan 27.
Artículo en Inglés | MEDLINE | ID: mdl-31586198

RESUMEN

OBJECTIVES: To assess differences in craniofacial growth at 8 years of age according to the different protocols for primary cleft surgery in the Scandcleft project. DESIGN AND SETTING: Prospective, randomized, controlled clinical trial (RCT) involving 10 centres, including non-syndromic Caucasians with unilateral cleft lip and palate (UCLP). In Trial 1, a common surgical method (1a) with soft palate closure at 3-4 months of age and hard palate closure at 12 months of age was tested against similar surgery but with hard palate repair at 36 months (delayed hard palate closure) (1b). In Trial 2, the common method (2a) was tested against simultaneous closure of both hard and soft palate at 1 year (2c). In Trial 3, the common method (3a) was tested against hard palate closure together with lip closure at 3 months of age and soft palate closure at 1 year of age (3d). Participants were randomly allocated by use of a dice. Operator blinding was not possible but all raters of all outcomes were blinded. SUBJECTS AND METHODS: The total number of participating patients at 8 years of age was 429. Lateral cephalograms (n = 408) were analysed. The cephalometric angles SNA and ANB were chosen for assessing maxillary growth for this part of the presentation. RESULTS: Within each trial (Trial 1a/1b, Trial 2a/2c, and Trial 3a/3d), there was no difference in cephalometric values between the common and the local arm. There were no statistically significant differences in the SNA and ANB angles between the common arm in Trial 1a (mean SNA 77.8, mean ANB 2.6) and Trial 2a (mean SNA 79.8, mean ANB 3.6) and no difference between Trial 1a and Trial 3a, but a statistical difference could be seen between Trial 2a and Trial 3a (mean SNA 76.9, mean ANB 1.7). However, the confidence interval was rather large. Intra- and inter-rater reliability were within acceptable range. CONCLUSIONS: The timing and the surgical method is not of major importance as far as growth outcomes (SNA and ANB) in UCLP are concerned. REGISTRATION: ISRCTN29932826. PROTOCOL: The protocol was not published before trial commencement.


Asunto(s)
Labio Leporino , Fisura del Paladar , Maxilar , Desarrollo Maxilofacial , Niño , Labio Leporino/cirugía , Fisura del Paladar/cirugía , Estudios de Seguimiento , Humanos , Maxilar/crecimiento & desarrollo , Maxilar/cirugía , Estudios Prospectivos , Ensayos Clínicos Controlados Aleatorios como Asunto , Reproducibilidad de los Resultados , Factores de Tiempo
16.
Int J Oral Maxillofac Implants ; 35(1): 79­90, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-31532823

RESUMEN

PURPOSE: The aim of this study was to compare tissue-engineered bone using mesenchymal stem cells (MSCs) and conventional bone grafts in terms of histomorphometric outcome, bone gained, and implant failure in the atrophic maxilla. MATERIALS AND METHODS: A systematic review and meta-analysis of randomized clinical trials (RCTs) was conducted. An electronic search of several databases was performed. RCTs comparing tissue-engineered bone using MSCs to bone graft alone in rehabilitation of the atrophic maxilla were included. Outcome variables were a mean percentage of new bone formation, residual graft particles, and connective tissue. Bone gained and implant failure rate were also assessed. Risk ratio (RR) or standardized mean differences (SMD) were statistically analyzed. RESULTS: A total of 190 augmented sites enrolled in 12 RCTs were included in this study. Nine of the 12 RCTs included 153 maxillary sinuses that underwent sinus elevation, and three RCTs included 28 patients with bone grafting only. There was no significant increase in new bone formation between the two groups at 3 to 4 months (SMD = -0.232, CI, -0.659 to 0.195, low-quality evidence). However, at 6 months postgrafting, a statistically significant increase in new bone formation was found in favor of the tissue-engineered bone using the MSC group (SMD = 0.869%, CI, -1.98 to 9.310, moderate-quality evidence). No substantial difference was found between the two groups with respect to residual graft particles, connective tissue, bone gained, and implant failure rate (RR = 2.8, CI: 0.517 to 16.6, P = .226, very low-quality evidence). CONCLUSION: There is moderate- to very low-quality evidence supporting the use of tissue-engineered bone using MSC therapy in maxillary alveolar bone regeneration compared with conventional bone grafting without MSCs.


Asunto(s)
Aumento de la Cresta Alveolar , Trasplante Óseo , Implantación Dental Endoósea , Células Madre Mesenquimatosas , Humanos , Maxilar/cirugía , Seno Maxilar
18.
J Craniomaxillofac Surg ; 47(12): 1868-1874, 2019 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-31812310

RESUMEN

BACKGROUND: Maxillary advancement may affect speech in cleft patients. AIMS: To evaluate whether the amount of maxillary advancement in Le Fort I osteotomy affects velopharyngeal function (VPF) in cleft patients. METHODS: Ninety-three non-syndromic cleft patients (51 females, 42 males) were evaluated retrospectively. All patients had undergone a Le Fort I or bimaxillary (n = 24) osteotomy at Helsinki Cleft Palate and Craniofacial Center. Preoperative and postoperative lateral cephalometric radiographs were digitized to measure the amount of maxillary advancement. Pre- and postoperative speech was assessed perceptually and instrumentally by experienced speech therapists. Student's t-test and Mann-Whitney's U-test were used in the statistical analyses. Kappa statistics were calculated to assess reliability. RESULTS: The mean advancement of A point was 4.0 mm horizontally (range: -2.8-11.3) and 3.9 mm vertically (range -14.2-3.9). Although there was a negative change in VPF, the amount of maxillary horizontal or vertical movement did not significantly influence the VPF. There was no difference between the patients with maxillary and bimaxillary osteotomy. CONCLUSIONS: The amount of maxillary advancement does not affect the velopharyngeal function in cleft patients.


Asunto(s)
Labio Leporino/cirugía , Fisura del Paladar/cirugía , Osteotomía Maxilar/métodos , Procedimientos Quirúrgicos Ortognáticos/métodos , Osteotomía Le Fort/métodos , Habla/fisiología , Insuficiencia Velofaríngea/fisiopatología , Adolescente , Adulto , Cefalometría/métodos , Labio Leporino/fisiopatología , Fisura del Paladar/fisiopatología , Femenino , Finlandia , Humanos , Masculino , Avance Mandibular/métodos , Maxilar/anomalías , Maxilar/cirugía , Persona de Mediana Edad , Reproducibilidad de los Resultados , Estudios Retrospectivos , Trastornos del Habla/fisiopatología , Trastornos del Habla/cirugía , Resultado del Tratamiento , Insuficiencia Velofaríngea/cirugía , Adulto Joven
19.
J Craniomaxillofac Surg ; 47(12): 1881-1886, 2019 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-31812313

RESUMEN

In synchronous primary premaxillary setback and cleft lip repair for bilateral cases with severely protruding premaxilla, stabilization of the premaxilla is mostly achieved by gingivoperiosteoplasty. This kind of repair carries risk of impairment of blood supply to the premaxilla and/or prolabium, and at the same time it cannot ensure adequate stabilization of the premaxilla postoperatively. To overcome these problems, we have developed a unique technique of fixation of the premaxilla. In this paper, we discussing this technique, its advantages, and potential complications associated with it. From 2016, 10 patients aged 4-10 months, with bilateral cleft lip and palate with premaxillary protrusion (≥10 mm) underwent premaxillary setback and cheilorhinoplasty in the same stage. Instead of gingivoperiosteoplasty, a 'lag screw' fixation technique was used to stabilize the premaxilla. The follow-up period ranged between 5 and 32 months. In all the cases, we achieved adequate stabilization of the premaxilla. None of the patients had any issue related to the vascularity of the premaxilla or prolabium. There was no impairment in the eruption process of deciduous teeth in the premaxillary segment. Overall aesthetic outcomes of the lip and nose were acceptable. This technique of premaxillary fixation with lag screw gives us the liberty to perform primary cheilorhinoplasty along with premaxillary setback in the same stage, without risking the vascularity of premaxilla and prolabium. It ensures adequate stabilization of the premaxilla, but evaluation of regular growth of the midface and, if needed, corrective orthodontic and surgical treatment in the follow-up periods are advisable.


Asunto(s)
Tornillos Óseos , Labio Leporino/cirugía , Fisura del Paladar/cirugía , Maxilar/anomalías , Maxilar/cirugía , Osteotomía Maxilar/métodos , Vómer/cirugía , Estética Dental , Femenino , Humanos , Lactante , Masculino , Procedimientos Ortopédicos/métodos , Resultado del Tratamiento
20.
J Mater Sci Mater Med ; 30(11): 125, 2019 Nov 14.
Artículo en Inglés | MEDLINE | ID: mdl-31728639

RESUMEN

OBJECTIVE: To evaluate the clinical outcomes of reconstruction of maxillary class III defect using 3D-printed titanium mesh. METHODS: Twelve patients with maxillary class III defect from April 2015 to December 2016 were retrospectively studied. A 3D individualized maxillary stereo model based on mirror images of the unaffected maxilla was obtained to fabricate an anatomically adapted titanium mesh using computer-assisted design and manufacture. The individual titanium mesh was inserted into the maxillary class III defect after total maxillectomy. The incidence of postoperative complications was evaluated. The postoperative orbital volume and protrusion degree of eye were measured. RESULTS: All patients were satisfied with their postoperative facial symmetry, without developing diplopia or endophthalmos. The postoperative orbital volumes were 26.41 ± 0.52 mL on the affected side and 26.55 ± 0.45 mL on the unaffected side. The postoperative protrusion degrees of affected and unaffected eyes were 16.21 ± 0.48 and 16.82 ± 0.79 mm, respectively. Titanium mesh exposure was observed in 2 patients and mild limitation of mouth opening was observed in 4 patients who underwent postoperative radiotherapy. CONCLUSION: Reconstruction of maxillary class III defect with 3D-printed titanium mesh can achieve successful clinical outcomes, which recovered orbital volume and protrusion degree of eye. Twelve patients with maxillary class III defect were satisfied with their postoperative facial symmetry, without developing diplopia or endophthalmos. We investigated that reconstruction of maxillary class III defect with 3D-printed titanium mesh can achieve successful clinical outcomes.


Asunto(s)
Materiales Biocompatibles , Neoplasias Óseas/cirugía , Maxilar/cirugía , Impresión Tridimensional , Andamios del Tejido , Titanio , Humanos , Masculino , Ensayo de Materiales , Osteosarcoma/cirugía , Adulto Joven
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