Predictable interproximal tissue removal with a surgical stent.

The correction of diastemas in the anterior region with composite resin is considered to be practical and conservative. Harmony between the restorative material and the periodontium is necessary to achieve satisfactory functional and esthetic results. Whenever excessive gingiva occurs in the interproximal region, removal is necessary to avoid excessively contoured restorations. A predictable technique is described to conservatively remove interproximal tissue in situations in which crown lengthening is required to treat bilateral diastemas. A surgical template based on the diagnostically waxed cast was produced to serve as a reference during periodontal surgery.

A tooth-stabilized surgical template for alveolectomy.

The supraeruption of teeth and bone in patients with long-standing partial edentulism often results in compromised interarch distance. A method is presented for the fabrication and predictable use of a tooth-stabilized surgical template for alveolectomy in instances where teeth are present.

Use of the piezosurgery technique for cutting bones in the autotransplantation of unerupted third molars.

Autotransplantation is a well-known method used in oral surgery. However, risk of failure, most commonly resulting from root resorption of the transplanted tooth or ankylosis, is quite high. Piezosurgery with specific device tip vibration frequencies enables selective tissue cutting, and therefore, tooth buds or teeth can easily be removed from bones with little injury to periodontal fibers or bud follicles.

Bone healing after bur and Er:YAG laser ostectomies.

PURPOSE: Ostectomies, performed by different methods, are often necessary in oral and maxillofacial surgery. Rotatory and reciprocating devices are most frequently used but have disadvantages, such as noise, vibration, and the potential for inducing thermal damage. Laser systems are interesting alternatives to these procedures. We analyzed bone healing in a rat model after mandibular ostectomy with a surgical bur or noncontact erbium:yttrium-aluminum-garnet laser using different energy levels. MATERIALS AND METHODS: Four groups of 5 rats each underwent ostectomy of the bone cortical of the mandibular body, with irrigation, using a surgical bur or erbium:yttrium-aluminum-garnet laser with different energy parameters. A metal plate was used for morphologic standardization of the cavities. The samples collected after 7, 14, 45, 60, and 90 days were analyzed by optical microscopy. RESULTS: The ostectomies performed with surgical burs resulted in bone healing from the cortical endosteum and remaining trabecular bone. The cortical endosteum was repaired after 45 days, followed by bone remodeling. After laser irradiation, healing involved bone neoformation from the external cortical surface and endosteum. Surface regions with thermal damage were observed after laser treatment in the 3 conditions used up to day 60, followed by bone remodeling. CONCLUSIONS: Laser ostectomies resulted in a thin layer of thermal damage. Bone healing was faster when surgical burs were used, with similar results reached after 90 days.

Contemporary periodontal surgery: 2. Surgical practice.

UNLABELLED: Contemporary surgical techniques emphasize gentle tissue handling with a minimum of trauma. This in turn provides a predictable operative environment and promotes healing. A modern surgical armamentarium may be very different from that encountered a decade ago. This is clear from the greater availability of dental microsurgical instruments. Whilst the complexity of microsurgery may not be routinely necessary in general dental practice, many of the principles and equipment used may make standard surgical management easier and more predictable. CLINICAL RELEVANCE: A greater understanding of the evidence base behind periodontal surgery will allow us to improve flap design, closure and operative management. Also, the use of microsurgical techniques and equipment will improve the quality and outcomes of periodontal surgery in practice.

Principles of endodontic microsurgery.

With bright illumination and magnification under the operating microscope, and addition of many microinstruments, endodontic surgery has become microsurgery. The microsurgical approaches allow the clinicians to perform endodontic surgery with smaller osteotomies, shallow bevels, preparation of isthmuses, examination of resected root surfaces, retropreparation in line with root canal, and precise placement of new filling materials. This article illustrates the advantages of microsurgery in endodontics.

Prospective study of dysesthesia following odontectomy of impacted mandibular third molars.

Dysesthesia following odontectomy of impacted mandibular third molars is observed in some patients. This prospective study reports the clinical incidence of this untoward sequela to occur in 3.3% of patients. An analysis of possible etiologic factors reveals that development of dysesthesia of the inferior alveolar and lingual nerves is more likely to occur with: complete bony impacted mandibular third molars; mesioangular impacted third molars; impacted third molars with the crown at the cemento-enamel junction of the second molar; and when burs are used to remove bone and when the roots approximate the inferior alveolar canal.