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1.
Niger J Clin Pract ; 24(6): 866-873, 2021 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-34121735

RESUMO

Aim: To evaluate the effect of prosthetic framework material and cantilever length on peri-implant strain in mandibular all-on-four implant-supported prostheses with different types of arch antagonist forces. Materials and Methods: Models simulating a completely edentulous mandibular arch fabricated in heat-cured acrylic resin were used. On the acrylic models, four implants were placed at regions 34, 32, 42, and 44 simulating all-on-four implant placements. Implant-supported screw-retained fixed prosthesis frameworks were fabricated using three different materials (cobalt-chromium, zirconia, and polyetheretherketone) and with three different cantilever lengths (zero mm, 15 mm, and 25 mm). Strain gauges were attached on the model at the buccal and lingual positions of each implant. Forces simulating opposing natural dentition, conventional complete denture, and the parafunctional habit were applied to the models. The peri-implant strain in each strain gauge was recorded. Results: Least peri-implant strains (67 microstrains) were observed when forces simulating conventional complete dentures were applied on the models and the highest peri-implant strains (9091 microstrains) were observed when forces simulating parafunctional habit were applied. One-way ANOVA test followed by Tukey's post hoc analysis was performed to compare the mean deformation scores between different materials at 50 N load. The level of significance [P-value] was set at P < 0.05. Tests showed significant differences between zero mm and the other types in all the different materials, and also between 1.5 x AP and 2.5 x AP for Zirconia and Peek material at P = 0.02 & P = .008, respectively. The results showed that the type of framework material, cantilever length, and occlusal forces from the opposing arch influence the peri-implant strain in the bone in all-on-four implant-supported prostheses. Conclusion: Rehabilitation of a single, completely edentulous arch with implant-supported prostheses should consider the situation of the opposing arch. The choice of framework material, as well as the cantilever length, should be altered based on the forces from the opposing arch.


Assuntos
Implantes Dentários , Prótese Total , Resinas Acrílicas , Força de Mordida , Parafusos Ósseos , Prótese Dentária Fixada por Implante , Humanos , Mandíbula/cirurgia
2.
Nan Fang Yi Ke Da Xue Xue Bao ; 41(5): 754-759, 2021 May 20.
Artigo em Chinês | MEDLINE | ID: mdl-34134964

RESUMO

OBJECTIVE: To investigate the anatomy of the perforator vessels of the deep circumflex iliac artery (DCIA) and the techniques for repairing mandibular complex defect using chimeric deep circumflex iliac artery perforator flap (DCIAPF). OBJECTIVE: We analyzed the origin, distribution, number and courses of the perforator vessels of the DCIA, and measured the outside diameters of the vessels at the origin in 6 adult cadaveric specimens (12 sides) with latex perfusion. From July, 2018 to September, 2019, based on the results of anatomical study and imaging findings and using the digital surgical guide plate, we harvested DCIAPF from 4 patients for repairing mandibular body or angle defects and oral soft tissue defects. OBJECTIVE: The perforating vessels of the DCIA included abdominal muscular branches, osteomusculocutaneous branches and terminal musculocutaneous branches. The abdominal muscle branches originated from the DCIA inguinal segment in 4 and from both the inguinal and iliac segments in 2 of the specimens. The osteomusculocutaneous branches all originated from the internal iliac crest in 75% and from both the inguinal and internal iliac crest segments in 25% of cases; the inguinal segment gave rise to only one perforating branch. The number of the musculocutaneous perforating branches was 1 (58.3%) or 2 (41.7%). In the 4 patients undergoing mandibular reconstruction, the DCIAPF survived in all cases with good recovery of the donor site wound. Satisfactory facial appearance with good oral morphology and occlusal relationship was achieved at 1 month postoperatively in all the patients. None of the patients experienced obvious functional abnormalities at the donor site, and imaging examination confirmed successful reconstruction of the oromandibular defects in all the cases. OBJECTIVE: A good understanding of the anatomic characteristics of the perforator vessels of the DCIA combined with imaging examinations and digital surgery technology facilitates the harvest of DCIAPF for repairing mandibular body or angle defects complicated by oral soft tissue defects.


Assuntos
Retalho Perfurante , Procedimentos Cirúrgicos Reconstrutivos , Adulto , Humanos , Artéria Ilíaca/cirurgia , Ílio , Mandíbula/cirurgia , Retalho Perfurante/cirurgia
3.
Pan Afr Med J ; 38: 257, 2021.
Artigo em Francês | MEDLINE | ID: mdl-34104305

RESUMO

Orofacial clefts are common congenital malformations. Tessier's classification system is the most widely used; it consists of 30 variants including median mandibular clefts (Tessier's cleft No. 30). They can be isolated or associated with cleft of the lower lip, tongue or more rarely, of the sternum. They are very rare, less than 70 cases (all types taken together) have been reported in the literature. We here report an exceptional case of mandibular and sternal cleft with literature review.


Assuntos
Mandíbula/anormalidades , Anormalidades Musculoesqueléticas/diagnóstico por imagem , Esterno/anormalidades , Anormalidades Múltiplas/diagnóstico por imagem , Feminino , Humanos , Mandíbula/diagnóstico por imagem , Mandíbula/cirurgia , Esterno/diagnóstico por imagem , Adulto Jovem
4.
J Craniomaxillofac Surg ; 49(6): 435-442, 2021 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-33934974

RESUMO

We aimed to compare the reliability of the surgery-first approach and the traditional orthodontic-first approach for the correction of facial asymmetry based on the new classification of facial asymmetry. Patients with facial asymmetry who underwent orthognathic surgery between January 2016 and January 2019 were included. Cephalometric changes and relapse ratios were analyzed 12 months before and after surgery. Patients were divided into horizontal and vertical asymmetry groups based on the asymmetry vector, and subgroup analysis was conducted. The surgery-first approach without presurgical orthodontic treatment and the orthodontic-first approach showed a similar degree of asymmetry correction and skeletal stability. The relapse ratios of the maxilla height in the surgery-first and orthodontic-first groups were 0.25 ± 0.21 and 0.27 ± 0.25, respectively (p = 0.63), the relapse ratios of the maxilla width were 0.31 ± 0.32 and 0.21 ± 0.2, respectively (p = 0.14), the mandibular height relapse ratios were 0.34 ± 0.58 and 0.29 ± 0.36, respectively (p = 0.69), and the mandibular width relapse ratios were 0.12 ± 0.22 and 0.26 ± 0.31, respectively (p = 0.058). The treatment period of the surgery-first group (18.5 ± 5.3 months) was significantly shorter than that of the orthodontic-first group (22.9 ± 7.5 months, p = 0.024). Among the surgery-first group, patients with vertical asymmetry (15.0 ± 3.2 months) had a shorter treatment than those with horizontal asymmetry (21.6 ± 6.8 months, p = 0.006). Although contesting traditional standards is always challenging, the surgery-first orthognathic approach may lead to a new era in traditional orthognathic approaches. This new classification of facial asymmetry could be useful and practical when treating patients with facial asymmetry regardless of the etiology.


Assuntos
Má Oclusão Classe III de Angle , Procedimentos Cirúrgicos Ortognáticos , Cefalometria , Assimetria Facial/diagnóstico por imagem , Assimetria Facial/cirurgia , Humanos , Mandíbula/diagnóstico por imagem , Mandíbula/cirurgia , Reprodutibilidade dos Testes , Resultado do Tratamento
5.
J Craniomaxillofac Surg ; 49(6): 443-448, 2021 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-33941436

RESUMO

The aim of this study was to explore how mandibular distraction osteogenesis influences morphological changes in the oropharynx and laryngopharynx. This was a retrospective study of airway parameter measurements in CFM patients undergoing mandibular distraction osteogenesis treatment. The indication for surgical treatment was the obvious facial asymmetry. Mimics 17.0 (Materialise Inc., Belgium) was used to build 3D models of the oro- and laryngopharynx. The minimum cross-sectional area (CSA), mean CSA, volume, length, and surface area were measured in the 3D models. All data were entered into SPSS v. 23.0 (SPSS Inc. USA), with statistical differences assessed pre- and postoperatively using the Wilcoxon test. Thirty-two patients diagnosed with CFM were included in this study. Five were classified as type IIa, 21 as type IIb, and six as type III, using the Pruzansky-Kaban classification. The average age of the patients was 8.34 years; 14 were females and 18 were males. The average traction time was 35.59 days and the average length of traction was 35.81 mm. The total volume of the airway was significantly increased after MDO (p = 0.001). In the oropharynx and laryngopharynx segments, the mean CSA, minimum CSA, and surface area were statistically significantly different. According to the results, expansion of oropharynx and laryngopharynx were evident after MDO. Mandibular distraction osteogenensis (MDO) can expand the volume of the oropharynx and laryngopharynx. Therefore, MDO can be considered a clinically useful treatment for changing the structure of the oropharynx and laryngopharynx.


Assuntos
Síndrome de Goldenhar , Osteogênese por Distração , Bélgica , Criança , Feminino , Síndrome de Goldenhar/diagnóstico por imagem , Síndrome de Goldenhar/cirurgia , Humanos , Masculino , Mandíbula/cirurgia , Estudos Retrospectivos
6.
Gerodontology ; 38(2): 228-231, 2021 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-34013564

RESUMO

OBJECTIVE: To present a feasible treatment method for fractures of severely atrophic mandibles in high-risk patients undergoing general anaesthesia (GA). CASE REPORT: A 77-year-old man presented with bilateral unfavourable fractures in an atrophic mandible. Pre-anaesthetic consultation revealed that the patient was at high risk for GA due to significant medical comorbid conditions of the patient, such as advanced age, chronic obstructive respiratory disease, diabetes mellitus and atherosclerosis. Thus, a modified treatment, consisting of open reduction and internal fixation using a combination of reconstruction plates and miniplates via an extraoral approach, was planned under local anaesthesia. The patient tolerated the surgical procedure well, without the need for sedation, and uneventful healing was achieved during postoperative period. CONCLUSION: Local anaesthesia may be considered as the anaesthetic technique of choice when managing atrophic mandible fractures to reduce the risk of complications and shorten the time needed for recovery, especially in elders with significant medical comorbidities.


Assuntos
Fraturas Mandibulares , Idoso , Anestesia Local , Placas Ósseas , Fixação Interna de Fraturas , Humanos , Masculino , Mandíbula/cirurgia , Fraturas Mandibulares/diagnóstico por imagem , Fraturas Mandibulares/cirurgia
7.
Medicine (Baltimore) ; 100(20): e25974, 2021 May 21.
Artigo em Inglês | MEDLINE | ID: mdl-34011085

RESUMO

ABSTRACT: Nerve injury especially inferior alveolar nerve (IAN) is the one of the complications that occur when the mandibular third molar (M3) is extracted and in case of high risk patients, coronectomy might be an alternative to tooth extraction. The purpose of this retrospective study was to analyze root migration and its influencing factors at 6 months after coronectomy in both 2- and 3-dimensions using periapical view and cone-beam computed tomography (CBCT). We analyzed 33 cases of root remnant after coronectomy and measured the amount of migration in CBCT. The following factors that could possibly affect root migration were also analyzed: age, gender, number of M3 roots, shape of M3s, Pell, and Gregory classification, mesiodistal (MD) angulation, buccolingual (BL) angulation, contact point with the second molar, root curvature, and complete removal of the coronal portion. Migration of greater than 2 mm was found in 64% of the roots in the 2-dimensional (2D) analysis, and the average root migration was 4.11 mm in the 3-dimensional (3D) analysis. The factors affecting migration were the root morphology, complete removal of the coronal portion, impaction depth, and MD angulation in the 2D analysis, and MD and BL angulation in the 3D analysis. Ensuring sufficient space for root migration especially considering angulation, depth and complete removal of the coronal portion might be important factors after coronectomy of the M3. Root remnant after coronectomy of M3 may migrate in young patients who has sufficient empty coronal space and this may reduce the nerve damage by the separation of IAN and M3.


Assuntos
Traumatismos do Nervo Mandibular/prevenção & controle , Dente Serotino/cirurgia , Procedimentos Cirúrgicos Bucais/efeitos adversos , Migração de Dente/etiologia , Dente Impactado/cirurgia , Adulto , Tomografia Computadorizada de Feixe Cônico , Feminino , Humanos , Masculino , Mandíbula/diagnóstico por imagem , Mandíbula/inervação , Mandíbula/cirurgia , Nervo Mandibular/diagnóstico por imagem , Traumatismos do Nervo Mandibular/etiologia , Pessoa de Meia-Idade , Dente Serotino/diagnóstico por imagem , Estudos Retrospectivos , Coroa do Dente/cirurgia , Migração de Dente/diagnóstico , Raiz Dentária/diagnóstico por imagem , Adulto Jovem
8.
Orthod Fr ; 92(1): 37-65, 2021 Mar 01.
Artigo em Francês | MEDLINE | ID: mdl-33792545

RESUMO

The discussion on whether to extract or not is still a source of debate. However, primacy must be given to the diagnosis based on a dental, skeletal, aesthetic and functional assessment. The therapeutic means are intended to achieve the goals resulting from this diagnosis which are the only way to individualize the treatment plan according to the patient. Symphyseal distraction is a surgical procedure intended to increase the mandibular bone base at the symphysis level and then allow an ideal positioning of the mandibular incisor. After explaining the procedure to integrate this intervention in the treatment plan, the author studied in 25 clinical cases the displacement of the mandibular incisor according to the initial crowding and the increase of the distance between the mandibular cuspids before and after bone distraction. Symphyseal distraction is an effective alternative to the treatment of dental crowding to the mandible by helping to restore nasal breathing by its association with maxillary disjunction while respecting of physiology and balance facial.


Assuntos
Má Oclusão , Osteogênese por Distração , Humanos , Incisivo , Má Oclusão/cirurgia , Mandíbula/cirurgia , Estudos Retrospectivos
9.
Stomatologiia (Mosk) ; 100(2): 64-72, 2021.
Artigo em Russo | MEDLINE | ID: mdl-33874664

RESUMO

The aim of this study is to develop algorithms for the treatment of patients with class II malocclusion and incisor protrusion using the combination of bracket system, functional fixed telescopic appliance (FFTA) and skeletal anchorage, which allows to achieve effective dentoalveolar compensation of skeletal forms of class II malocclusion. MATERIALS AND METHODS: Orthodontic treatment of 60 patients with class II malocclusion at the age of 18 to 44 years, using the bracket system, FFTA and orthodontic miniscrews was performed. In order to assess the results of treatment, cone-beam computed tomography were obtained at the beginning and at the end of treatment. RESULTS: As a result of the treatment normalization of lower jaw position, dental position and occlusion were achieved, the lower incisors protrusion was eliminated and the facial profile was improved, reliably confirmed by lateral cephalograms. CONCLUSION: The proposed treatment algorithm proved to be effective for stable correction of skeletal class II malocclusion in patients rejecting orthognathic surgery.


Assuntos
Má Oclusão Classe II de Angle , Cirurgia Ortognática , Adolescente , Adulto , Algoritmos , Cefalometria , Humanos , Má Oclusão Classe II de Angle/diagnóstico por imagem , Má Oclusão Classe II de Angle/cirurgia , Mandíbula/diagnóstico por imagem , Mandíbula/cirurgia , Adulto Jovem
10.
Stomatologiia (Mosk) ; 100(2): 90-96, 2021.
Artigo em Russo | MEDLINE | ID: mdl-33874668

RESUMO

Correction of disorders during transformation into one of the most difficult tasks, both in orthodontics and in maxillofacial (orthognathic) surgery. This article presents two clinical cases of median osteotomy/ostectomy. The stages of operations are described. Surgical technique of transversal correction by osteotomy/ ostectomy is presented. Operation is combined with bilateral retromolar osteotomy. Three dimensional fragments moving helps to change lower jaw shape. Indications for this surgical manipulation: one or two side cross-bite, discrepancies between size of teeth and length of alveolar bone (lower macrognathia, microdentia, extra-teeth, huge diastema), asymmetry of mandible.


Assuntos
Má Oclusão , Procedimentos Cirúrgicos Reconstrutivos , Cefalometria , Humanos , Má Oclusão/cirurgia , Mandíbula/cirurgia , Osteotomia
11.
Swiss Dent J ; 131(4): 349-352, 2021 Apr 06.
Artigo em Francês | MEDLINE | ID: mdl-33789418

RESUMO

Bone resorption is a consequence of the loss of a tooth. Alveolar ridge resorption can restrict the volume of bone available for the positioning of a dental implant. Bone graft is a routinely performed procedure in order to increase this volume and provide an adequate situation for the replacement of the tooth. However, autogenous bone is the gold standard for this procedure, xenogenous bone is a good alternative. It presents reliable results and a low complication rate. In this article, we describe the case of an infection resulting in a facial skin fistula following a guided bone regeneration. A 52-year-old woman visited a maxillofacial unit with complaints of persistent swelling of the right cheek, associated to a facial skin fistula. She had a history of xenograft with OsteoBiol Gen-os©, performed at a dental office nine months earlier. Clinical examination and computed tomography suggested that there was a migration process of the bone substitute inside the cheek, which had led to the infection with a facial skin fistula. Loss of stability of the bone graft and particular anatomy of the posterior region of the mandible could explain the migration of the particles and the formation of the fistula.


Assuntos
Aumento do Rebordo Alveolar , Fístula Cutânea , Regeneração Óssea , Fístula Cutânea/diagnóstico por imagem , Fístula Cutânea/etiologia , Fístula Cutânea/cirurgia , Implantação Dentária Endo-Óssea , Feminino , Humanos , Mandíbula/cirurgia , Pessoa de Meia-Idade , Complicações Pós-Operatórias/etiologia , Complicações Pós-Operatórias/terapia
13.
Shanghai Kou Qiang Yi Xue ; 30(1): 93-96, 2021 Feb.
Artigo em Chinês | MEDLINE | ID: mdl-33907788

RESUMO

PURPOSE: To investigate the effect of vascularized free fibular flap in repairing segmental mandibular defects. METHODS: Eighty patients with segmental mandibular defects treated in our hospital from June 2015 to May 2018 were enrolled. Both groups of patients were operated by the same group of medical staff with more than 5 years of clinical experience. Patients were divided into 2 groups using a random number table method, 40 in each group. Patients in the control group underwent non-vascularized iliac bone graft while patients in the experimental, group underwent vascularized free fibular bone flap repair. The graft survival, pain, quality of life, negative emotions and complications were compared between the two groups using SPSS 22.0 software package. RESULTS: There was no significant difference in the scores of the proximal gingival papilla, distal gingival papilla, labial margin and labial margin (P>0.05). The gingival texture, color score and total score of the root surface of the experimental group were significantly higher than the control group (P<0.05). The scores of VAS, anxiety and depression in both groups were significantly decreased after operation, but the decrease in the experimental group was greater(P<0.05). Physical function, psychological and social function, life quality of the two groups were significantly increased, but the increase of the experimental group was greater (P<0.05).Three cases (7.5%) developed complications in the control group, including 1 case of pneumonia, 1 case of infection and 1 case of wound recurrence. Two cases(5%) in the experimental group developed of complications, including 1 case of wound recurrence and 1 case of pneumonia, the difference was not statistically significant (P>0.05). CONCLUSIONS: Repair of mandibular segmental defect with vascularized free fibular bone flap can significantly improve the overall effect, relieve pain and negative emotion, improve quality of life of patients and decrease incidence of complications.


Assuntos
Retalhos de Tecido Biológico , Procedimentos Cirúrgicos Reconstrutivos , Transplante Ósseo , Fíbula/cirurgia , Humanos , Mandíbula/cirurgia , Qualidade de Vida
14.
Int J Oral Maxillofac Implants ; 36(2): e7-e21, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33909715

RESUMO

PURPOSE: This numerical study examined the efficacy and challenges of using resonance frequency analysis to identify the stability of implants placed in mandibles. The study also examined the feasibility of using angular stiffness as an alternative index to quantify dental implant stability in mandibles. MATERIALS AND METHODS: A finite element model consisting of a mandible, an implant, an abutment, and a bonding layer (between the implant and the mandible) was created in commercially available software ANSYS. The level of osseointegration was modeled by varying the stiffness of the bonding layer. Three sets of boundary conditions were imposed on the mandible: fixed, rotationally free, and rotationally restrained. Three implant locations were studied: central, premolar, and molar positions. An alternative abutment mimicking SmartPeg and eight different implant lengths were also included. A modal analysis and a static analysis were conducted to calculate resonance frequencies and angular stiffness, respectively. RESULTS: Two types of vibration modes were found. One was jawbone modes, for which the mandible deformed significantly but not the bonding layer. Resonance frequencies of the jawbone modes were not sensitive to the level of osseointegration. The other was implant modes, for which the bonding layer deformed significantly but not the mandible. Among multiple implant modes obtained, only one was trackable as the level of osseointegration increased. The resonance frequency of the trackable implant mode was very sensitive to the implant location as well as boundary conditions, but not as much to the level of osseointegration. In contrast, angular stiffness was sensitive to the level of osseointegration but not as much to boundary conditions. CONCLUSION: The efficacy of using resonance frequency analysis to quantify the stability of a dental implant is questionable. Its high sensitivity to implant locations and boundary conditions as well as its low sensitivity to the level of osseointegration cause huge uncertainties in correlating measured resonance frequencies to implant stability. Angular stiffness is a much more reliable indicator because of its high sensitivity to the level of osseointegration and low sensitivity to boundary conditions.


Assuntos
Implantes Dentários , Implantação Dentária Endo-Óssea , Planejamento de Prótese Dentária , Retenção em Prótese Dentária , Mandíbula/diagnóstico por imagem , Mandíbula/cirurgia , Osseointegração , Análise de Frequência de Ressonância , Vibração
15.
Int J Oral Maxillofac Implants ; 36(2): 346-354, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33909726

RESUMO

PURPOSE: This study aimed to examine clinical and patient-centered outcomes of resilient stud and stress-free bar attachments used for immediately loaded implants supporting mandibular overdentures. MATERIALS AND METHODS: Thirty edentulous patients with sufficient bone mesial and distal to the mental foramen received new dentures. The patients were randomly assigned into two groups. After 3 months of adaptation, four implants were placed in the canine and second premolar areas of the mandible using computer-guided surgery and the flapless surgical approach. Overdentures were connected immediately to the implants using either resilient stud (Locator) or stress-free implant bar (SFI-Bar) attachments. Marginal resorption of bone, plaque and gingival indices, pocket depth, and implant stability were evaluated for both groups at baseline (prosthesis delivery) and 6 and 12 months thereafter. Implant survival and patient satisfaction were calculated after 12 months. RESULTS: For both groups, marginal bone loss (P < .043), plaque scores (P < .001), and probing depth (P < .002) increased significantly with time. SFI-Bar recorded lower marginal bone loss (P = .048) and higher plaque scores (P = .021) and probing depth (P = .001) than Locator after 12 months of denture insertion. The implant survival was 96.6% and 98.3% for Locator and SFI-Bar, respectively. No significant difference was found in the survival rate between groups (P = .56). Locator showed significantly higher general satisfaction, satisfaction with retention, comfort, and cleaning of overdentures compared with SFI-Bar (P < .001). CONCLUSION: Within the limits of this investigation, both resilient stud and stress-free bar attachments can be used successfully with mandibular four-implant overdentures subjected to an immediate loading protocol. However, studs may be preferred regarding peri-implant soft tissue health, patient satisfaction with retention, cleaning, and comfort, and stress-free bar attachments could be more effective in terms of marginal bone preservation.


Assuntos
Implantes Dentários , Arcada Edêntula , Prótese Dentária Fixada por Implante , Retenção de Dentadura , Revestimento de Dentadura , Humanos , Arcada Edêntula/cirurgia , Mandíbula/cirurgia
16.
Int J Oral Maxillofac Implants ; 36(2): 379-387, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33909731

RESUMO

PURPOSE: The aim of this study was to clinically and radiographically evaluate mandibular overdentures supported by four short implants combined with two different doses of photobiomodulation (PBM). MATERIALS AND METHODS: A split-mouth design was applied; six completely edentulous male subjects received four short implants in the canine and second premolar area. Short implants were inserted via a digital fully guided approach with a stereolithographic surgical guide. All patients received five PBM sessions immediately after surgery and every 48 hours. Group A (n = 6) implants on the right side received a dose of 3.75 J/cm2, and group B (n = 6) implants on the left side received a dose of 7.5 J/cm2. Evaluation of peri-implant probing depth (PIPD), modified Gingival Index (MGI), and vertical bone loss was performed at the time of prosthetic loading and 6 and 12 months later. The implant stability quotient (ISQ) was also assessed 6 and 12 months after loading. RESULTS: There was no significant difference between both groups regarding PIPD values. However, a minor but significant increase from the baseline (P < .001) was observed in PIPD values in both groups after 12 months. The MGI scores at the different time intervals were very low for both groups. The mean vertical bone loss after 12 months was minimal for both groups but statistically significant from the baseline (P < .001). ISQ values for both groups after 12 months revealed a significant increase from the baseline, and group B values were significantly higher than those of group A. CONCLUSION: Within the limitations of this study, a mandibular overdenture supported by four short implants is a valid treatment modality for atrophic mandibles, and a PBM dose of 7.5 J/cm2 has a potential positive influence on implant healing and osseointegration.


Assuntos
Perda do Osso Alveolar , Implantes Dentários , Terapia com Luz de Baixa Intensidade , Perda do Osso Alveolar/diagnóstico por imagem , Prótese Dentária Fixada por Implante , Revestimento de Dentadura , Seguimentos , Humanos , Masculino , Mandíbula/diagnóstico por imagem , Mandíbula/cirurgia , Resultado do Tratamento
17.
J Laryngol Otol ; 135(4): 348-354, 2021 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-33818328

RESUMO

OBJECTIVE: To compare the post-operative outcomes of transoral laser microsurgery, lateral pharyngotomy and transmandibular surgery in oropharyngeal cancer management. METHODS: Records of 162 patients treated with transmandibular surgery, transoral laser microsurgery or lateral pharyngotomy were reviewed. The transoral laser microsurgery cohort was matched with the lateral pharyngotomy and transmandibular surgery cohorts for tumour stage, tumour subsite and human papilloma virus status, and the intra- and post-operative outcomes were compared. RESULTS: Duration of surgery and hospital stay were significantly longer for transmandibular surgery. Tracheostomy and nasogastric feeding tube rates were similar, but time to decannulation and to oral feeding were longer in the transmandibular surgery group. Transmandibular surgery more frequently required flap reconstruction and had a greater complication rate. Negative margins were fewer in the lateral pharyngotomy group than in the transoral laser microsurgery and transmandibular surgery groups. CONCLUSION: In comparison with transmandibular surgery, transoral laser microsurgery and lateral pharyngotomy were associated with fewer complications and faster functional recovery. Lateral pharyngotomy had a higher rate of positive margins than transoral laser microsurgery, with a consequently greater need for adjuvant therapy. Many patients are nonetheless unsuitable for transoral surgery. All these factors should be considered when deciding on oropharyngeal cancer surgical treatment.


Assuntos
Terapia a Laser/métodos , Mandíbula/cirurgia , Microcirurgia/métodos , Neoplasias Orofaríngeas/cirurgia , Faringectomia/métodos , Carcinoma de Células Escamosas de Cabeça e Pescoço/cirurgia , Adulto , Estudos de Casos e Controles , Feminino , Humanos , Masculino , Resultado do Tratamento
18.
Quintessence Int ; 52(6): 538-546, 2021 May 07.
Artigo em Inglês | MEDLINE | ID: mdl-33880908

RESUMO

An orthodontic extraction technique with a ramus mini-screw was used to remove a deeply impacted mandibular third molar contacting the inferior alveolar nerve, avoiding damage to the inferior alveolar nerve and relieving postsurgery inflammation. Case presentation: A 24-year-old man was required to extract impacted third molars for orthodontic treatment. Panoramic radiographs and CBCT images showed that his mandibular left third molar penetrated into the inferior alveolar nerve canal and a distomolar was inverted and impacted distally to the third molar. The distomolar was directly removed and the impacted third molar was extruded with the aid of a ramus mini-screw. After 4 months of traction, the mandibular left third molar was successfully moved away from the inferior alveolar nerve canal. No nerve injury occurred after the surgical extraction and the patient was very satisfied with the treatment outcome. Conclusion: Orthodontic extraction, with the aid of ramus mini-screws, is a safe, effective, and efficient technique for the removal of high-risk impacted molars contacting the inferior alveolar nerve. (Quintessence Int 2021;52:538-546; doi: 10.3290/j.qi.b1244345).


Assuntos
Dente Impactado , Traumatismos do Nervo Trigêmeo , Adulto , Parafusos Ósseos , Humanos , Masculino , Mandíbula/cirurgia , Nervo Mandibular , Dente Molar , Dente Serotino/diagnóstico por imagem , Dente Serotino/cirurgia , Radiografia Panorâmica , Extração Dentária , Dente Impactado/diagnóstico por imagem , Dente Impactado/cirurgia , Traumatismos do Nervo Trigêmeo/prevenção & controle , Adulto Jovem
19.
Am J Orthod Dentofacial Orthop ; 159(6): 743-749, 2021 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-33795190

RESUMO

INTRODUCTION: The purpose of this study was to assess the stability of changes in the upper airways 4 years after orthognathic surgery in patients with skeletal Class II malocclusion. METHODS: A retrospective clinical study was conducted including 33 cone-beam computed tomography images from 11 patients (average age of 35.91 years) followed up longitudinally for 4 years. The airways were measured with the help of the Dolphin Imaging software (Dolphin Imaging and Management Systems, Chatsworth, Calif) at 3 points: T1 (preoperative), T2 (6 months after surgery), and T3 (4 years after surgery). The parameters assessed were surface area (SA), minimum axial area, and volume (VOL) of the pharyngeal airway space. The times were compared using analysis of variance and Tukey's test. Pearson's analysis was performed to assess the correlation with surgical changes and age (P <0.05). RESULTS: Four years after operating on the airway spaces, the means of SA and VOL were significantly higher than those observed before the surgery (P <0.05). The means at 6 months were intermediate, with no significant difference before the surgery and 4 years after it (P >0.05). There was no significant correlation of the changes in SA, VOL, and minimum axial area with the amount of mandibular advancement, counterclockwise rotation of the occlusal plane, and age of the patient (P >0.05). CONCLUSIONS: Four years after mandibular advancement surgery in patients with skeletal Class II malocclusion, the increases in the airways remained stable.


Assuntos
Avanço Mandibular , Cirurgia Ortognática , Procedimentos Cirúrgicos Ortognáticos , Cefalometria , Tomografia Computadorizada de Feixe Cônico , Seguimentos , Humanos , Mandíbula/diagnóstico por imagem , Mandíbula/cirurgia , Faringe/diagnóstico por imagem , Estudos Retrospectivos
20.
Am J Orthod Dentofacial Orthop ; 159(6): 836-851, 2021 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-33840530

RESUMO

Interdisciplinary treatment for patients with Treacher Collins syndrome is challenging because of the rarity of the condition and the wide variety of phenotypic expression. A 23-year-old male was diagnosed with Treacher Collins syndrome with a history of severe obstructive sleep apnea. He presented with a Pruzansky-Kaban classification grade I mandible, skeletal type II pattern with a hyperdivergent mandibular plane, severe convex profile, and Class II malocclusion with a missing mandibular incisor. Improvement of facial esthetics was achieved by a combination of orthodontics, mandibular distraction osteogenesis, and 2-jaw maxillomandibular advancement surgery. Presurgical orthodontic treatment involved permanent tooth extraction to relieve severe crowding, and Class III mechanics were employed to increase overjet. Correction of mandibular hypoplasia by increasing ramal height and the mandibular length was done by intraoral mandibular distraction osteogenesis. Counterclockwise rotation of the mandibular plane angle and a Class III occlusion with negative overjet were achieved after mandibular distraction osteogenesis. A postdistraction posterior open bite was maintained with a biteplane during the consolidation period. Subsequently, 2-jaw orthognathic surgery was performed. LeFort I osteotomy was done for maxillary advancement to correct an anterior crossbite, eliminate canting, and reestablish occlusal contact at the mandibular occlusal plane. Bilateral sagittal split ramus osteotomy was done to correct the residual mandibular deviation. A genioplasty was also performed to improve chin projection. Postoperatively, the oropharyngeal airway was enlarged. The patient's facial profile and obstructive sleep apnea problem were improved as a result of advancement and counterclockwise rotation of the maxillomandibular complex.


Assuntos
Disostose Mandibulofacial , Cirurgia Ortognática , Procedimentos Cirúrgicos Ortognáticos , Osteogênese por Distração , Adulto , Cefalometria , Humanos , Masculino , Mandíbula/diagnóstico por imagem , Mandíbula/cirurgia , Disostose Mandibulofacial/complicações , Disostose Mandibulofacial/cirurgia , Adulto Jovem
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