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1.
BMC Oral Health ; 22(1): 155, 2022 05 02.
Artigo em Inglês | MEDLINE | ID: mdl-35501780

RESUMO

BACKGROUND: The abnormal facial features in maxillary transverse deficiency (MTD) are minimal and limited to a deficiency of the middle facial third, narrow nares and nasal base, and deepened nasolabial folds. The surgical expansion of the narrow maxilla has most obvious effects on widening of the maxillary dental arch and expansion of the maxillary and palatal structures in the transverse plane, however sagittal changes also occurs. The purpose of this observational study was to evaluate the three-dimensional (3D) facial soft tissue changes following surgically assisted rapid maxillary expansion (SARME). METHODS: In 15 skeletally mature patients with severe maxillary transverse deficiency, the planned maxillary expansion (on average 8.8 mm ± 2.3 mm) was achieved with a bone-borne palatal distractor. The 3D optical scans of the facial surface were obtained before and six months after SARME. In the first part, we defined different anatomical landmarks on both scans and compared cephalometric measurements. In the second part, we registered both 3D scans in the same workplace using the regional best-fit method (forehead, supraorbital and nasal root regions were selected for the superimposition) and conducted surface analysis. RESULTS: The largest differences between the pre- and post-operation scans were observed in the paranasal and cheek area (1.4 ± 1.0 mm). Significant differences occurred for an increased nasal width, a decreased upper-face height with an unchanged lower height, an increased vertical philtrum height and an increased nasolabial angle. A significant increase in the facial profile angle was also observed, resulting in an increased facial convexity and anterior displacement of the upper-lip area. CONCLUSIONS: The widening of the nose and increased projection in the cheek and paranasal area in the lateral direction after maxillary expansion were confirmed; moreover, facial convexity increases, reflecting the underlying advancement of the maxilla.


Assuntos
Maxila , Técnica de Expansão Palatina , Cefalometria , Face , Humanos , Maxila/diagnóstico por imagem , Maxila/cirurgia , Palato
2.
Med Eng Phys ; 103: 103783, 2022 May.
Artigo em Inglês | MEDLINE | ID: mdl-35500986

RESUMO

Dynamic computer-aided implant surgery (DCAIS) can improve dental implantation accuracy and reduce surgical risks. In the registration procedure of DCAIS, the type and the number of registration markers significantly impact the accuracy of DCAIS. One problem of DCAIS in clinical application is that only invasive screw markers can be used for implantation in edentulous patients. It could cause additional trauma, scar formation and usually increase patient discomfort. In this experiment, a personalized 3D-printed edentulous maxillary model was used for simulating clinical situations, and a 3D-printed noninvasive adhesive marker (3D-PNAM) was designed to figure out the above problem. In this research, six target screws were implanted into the model's maxillary alveolar ridge as targets for accuracy analysis. This study used target registration error (TRE) as an index to evaluate the accuracy of invasive screw makers and noninvasive adhesive markers. Results showed that 3D-PNAMs had the same accuracy as screw markers, and placing at least six registration markers in the maxilla was needed for good registration accuracy. The registration markers should be further improved and designed according to application areas' clinical needs and anatomical characteristics in future clinical studies.


Assuntos
Maxila , Cirurgia Assistida por Computador , Adesivos , Humanos , Maxila/cirurgia , Impressão Tridimensional , Próteses e Implantes , Cirurgia Assistida por Computador/métodos
3.
Braz Dent J ; 33(2): 44-51, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35508035

RESUMO

Le Fort I osteotomy is widely used in orthognathic surgery to correct maxillary deformities. However, this osteotomy may be related with the increase of alar base width. The aims of the present study were to compare two alar cinch suture after Le Fort I osteotomy and observe which type presents a better result in controlling the enlargement of the alar base after maxillary repositioning in orthognathic surgery. A randomized clinical trial was carried out with 40 patients randomly assigned in two intervention groups: group 1 - patients submitted to internal suture and group 2 - patients submitted to external suture. Of the 40 patients, 65% were female and 35% were male. The mean age of the patients was 30,25 in group I and 28,6 in group II. There was an increase in the alar base width in both groups, with significant difference between the means (P < 0,001). It was possible to compare the evolution of the means of the alar base width between group I and group II. Thus, it was observed that the external technique (group II) better controlled alar base width after Le Fort I osteotomy. It was not possible to relate the enlargement of the alar cinch with maxillary movement performed (P > 0,05). Overall, alar base cinch suture is an essential component of Le Fort osteotomies to control the alar base width. In this study, the external technique was more effective when compared to the internal technique in controlling the enlargement of the alar base width.


Assuntos
Cirurgia Ortognática , Cefalometria/métodos , Feminino , Humanos , Masculino , Maxila/cirurgia , Cartilagens Nasais/cirurgia , Osteotomia de Le Fort/métodos , Técnicas de Sutura , Suturas
4.
Orv Hetil ; 163(14): 558-563, 2022 Apr 03.
Artigo em Inglês | MEDLINE | ID: mdl-35377855

RESUMO

Összefoglaló. Bevezetés: A fogmedernyúlvány vertikális augmentációja implantátumon elhorgonyzott protetikai rehabilitáció céljából jól ismert eljárás. A szakirodalomban a fogmedernyúlvány szájüreg felé történo vertikális felépítése során a szövodmények elofordulása és a csontfelszívódás kockázata emelkedettebb a lateralis fogmedernyúlvány felépítésénél, illetve a sinuselevatiónál tapasztaltakhoz képest. Célkituzés: Retrospektíven vizsgáltuk a vertikális augmentáció sikerességét a felépített csont stabilitása és az esetleges szövodmények szempontjából. Módszer: 186, monokortikális csontaugmentációval ellátott betegünk dokumentációját tekintettük át és szukítettük két csoportra. Az egyik csoportba azokat a betegeket soroltuk, akik esetében a vertikális augmentációt a sinus maxillaris nyálkahártyájának emelésével végeztük, a másik csoportba azokat a betegeket választottuk be, akiknél a fogmedernyúlvány vertikális emelése a szájüreg felé történt monocorticalis csontblokk átültetésével. Mindkét csoportba olyan a betegek kerültek, akiknél legalább 3 éves, röntgenfelvétellel alátámasztott klinikai után követési dokumentáció állt rendelkezésre. A panorámaröntgen-felvételeken az implantátumok körül kialakult csontfelszívódás mértékét vizsgáltuk, a klinikai feljegyzésekbol pedig az implantátum körüli lágy szövetek állapotáról és az esetleges szövodményekrol tájékozódtunk. Eredmények: A sinus maxillaris nyálkahártyájának emelésével elért augmentáció során az implantátum csúcsánál, illetve a nyaki területen 11 esetbol 8-ban nem észleltünk csontfelszívódást (72%). A fennmaradó 3 esetben összesen 3 implantátum volt érintett, ami a beültetett 36 implantátum 8%-a. Tehát a beültetett összes implantátum 92%-át nem érintette csontfelszívódás. A fogmedernyúlvány szájüreg felé történo vertikális augmentációja során az esetek 46%-ában nem tapasztaltunk csontfelszívódást, ami az implantátumokra vonatkoztatva 24% volt. Implantátumvesztés egyik csoportban sem történt, szövodmény sem volt észlelheto. Következtetés: A szájüreg felé történt vertikális csontfelépítés a nyaki reszorpció szempontjából vizsgálatunkban emelkedett kockázattal járt, azonban gyulladást, implantátumvesztést hosszú követési ido alatt sem észleltünk. Orv Hetil. 2022; 163(14): 558-563. INTRODUCTION: Vertical augmentation of the alveolar process for dental implantation is a well-established approach. The literature suggests that vertical ridge augmentation is associated with an elevated risk of complications and bone resorption compared to lateral bone augmentation or sinus elevation. OBJECTIVE: We sought to retrospectively analyze the long-term success of vertical augmentation in terms of bone stability and complications. METHOD: We reviewed the medical records of 186 patients who underwent monocortical bone augmentation and narrowed them down to two smaller groups. Patients in one group were treated by sinus elevation, while patients in the other group were treated by vertical ridge augmentation. In both groups, the treatment was carried out utilizing autogenous monocortical bone blocks. Only those files were selected for analysis where follow-up documentation of a minimum of 3 years with panoramic X-ray images was available. We analyzed the frequency and degree of bone resorption and the frequency of implant loss and complications. RESULTS: 72% of the augmentation cases and 92% of the implants in the sinus elevation group were free of bone resorption in contrast to the vertical ridge augmentation group where only 46% of the augmentation cases and 24% of the implants were free of bone resorption. No implant loss or peri-implant complications were observed in either group. CONCLUSION: The results support the literature in that the risk of bone resorption is higher in cases of vertical ridge augmentation. However, this was not accompanied by functional alterations, peri-implant complications, or inflammatory phenomena and neither did it lead to implant loss, even in cases with more than a decade of follow-up. Orv Hetil. 2022; 163(14): 558-563.


Assuntos
Aumento do Rebordo Alveolar , Maxila , Aumento do Rebordo Alveolar/métodos , Transplante Ósseo/métodos , Humanos , Mandíbula/cirurgia , Maxila/cirurgia , Estudos Retrospectivos
5.
J Long Term Eff Med Implants ; 32(1): 25-32, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35377991

RESUMO

Implant therapy is a treatment option to ensure prosthesis survival rate and it is also done as a fixed dental prosthesis for replacing single and multiunit gaps. Posterior maxilla often has insufficient bone quality and quantity; for this reason it makes implant placement challenging in the site. Posterior edentulous maxilla presents special challenges to implant surgeons that are unique to this region compared to other regions of the maxilla. Thus, the aim of this study is to determine the common implant dimensions used in posterior maxilla. Completed case sheets were collected from a private dental hospital software system. Case sheets were taken from June 2019 to March 2020. Data was retrieved and evaluated by two reviewers. The parameters taken were patients, age groups, gender, teeth indicated for implants (maxillary premolars and molars), implant height, and implant width. Two-hundred fifty-four implants have been placed on the posterior maxilla of which 139 were premolars and 115 were molars. There was no statistical significance between the implants placed in both males and females (p value: 0.274). Between the age groups, the highest number of implants was seen in 41-60 years (n = 146) followed by 17-40 years (n = 78) and finally > 61 years (n = 30). The p value was 0.000, which was statistically significant. Various implant sizes for posterior maxilla have been introduced due to its challenging site. Thus in our study, we can see there is a difference in sizes for premolars and molars. Implant dimensions with increased height are used in the premolars compared to the molars. Implant dimensions with increased width are used in the molars compared to the premolars. In general, implant width and implant height can range from 3.6 to 4.5 mm and implant height ranging from 9.50 to 12.00 mm.


Assuntos
Maxila , Próteses e Implantes , Adulto , Feminino , Humanos , Masculino , Maxila/cirurgia , Pessoa de Meia-Idade , Estudos Retrospectivos
6.
BMC Oral Health ; 22(1): 114, 2022 04 08.
Artigo em Inglês | MEDLINE | ID: mdl-35395801

RESUMO

BACKGROUND: This prospective randomized clinical trial aimed to evaluate the immediate and short-term skeletal, dentoalveolar, and periodontal effects of rapid palatal expansion (RPE) and miniscrew-assisted RPE (MARPE) in adolescent and young adult patients. METHODS: This study followed a two-arm, parallel, randomized clinical trial design that recruited patients with transverse maxillary deficiency in a 1:1 allocation ratio. Forty patients (14 men and 26 women) requiring maxillary expansion were randomly allocated to the RPE (n = 20, age = 14.0 ± 4.5) or MARPE (n = 20, age = 14.1 ± 4.2) groups. The assignment was performed via computer-generated block randomization, with a block size of four. Upon identical (35 turns) amount of expansion, low-dose cone-beam computed tomography images were taken before treatment (T0), immediately after expansion (T1), and after a 3-month consolidation period (T2). The primary outcome of this study comprised the assessment of midpalatal suture separation. Secondary outcomes included, skeletal, dentoalveolar, and periodontal measurements, which were performed at each time point. RESULTS: The frequency of midpalatal suture separation was 90% (18/20) and 95% (19/20) for the RPE and MARPE groups, respectively. A greater increase in nasal width in the molar region (M-NW) and greater palatine foramen (GPF) was observed immediately after the expansion (T1-T0) and consolidation periods (T2-T0) in the MARPE group compared to the RPE group (P < 0.05). The MARPE and RPE groups showed similar dentoalveolar changes except for the maxillary width (PM-MW, M-MW). The MARPE group presented greater bilateral first premolar (PM-MW) and molar (M-MW) maxillary width in relation to the RPE group (P < 0.05). Through the expansion and consolidation periods (T2-T0), lesser buccal displacement of the anchor teeth was observed in the MARPE group (PM-BBPT, PM-PBPT, M-BBPT [mesial and distal roots], and M-PBPT)( P < 0.05). CONCLUSIONS: Midpalatal suture separation was observed in 90% and 95% of patients in the RPE and MARPE groups, respectively. Both RPE and MARPE groups exhibited significant triangular basal bone expansion and skeletal relapse during consolidation. Under identical amounts of expansion, the MARPE group showed lower decrease in the skeletal, dentoalveolar and periodontal variables after consolidation. The reinforcement of RPE with miniscrews contributes to the maintenance of the basal bone during consolidation period. Trial registration WHO Institutional Clinical Trials Registry Platform (IRB No. KCT0006871 / Registration date 27/12/2021).


Assuntos
Técnica de Expansão Palatina , Tomografia Computadorizada de Feixe Cônico Espiral , Adolescente , Criança , Tomografia Computadorizada de Feixe Cônico/métodos , Feminino , Humanos , Masculino , Maxila/diagnóstico por imagem , Maxila/cirurgia , Recidiva Local de Neoplasia , Palato/diagnóstico por imagem , Estudos Prospectivos , Adulto Jovem
7.
PLoS One ; 17(4): e0267677, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35482658

RESUMO

Morphological changes in the upper airway and the resulting alteration in the nasal respiratory function after jawbone repositioning during orthognathic surgery have garnered attention recently. In particular, nasopharyngeal stenosis, because of the complex influence of both jaws, the effects of which have not yet been clarified owing to postero-superior repositioning of the maxilla, may significantly impact sleep and respiratory function, necessitating further functional evaluation. This study aimed to perform a functional evaluation of the effects of surgery involving maxillary repositioning, which may result in a larger airway resistance if the stenosis worsens the respiratory function, using CFD for treatment planning. A model was developed from CT images obtained preoperatively (PRE) and postoperatively (POST) in females (n = 3) who underwent maxillary postero-superior repositioning using Mimics and ICEM CFD. Simultaneously, a model of stenosis (STENOSIS) was developed by adjusting the severity of stenosis around the PNS to simulate greater repositioning than that in the POST. Inhalation at rest and atmospheric pressure were simulated in each model using Fluent, whereas pressure drop (ΔP) was evaluated using CFD Post. In this study, ΔP was proportional to airway resistance because the flow rate was constant. Therefore, the magnitude of ΔP was evaluated as the level of airway resistance. The ΔP in the airway was lower in the POST compared to the PRE, indicating that the analysis of the effects of repositioning on nasal ventilation showed that current surgery is appropriate with respect to functionality, as it does not compromise respiratory function. The rate of change in the cross-sectional area of the mass extending pharynx (α) was calculated as the ratio of each neighboring section. The closer the α-value is to 1, the smaller the ΔP, so ideally the airway should be constant. This study identified airway shapes that are favorable from the perspective of fluid dynamics.


Assuntos
Biologia Computacional , Hidrodinâmica , Maxila , Constrição Patológica , Feminino , Humanos , Maxila/diagnóstico por imagem , Maxila/cirurgia , Faringe
8.
BMC Oral Health ; 22(1): 110, 2022 04 05.
Artigo em Inglês | MEDLINE | ID: mdl-35382808

RESUMO

BACKGROUND: Tooth extraction is often followed by remodeling of hard and soft tissues, while socket shield technique has been proposed to prevent or minimize this remodeling. Socket shield accompanied with delayed implant placement is a novel technique that could be used when delayed implantation is selected; however, more scientific based evidence is required to recommend this technique as everyday clinical practice. Thus, the aim of this case series was to assess the clinical, radiographic, and esthetic outcomes of the delayed placed implants associated with previously prepared socket shield at 3-15 months follow-up after loading. The stability of the shield and the depth of soft tissue penetration palatal to the shield at reentry of 3-6 months were also assessed. CASES PRESENTATION: Five case reports of socket shield with delayed implant placement were described in the study. The facial shields were prepared and simultaneously the sockets were grafted with mineralized allograft particles, then the implants were placed 3-6 months later. Periodontal probe was used to measure the depth of soft tissue penetration palatal to the shield at reentry. Clinical indices of bleeding index, plaque index, and probing depths were recorded. Radiographic evaluation to record the amount of marginal bone loss post-loading, esthetic assessment using modified pink esthetic score, and patient assessed outcomes were also evaluated at 3-15 months follow-up after loading. At 3-6 months reentry, all shields were stable with maintenance of the facial bone and with extreme hard tissue formation in the sockets. All five implants were successful and functional without any pain or inflammation, with optimal soft tissue health and esthetics, and with minimal radiographic marginal bone loss at the last follow-up visit (3-15 months after loading). CONCLUSIONS: Within the limits of this study, socket shield technique with delayed implant placement could be a predictable minimally invasive option for cases requiring delayed implant placement; however, a long-term well-designed clinical proof is warranted.


Assuntos
Implantes Dentários para Um Único Dente , Implantes Dentários , Carga Imediata em Implante Dentário , Estética Dentária , Humanos , Maxila/cirurgia , Extração Dentária/métodos , Alvéolo Dental/diagnóstico por imagem , Alvéolo Dental/cirurgia , Resultado do Tratamento
9.
Quintessence Int ; 53(6): 502-509, 2022 May 11.
Artigo em Inglês | MEDLINE | ID: mdl-35380207

RESUMO

OBJECTIVE: The aim of this study was to evaluate functional and esthetic clinical outcomes and patient satisfaction with narrow-diameter implants in comparison to standard-diameter implants in the anterior zone of the maxilla in a follow-up examination after 1 to 6 years. METHOD AND MATERIALS: The study was designed as a retrospective cohort study investigation including 27 patients receiving a 3.3-mm diameter single implant (NDI, n = 14) or a standard-diameter 4.1-mm single implant in the anterior zone of the maxilla (SDI, n = 16). Descriptive and analytical statistics were performed comparing both groups with regard to clinical examination including esthetic outcome, sulcus fluid flow-rate, crown esthetics, patients' satisfaction on visual analog scales, occurrence of biologic or technical complication, probing pocket depths (Fisher exact test), pink esthetic score (PES) and Periotest (Mann-Whitney U test). The level of significance was set at α = .05. RESULTS: The mean observation period was 4.8 years after crown insertion in the NDI group, and 4.9 years in the SDI group. Significant differences were observed for Periotest values in favor of the 4.1-mm implants (P = .014). No differences were found with regards to esthetics (PES; P = .27) or sulcus fluid flow-rate (P = 0.73) and probing pocket depths (P = .35). Overall patient satisfaction was high for both groups with visual analog scale scores of 9.3 ± 1.1 for NDI and 9.4 ± 1.0 for SDI (P = .39). CONCLUSION: Clinical outcome with narrow-diameter implants was comparable to standard-diameter implants in the anterior zone of the maxilla with similar esthetic assessments and patients' satisfaction.


Assuntos
Implantes Dentários para Um Único Dente , Implantes Dentários , Estudos de Coortes , Coroas , Estética Dentária , Humanos , Maxila/cirurgia , Estudos Retrospectivos , Resultado do Tratamento
10.
Clin Ter ; 173(2): 180-183, 2022 Apr 04.
Artigo em Inglês | MEDLINE | ID: mdl-35385042

RESUMO

Introduction: In the rehabilitation of total edentulous patients, lack of bone availability in posterior maxillary regions is common due to pneumatization of the maxillary sinus and posterior mandible due to the presence of the lower alveolar nerve. And to rehabilitate this type of patient, one of them is the use of short implants. Methods: The work aims to evaluate the success rate of treatment of short implants through a literature review. The search was carried out in august 2020 in the Pubmed (MedLine), Scopus and Embase databases, using the keywords: extra short implants, short implants, survival rate, single implant, atrophic mandible. The keywords followed the AND or OR criteria previously elaborated by the PICO question. The inclu-sion criteria were: implants with a length of 4 to 8 mm, which were single and in the posterior region of atrophic mandible and which had 5 years of follow-up. Articles were excluded from the review where the implants were splinted, had a follow-up of less than 5 years and considered short implants larger than 8 mm. Results: After the search, 4 articles were separated, which totaled an n = 172 short implants obtaining a success rate of 93.47% in 5 years. After the search, 4 articles were separated, which totaled an n = 172 short implants obtaining a success rate of 93.47% in 5 years. Conclusion: We can conclude that the use of short implants, even in single prostheses, has a high success rate, which can provide the edentulous patient with little bone bioavailability for rehabilitation.


Assuntos
Aumento do Rebordo Alveolar , Implantes Dentários , Atrofia/patologia , Implantação Dentária Endo-Óssea , Planejamento de Prótese Dentária , Seguimentos , Humanos , Mandíbula/cirurgia , Maxila/cirurgia , Próteses e Implantes , Resultado do Tratamento
11.
J Craniofac Surg ; 33(2): e107-e109, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35385232

RESUMO

ABSTRACT: Secondary alveolar bone grafting may not be feasible in a considerable number of patients who have cleft lip and palate, mainly because of the requirement for sizeable bony restitution and the insufficient amount of soft tissue for reliable coverage. Bone transport distraction and free vascularized bone transfers are the salvage techniques for treating these deformities and accomplishing successful bone grafting. This report presents a case of bilateral cleft lip and palate with a large palatoalveolar fistula and a rudimentary premaxilla after prior failed attempts at bone grafting. The authors used the free vascularized iliac bone flap with the osteotomies like puzzle for definitive restoration of the deformity.


Assuntos
Enxerto de Osso Alveolar , Fenda Labial , Fissura Palatina , Enxerto de Osso Alveolar/métodos , Transplante Ósseo/métodos , Fenda Labial/cirurgia , Fissura Palatina/cirurgia , Humanos , Maxila/cirurgia
12.
J Craniofac Surg ; 33(2): 390-394, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35385903

RESUMO

ABSTRACT: The efficacy of trans-sutural distraction osteogenesis therapy (TSDO) in treating midfacial hypoplasia in children with cleft lip and palate has been confirmed. However, few studies have reported that changes occur in the palate after TSDO treatment. To study the effect of TSDO on palatal morphology and its relative position in the craniofacial region, we retrospectively collected and measured the computed tomography images of 29 growing children with cleft lip and palate and midfacial hypoplasia, before and after TSDO. The results showed that the length and height of the palate did not change significantly, but the width and arch length increased, and the anterior area was more pronounced than the posterior area, with the median palatine suture still centered without obvious deviation. This suggests lateral palate growth after distraction, most likely around the median palatine suture. The distance from the palate to the cranial base also increased after distraction, and the anterior nasal spine moved forward, whereas the palate rotated by an average of 10.04° downward from the center of the anterior nasal spine. The increasing distance between the palate and cranial base may result from the growth of the nasal bone or the skull base. The oropharyngeal airway volume was also increased by an average of 2256.36 mm3, which may be beneficial to children's ventilatory function. In conclusion, TSDO therapy has influence on patients' palatal morphology and position, which should be considered before surgery.


Assuntos
Fenda Labial , Fissura Palatina , Osteogênese por Distração , Criança , Fenda Labial/diagnóstico por imagem , Fenda Labial/cirurgia , Fissura Palatina/diagnóstico por imagem , Fissura Palatina/cirurgia , Humanos , Maxila/cirurgia , Osteogênese por Distração/métodos , Palato Duro , Estudos Retrospectivos
13.
Medicina (Kaunas) ; 58(4)2022 Mar 23.
Artigo em Inglês | MEDLINE | ID: mdl-35454307

RESUMO

Background and Objectives: Corticotomy-facilitated orthodontics is an approach that can be useful in treating complex orthodontic cases and that could enhance the rate of tooth movement. The aim of this study was to evaluate the changes that occurred in the buccal cortical bone and at the root level after an orthodontic treatment when corticotomy was used, in Romanian patients. Materials and Methods: After dividing the subjects into two groups (maxillary and mandibular corticotomy), based on CBCT, measurements were made of the thickness of the cortical buccal bone at the cervical, median and apical level, and of the root length at T0 (before corticotomy) and T1 (6 months after surgery). Several tests were used for statistical analysis of the data. Results: In the maxillary arch, the bone thickness measured after corticotomy in males was 0.64 mm at the cervical level, 0.53 mm at the medial level and 0.30 mm in the apical area. In females, the values were 0.46 mm (cervical), 0.37 mm (medial) and 0.36 mm (apical). In the lower arch, the values obtained for these three regions were 0.37 mm, 0.30 mm and 0.37 mm for males and 0.58 mm, 0.32 mm and 0.43 mm for female subjects. All values were statistically significant. The root length for the lower teeth at T0 was 11.98 ± 2.24 mm at T0 and 11.97 ± 2.24 mm at T1. For the upper teeth, the root length at T0 was 13.83 ± 2.28 mm and 13.81 ± 2.28 mm. Conclusions: Comparing the measurements, it was observed that the biggest changes in the cortical bone were at the cervical level. In the maxillary arch, the most significant modifications were registered at the canines and the level of the first premolars, and in the lower arch at the incisors level. The measured root resorption of the teeth was considered to be statistically insignificant.


Assuntos
Processo Alveolar , Reabsorção da Raiz , Processo Alveolar/cirurgia , Feminino , Humanos , Masculino , Maxila/cirurgia , Romênia , Reabsorção da Raiz/etiologia , Técnicas de Movimentação Dentária , Raiz Dentária
14.
Zhonghua Kou Qiang Yi Xue Za Zhi ; 57(4): 346-351, 2022 Apr 09.
Artigo em Chinês | MEDLINE | ID: mdl-35368160

RESUMO

Objective: To evaluate the pink and white esthetics of conventional and socket shield technique (SST) immediate implant restoration. Methods: Thirty volunteers were recruited according to preset criteria, and were assigned to 3 groups. Natural teeth group (ten undergraduates or postgraduates from Peking University School and Hospital of Stomatology in January 2020, n=10): all volunteers' maxillary anterior teeth were natural teeth with healthy gingiva, and none of the teeth were restored by crowns or composite. Conventional group and SST group (patients had a maxillary central incisor immediate implant placed in Department of Prosthodontics, Peking University School and Hospital of Stomatology during October 2016 to January 2021, n=10 for each group): the volunteer had an unrestored natural maxillary central incisor, and the contralateral maxillary central incisor was restored by conventional or SST immediate implant placement, temporization and all ceramic final restoration, photos were taken 12 months post-surgery. Three groups of evaluators namely layperson (staff from Second Clinical Division of Peking University School and Hospital of Stomatology and 2 family members, n=10), dental students (class 2015 undergraduates from Peking University School and Hospital of Stomatology, n=10) and prosthodontists (from Department of Prosthodontics, Peking University School and Hospital of Stomatology, n=10) were invited to assess the esthetics using pink esthetic score (PES) and white esthetic score (WES). The results were statistically analyzed. Results: PES and WES of natural teeth group [9(8, 10) and 8(7, 10)] were significantly higher than conventional group [7(6,8) and 7(6,9)] (H=287.08, 132.79,P<0.01) and SST group [7(6, 9) and 8(7, 9)] (H=216.01, 101.21, P<0.01). SST group yielded higher PES than the conventional group (H=-71.06, P<0.01), yet had similar WES (H=-31.57, P>0.05). Dental students had significant lower PES and WES than prosthodontists (H=-120.90, -218.86, P<0.01) and layperson (H=-109.55, 134.97, P<0.01). Prosthodontists and layperson got similar PES (H=-11.36, P>0.05), however yielded different WES (H=-83.89, P<0.01). Conclusions: SST immediate implant placement obtained better pink esthetics than conventional protocol 12-month after implant surgery, profession may have significant impact on evaluators during pink and white esthetic evaluation.


Assuntos
Implantes Dentários para Um Único Dente , Implantes Dentários , Carga Imediata em Implante Dentário , Coroas , Estética Dentária , Humanos , Maxila/cirurgia , Resultado do Tratamento
15.
Zhonghua Kou Qiang Yi Xue Za Zhi ; 57(4): 430-435, 2022 Apr 09.
Artigo em Chinês | MEDLINE | ID: mdl-35368172

RESUMO

Recently, among the edentulous patients who undergo dental implants, the proportion of hypertensive patients remains high, which poses a greater challenge for clinicians to operate and to maintain the therapeutic effect. The present review comprehensively summarized clinical researches about the adverse effects on dental implants, outlined molecular mechanisms of the positive effects of various antihypertensive drugs on bone metabolism, and proposed that clinicians should select preventive strategies during preoperative and intraoperative procedures according to the blood pressure of patients with hypertension.


Assuntos
Perda do Osso Alveolar , Implantes Dentários , Hipertensão , Arcada Edêntula , Implantação Dentária Endo-Óssea/métodos , Prótese Dentária Fixada por Implante , Falha de Restauração Dentária , Humanos , Hipertensão/cirurgia , Maxila/cirurgia , Medição de Risco
16.
Head Face Med ; 18(1): 14, 2022 Apr 19.
Artigo em Inglês | MEDLINE | ID: mdl-35440012

RESUMO

BACKGROUND: Bimaxillary surgery is often performed for class III malocclusion, and its complex influence on the upper airway has been well considered. The aim of this research was to provide a scaled formula between upper airway volume changes and bone movements in Class III patients after orthognathic surgery. MATERIALS AND METHODS: Using a retrospective study design, the investigators enrolled a total of 30 class III malocclusion patients who were undergoing bimaxillary surgery as the study subjects. The subjects included 15 males and 15 females, and their average age was 23.3 ± 3.4 years. CBCT (cone beam tomography) was performed both before and one year after the surgery for each patient. The changes in the soft palate, tongue and upper airway were measured by using CBCT data that was collected before and after surgery. 3D superimposition of CBCT was performed to calculate three-dimensional jaw movements. A multiple regression analysis was used to calculate the quantitative relationship between airway volume changes and jaw movements. RESULTS: The nasopharynx airway volume was observed to be increased by 1064.0 ± 1336.2 mm3, whereas the retropalatal and retroglossal airway volumes were observed to be decreased by 1399.0 ± 2881.6 mm3 and 1433.8 ± 3043.4 mm3, respectively, after the surgery. One millimetre forward and downward movements of the PNS resulted in increases of 626.90 mm3 and 392.18 mm3 in nasopharynx airway volume, respectively. Moreover, one millimetre retrogression of the B point caused decreases of 314.6 mm3 and 656.6 mm3 in the retropalatal and retroglossal airway volume, respectively. The changes in the soft palate contributed to the decrease in the retropalatal airway volume, whereas the tongue compensated for the decrease in the retroglossal airway volume. CONCLUSION: The movements of the PNS and B points could be used to predict upper airway volumetric changes in Class III patients after maxillary advancement and mandibular setback.


Assuntos
Má Oclusão Classe III de Angle , Procedimentos Cirúrgicos Ortognáticos , Adulto , Cefalometria/métodos , Tomografia Computadorizada de Feixe Cônico/métodos , Feminino , Humanos , Masculino , Má Oclusão Classe III de Angle/diagnóstico por imagem , Má Oclusão Classe III de Angle/cirurgia , Mandíbula/cirurgia , Maxila/diagnóstico por imagem , Maxila/cirurgia , Procedimentos Cirúrgicos Ortognáticos/métodos , Faringe/diagnóstico por imagem , Estudos Retrospectivos , Adulto Jovem
17.
Artigo em Inglês | MEDLINE | ID: mdl-35472109

RESUMO

This prospective clinical study involved 20 patients in whom implants were immediately placed in extraction sockets. Residual bone defects were grafted, and the buccal bone plate was overcontoured with a xenogeneic bone substitute and covered by a collagen membrane. One year after implant placement, CBCT images were acquired to evaluate buccal bone, and implant stability was analyzed through resonance frequency analysis. Results showed that buccal bone covered the rough surface of all implants 1 year after implantation. Hard tissues responded more favorably in the flapless group. No correlation was found between initial bone defects and bone dimensions in the follow-up exam.


Assuntos
Perda do Osso Alveolar , Implantes Dentários para Um Único Dente , Carga Imediata em Implante Dentário , Perda do Osso Alveolar/cirurgia , Implantação Dentária Endo-Óssea/métodos , Humanos , Carga Imediata em Implante Dentário/métodos , Maxila/diagnóstico por imagem , Maxila/cirurgia , Estudos Prospectivos , Extração Dentária/métodos , Alvéolo Dental/diagnóstico por imagem , Alvéolo Dental/cirurgia , Resultado do Tratamento
18.
Artigo em Inglês | MEDLINE | ID: mdl-35472106

RESUMO

Maxillary sinus wall fenestration at the lateral wall or floor of the sinus can result from many potential factors, such as the repair of oro-antral communication, Caldwell-Luc antrostomy, tooth extraction after an endodontic or periodontal infection that eroded the sinus wall, and the combination of sinus pneumatization and alveolar ridge resorption after teeth removal. When sinus wall fenestration is observed on radiographs, it usually indicates adhesion between the sinus membrane and buccal flap, which makes the reentry surgery for subsequent sinus augmentation challenging. To minimize surgical complications in these challenging scenarios, this paper presents a split-flap surgical technique for the management of soft tissue adhesion between the sinus membrane and alveolar mucosa when attempting a lateral window sinus augmentation.


Assuntos
Seio Maxilar , Levantamento do Assoalho do Seio Maxilar , Processo Alveolar , Humanos , Maxila/diagnóstico por imagem , Maxila/cirurgia , Seio Maxilar/diagnóstico por imagem , Seio Maxilar/cirurgia , Levantamento do Assoalho do Seio Maxilar/métodos , Retalhos Cirúrgicos , Extração Dentária
19.
Artigo em Inglês | MEDLINE | ID: mdl-35472115

RESUMO

Connective tissue grafts have become a standard for compensating horizontal volume loss in immediate implant placement. The use of new biomaterials like acellular matrices may avoid the need to harvest autogenous grafts, yielding less postoperative morbidity. This randomized comparative study evaluated the clinical outcomes following extraction and immediate implant placement in conjunction with anorganic bovine bone mineral (ABBM) and the use of a porcine acellular dermal matrix (ADM) vs an autogenous connective tissue graft (CTG) in the anterior maxilla. Twenty patients (11 men, 9 women) with a mean age of 48.9 years (range: 21 to 72 years) were included in the study and randomly assigned to either the test (ADM) or control (CTG) group. They underwent tooth extraction and immediate implant placement together with ABBM for socket grafting and either ADM or CTG for soft tissue augmentation. Twelve months after implant placement, the cases were evaluated clinically and volumetrically. All implants achieved osseointegration and were restored. The average horizontal change of the ridge dimension at 1 year postsurgery was -0.55 ± 0.32 mm for the ADM group and -0.60 ± 0.49 mm for the CTG group. Patients of the ADM group reported significantly less postoperative pain. Using xenografts for hard and soft tissue augmentation in conjunction with immediate implant placement showed no difference in the volume change in comparison to an autogenous soft tissue graft, and showed significantly less postoperative morbidity.


Assuntos
Derme Acelular , Implantes Dentários , Carga Imediata em Implante Dentário , Animais , Bovinos , Tecido Conjuntivo/transplante , Feminino , Humanos , Carga Imediata em Implante Dentário/métodos , Masculino , Maxila/cirurgia , Suínos , Extração Dentária , Alvéolo Dental/cirurgia
20.
Beijing Da Xue Xue Bao Yi Xue Ban ; 54(2): 356-362, 2022 Apr 18.
Artigo em Chinês | MEDLINE | ID: mdl-35435204

RESUMO

OBJECTIVE: To evaluate the effect and summarize the characteristics of different treatment methods in repairing zygomatic defect. METHODS: A total of 37 patients with zygomatic defect were reviewed in the Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology from August 2012 to August 2019. According to the anatomical scope of defect, the zygomatic defects were divided into four categories: Class 0, the defect did not involve changes in zygomatic structure or continuity, only deficiency in thickness or projection; Class Ⅰ, defect was located in the zygomatic body or involved only one process; Class Ⅱ, a single defect involved two processes; Class Ⅲa, referred to a single defect involving three processes and above; Class Ⅲb, referred to zygomatic defects associated with large maxillary defects. The etiology, defect time, defect size and characteristics of zygomatic defects, the repair and reconstruction methods, and postoperative complications were collected and analyzed. Postoperative computed tomography (CT) data were collected to evaluate the outcome of zygomatic protrusion. Chromatographic analysis was used to assess the postoperative stability. RESULTS: Among the causes of defects, 25 cases (67.57%) were caused by trauma, and 11 cases (29.73%) were of surgical defects following tumor resection. We performed autologous bone grafts in 19 cases, 6 cases underwent vascularized tissue flap, 5 cases underwent external implants alone, and 7 cases underwent vascularized tissue flap combined with external implants. After the recovery of the affected side, the average difference of the zygomatic projection between the navigation group and the non-navigation group was 0.45 mm (0.20-2.50 mm) and 1.60 mm (0.10-2.90 mm), with a significant difference (P=0.045). Two patients repaired with titanium mesh combined with anterolateral thigh flap had obvious deformation or fracture of titanium mesh; 2 patients with customized casting prosthesis had infection after surgery and fetched out the prosthesis finally. CONCLUSION: Autologous free grafts or alloplastic materials may be used in cases without significant structural changes. Pedicle skull flap or vascularized bone tissue flap is recommended for zygomatic bone defects with bone pillar destruction, chronic inflammation, oral and nasal communication or significant soft tissue insufficiency. Titanium mesh can be used to repair a large defect of zygomatic bone, and it is suggested to combine with vascularized bone flap transplantation.


Assuntos
Procedimentos Cirúrgicos Reconstrutivos , Titânio , Humanos , Maxila/cirurgia , Prognóstico , Procedimentos Cirúrgicos Reconstrutivos/métodos , Estudos Retrospectivos
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