Transcrestal sinus lift and implant placementusing the sinus balloon technique

Objective: A description is made of transcrestal sinus lift using the sinus balloon technique, evaluating the bone height achieved and implant success one year after prosthetic loading. Material and method: Between January and July 2007, transcrestal sinus lift using the sinus balloon technique for dental implant placement was carried out in 6 patients. A panoramic X-ray study and maxillary computed tomography scan were carried out before the operation, in order to discard possible sinus pathology. During the intervention, the integrity of the sinus membrane was evaluated using a Medi Pack Pal endoscope (Farol Store and Co., Tuttlingen, Germany), and the intraoperative complications were analyzed. The dental implants were placed in the same surgical step in the presence of 3 mm or more of residual bone. Following the operation, panoramic X-rays were used to assess the bone height gained. One year after prosthetic loading, the implant success rate was determined based on the criteria of Buser. Results: One patient was excluded due to Schneider’s membrane perforation as confirmed by endoscopy. Transcrestalsinus lift was carried out in 5 males with a mean age of 41.6 years (range 27-51), without antecedents of sinus disease. There were no intraoperative complications. In four patients the implants were placed simultaneous to sinus lift, while in another case implant placement was postponed due to insufficient remaining bone height. The mean gain in height after the operation was 8.7 mm. One year after prosthetic loading, the implant success rate was 100% (AU)

Transcrestal sinus lift and implant placement using the sinus balloon technique.

OBJECTIVE: A description is made of transcrestal sinus lift using the sinus balloon technique, evaluating the bone height achieved and implant success one year after prosthetic loading. MATERIAL AND METHOD: Between January and July 2007, transcrestal sinus lift using the sinus balloon technique for dental implant placement was carried out in 6 patients. A panoramic X-ray study and maxillary computed tomography scan were carried out before the operation, in order to discard possible sinus pathology. During the intervention, the integrity of the sinus membrane was evaluated using a Medi Pack Pal endoscope (Farol Store and Co., Tuttlingen, Germany), and the intraoperative complications were analyzed. The dental implants were placed in the same surgical step in the presence of 3 mm or more of residual bone. Following the operation, panoramic X-rays were used to assess the bone height gained. One year after prosthetic loading, the implant success rate was determined based on the criteria of Buser. RESULTS: One patient was excluded due to Schneider's membrane perforation as confirmed by endoscopy. Transcrestal sinus lift was carried out in 5 males with a mean age of 41.6 years (range 27-51), without antecedents of sinus disease. There were no intraoperative complications. In four patients the implants were placed simultaneous to sinus lift, while in another case implant placement was postponed due to insufficient remaining bone height. The mean gain in height after the operation was 8.7 mm. One year after prosthetic loading, the implant success rate was 100%. CONCLUSIONS: Transcrestal sinus lift using the sinus balloon technique is a minimally invasive procedure. In 5 patients the bone height gained proved sufficient to allow implant placement even in the presence of 3 mm of residual bone.

Radiographic findings in the maxillary sinus: comparison of panoramic radiography with computed tomography.

PURPOSE: To assess the prevalence of radiographic signs of maxillary sinus pathology in patients undergoing dental implant treatment and to compare the efficacy of panoramic radiography, computed tomography (CT), and three-dimensional (3D) CT with Implametric software in the diagnosis of sinus pathology. MATERIALS AND METHODS: Thirty patients were selected at random from those being treatment-planned to receive implant-supported restorations in the maxilla and who had a panoramic radiograph, a conventional CT scan in acetate, and a 3D CT scan in digital format. The radiographic maxillary sinus findings were categorized as: (1) no sign of pathology, (2) mucosal thickening, (3) mucous cyst, or (4) occupation of the entire sinus. RESULTS: Seventeen women and 13 men were included, with a mean age of 50.9 years. There was a 38.3% prevalence of radiographic abnormalities (23.3% mucosal thickenings, 10% mucous cysts, and 5% occupation of the entire sinus). Of the 23 sinuses that displayed radiographic signs of pathology, only 1 (4.3%) was correctly diagnosed by the panoramic radiograph. CONCLUSIONS: The most common radiographic maxillary sinus finding was mucosal thickening, followed by mucous cysts and occupation of the whole sinus. Conventional CT can be considered a reliable method for the diagnosis of maxillary sinus pathology.

Pediatric oral ranula: Clinical follow-up study of 57 cases

Objective: To present 57 cases of oral ranula in children, analyzing the clinical characteristics, treatment andoutcome of these lesions.Methods: The clinical histories of patients diagnosed with oral ranula, seen between 1998 and 2008 at the Oral andMaxillofacial Surgery Unit of a reference Children’s Hospital (0-14 years) were reviewed. All patients with clinicaldiagnosis of oral ranula were included.Results: Fifty-seven patients, 21 boys and 36 girls, with a mean age of 5.1 years were included in the study. Thirtytwocases were located on the left side of the floor of the mouth. The lesion diameter varied between 1 and 3 cm in27 cases, 22 were less than 1 cm, and 8 were larger than 3 cm. Fifty-four cases were asymptomatic and 3 ranulashad pain on swallowing. Twenty-two cases were resolved by opening with a tract dilator and 35 by marsupialization.Seven cases recurred at a mean of 12 months after treatment, three of these from the marsupialization group.Conclusion: The majority of the oral ranulas occurred in females, asymptomatic, on the left side of the floor of themouth, with a mean size of 1 to 3 cm; all lesions were treated by surgery, of which 7 recurred (AU)

Pediatric oral ranula: clinical follow-up study of 57 cases.

OBJECTIVE: To present 57 cases of oral ranula in children, analyzing the clinical characteristics, treatment and outcome of these lesions. METHODS: The clinical histories of patients diagnosed with oral ranula, seen between 1998 and 2008 at the Oral and Maxillofacial Surgery Unit of a reference Children 's Hospital (0-14 years) were reviewed. All patients with clinical diagnosis of oral ranula were included. RESULTS: Fifty-seven patients, 21 boys and 36 girls, with a mean age of 5.1 years were included in the study. Thirty-two cases were located on the left side of the floor of the mouth. The lesion diameter varied between 1 and 3 cm in 27 cases, 22 were less than 1 cm, and 8 were larger than 3 cm. Fifty-four cases were asymptomatic and 3 ranulas had pain on swallowing. Twenty-two cases were resolved by opening with a tract dilator and 35 by marsupialization. Seven cases recurred at a mean of 12 months after treatment, three of these from the marsupialization group. CONCLUSION: The majority of the oral ranulas occurred in females, asymptomatic, on the left side of the floor of the mouth, with a mean size of 1 to 3 cm; all lesions were treated by surgery, of which 7 recurred.

Prevalence, location, and size of maxillary sinus septa: panoramic radiograph versus computed tomography scan.

PURPOSE: To determine the prevalence, location, and size of maxillary sinus septa, and to compare the results of panoramic radiographs and computed tomography (CT) scans. MATERIALS AND METHODS: This study included 30 patients, 17 women and 13 men, with a mean age of 50.9 years (range, 28-73 years), undergoing treatment planning for implant-supported restorations in the maxilla. Three observers analyzed the panoramic radiographs, the conventional CT scans in acetate, and the Implametric 3-dimensional CT (3Dent, Valencia, Spain). The maxillary sinus septa of each patient and the type of septa, as well as its location and size, were recorded. RESULTS: In 60 maxillary sinuses, panoramic radiographs showed 32 septa (53.3%); CT in acetate showed 42 septa (70%); and Implametric 3-dimensional CT showed 40 septa (66.7%). Most septa (60%) were located in the middle region of the maxillary sinus, 22.5% in the posterior region, and 17.5% in the anterior region. The mean height of the septa was 4.78 ± 1.76 mm. Panoramic radiographs led to an erroneous diagnosis in 46.5% of the cases. CONCLUSIONS: Maxillary sinus septa are a frequent anatomic variation. They can be found in any of the maxillary sinus regions independently of patient edentulism. The panoramic radiograph can lead to false-positive and false-negative findings in the visualization of septa in almost half of cases. Therefore, whenever a maxillary sinus lift is planned, a thorough study of the affected sinus should be made using CT.

Clinical characteristics, treatment and outcome of 28 oral haemangiomas in pediatric patients

Objective: To present a large series of oral haemangiomas in children, analyzing the clinical characteristics, treatmentand outcome of oral haemangiomas in 28 children.Material and Methods: We conducted an observational retrospective study, reviewing medical records with clinicaldiagnosis of haemangioma between 1990 and 2006 at the Children’s Maxillofacial Surgery Service of the Hospital Universitario la Fe, Valencia. All patients with a clinical, radiographic, pathologically confirmed diagnosis of oral haemangioma were included.Results: The study included 28 patients (19 females and 9 males) with a mean age of 4.27 years (range 0-14 years).Nine were congenital haemangioma. The most frequent location of oral haemangioma was in the lip with 23 cases,followed by three cases in the tongue and 2 in the buccal mucosa. The mean diameter of the lesion was 1.67 cm(range 1-3cm). The mean duration of the lesion was 6.3 months (range 1 month to 5 years). Of the 28 haemangiomas,13 were surgically removed, 2 were treated with embolization and 13 disappeared spontaneously. The meanfollow up was 2.7 months (1-8 months). There were no cases of recurrence.Conclusions: Haemangiomas usually present in children, and can be seen from birth. They have a predilectionfor females. They are uncommon in the oral cavity. In the oral region, the most common location is the lip. Mostcongenital haemangioma regress spontaneously without treatment. The treatment of choice is surgical excisionof the lesion (AU)

Clinical characteristics, treatment and outcome of 28 oral haemangiomas in pediatric patients.

OBJECTIVE: To present a large series of oral haemangiomas in children, analyzing the clinical characteristics, treatment and outcome of oral haemangiomas in 28 children. MATERIAL AND METHODS: We conducted an observational retrospective study, reviewing medical records with clinical diagnosis of haemangioma between 1990 and 2006 at the Children's Maxillofacial Surgery Service of the Hospital Universitario la Fe, Valencia. All patients with a clinical, radiographic, pathologically confirmed diagnosis of oral haemangioma were included. RESULTS: The study included 28 patients (19 females and 9 males) with a mean age of 4.27 years (range 0-14 years). Nine were congenital haemangioma. The most frequent location of oral haemangioma was in the lip with 23 cases, followed by three cases in the tongue and 2 in the buccal mucosa. The mean diameter of the lesion was 1.67 cm (range 1-3 cm). The mean duration of the lesion was 6.3 months (range 1 month to 5 years). Of the 28 haemangiomas, 13 were surgically removed, 2 were treated with embolization and 13 disappeared spontaneously. The mean follow up was 2.7 months (1-8 months). There were no cases of recurrence. CONCLUSIONS: Haemangiomas usually present in children, and can be seen from birth. They have a predilection for females. They are uncommon in the oral cavity. In the oral region, the most common location is the lip. Most congenital haemangioma regress spontaneously without treatment. The treatment of choice is surgical excision of the lesion.

Maxillary sinus septa: A systematic review

This review analyzes articles published on the presence of septa in maxillary sinuses. An automated search wasconducted on PubMed using different key words. This search resulted in 11 papers in which the presence of antralsepta was assessed. These septa are barriers of cortical bone that arise from the floor or from the walls of the sinusand may even divide the sinus into two or more cavities. They may originate during maxillary development andtooth growth, in which case they are known as primary septa; or they may be acquired structures resulting fromthe pneumatization of maxillary sinus after tooth loss, in which case they are called secondary septa. Several methodshave been used in their study, direct observation on dried skulls or during sinus lift procedures; and radiographicobservation using panoramic radiographs or computed tomographs. Between 13 and 35.3% of maxillarysinuses have septa. They can be located in any region of the maxillary sinus and their size can vary between 2.5and 12.7 mm in mean length. Some authors have reported a higher prevalence of septa in atrophic edentulous areasthan in non-atrophic ones. If a sinus lift is conducted in the presence of maxillary sinus septa, it may be necessaryto modify the design of the lateral window in order to avoid fracturing the septa (AU)

Maxillary sinus septa: a systematic review.

This review analyzes articles published on the presence of septa in maxillary sinuses. An automated search was conducted on PubMed using different key words. This search resulted in 11 papers in which the presence of antral septa was assessed. These septa are barriers of cortical bone that arise from the floor or from the walls of the sinus and may even divide the sinus into two or more cavities. They may originate during maxillary development and tooth growth, in which case they are known as primary septa; or they may be acquired structures resulting from the pneumatization of maxillary sinus after tooth loss, in which case they are called secondary septa. Several methods have been used in their study, direct observation on dried skulls or during sinus lift procedures; and radiographic observation using panoramic radiographs or computed tomographs. Between 13 and 35.3% of maxillary sinuses have septa. They can be located in any region of the maxillary sinus and their size can vary between 2.5 and 12.7 mm in mean length. Some authors have reported a higher prevalence of septa in atrophic edentulous areas than in non-atrophic ones. If a sinus lift is conducted in the presence of maxillary sinus septa, it may be necessary to modify the design of the lateral window in order to avoid fracturing the septa.

Malignant mental nerve neuropathy: systematic review.

Malignant mental neuropathy (MMN) is a neurological manifestation of cancer, characterized by the presence of hypoesthesia or anesthesia restricted to the territory of the mental branch of the mandibular nerve. A systematic review of the literature has been made on MMN, analyzing the etiology, pathogeny, clinical characteristics, complementary tests and the prognosis. Sixteen studies, providing 136 cases were selected. Breast cancer and lymphomas were the most frequently associated malignant diseases. The most frequent pathogenic mechanisms producing neurological involvement were: peripherally, mandibular lesions; and centrally, tumors at the base of the cranium. Regarding clinical characteristics, manifestation of MMN was the primary symptom of malignant disease in 27.7% of cases, and a first symptom of recurrence in 37.7%. The group of selected studies included 50 orthopantomographs, 9 mandibular computed tomographies and 50 radiographic examinations of the cranial region. The most affected region was the mandible. The appearance of MMN is an ominous prognosis for the progression of the disease, with a mortality of 78.5% within a mean of 6.9 months.

Malignant mental nerve neuropathy: systematic review

No disponible

Malignant mental neuropathy (MMN) is a neurological manifestation of cancer, characterized by the presence of hypoesthesia or anesthesia restricted to the territory of the mental branch of the mandibular nerve. A systematic review of the literature has been made on MMN, analyzing the etiology, pathogeny, clinical characteristics, complementary tests and the prognosis. Sixteen studies, providing 136 cases were selected. Breast cancer and lymphomas were the most frequently associated malignant diseases. The most frequent pathogenic mechanisms producing neurological involvement were: peripherally, mandibular lesions; and centrally, tumors at the base of the cranium. Regarding clinical characteristics, manifestation of MMN was the primary symptom of malignant disease in 27.7% of cases, and a first symptom of recurrence in 37.7%. The group of selected studies included 50 orthopantomographs,9 mandibular computed tomographies and 50 radiographic examinations of the cranial region. The most affectedregion was the mandible. The appearance of MMN is an ominous prognosis for the progression of the disease, with a mortality of 78.5% within a mean of 6.9 months

Vestibular bone window for the extraction of impacted lower third molars: four case reports.

Four patients attending for the extraction of an impacted lower third molar are reported. The aim of this paper is was to describe a technical approach, which facilitates impacted lower third molar extraction, minimizing the ostectomy, thus reducing secondary postoperative manifestations and avoiding possible periodontal defects on the distal side of the second mandibular molar. To facilitate the extraction of the crown, roots or the complete molar, a small ostectomy in the form of a window can be made in the vestibular cortical, approaching the extraction through the resultant mesial space.

Vestibular bone window for the extraction of impacted lower third molars: Four case reports

No disponible

Four patients attending for the extraction of an impacted lower third molar are reported. The aim of this paper is was to describe a technical approach, which facilitates impacted lower third molar extraction, minimizing the ostectomy, thus reducing secondary postoperative manifestations and avoiding possible periodontal defects on the distal side of the second mandibular molar. To facilitate the extraction of the crown, roots or the complete molar, a small ostectomy in the form of a window can be made in the vestibular cortical, approaching the extraction through theresultant mesial space