Periodontal evaluation of palatally impacted maxillary canines treated by closed approach with ultrasonic surgery and orthodontic treatment: a retrospective pilot study.

Aim of this study is the evaluation of the periodontal status of impacted canines treated by closed approach with ultrasonic surgery and orthodontic treatment compared with contralateral spontaneously erupted teeth. The periodontal conditions of the teeth adjacent to the canines (lateral incisors and first premolar) were also considered. 17 patients (9 females and 8 males; mean age: 15.2 years) with unilateral palatal impaction of maxillary canine were selected. All patients were treated by closed-flap surgery with ultrasonic instruments. Periodontal status was evaluated by assessing probing depth (PD), gingival recession and width of keratinized tissue (KT) 4.6 months after the end of the orthodontic treatment, on average. Test group was composed by impacted elements and adjacent teeth and control group by contralateral spontaneously erupted canines and adjacent teeth. Student's t-test was used to compare test and control group values of PD and width of KT. Significance threshold for Student's t-test was set at p < 0.05. The average probing depth values show no significant clinical differences between the test and control groups. Probing depths recorded at the mesiovestibular and distopalatal sides of the impacted canine were statistically significant compared to the control elements (p < 0.05). No gingival recession was detected on the treated canines. The measurement of KT did not differ significantly between the test and the control groups. In conclusion, the ultrasonic surgery for disinclusion associated with a closed approach and orthodontic traction allows the alignment of an impacted palatal canine without damaging the periodontium.

Treatment of an upper impacted cuspid using ultrasonic surgery and a modified RPE. A case report.

This case report describes the possibility to use a modified rapid palatal expander like anchorage to reposition an included maxillary cuspid. Moreover it is enphasized the use of an ultrasonic device during surgery to expose the impacted tooth.

The use of piezosurgery to mobilize the mandibular alveolar nerve followed immediately by implant insertion: a case series evaluating neurosensory disturbance.

One of the therapeutic options proposed for reconstruction of the atrophic posterior mandible is inferior alveolar nerve (IAN) mobilization with simultaneous implant placement. However, studies on the functionality of this neurovascular bundle after its mobilization have shown mixed results. This variability can be attributed both to the test methodology, which typically requires subjective answers from patients, and to the surgical procedure itself, which is highly dependent on operator technique. This article reports on a series of 10 cases of IAN mobilization using a device specifically engineered to simplify bone surgery. This device enables the oral surgeon to avoid overstretching the nerve by creating a smaller bone window and using an apicocoronal inclination of instruments to capture the neurovascular bundle. Evaluation by means of neurosurgery function tests over a 36-month period found that all patients had a return to normal sensation after a brief period of neurosensory disturbance. Subjective responses to a patient questionnaire confirmed these findings. The implant success rate was 100%.

Mobilization of the inferior alveolar nerve with simultaneous implant insertion: a new technique. Case report.

For reconstruction of an atrophied posterior mandible, different therapeutic options have been proposed, such as autologous bone grafting, guided bone regeneration for vertical ridge augmentation, and inferior alveolar nerve (IAN) mobilization with simultaneous implant placement. The possible dehiscence of soft tissues covering the surgical zone makes the first and second techniques unpredictable. Moreover, two surgical sites are necessary and a long treatment time is required (about 12 months). With IAN mobilization, only one surgical intervention is required and the total treatment time is shorter (about 6 months). However, this technique risks irreversible damage to the IAN, with consequent functional alterations. Current studies have shown extreme variability in the examination of functionality of the neurovascular bundle after its mobilization. This variability can be attributed both to the methodology used for the tests, which evoke subjective answers from the patient, and to the surgical procedure, which is highly dependent on operator technique. Nerve damage can be the result of an overstretched mucoperiosteal flap in the premolar area to achieve optimal visibility of the surgical zone. This article reports a case in which a new surgical approach to IAN mobilization is performed using a specifically engineered device for simplified bone surgery (Mectron Piezosurgery). This device enables the surgeon to cut hard tissue without injuring the soft tissues. Therefore, there is a lower risk of damaging the IAN, and it is possible to reduce overstretching of the mental nerve by creating a smaller bone window and using an apicocoronal inclination of instruments to capture the neurovascular bundle.

Maxillary sinus augmentation using prehardened calcium sulfate: a case report.

Prehardened medical-grade calcium sulfate hemihydrate was placed as a grafting material for sinus floor elevation in the left posterior maxilla. After 8 months of healing, three titanium plasma-sprayed screw implants (Biolock) were placed. At the same time, a bone biopsy was harvested for histologic evaluation. The specimen was processed according to standard techniques for hard tissue histology. In both the grafted area and the previously existing area of sinus floor, the histology showed complete calcium sulfate resorption and the bone was primarily of lamellar structure. In the 5-month radiograph, a new trabecular design appeared from the periphery of the grafted area, and on the 8-month radiograph, the graft material was no longer detectable and the augmented area was filled by new tissue showing a trabecular design. This case report documented that medical-grade calcium sulfate hemihydrate, when used as a grafting material for augmentation of the sinus floor, may lead to proper osseointegration of dental implants.