RESUMEN
OBJECTIVE: The aim of this study was to estimate the influence of flap design on alveolar osteitis (AO) and postoperative side effects following third molar surgery. STUDY DESIGN: This study was designed as a randomized single-blind clinical trial. The predictor variable was flap type. Envelope flap and modified triangular flap techniques were used. The primary outcome variable was AO. The secondary outcome variables were pain, swelling, and trismus. Descriptive and bivariate statistics were computed. Statistical significance was set at P ≤ .05. RESULTS: Eighty patients with impacted mandibular third molars participated in the study. The envelope flap design was associated with a higher incidence of AO that was not statistically significant. On the second day, postoperative pain and swelling was observed as significantly different with the envelope flap technique. CONCLUSIONS: The modified triangular flap had the advantage of less postoperative pain and swelling but had the disadvantage of AO.
Asunto(s)
Alveolo Seco/etiología , Tercer Molar/cirugía , Dolor Postoperatorio , Complicaciones Posoperatorias , Colgajos Quirúrgicos/efectos adversos , Extracción Dental/efectos adversos , Diente Impactado/cirugía , Adolescente , Adulto , Femenino , Humanos , Masculino , Persona de Mediana Edad , Estudios Prospectivos , Método Simple Ciego , Estadísticas no Paramétricas , Extracción Dental/métodosRESUMEN
PURPOSE: To identify the quality of newly formed bone in the distraction region and to determine the percentage of mineralized bone formed in the distraction area. METHODS: Ten patients with vertically deficient mandibular alveolar ridges were treated by means of distraction osteogenesis. Four months after consolidation of distracted segments, a total of 40 dental implants were inserted in native bone and distracted bone. Bone biopsies were taken at the implant sites with trephine burrs for histological and histometric analyses. Four months after implant placement, abutments were connected, and prosthetic loading of the implants was started. RESULTS: The mean bone gain at the end of distraction was 7.2 ± 0.8 mm. The cumulative success rate of implants 3 years after the onset of prosthetic loading was 100%. The newly formed bone consisted of woven bone reinforced by parallel-fibered bone with bone marrow spaces and the percentage of mineralized bone ranged from 50.56% to 76.88%. CONCLUSIONS: Alveolar distraction osteogenesis is able to produce adequate mature bone for the correction of mandibular bone deficits before dental implant insertion.
Asunto(s)
Aumento de la Cresta Alveolar/métodos , Mandíbula/cirugía , Osteogénesis por Distracción/métodos , Biopsia , Médula Ósea/patología , Calcificación Fisiológica/fisiología , Estudios de Cohortes , Diseño de Implante Dental-Pilar , Implantación Dental Endoósea , Prótesis Dental de Soporte Implantado , Estudios de Seguimiento , Humanos , Procesamiento de Imagen Asistido por Computador/métodos , Fijadores Internos , Arcada Edéntula/rehabilitación , Arcada Edéntula/cirugía , Mandíbula/patología , Osteogénesis/fisiología , Osteogénesis por Distracción/instrumentación , Resultado del TratamientoRESUMEN
Treatment of a woman suffering from oligodontia and multiple diastemata with insufficient alveolar ridges in both the maxilla and mandible is described in this clinical report. The total number of missing teeth was 11 (excluding the wisdom teeth). The treatment strategy consisted of an interdisciplinary team approach of orthodontic, surgical, and prosthodontic phases. Sinus floor augmentation, alveolar ridge augmentation via vertical alveolar distraction, and lateral augmentation with ramus graft procedures were performed after fixed orthodontic treatment and prior to dental implant placement. Oral rehabilitation of the patient was completed with the placement of fixed prostheses in the maxillary and mandibular posterior edentulous areas. Early dental intervention improved the patient's appearance and minimized the onset of emotional and psychosocial problems.
Asunto(s)
Pérdida de Hueso Alveolar/cirugía , Anodoncia/rehabilitación , Implantación Dental Endoósea , Prótesis Dental de Soporte Implantado , Procedimientos Quirúrgicos Preprotésicos Orales/métodos , Pérdida de Hueso Alveolar/complicaciones , Anodoncia/complicaciones , Trasplante Óseo , Diastema/terapia , Femenino , Humanos , Maloclusión Clase II de Angle/terapia , Seno Maxilar/cirugía , Ortodoncia Correctiva , Osteogénesis por Distracción , Grupo de Atención al Paciente , Dimensión Vertical , Adulto JovenRESUMEN
Myofibroma is a benign mesenchymal neoplasm composed of myofibroblasts which has been described with different synonyms since the first report in 1951. It occurs most commonly as a solitary lesion of soft tissue, skin, or bone in infancy. The prognosis of oral myofibromas is excellent, and surgical excision is curative. Recurrence is rare. Awareness and recognition of this benign tumor is important to establish the correct diagnosis and avoid morbidity of unnecessary aggressive therapy. This report describes a myofibroma of the gingiva in a 14 year old girl and is reported together with the conventional histologic, and immunohistochemical findings. The tumor showed rapid increase in size and clinical features suggestive of malignancy. However on histopathologic evaluation it was diagnosed as a benign neoplasm, and this diagnosis was supported by immunohistochemical markers. The spindle cells were immunopositive for smooth muscle actin, and vimentin but were negative for desmin and S-100 protein. The patient was treated with surgical excision, and is followed-up for 33 months without any signs of recurrence.
Asunto(s)
Neoplasias Gingivales/diagnóstico , Miofibroma/diagnóstico , Actinas/análisis , Adolescente , Desmina/análisis , Diagnóstico Diferencial , Femenino , Estudios de Seguimiento , Neoplasias Gingivales/patología , Humanos , Inmunohistoquímica , Miofibroma/patología , Proteínas S100/análisis , Vimentina/análisisRESUMEN
PURPOSE: The aim of this clinical study was to analyze the outcome, complications, and long-term results of transpalatal distraction for the correction of maxillary transverse deficiency (MTD) and assess skeletal and dental changes in the sagittal, vertical, and transverse planes through cephalograms and dental casts. PATIENTS AND METHODS: Ten adult patients with MTD were treated with a Transpalatal Distractor (Surgi-Tec, Bruges, Belgium). Lateral and posteroanterior cephalometric films and dental casts were taken before surgery and at the end of the consolidation period. The statistical analysis of cephalometric film and dental cast measurements was undertaken with paired t tests. RESULTS: The intraoperative and postoperative problems encountered were damage to the central incisive teeth as a result of vertical osteotomy, wound dehiscence after the latent period, pain during the distraction period, and loosening of the distractor and buccal displacement of the left alveolar segment during the consolidation period. Model analysis showed that the greatest amount of transverse increase was in the premolar region (7.07 mm for first premolar and 7.10 mm for second premolar). Frontal cephalometric analysis indicated that transverse distances increased more at the alveolar level (7.75 mm) than in the maxillary base (5.25 mm) and nasal region (4.3 mm). The asymmetries between the left and right sides in both dental and skeletal expansions were statistically nonsignificant. The changes in the Sella-nasion-point A, Sella-nasion-point B, Sella-nasion and gonion-gnasion angles were statistically significant. CONCLUSIONS: According to the results of this study, transpalatal distraction was found to be a clinically effective technique for palatal expansion in adult patients with MTD. However, treatment planning and regular clinical follow-up visits are necessary for long-term clinical success.
Asunto(s)
Osteogénesis por Distracción/instrumentación , Técnica de Expansión Palatina/instrumentación , Paladar Duro/cirugía , Adolescente , Adulto , Cefalometría , Falla de Equipo , Femenino , Humanos , Incisivo/lesiones , Masculino , Osteogénesis por Distracción/efectos adversos , Dolor Postoperatorio/etiología , Técnica de Expansión Palatina/efectos adversos , Dehiscencia de la Herida Operatoria , Adulto JovenRESUMEN
OBJECTIVE: The aim of this retrospective study was to analyze the outcome and complications of alveolar distraction osteogenesis for the correction of vertically deficient ridges by using intraosseous and extraosseous distractors. STUDY DESIGN: Seven patients with severely atrophic alveolar crests were treated by distraction osteogenesis in 5 alveolar ridge deficiencies by intraosseous distractors and in 2 alveolar ridge deficiencies by extraosseous distractors. The bone deficiencies were secondary to atrophy after periodontal disease, tooth extraction, or trauma. Three months after consolidation of the distracted segments, implants were placed in the distracted areas. The average follow-up period after prosthetic loading was 50 months. RESULTS: The mean alveolar height achieved was 7.8 mm (range, 4-9 mm). The intraoperative and postoperative problems encountered were lack of device activation (n = 1), lingual displacement of the distracted segment (n = 1), paresthesia of the lower lip (n = 4), and dehiscence and plate exposure (n = 2). Most of these complications were considered to be minor complications and were solved without any problems. CONCLUSION: It was concluded that alveolar distraction osteogenesis seems to be an effective technique to treat vertical alveolar ridge deficiencies, but adequate treatment planning is necessary for success. The complications related to this technique can be solved with simple treatments.