Stress isn’t just a mental burden—it can sneak into your oral health too! While you might not think of your teeth when you’re feeling overwhelmed, the connection between stress and dental well-being is real. The good news? Understanding this link can help you protect your smile—no matter how hectic life gets. From bustling cities like New York to serene retreats in Bali, everyone deserves ...
Short Answer
Ignoring a cavity can lead to severe pain, infections, tooth loss, and even systemic health issues. Early treatment by a dentist, like Dr. Andreas Tjandra at Doctor Dentist Clinic in West Jakarta, can prevent complications and save your smile.
Long Answer
A cavity is more than just a small hole in your tooth—it’s a warning sign of decay that, if left untreated, can spiral into ...
Short Answer
Ignoring a cavity can lead to severe dental problems, including tooth loss, infections, and even systemic health issues. Untreated cavities worsen over time, causing pain, sensitivity, and damage to surrounding teeth. Early treatment prevents complications and preserves oral health.
Long Answer
A cavity is a small hole in your tooth caused by decay, often due to poo...
Fluoride is a natural mineral that plays a crucial role in maintaining strong, cavity-free teeth. Whether you’re drinking fluoridated water or using fluoride toothpaste, this mineral helps protect your enamel and prevent tooth decay. But why is fluoride so important for dental health? Let’s break it down.
Short Answer
Fluoride strengthens tooth enamel, making it more resistant to acid attack...
Dental work like crowns and bridges can restore your smile and improve functionality, but they require proper care to last. Whether you’ve recently had a crown or bridge placed or want to maintain existing ones, knowing how to care for them is essential.
Short Answer
To care for dental crowns and bridges:
Brush and floss daily to prevent decay around the restoration.
Avoid hard or sticky f...
Gum disease, also known as periodontal disease, is a common but preventable condition that affects the tissues supporting your teeth. Left untreated, it can lead to tooth loss and other serious health issues. The good news is that with proper care, you can keep your gums healthy and prevent gum disease from developing.
Short Answer
To prevent gum disease, maintain good oral hygiene by brushing t...
Losing a tooth can affect your confidence, speech, and ability to chew properly. Fortunately, modern dentistry offers several effective solutions for replacing missing teeth. Whether you’ve lost a tooth due to decay, injury, or gum disease, understanding your options can help you make an informed decision.
Short Answer
The main options for replacing missing teeth include:- Dental implants (per...
If you're looking for a brighter smile, you're not alone. Teeth whitening is a popular cosmetic procedure, but it's essential to do it safely to avoid damaging your enamel or gums. The short answer is: use whitening toothpaste, baking soda, or professional treatments under dental supervision. For a deeper dive, let's explore safe and effective methods.
The long answer involves understanding the c...
Bad breath, or halitosis, can be embarrassing and frustrating. Whether it’s occasional or persistent, addressing the root cause is key to fresh breath. Here’s what you can do—quickly and in detail.
Short Answer
To combat bad breath, brush and floss daily, clean your tongue, stay hydrated, avoid strong-smelling foods, and visit your dentist regularly. If the issue persists, consult a doctor...
Short Answer:Yes, dental X-rays are generally safe when performed with modern equipment and proper precautions. The radiation exposure is minimal, and the benefits of early detection of dental issues far outweigh the risks.
Long Answer:Dental X-rays, also known as radiographs, are a crucial diagnostic tool in dentistry. They help dentists detect hidden dental problems like cavities, bone infectio...
Short Answer
During a dental check-up, you can expect a thorough examination of your teeth, gums, and mouth. The dentist will check for cavities, gum disease, and signs of oral cancer. They may also perform a professional cleaning, take X-rays if needed, and discuss oral hygiene tips. The visit typically lasts 30-60 minutes and is painless for most people.
Long Answer
A dental check-up is a rou...
Short Answer
A dentist focuses on general oral health, including cleanings, fillings, and tooth extractions, while an orthodontist specializes in correcting misaligned teeth and jaws using braces, aligners, and other treatments.
Long Answer
While both dentists and orthodontists are dental professionals, their roles and expertise differ significantly. Understanding these differences can help you...
Maintaining good oral hygiene is essential for a healthy smile and overall well-being. Proper brushing and flossing are the cornerstones of dental care, yet many people overlook the correct techniques. Whether you're a dental novice or a seasoned brusher, understanding the right methods can prevent cavities, gum disease, and bad breath.
Short Answer
The proper way to brush and floss teeth involv...
Short Answer
You should visit the dentist every 6 months for a routine check-up and cleaning. However, if you have specific dental concerns—such as gum disease, frequent cavities, or other oral health issues—your dentist may recommend more frequent visits.
Long Answer
Maintaining good oral hygiene goes beyond brushing and flossing daily. Regular dental visits are crucial for preventing prob...
Cavities, also known as dental caries, are one of the most common dental issues worldwide. They occur when bacteria in your mouth produce acids that erode tooth enamel, leading to decay. Recognizing the early signs of a cavity can help you seek timely treatment and prevent further damage. In this post, we willll explore the key indicators of a cavity, so you can take action before it worsens.
1. ...
Few treats are as universally loved as chocolate. Whether it is a creamy milk chocolate bar, a rich dark chocolate truffle, or a sweet white chocolate dessert, indulging in chocolate is a simple pleasure for many. But if you've ever wondered, "Is chocolate bad for my teeth?", you are not alone.
The answer isn't as straightforward as "yes" or "no." Chocolate can have both positive and negative eff...
A healthy mouth is more than just a bright smile—it’s a gateway to overall well-being. Poor oral hygiene can lead to gum disease, tooth decay, and even serious systemic health issues. On the other hand, maintaining good oral health boosts confidence, improves digestion, and reduces the risk of chronic diseases.
In this post, we’ll explore seven compelling reasons why keeping your mouth heal...
The All-on-4® implant technique is revolutionizing dental restoration, providing patients with a viable solution for full-arch tooth replacement. Ideal for those facing significant bone loss or decay, this innovative method utilizes just four strategically placed implants to support a complete set of teeth. In this blog post, we will explore the intricacies of All-on-4 implants, their benefits, t...
Abstract
Dental implants have revolutionized the field of prosthodontics, offering patients a more comfortable, functional, and durable alternative to traditional dentures and bridges. This paper examines the advantages of dental implants, including superior comfort, improved function, and biocompatibility, based on current research. We discuss how implants provide enhanced stability and confiden...
Abstract
Tooth loss represents a significant health concern that leads to profound functional and aesthetic challenges. One of the most critical consequences of tooth loss is the subsequent resorption of the underlying jawbone, a process accelerated by traditional dental solutions such as dentures and bridges. In contrast, dental implants have proven effective in preserving bone structure by stim...
Let's be real for a second—losing a tooth sucks. Whether you're dealing with it because you're getting older, you had an unfortunate accident, or your teeth just decided to betray you through disease, the impact goes way beyond just having a gap in your smile. It messes with your confidence, makes eating certain foods a nightmare, and honestly? It can make you feel like you've aged ten years ove...
Abstract
Osseointegration represents the biological cornerstone of contemporary dental implant therapy and is fundamental to achieving predictable long-term clinical success. First described by Brånemark, osseointegration is defined as a direct structural and functional connection between living bone and the surface of a load-bearing implant, without the interposition of fibrous tissue [1,2]. Th...
As we usher in the warmth and magic of Christmas and the excitement of the New Year, it's a time for reflection, celebration, and, of course, indulging in some of our favorite seasonal treats. While these festivities bring us joy and togetherness, they can also challenge our dental health. Between the candy canes, rich desserts, and festive meals, it’s easy for our teeth to take a backseat i...
As we usher in the warmth and magic of Christmas and the excitement of the New Year, it's a time for reflection, celebration, and, of course, indulging in some of our favorite seasonal treats. While these festivities bring us joy and togetherness, they can also challenge our dental health. Between the candy canes, rich desserts, and festive meals, it’s easy for our teeth to take a backseat i...
While the Bible does not mention "dentistry" as a modern profession, it contains several verses that describe teeth as symbols of beauty, health, and even spiritual discipline.
Here are the most relevant verses for dental professionals and patients:
1. Teeth as a Sign of Beauty and Health
In the Old Testament, having a full set of healthy, white teeth was a hallmark of physical perfection.
...
1. Overview of the Dental Implant Procedure
1.1. What Is a Dental Implant?
A dental implant is a modern solution for replacing missing or severely damaged teeth. It consists of a small titanium post, which serves as a replacement for the root of a missing tooth. This post is surgically placed into the jawbone, where it integrates over time through a process known as osseointegration. Once this p...
Abstract
Dental implants have become one of the most common and reliable solutions for replacing missing teeth. However, the success and longevity of dental implants are closely linked to the patient's commitment to maintaining optimal oral hygiene. Implants, unlike natural teeth, require specific care to avoid complications such as peri-implantitis and implant failure. This paper explores the cr...
Treatment arrangement and ground
The patient was first referred to the school of hygiene to treat the gum inflammation and improve his oral care. The treatment was planned in two main stages. In the first stage, the goal was to use growth to reduce the overjet, get the molars and canines into a normal Class I relationship, and create more room for the missing front tooth. This was done using a Tw...
Abstract
Children with an overjet of more than 6 mm have a threefold higher risk of upper incisor injuries than children with a typical overjet. This might be compounded by the avulsion of the permanent incisor and the loss of tooth space. Functional appliances are often utilized to address Class II skeletal patterns and increasing overjet in growing individuals. In the following example,...
After explaining the study's specifics, all patients provided written and informed consent. A medical questionnaire was used to collect a detailed history of the subjects, and a clinical oral examination was undertaken. Routine laboratory examinations were performed and documented for all individuals.
Maxillary and mandibular full dentures were made for all patients 6 to 8 weeks prior to implant ...
Introduction
Ineffective oral function, loss of structural balance, poor aesthetics, and psychological repercussions are all consequences of replacing lost teeth or teeth brought on by dental caries, chronic periodontitis, trauma, or anodontia. For these individuals to regain their natural shape, function, comfort, appearance, speech, and general health, restoration is necessary. For millennia, a...
Extensive research is necessary to determine the true reasons for extraction on nondental and nonmedical grounds in adults' permanent dentition (apart from third molars); this includes determining when such requests are fulfilled by extracting the tooth and the arguments for and against performing the extraction. Multiple well defined categories for non-dental and non-medical reaso...
The same is true of the few and poorly defined categories pertaining to the extraction indications in the included and examined research. For instance, there were either no descriptions of categories or a wide range of categories utilized in the three research that were analyzed. Two studies put impacted teeth, pericoronitis, and unidentified causes under the "other reasons" category, whereas one ...
Discussion
According to the review's findings, the primary reasons why oral (and maxillofacial) surgeons and dentists undertake dental extractions are periodontitis and cavities. Orthodontics, periapical illness, trauma, and other causes are also common indications. In general, this is consistent with earlier research, including that which did not fit the current review's inclusion requirements. ...
SBP (mmHg)
DBP (mmHg)
PR (bpm)
RPP (bpm × mmHg)
Normotensive patients (N = 410)
On arrival at the office
133.0 ± 18.4
76.4 ± 12.5
79.2 ± 13...
SBP (>160 mmHg)
RPP (>12,000 bpm × mmHg)
Normotensive group (N = 410)
On arrival at the office
41 (10.0%)
111 (27.1%)
Prior to sedation
...
Normotensive group
Hypertensive group
p
value
Number (male: female)
410 (127: 283)
106 (37: 69)
0.170
Age (year mean ± SD)
...
Kimura, M., Takasugi, Y., Hanano, S. et al. Efficacy of intravenous sedation and oral nifedipine in dental implant patients with preoperative hypertension - a retrospective study of 516 cases. Int J Implant Dent 1, 6 (2015). https://doi.org/10.1186/s40729-015-0004-4
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Received: 08 October 2014
Accepted: 14 January 2015
Published: 18 March 2015
DOI: https://doi.org/10.1186/s407...
Motoshi Kimura, Yoshihiro Takasugi, Shigeyoshi Hanano, Katsuyuki Terabe and Yuko Kimura declare that they have no competing interests.
YT and MK designed the study; MK, SH, and KT performed the surgeries; YT performed the intravenous sedation. YT, MK, and YK collected and analyzed the data; MK wrote the manuscript. YT revised the manuscript. All authors read and approved the final manuscript.
Hanano Dental Clinic, 4-2-3 Yamanoue, Hirakata, Osaka, 573-0047, Japan
Motoshi Kimura & Shigeyoshi Hanano
Department of Anesthesiology, Kinki University Faculty of Medicine, 377-2 Ohno-Higashi, Osaka-Sayama, Osaka, 589-8511, Japan
Yoshihiro Takasugi
Terabe Dental Clinic, 4-249 Sakae-cho, Tsu, Mie, 514-0004, Japan
Katsuyuki Terabe
First Department of Internal Medicine, Osaka Medical College...
Abraham-Inpijn L, Borgmeijer-Hoelen A, Gortzak RAT. Changes in blood pressure, heart rate, and electrocardiogram during dental treatment with use of local anesthesia. J Am Dent Assoc. 1988;116:531–6.
Brand HS, Gortzak RA, Palmer-Bouva CC, Abraham RE, Abraham-Inpijn L. Cardiovascular and neuroendocrine responses during acute stress induced by different types of dental treatment. Int Dent J. 1995...
Little JW. The impact on dentistry of recent advances in the management of hypertension. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2000;90:591–9.
Aubertin MA. The hypertensive patient in dental practice: updated recommendations for classification, prevention, monitoring, and dental management. Gen Dent. 2004;52:544–52.
Vaughan CJ, Delanty N. Hypertensive emergencies. Lancet. 2000;356...
Systolic blood pressure
Diastolic blood pressure
Pulse rate
Rate pressure product
Electrocardiogram
Percutaneous oxygen saturation
Analysis of variance
Immediate-release
In this study, we showed that the stable hemodynamic was obtained by performing intravenous sedation and oral administration of nifedipine for patients with hypertension. It is important not only to understand the systemic management of the patient but also to obtain stabled hemodynamic by performing intravenous sedation and oral administration of nifedipine for patients with hypertension in order...
Implant surgery is performed in patients with a wide age range, including elderly patients with hypertension. Dentists or oral surgeons often encounter hypertensive patients who are undiagnosed or noncompliant. Among Japanese over the age of 30, 60% of men and 44.6% of women suffer from high blood pressure, and 33.8% of men and 25.6% of women with a history of hypertension have not been managed me...
For patients with stage 2 hypertension before operation, it is difficult to maintain the recommended blood pressure during surgery using only intravenous sedation, and it is necessary to decrease blood pressure by antihypertensive drugs. In this study, the blood pressure of patients with sustained hypertension was reduced to stage I hypertension about 30 min after administration of oral nifedipin...
In 44 (8.5%) of the 516 implant surgery cases, oral nifedipine had to be administered, since preoperative SBP was higher than 160 mmHg in these patients. Within 30 min of administration of nifedipine, SBP of hypertensive patients decreased to a similar range as that of hypertensive patients who did not need administration of oral nifedipine. Intravenous sedation after nifedipine administration t...
In patients with oral nifedipine in the hypertensive group, the PR value slightly increased prior to initiation of intravenous sedation (p = 0.224) and then significantly decreased until completion of the operation (p 160 mmHg during and at completion of operation showed maximum SBP of 180 mmHg in the normotensive group, 190 mmHg on the hypertensive group without preoperative oral nifedip...
Patient demographics and clinical characteristics are summarized in Table 1. There were significant differences in age (p
This study protocol was approved by the ethics committee of Japanese Dental Society of Anesthesiology (No. 2015–4).
Following confirmation of a sufficient anesthetic effect, intravenous sedation with continuous infusion of propofol 1 to 2 mg/kg/h and midazolam 20 to 40 μg/kg bolus together with inhalation of oxygen 3 L/min via nasal cannula was initiated. After confirming Verrill sign, implant surgery was initiated. During operation, the propofol dose was adjusted to maintain the optimum conscious sedative ...
A retrospective review of the clinical records was conducted for 336 patients who received dental implant-related surgeries combined with intravenous sedation between January 2008 and February 2012 at our outpatient dental offices. Among the patients, 125 patients received multiple surgeries during the observation period: 4 patients underwent surgery five times, 7 patients four times, 29 patients ...
Osseointegrated dental implants were introduced in Japan in 1983, and the procedures are now performed very frequently. Dental implants are placed in a wide age range of patients, including elderly patients with hypertension. Patients with very high blood pressure are at great risk for acute medical problems when undergoing stressful dental procedures, such as oral surgery, periodontal surgery, an...
To examine the effects of intravenous sedation and oral nifedipine on blood pressure and pulse rate in patients with perioperative high blood pressure undergoing implant surgery, the clinical records of dental implant patients managed by intravenous sedation at our outpatient dental offices were retrospectively evaluated.
A total of 516 clinical charts were evaluated. The subjects were divided in...
Fig. 7. The epithesis allows both prompt inspection of the resection site and makes daily care easier
Fig. 7. The epithesis allows both prompt inspection of the resection site and makes daily care easier
Fig. 6. Frontal view of the patient after superior overdenture and nasal prosthesis delivery
Fig. 6. Frontal view of the patient after superior overdenture and nasal prosthesis delivery
Fig. 5. The intraoral bar crossing the palatal defect arising the nasal understructure
Fig. 5. The intraoral bar crossing the palatal defect arising the nasal understructure
Fig. 4. A front view of the bar with the intraoral portion and the metal extension for epithesis attachment
Fig. 4. A front view of the bar with the intraoral portion and the metal extension for epithesis attachment
Fig. 3. Postoperative panorex showing the symmetric distribution of the fixtures
Fig. 3. Postoperative panorex showing the symmetric distribution of the fixtures
Fig. 2. The healing abutments positioned onto fixtures and the oronasal communication
Fig. 2. The healing abutments positioned onto fixtures and the oronasal communication
Fig. 1. Intraoperative view of the zygoma implants placed in the residual maxilla
Fig. 1. Intraoperative view of the zygoma implants placed in the residual maxilla
Trevisiol, L., Procacci, P., D’Agostino, A. et al. Rehabilitation of a complex midfacial defect by means of a zygoma-implant-supported prosthesis and nasal epithesis: a novel technique.
Int J Implant Dent 2, 7 (2016). https://doi.org/10.1186/s40729-016-0043-5
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Received: 22 July 2015
Accepted: 23 March 2016
Published: 01 April 2016
DOI: https://doi.org/1...
Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were...
Francesca Ferrari, Pasquale Procacci, Lorenzo Trevisiol, Pier Francesco Nocini, Daniele De Santis and Antonio D’Agostino declare that they have no competing interests.
FF was involved in revising the manuscript critically. PP was involved in drafting the manuscript. LT is another surgeon that belongs to surgery equipment. PFN, head professor and surgeon, operated the patient. DDeS was involved ...
Department of Surgery, Section of Oral and Maxillofacial Surgery, University of Verona, Policlinico “Giovanni Battista Rossi”, Piazzale Ludovico Antonio Scuro, 10, 37134, Verona, Italy
Lorenzo Trevisiol, Pasquale Procacci, Antonio D’Agostino, Francesca Ferrari, Daniele De Santis & Pier Francesco Nocini
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Karakoca S, Aydin C, Handan Y, Bal BT. Retrospective study of treatment outcomes with implant- retained extraoral prostheses: survival rates and prosthetic complications. J Prosthet Dent. 2010;103:118–26.
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Parel SM, Branemark PI, Ohrnell LO, Svensson B. Remote implant anchorage for the rehabilitation of maxillary defects. J Prosthet Dent. 2001;86:377–81.
Bowden JR, Flood TR, Downie IP. Zygomaticus implants for retention of nasal prostheses after rhinectomy. Br J Oral Maxillofac Surg. 2006;44:54–6.
D’Agostino A, Procacci P, Ferrari F, Trevisiol L, Nocini PF. Zygoma implant-supported prostheti...
Written informed consent was obtained from the patient for publication of this case report and any accompanying images. A copy of the written consent is available for review by the Editor-in-Chief of this journal.
Implant-supported prosthesis is a valid method to restore resected oral and head cancer patients and offers a good chance to social reintegration. The aesthetic result and facial camouflage are more achievable by means of dentures and epithesis than with several reconstructive interventions. Furthermore, due to the high risk of recurrences, it is sometime mandatory to keep the defect inspectionabl...
Rethinking globally of the possible indications to the adoption of this technique and its advantages compared to reconstructive microsurgery, the use of zygoma-implant-supported prosthesis may be suitable for patients whose systemic conditions are poor. The duration of surgery and of the postoperative recovery would be remarkably shortened avoiding the complications related to the harvesting of a ...
As far as prosthetic design is concerned, it is mandatory to avoid or, if not possible, limit as much as possible distal cantilever: given the absence of the premaxilla, an anterior cantilever is already present. Implant splintage is recommended [1, 8], and the bar design must respect technical data (implant-to-implant distance, cross-arch stabilization avoiding to cover oronasal communication and...
Patients with advanced orofacial cancer may require extensive surgical resection; the wider and more evident is the amputated region, the more this condition is generating inability for patients [6]. Visible head site mutilation and functional impairment in speech prevent social reintegration, and abnormal self-perception leads patients to depression [6].
Even if modern surgery offers many techni...
Cortical steroids were administered for the first two postoperative days. A postoperative 10-day cycle of antibiotic therapy (amoxicillin 1000 mg TID) was administered. Analgesics were administered as required. Sutures were removed 15 days after surgery. A soft diet was recommended for the first 2 weeks.
Three months afterwards, healing abutments were connected (Fig. 2) [4].
Approximately 4...
The patient, a male 46 years old at the time of our visit, underwent surgical resection of nasal pyramid and premaxilla including the whole upper jaw teeth sparing nasal bones. When the patient came to our clinic, apart from the defect resulting from the resection, he presented with a retraction scar crossing the upper lip from the floor of the nasal defect through the filtrum. The surgical resec...
The use of zygoma implants in the rehabilitation of patients who underwent surgical resection for oral cancer has been widely described [1–3]. There are several possibilities that can be considered when evaluating the possibility of surgical reconstruction after the first cancer resection, such as microvascular free flaps or rotation flaps, but it is sometimes necessary to monitor the healing pr...
Several authors have described zygoma implants as a reliable surgical option to rehabilitate severe maxillary defects in case of extreme atrophy or oncological resections. The aim of this study is to report a new technical approach to the rehabilitation of a complex oronasal defect by means of a zygoma-implant-supported full-arch dental prosthesis combined with a nasal epithesis.
The patient pres...
Fig. 5. Total score for physical and psychological disabilities before (gray) and after (hatched) sinus augmentation according to indications
Fig. 5. Total score for physical and psychological disabilities before (gray) and after (hatched) sinus augmentation according to indications
Fig. 4. Total score for functional limitations before (gray) and after (hatched) sinus augmentation according to indications
Fig. 4. Total score for functional limitations before (gray) and after (hatched) sinus augmentation according to indications
Fig. 3. Total score for complaints due to surgical procedure pre-operative, post-operative, and recently
Fig. 3. Total score for complaints due to surgical procedure pre-operative, post-operative, and recently
Fig. 2. Cumulative survival rate according to Kaplan–Meier and sinus augmentation procedure
Fig. 2. Cumulative survival rate according to Kaplan–Meier and sinus augmentation procedure
Fig. 1. Flow chart of patients included in the study
Fig. 1. Flow chart of patients included in the study
Item
Mean ± SD pre-operative
Mean ± SD post-operative
Mean ± SD in the last time
Have you felt pain in your mouth?
...
Item
Mean ± SD before sinus lift
Mean ± SD after sinus lift
p value
Have you felt tense because of problems with your teeth, mouth or dentures?
...
Item
Mean ± SD before sinus lift
Mean ± SD after sinus lift
p value
Have you had difficulty chewing any foods?
...
Schiegnitz, E., Kämmerer, P.W., Sagheb, K. et al. Impact of maxillary sinus augmentation on oral health-related quality of life. Int J Implant Dent 3, 10 (2017). https://doi.org/10.1186/s40729-017-0072-8
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Received: 20 November 2016
Accepted: 12 March 2017
Published: 28 March 2017
DOI: https://doi.org/10.1186/s40729-017-0072-8
Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were m...
Department of Oral and Maxillofacial Surgery, Plastic Surgery, University Medical Centre of the Johannes Gutenberg-University, Augustusplatz 2, 55131, Mainz, Germany
E. Schiegnitz, K. Sagheb, A. Pabst, B. Al-Nawas & M. O. Klein
Department of Oral and Maxillofacial Surgery, Plastic Surgery, University of Rostock, Rostock, Germany
P. W. Kämmerer
Department of Prosthodontics, University of ...
Stellingsma K, Bouma J, Stegenga B, Meijer HJ, Raghoebar GM. Satisfaction and psychosocial aspects of patients with an extremely resorbed mandible treated with implant-retained overdentures. A prospective, comparative study. Clin Oral Implants Res. 2003;14(2):166–72.
Heydecke G, Locker D, Awad MA, Lund JP, Feine JS. Oral and general health-related quality of life with conventional and implant d...
Locker D. Self-esteem and socioeconomic disparities in self-perceived oral health. J Public Health Dent. 2009 Winter;69(1):1-8.
Allen PF, McMillan AS, Walshaw D. A patient-based assessment of implant-stabilized and conventional complete dentures. J Prosthet Dent. 2001;85(2):141–7.
Ohrn K, Jonsson B. A comparison of two questionnaires measuring oral health-related quality of life before and aft...
Al-Nawas B, Schiegnitz E. Augmentation procedures using bone substitute materials or autogenous bone—a systematic review and meta-analysis. Eur J Oral Implantol. 2014 Summer;7 Suppl 2:S219-34.
Derks J, Hakansson J, Wennstrom JL, Tomasi C, Larsson M, Berglundh T. Effectiveness of implant therapy analyzed in a Swedish population: early and late implant loss. J Dent Res. 2015;94(3 Suppl):44S–51S...
Within the limitations of this study, the results demonstrated a high long-term survival for sinus augmentation procedures and significant improvement of OHRQoL after this procedure. Therefore, sinus augmentation procedures are highly valuable treatment options in implant dentistry.
In order to measure OHRQoL in the present study, a specific and shortened questionnaire based on the validated and reliable OHIP score was developed to consider representative impairments of maxillary sinus augmentation like sinusitis and to relieve the clinical application. In a cross sectional study, Allen et McMillan proofed that a shortened OHIP-14 version showed a similar ability to assess OH...
The clinical and radiological outcomes of sinus augmentation procedures have been published in several studies [1, 3, 6, 7]. However, little data on the physical and psychological impact of this procedure on the patient is available yet. The present study evaluated pre-operative and post-treatment OHRQoL self-assessment scores of patients treated with dental implants after sinus augmentation proce...
Concerning functional limitations, all posed questions showed significant better values for OHRQoL after sinus augmentation procedure than before the treatment (p
After an average time in situ of 41.2 ± 27 months (3.4 years; range 0–96 months), 40 of the 863 implants were lost. These results indicated an in situ rate of 95.4%. One-year and five-year survival rate according to Kaplan–Meier were 95.4 and 94.4%. In patients receiving an external sinus lift an in situ rate of 95.1% and in patients with an internal sinus lift an in situ rate of 96.4%...
The Kaplan–Meier survival function was applied for the description of survival rates. To examine the statistical difference between survival rates, a log-rank test was used. Implant-related data were calculated. For statistical comparison of the paired questions and the total scores, a Wilcoxon test was applied. The intention of this study was descriptive, exploratory without a primary hypothesi...
This retrospective study addresses the oral health-related quality of life after maxillary sinus augmentation. Therefore, all patients that received an implantation after maxillary sinus augmentation in the Department of Oral and Maxillofacial Surgery of the University Medical Centre Mainz, Germany, between July 2002 and December 2007 were included in this study. There were no specific exclusion c...
In conclusion, little information is available about patient’s perception of sinus augmentation procedures. The aim of the present study was to assess whether sinus augmentation procedures together with implant placement and prosthetic rehabilitation improve quality of life in dental patients using a modified German OHIP and to examine the survival rates after this procedure.
Rehabilitation of completely and partial edentulous patients with dental implants has proved to be a safe and predictable procedure [1–3]. However, reduced bone height and the proximity of the maxillary sinus are challenging limitations for dental implant placement in the posterior maxilla [3]. Besides the use of short and tilted implants [4], one of the most frequently used surgical techniques ...
The aim of this study was to measure the oral health-related quality of life (OHRQoL) after maxillary sinus augmentation to determine the physical and psychological impact of this procedure for the patient.
Three hundred sixteen patients treated with an external or internal maxillary sinus augmentation and a total of 863 implants in the Department of Oral and Maxillofacial Surgery, Johannes Guten...
Fig. 5. Survival rate of dental implants after autologous bone augmentation
Fig. 5. Survival rate of dental implants after autologous bone augmentation
Fig. 4. Postoperative nerve alterations. Single asterisk, N refers to the total number of the surgical approaches in the mandible (N = 155). Double asterisk, N refers to the total number of the surgical approaches in the maxilla (N = 225)
Fig. 4. Postoperative nerve alterations. Single asterisk, N refers to the total number of the surgical approaches in the mandible (N = 155). Dou...
Fig. 3. Surgical outcome after autologous augmentation procedures from different donor sites
Fig. 3. Surgical outcome after autologous augmentation procedures from different donor sites
Fig. 2. Survival rate of autologous bone grafts
Fig. 2. Survival rate of autologous bone grafts
Fig. 1. Postoperative complications at the donor and recipient site, N refers to the total number of the donor sites (N = 300), N refers to the total number of the recipient sites (N = 378)
Fig. 1. Postoperative complications at the donor and recipient site, N refers to the total number of the donor sites (N = 300), N refers to the total number of the recipient sites (N = 378)
Postoperative complications
%/procedures (N)
At donor sitea
Wound infection
2.6% (8/300)
At recipient site...
Donor site
Bone grafts (N)/patients (N)
Lateral zygomatic buttress
113/112
Mandibular ramus (retromolar)
...
Patient characteristics
N (%)
Gendera
Male
250 (89.6%)
Female
29 (10.4%)
...
Sakkas, A., Wilde, F., Heufelder, M. et al. Autogenous bone grafts in oral implantology—is it still a “gold standard”? A consecutive review of 279 patients with 456 clinical procedures.
Int J Implant Dent 3, 23 (2017). https://doi.org/10.1186/s40729-017-0084-4
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Received: 27 February 2017
Accepted: 22 May 2017
Published: 01 June 2017
DOI: https://doi...
Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were...
Department of Oral and Plastic Maxillofacial Surgery, Military Hospital Ulm, Academic Hospital of the University of Ulm, Oberer Eselsberg 40, 89081, Ulm, Germany
Andreas Sakkas, Frank Wilde, Marcus Heufelder & Alexander Schramm
Institute of Anatomy, Medical Faculty of Leipzig University, Leipzig, Germany
Karsten Winter
Department of Oral and Plastic Maxillofacial Surgery, University Hospit...
The authors thank the patients for their kindness to participate as study cases and the whole medical team at the Bundeswehrkrankenhaus Ulm.
AS participated in its design and coordination, carried out the data selection, and drafted the manuscript, and is the corresponding author. FW participated in its design and coordination and helped in drafting the manuscript. MH participated in its design a...
Semper W, Kraft S, Mehrhof J, Nelson K. Impact of abutment rotation and angulation on marginal fit: theoretical considerations. Int J Oral Maxillofac Implants. 2010;25:752–8.
Wiltfang J, Jätschmann N, Hedderich J, Neukam FW, Schlegel KA, Gierloff M. Effect of deproteinized bovine bone matrix coverage on the resorption of iliac cortico-spongeous bone grafts—a prospective study of two cohorts....
Chiapasco M, Zaniboni M. Clinical outcomes of GBR procedures to correct peri-implant dehiscences and fenestrations: a systematic review. Clin Oral Implants Res. 2009;20:113–23.
Felice P, Pellegrino G, Checchi L, Pistilli R, Esposito M. Vertical augmentation with interpositional blocks of anorganic bovine bone vs. 7-mm-long implants in posterior mandibles: 1-year results of a randomized clinical...
Verdugo F, Castillo A, Moragues MD, Pontón J. Bone microbial contamination influences autogenous grafting in sinus augmentation. J Periodontol. 2009;80:1355–64.
Wiltfang J, Schultze-Mosgau S, Merten HA, Kessler P, Ludwig A, Engelke W. Endoscopic and ultrasonographic evaluation of the maxillary sinus after combined sinus floor augmentation and implant insertion. Oral Surg Oral Med Oral Pathol O...
von Arx T, Buser D. Horizontal ridge augmentation using autogenous block grafts and the guided bone regeneration technique with collagen membranes: a clinical study with 42 patients. Clin Oral Implants Res. 2006;17:359–66.
Levin L, Nitzan D, Schwartz-Arad D. Success of dental implants placed in intraoral block bone grafts. J Periodontol. 2007;78:18–21.
Andersson L. Patient self-evaluation of...
Aghaloo TL, Moy PK. Which hard tissue augmentation techniques are the most successful in furnishing bony support for implant placement? Int J Oral Maxillofac Implants. 2007;22:49–70.
Margonar R, dos Santos PL, Queiroz TP, Marcantonio E. Rehabilitation of atrophic maxilla using the combination of autogenous and allogeneic bone grafts followed by protocol-type prosthesis. J Craniofac Surg. 2010;2...
Schwartz-Arad D, Dori S. Intraoral autogenous onlay block bone grafting for implant dentistry. Refuat Hapeh Vehashinayim. 2002;19:35–9. 77.
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Altiparmak N, Soydan SS, Uckan S. The effect of conventional surgery and pi...
Jensen AT, Jensen SS, Worsaae N. Complications related to bone augmentation procedures of localized defects in the alveolar ridge. A retrospective clinical study. Oral Maxillofac Surg. 2016;20(2):115–22 [Epub ahead of print].
Buser D, Dula K, Hirt HP, Schenk RK. Lateral ridge augmentation using autografts and barrier membranes: clinical study with 40 partially edentulous patients. J Oral Maxill...
The results of the clinical study proves the reliability and low comorbidity of autologous bone grafts in preprosthetic alveolar ridge reconstructions prior to implant insertion. The high graft success rate (95.6%) and the low early implant failure rate (0.38%) in a surveillance of all patients treated in three following years with this technique showing no exclusion and no dropout of any case for...
Data on risk factors based on the original examination and documentation are difficult to assess the adverse effects of variable factors on the surgical prognosis because of the multifactorial genesis of surgical complications [73]. Factors such as gender, age, or smoking habit could be associated with postoperative complications after two-stage dentoalveolar reconstruction with autologous bone gr...
The results of the present study have to take into account the absence of a control group with patients undergoing bone augmentation procedures with bone substitutes (allogen, alloplastic, exogen). Without a comparative group of grafting surgeries using alternative bone material, only limited statements can be made.
However, the excellent surgical outcome of autologous surgical methods providing ...
The use of autologous bone in this study has shown excellent graft survival and success rate (95.6%). This is equal to the results from the studies on implants inserted in reconstructed sites [6, 8, 24]. The early implant survival rate of 99.7% found in the present material is very high comparable to that in the previous systematic reviews after staged horizontal ridge augmentation [9, 10, 22, 62,...
Of the sinus floor elevations performed in this study, 84.8% were defined absolutely successful. Only two of our 72 patients having sinus lift operations could not finally be treated with dental implants. These results are comparable to other studies considering the sinus graft to be a safe treatment modality with few complications [6, 8, 51,52,53]. Raghoebar et al. reported incidences of sinus co...
Postoperative morbidity after mandibular bone harvesting procedures was reported to be mainly related to temporary or permanent neural disturbances involving the inferior alveolar nerve and its branches [19]. In this study, only the incidence of the temporary hypoesthesia of the mandibular and lingual nerve after harvesting from the retromolar area could be detected. It was 10.4 and 2.8%, respecti...
Systematic reviews have failed to find evidence that one particular grafting technique is superior to others [10]. Intraoral bone grafts from the mandibular symphysis, mandibular ramus, and maxillary tuberosity provide a good treatment modality for ridge augmentation, and the amount of bone available for harvesting is sufficient for defects up to the width of three teeth [42]. Harvesting of retrom...
Several grafting procedures have been described to create sufficient volume of bone for implant placement [8, 9]. Autologous bone grafts can be harvested by an intraoral approach (mandibular ramus, mandibular symphysis, zygomatic buttress) or from distant sites (iliac crest, calvaria, and etc.) [17, 36, 37]. However, bone harvesting potentially causes donor site morbidity which is a major issue fo...
The average healing period until implant placement after bone harvesting was 4.53 months. Initially, 546 implants in 279 patients were planned. After the healing period, it was possible to place 525 implants in 436 successfully augmented areas in 259 patients. Three hundred implants were inserted in the maxilla and 225 in the mandible. The remaining 21 implants planned for 20 patients could not b...
Regarding intraoperative complications, all sinus membrane perforations were covered with a resorbable collagen membrane (Bio-Gide®, Geistlich Biomaterials, Baden-Baden, Germany) which applied as sealant to overlap the site of perforation prior to insertion of the graft material. These patients were advised to avoid physical stress, blowing their noses, or sneezing for a period of 3 weeks, and n...
No permanent damage to any trigeminal nerves was evident in any of our entire cohort. All cases of postoperative hypoesthesia of the mental, lingual, or infraorbital nerve were just a temporary nature. At the time of implant surgery, none of these patients reported any persisting neural disturbances (Fig. 4).
In eleven patients, hypoesthesia of the mental area was mentioned, and three of them al...
Thirty-eight patients underwent a total of 116 augmentation procedures harvesting from the iliac crest. In 20 patients, a bone graft augmentation of the maxilla and the mandible in combination with bilateral sinus floor augmentations was performed. Eighteen patients had augmentations only in the maxilla, involving bone grafting and sinus lift elevations. Totally, 76 sinus lifts with bone material ...
In six patients, a partial graft resorption was detected at the time of implantation and an additional simultaneous augmentation with bone chips harvested with the Safescraper device (C.G.M. S.p.A., Divisione Medicale META, Italy) was then necessary in order to ensure the osseointegration of the implants. Two out of these six cases had grafts from the crista zygomatico-alveolaris, two from the ram...
A total of 112 sinus floor elevations were performed. In all of the cases, implants were inserted in a two-stage procedure. The donor site for harvesting the bone for the sinus elevations was in 76 procedures in the iliac crest area, and in 36 procedures, the bone was harvested with a bone scraper device from the lateral sinus wall at the site of sinus lifting.
The distribution and number of tran...
Two hundred seventy-nine patients—250 men and 29 women—underwent 456 augmentation procedures involving autologous bone grafts prior to implant placement. The patients ranged in age from 18.5 to 71.5 years (average 43.1 years) at the moment of augmentation surgery.
Of those patients, 162 (58.1%) were younger than 40 years of age and 117 (41.9%) were older than 40 years of age. Caries or pe...
Early and late implant loss was documented in this study, defining the clinical success of osseointegration. Early implant failures were assessed before the acquisition of osseointegration, i.e., before the placement of prosthodontic restorations. Early implant failure could occur from the time of placement, during the healing phase and before abutment connection. The implant inserted after re-aug...
Medical history of patient
Age of patient at the time of bone harvesting and augmentation
History of periodontal disease
Smoking habits
Donor site
Jaw area and dental situation of the recipient site
Intraoperative complications
Postoperative complications after augmentation
Management of complications
Bone graft stability and clinical resorption prior to implant placement
Complications a...
In addition to the bone already gained with the bone scraper device from the sinus wall during the antrostomy, bone was harvested with the same device from the maxillary buccal buttress, if more volume was needed. By taking this approach, the collection of enough bone for the augmentation of at least two implantation sites was feasible with a mean surgical time of 5 to 10 min for harvesting. In c...
Grafting from the iliac crest was always performed under general anesthesia in a two-team approach. The iliac crest was exposed and autogenous grafts from the anterosuperior inner edge of the iliac wing were harvested with an oscillating saw and/or a chisel, keeping a safe distance of around 2 cm from the anterosuperior iliac spine. After harvesting the bone grafts, the corticocancellous bone blo...
A standardized two-stage surgical protocol was used, and all sites were treated in a similar fashion. In the first intervention, a bone block harvested from the donor site was fixed with osteosynthesis titanium screws to the recipient site as an onlay graft to achieve a horizontal and/or vertical enlargement of the alveolar ridge. Placement of the bone graft was always guided by an augmentation te...
For this retrospective cohort study, we reviewed the records of all patients without exclusion criteria who were referred to the department of oral and plastic maxillofacial surgery at the military hospital of Ulm, Germany, between January 2009 and December 2011 for alveolar ridge augmentations prior to implant insertions using autologous bone grafts harvested from different donor sites and unilat...
In our military outpatient center exclusively, autologous bone transplantations harvested from different donor sites were used intraorally (crista zygomatico-alveolaris, ramus mandible, symphysis mandible, anterior sinus wall) and extraorally (iliac crest) to reconstruct severe horizontal and/or vertical alveolar ridge atrophy prior to implant placement. The aim of this study was to assess the cli...
Although the iliac crest is most often used in jaw reconstruction, a significant bone resorption has been mentioned [12]. This disadvantage, and the fact that dental implants do not always require a large amount of bone, has increased the use of autologous block bone grafts from intraoral sources [13]. Bone grafts from intraoral donor sites offer several benefits like surgical accessibility, proxi...
Oral implantation has a significant role in the rehabilitation of patients. Bone reconstruction techniques have been advanced in order to optimize the esthetic and functional outcome. However, the restoration of the oral function of atrophic alveolar crests still remains a challenge in oral implantology. Bone augmentation procedures are often indicated to allow implant placement in an optimal thre...
This review demonstrates the predictability of autologous bone material in alveolar ridge reconstructions prior to implant insertion, independent from donor and recipient site including even autologous bone chips for sinus elevation. Due to the low harvesting morbidity of autologous bone grafts, the clinical results of our study indicate that autologous bone grafts still remain the “gold standar...
This study assessed the clinical outcomes of graft success rate and early implant survival rate after preprosthetic alveolar ridge reconstruction with autologous bone grafts.
A consecutive retrospective study was conducted on all patients who were treated at the military outpatient clinic of the Department of Oral and Plastic Maxillofacial Surgery at the military hospital in Ulm (Germany) in the ...
Fig. 17. The appearance of the case shown in Fig. 16 with the polythene “washer” removed at 2 weeks post-surgery, providing access to the zygomatic oncology implants
Fig. 17. The appearance of the case shown in Fig. 16 with the polythene “washer” removed at 2 weeks post-surgery, providing access to the zygomatic oncology implants
Fig. 16. Another ZIP flap case demonstrating the use of a perforated polythene “washer” to keep the flap from overgrowing the implant abutments during the healing phase
Fig. 16. Another ZIP flap case demonstrating the use of a perforated polythene “washer” to keep the flap from overgrowing the implant abutments during the healing phase
Fig. 15. Facial appearance 18 months following treatment
Fig. 15. Facial appearance 18 months following treatment
Fig. 14. Intra-oral view of perforated flap 3 weeks following radiotherapy
Fig. 14. Intra-oral view of perforated flap 3 weeks following radiotherapy
Fig. 13. Panoramic dental radiograph showing the position of the zygomatic implants and the seating of the initial fixed prosthesis
Fig. 13. Panoramic dental radiograph showing the position of the zygomatic implants and the seating of the initial fixed prosthesis
Fig. 12. Provisional acrylic fixed dental prosthesis fitted at 4 weeks post-surgery
Fig. 12. Provisional acrylic fixed dental prosthesis fitted at 4 weeks post-surgery
Fig. 11. Intra-oral view of the soft tissue flap at 3 weeks post-operatively with overgrowth of flap over the zygomatic oncology implants
Fig. 11. Intra-oral view of the soft tissue flap at 3 weeks post-operatively with overgrowth of flap over the zygomatic oncology implants
Fig. 10. Radial forearm flap inset and sutured into the maxillary defect and perforated by the zygomatic oncology implant abutments
Fig. 10. Radial forearm flap inset and sutured into the maxillary defect and perforated by the zygomatic oncology implant abutments
Fig. 9. Inter-occlusal registration using the pre-fabricated maxillary denture prosthesis relined with silicone putty over the implant abutment protection caps
Fig. 9. Inter-occlusal registration using the pre-fabricated maxillary denture prosthesis relined with silicone putty over the implant abutment protection caps
Fig. 8. Abutment level impression utilising light-cured acrylic tray material
Fig. 8. Abutment level impression utilising light-cured acrylic tray material
Fig. 7. Conventional zygomatic implant insertion on the non-defect side of the maxilla following extraction of the remaining teeth and an alveoloplasty
Fig. 7. Conventional zygomatic implant insertion on the non-defect side of the maxilla following extraction of the remaining teeth and an alveoloplasty
Fig. 6. Zygomatic oncology implants sited in the residual zygomatic bone on the defect side of the maxilla
Fig. 6. Zygomatic oncology implants sited in the residual zygomatic bone on the defect side of the maxilla
Fig. 5. Left-sided maxillary resection (Brown class 2b)
Fig. 5. Left-sided maxillary resection (Brown class 2b)
Fig. 4. Panoramic dental radiograph showing dental status at presentation
Fig. 4. Panoramic dental radiograph showing dental status at presentation
Fig. 3. Staging CT scan confirming maxillary destruction but preservation of the orbital floor
Fig. 3. Staging CT scan confirming maxillary destruction but preservation of the orbital floor
Fig. 2. Staging MRI scan showing destructive lesion left maxilla
Fig. 2. Staging MRI scan showing destructive lesion left maxilla
Fig. 1. Clinical view of left-sided maxillary tumour at presentation
Fig. 1. Clinical view of left-sided maxillary tumour at presentation
Domain
Score
Activity
100 (“I am as active as I have ever been”)
Anxiety
100 (“...
Butterworth, C.J., Rogers, S.N. The zygomatic implant perforated (ZIP) flap: a new technique for combined surgical reconstruction and rapid fixed dental rehabilitation following low-level maxillectomy.
Int J Implant Dent 3, 37 (2017). https://doi.org/10.1186/s40729-017-0100-8
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Received: 14 May 2017
Accepted: 23 July 2017
Published: 29 July 2017
DOI: https...
Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were...
Consent has been obtained from the patient for the use and publication of all images.
Chris Butterworth and Simon Rogers declare that they have no competing interests.
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Department of Oral & Maxillofacial Surgery, University Hospital Aintree, Lower Lane, Liverpool, L9 7AL, UK
C. J. Butterworth & S. N. Rogers
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CB devised the treatment concept and undertook all implant surgeries and prostho...
Okay DJ, Genden E, Buchbinder D, Urken M. Prosthodontic guidelines for surgical reconstruction of the maxilla: a classification system of defects. J Prosthet Dent. 2001;86(4):352–63.
Rohner D, Bucher P, Hammer B. Prefabricated fibular flaps for reconstruction of defects of the maxillofacial skeleton: planning, technique, and long-term experience. Int J Oral Maxillofac Implants. 2013;28(5):e221...
The ZIP flap technique represents an innovative approach to the management of patients presenting with low-level malignant maxillary tumours. It provides effective closure of the resulting maxillary defect restoring speech and swallowing functions and also establishing a high-quality fixed dental rehabilitation in a rapid timescale, thus facilitating a more timely return to function and restored f...
Whilst technically, it would be possible to construct and fit the prosthesis on the same day or even a week later, the need for microvascular flap monitoring in the immediate post-operative period, together with the significant recovery period required by the patient following surgery has lead the authors to delay the fitting of the prosthesis at the 4 to 6-week period post-operatively. In terms o...
In contrast, the use of a soft tissue flap such as the RFFF or antero-lateral thigh flap can often be safely employed in elderly patients with peripheral vascular disease without unduly lengthening the operation too significantly with two-team operating. In addition, the predictability of these flaps with their excellent pedicle lengths is ideal for closure of the resulting oro-nasal surgical defe...
In low-level maxillectomy (Brown class II), the need for bony reconstruction is questionable depending on the horizontal component. With the preservation of the orbital floor, zygomatic prominence and some bony support for the nose, facial appearance, in the experience of the authors and, as demonstrated by this case, is not significantly worsened despite low-level removal of the maxilla. The key ...
In order to address some of the issues highlighted in this early case, the technique was modified slightly to try and prevent flap overgrowth and prosthesis fracture in the early stages. In order to prevent flap overgrowth over the zygomatic oncology implant abutments, the use of a polythene washer was instituted on subsequent cases treated in the unit. Once the flap was perforated, a 2-mm thick p...
The implant positions were then accurately registered by utilising light-cured resin tray material (Individo® Lux, Voco Gmbh, Germany) and abutment level impression copings. The resin material was applied in sections around the impression copings and cured incrementally to ensure a rigid splinting of the impression copings (Fig. 8). Abutment protection caps were then placed over all four abutment...
A 66-year-old male patient presented with an enlarging mass in the left maxilla (Fig. 1). The mass had been present for a few weeks. An incisional biopsy revealed squamous cell carcinoma. Staging scans were undertaken (Fig. 2) which demonstrated a T4N0M0 maxillary alveolus tumour in close proximity to the left orbital floor with obliteration of the maxillary antrum and destruction of the lateral m...
The surgical management and prosthodontic rehabilitation of the maxillectomy patient is complex with a variety of options available to the head and neck cancer team ranging from simple prosthodontic obturation [1] to reconstruction using pre-fabricated or digitally planned composite flaps [2] with or without the placement of osseointegrated implants [3]. The primary aims of treatment include effec...
This aim of this report is to describe the development and evolution of a new surgical technique for the immediate surgical reconstruction and rapid post-operative prosthodontic rehabilitation with a fixed dental prosthesis following low-level maxillectomy for malignant disease.
The technique involves the use of a zygomatic oncology implant perforated micro-vascular soft tissue flap (ZIP flap) fo...
Fig. 2. Clinical image of patient 4: a region 21 before implant placement. b, c Implant placement using the GBR procedure with a synthetic bone substitute material composed of HA + β-TCP
Fig. 2. Clinical image of patient 4: a region 21 before implant placement. b, c Implant placement using the GBR procedure with a synthetic bone substitute material composed of HA + β-TCP
Fig. 1. Schematic representation of the technical characteristics of the investigated C-Tech Esthetic Line implant system (provided by the manufacturer)
Fig. 1. Schematic representation of the technical characteristics of the investigated C-Tech Esthetic Line implant system (provided by the manufacturer)
Patient
Implant-localization (region)
Implant loss (+/−)
Buccal width of keratinized peri-implant gingiva (mm)
Buccal thickness of keratinized peri-implant gi...
Patient
Gender (m/f)
Age (years)
Implant localization (region)
Implant diameter (mm)
...
Lorenz, J., Lerner, H., Sader, R.A. et al. Investigation of peri-implant tissue conditions and peri-implant tissue stability in implants placed with simultaneous augmentation procedure: a 3-year retrospective follow-up analysis of a newly developed bone level implant system.
Int J Implant Dent 3, 41 (2017). https://doi.org/10.1186/s40729-017-0104-4
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Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were...
This study was conducted in compliance with the principles of the Declaration of Helsinki, and the approval of the ethics committee required for the study was obtained from the Ethics Committee of the Medical Center of the Goethe University Frankfurt. The procedures to be performed were explained in detail, and the patients signed the consent form.
Jonas Lorenz, Henriette Lerner, Robert Sader, an...
Department for Oral, FORM-Lab, Cranio-Maxillofacial, and Facial Plastic Surgery, Medical Center of the Goethe University Frankfurt, Frankfurt am Main, Germany
Jonas Lorenz, Robert A. Sader & Shahram Ghanaati
HL-Dentclinic, Baden-Baden, Germany
Henriette Lerner
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Lerner H, Lorenz J, Sader R, Ghanaati S. Two-year retrospective study of periimplant health and periimplant bone stability after immediate implant placement of a newly developed bone level implant system—a first report. EDI Journal (European Association of Dental Implantologists, Teamwork Media); 2017; ahead of print.
Ghanaati S, Lorenz J, Obreja K, Choukroun J, Landes C, Sader R. Nanocrystalli...
Gurgel BC, Montenegro SC, Dantas PM, Pascoal AL, Lima KC, Calderon PD. Frequency of peri-implant diseases and associated factors. Clin Oral Implants Res. 2016; doi: 10.1111/clr.12944
Qian J, Wennerberg A, Albrektsson T. Reasons for marginal bone loss around oral implants. Clin Implant Dent Relat Res. 2012;14(6):792–807.
Berglundh T, Lindhe J, Ericsson I, Marinello C, Liljenberg B, Thomsen P....
β-tricalcium phosphate
Bleeding on probing
Fixed prosthetics
Guided bone regeneration
Hydroxyapatite
Multinucleated giant cells
Pink Esthetic Score
Removable prosthetics
In the present study, the implant and peri-implant hard- and soft-tissue stability was analyzed in a bone level implant system placed simultaneously with a GBR procedure 3 years after prosthetic loading. Peri-implant hard- and soft-tissue parameters such as width and thickness of peri-implant keratinized gingiva, probing depth, BOP, PES, peri-implant bone loss, and the presence of peri-implant os...
Comparing the present results to the aforementioned study with the same implant system on immediately placed implants, it seems that the GBR augmentation procedure has no influence on the long-term stability of the implants. In both studies with different placement modalities and protocols, comparable clinical and radiological results were achieved. This leads to the assumption that the investigat...
The tissue reaction, however, did not only differ in bone substitute materials of different origin but also in bone substitute materials of the same origin. In an in vivo trial, two xenogeneic bone substitute materials processed with different techniques were implanted subcutaneously in CD-1 mice for up to 60 days. Both bone substitute materials showed good integration within the peri-implant tis...
In the present retrospective study, C-Tech bone level implants placed simultaneously with a GBR procedure around the implant shoulder were investigated clinically and radiologically after at least 3 years of loading to assess peri-implant tissue conditions and document peri-implant tissue stability.
A total of 47 implants were placed in the upper (23 implants) and lower jaw (24 implants) of 20 p...
Investigation of the esthetic appearance via PES revealed a mean point score of 10.1 (ranging from 7 to 13) from a maximum of 14. The highest values and therefore acceptance were found in the alveolar process deficiency and the soft-tissue level, which can be interpreted as a benefit of the augmentation procedure around the implant shoulder.
Peri-implant bone loss calculated using the average bon...
Altogether, 47 implants were placed in the upper and lower jaws of a total of 20 patients. In all implants, lateral augmentation in a GBR process was performed simultaneously with implant placement due to reduced horizontal or vertical height of the alveolar crest. A total of 23 implants were placed in the upper jaw and 24 implants in the lower jaw. The implant diameter varied between 3.5 mm (32 ...
Investigation parameters:
Implant being in situ
Width and thickness of peri-implant keratinized gingiva
Pink Esthetic Score (PES)
Probing depth
BOP
Peri-implant bone loss
Presence of peri-implant osteolysis
In the present retrospective study, bone level implants (C-Tech Esthetic Line implants) were investigated clinically and radiologically. The bone level implant system has a Morse-locking conical implant-abutment connection with platform switching and an indexing hex that allows subcrestal implant placement and aims to prevent peri-implant bone loss. The surface of the implant system is manufacture...
In the present retrospective study, 47 dental implants (C-Tech Esthetic Line implants) from 20 patients (11 female, 9 male) with a mean age of 58.5 years (45–75 years) were analyzed clinically and radiologically. Implant placement and follow-up investigation was performed at the HL Dentclinic in Baden-Baden, Germany. The study was approved by the ethics commission of the medical department of ...
The aim of the present retrospective investigation was to assess clinically and radiologically peri-implant tissue conditions and document peri-implant tissue stability in C-Tech implants when placed simultaneously with a GBR augmentation procedure after at least 3 years of loading.
The ability of bone substitute materials to form a sufficient and stable implantation bed has been proven in numerous clinical trials; however, it is still to a certain degree unclear if the different tissue reactions have an impact on the establishment of a peri-implant infection, especially when these biomaterials are used for augmentations around the implant shoulder. Due to the two-stage desig...
The prevalence of peri-implantitis has grown in the past few years and has become a major issue in implant dentistry. Long-term stable and healthy soft- and hard-tissue conditions should be achieved in combination with esthetically and functionally satisfying results. However, the rising number of placed implants in the past decades has come with an increase in the prevalence of peri-implantitis [...
Guided bone regeneration (GBR) has been proven to be a reliable therapy to regenerate missing bone in cases of atrophy of the alveolar crest. The aim of the present retrospective analysis was to assess peri-implant tissue conditions and document peri-implant tissue stability in C-Tech implants when placed simultaneously with a GBR augmentation procedure.
A total of 47 implants, which were placed ...
Fig. 6. Postoperative intraoral finding and radiograph
Fig. 6. Postoperative intraoral finding and radiograph
Fig. 5. High p53, p63, and Ki-67 reactivity are also observed in the basal cell layer (immunohistological staining, bar 400 μm)
Fig. 5. High p53, p63, and Ki-67 reactivity are also observed in the basal cell layer (immunohistological staining, bar 400 μm)
Fig. 4. Immunohistological findings show a negative staining mosaic pattern for keratin 13 (k13) and positive staining for keratin 17 (k17) (immunohistological staining, bar 400 μm)
Fig. 4. Immunohistological findings show a negative staining mosaic pattern for keratin 13 (k13) and positive staining for keratin 17 (k17) (immunohistological staining, bar 400 μm)
Fig. 3. Pathological microscopic examination reveals thickened squamous epithelia with slight nuclear atypism and disorders of the epithelial rete pegs accompanied by moderate grade inflammatory cell infiltration (HE staining, bar: 400 μm)
Fig. 3. Pathological microscopic examination reveals thickened squamous epithelia with slight nuclear atypism and disorders of the epithelial rete pegs a...
Fig. 2. Panoramic radiograph shows slight vertical bone resorption around the implants in the right side of the mandible
Fig. 2. Panoramic radiograph shows slight vertical bone resorption around the implants in the right side of the mandible
Fig. 1. Well-circumscribed gingival swelling on the lingual side of the right side of the mandible
Fig. 1. Well-circumscribed gingival swelling on the lingual side of the right side of the mandible
Antibody
Sorce
Clone
Staining
Keratin 13
DAKO
DE-K13
...
Noguchi, M., Tsuno, H., Ishizaka, R. et al. Primary peri-implant oral intra-epithelial neoplasia/carcinoma in situ: a case report considering risk factors for carcinogenesis.
Int J Implant Dent 3, 47 (2017). https://doi.org/10.1186/s40729-017-0109-z
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Received: 15 March 2017
Accepted: 25 October 2017
Published: 16 November 2017
DOI: https://doi.org/10.1186...
Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were...
Written informed consent was obtained from the patient for publication of this case report and any accompanying images.
Makoto Nogchi, Hiroaki Tsuno, Risa Ishizaka, Kumiko Fujiwara, Shuichi Imaue, and Kei Tomihara declare that they have no competing interests.
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Correspondence to
Makoto Noguchi.
Department of Oral and Maxillofacial Surgery, Graduate School of Medicine and Pharmaceutical Sciences for Research, University of Toyama, 2630 Sugitani Toyama city, Toyama, 9300194, Japan
Makoto Noguchi, Hiroaki Tsuno, Risa Ishizaka, Kumiko Fujiwara, Shuichi Imaue & Kei Tomihara
Department of Diagnosis Pathology, Graduate School of Medicine and Pharmaceutical Sciences for Research, Univers...
Vasilescu F, Ceauşu M, Tänsen C, et al. P53, p63 and ki-67 assessment in HPV-induced cervical neoplasia. RJME. 2009;50:357–61.
Ndiaye C, Mena M, Alemany L, et al. HPV DNA, E6/E7 mRNA, and p16INK4a detection in head and neck cancers: a systematic review and meta-analysis. Lancet Oncol. 2014;15:1319–31.
Nagy K, Sonkodi I, Szöke I, et al. The microflora associated with human oral carcinoma. ...
Sah JP, Johnson NW, Batsakis JG. Oral cancer. London: Informa Healthcare; 2011. p. 3–32.
Japan Society for Oral Tumors. General rules for clinical and pathological studies on oral cancer. 1st ed. Tokyo: Kanehara-shuppan Co; 2010. p. 44–7.
Laprise C, Shahl HP, Madathil SA, et al. Periodontal diseases and risk of oral cancer in Southern India: results from the HeNCe Life Study. Int J Cancer. 2...
Deoxyribonucleic acid
Human papilloma virus
Oral intra-epithelial neoplasia/carcinoma in situ
Squamous cell carcinoma
In our case, the persistence of peri-implant mucositis or peri-implantitis around the dental implant was implicated as being a plausible risk factor for carcinogenesis. Regular follow-up to ensure the maintenance of oral hygiene after dental implant therapy has again been shown to be important for preventing peri-implantitis, a plausible risk factor for carcinogenesis.
The latest evidence implies that the human papilloma virus (HPV) may be responsible for carcinogenesis in the oral cavity [12, 13]; however, its role is debatable. The interaction of the HPV’s E6 and E7 oncoproteins with cell cycle proteins disturbs the cell cycle mechanism and subsequent alteration in the expression of proteins such as p53, p63, and Ki-67 [14]. In our case, the immunohistochemi...
OIN/CIS can sometimes be difficult to distinguish pathologically from epithelial dysplasia on hematoxylin- and eosin-staining sections; this has proved challenging for oral pathologists [9]. Recently, it has been reported that combined immunohistochemistry for k13 and k17 was useful for the differential diagnosis [9, 10]. K13 is a marker for cellular differentiation toward prickle cells in normal ...
A 65-year-old woman was referred to our clinic with a tumor in the right lower gingiva. Her medical history included breast cancer without metastatic lesion, diabetes mellitus, hyperlipidemia, and hypertension. She had taken orally aspirin, amlodipine, pravastatin, and bepotastine for 2 years. She drank alcohol socially, but she had no history of tobacco smoking habit.
About 10 years prior to h...
Oral cancer ranks sixth among the malignancies in terms of worldwide prevalence, with more than 90% being pathologically squamous cell carcinoma (SCC) [1]. Oral SCC generally develops via multistep carcinogenesis. The squamous epithelium goes into irreversible change, including epithelial dysplasia and oral intra-epithelial neoplasia/carcinoma in-situ (OIN/CIS) [2], finally resulting in the develo...
In this case, prolonged peri-implant mucositis or peri-implantitis may have been a plausible risk factor for carcinogenesis.
Major risk factors for oral squamous cell carcinoma (SCC) are tobacco smoking, a betel quid chewing habit, and heavy alcohol consumption. However, around 15% of oral SCCs cannot be explained by these risk factors. Although oral SCC associated with dental implants is quite rare, there has been a recent gradual accumulation of reports about it. Here, we report a case of primary peri-implant oral int...
Fig. 5. Survival rate of dental implants after autologous bone augmentation
Fig. 5. Survival rate of dental implants after autologous bone augmentation
Fig. 4. Postoperative nerve alterations. Single asterisk, N refers to the total number of the surgical approaches in the mandible (N = 155). Double asterisk, N refers to the total number of the surgical approaches in the maxilla (N = 225)
Fig. 4. Postoperative nerve alterations. Single asterisk, N refers to the total number of the surgical approaches in the mandible (N = 155). Dou...
Fig. 3. Surgical outcome after autologous augmentation procedures from different donor sites
Fig. 3. Surgical outcome after autologous augmentation procedures from different donor sites
Fig. 2. Survival rate of autologous bone grafts
Fig. 2. Survival rate of autologous bone grafts
Fig. 1. Postoperative complications at the donor and recipient site, N refers to the total number of the donor sites (N = 300), N refers to the total number of the recipient sites (N = 378)
Fig. 1. Postoperative complications at the donor and recipient site, N refers to the total number of the donor sites (N = 300), N refers to the total number of the recipient sites (N = 378)
Postoperative complications
%/procedures (N)
At donor sitea
Wound infection
2.6% (8/300)
At recipient site...
Donor site
Bone grafts (N)/patients (N)
Lateral zygomatic buttress
113/112
Mandibular ramus (retromolar)
...
Patient characteristics
N (%)
Gendera
Male
250 (89.6%)
Female
29 (10.4%)
...
Sakkas, A., Wilde, F., Heufelder, M. et al. Autogenous bone grafts in oral implantology—is it still a “gold standard”? A consecutive review of 279 patients with 456 clinical procedures.
Int J Implant Dent 3, 23 (2017). https://doi.org/10.1186/s40729-017-0084-4
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Received: 27 February 2017
Accepted: 22 May 2017
Published: 01 June 2017
DOI: https://doi...
Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were...
Department of Oral and Plastic Maxillofacial Surgery, Military Hospital Ulm, Academic Hospital of the University of Ulm, Oberer Eselsberg 40, 89081, Ulm, Germany
Andreas Sakkas, Frank Wilde, Marcus Heufelder & Alexander Schramm
Institute of Anatomy, Medical Faculty of Leipzig University, Leipzig, Germany
Karsten Winter
Department of Oral and Plastic Maxillofacial Surgery, University Hospit...
The authors thank the patients for their kindness to participate as study cases and the whole medical team at the Bundeswehrkrankenhaus Ulm.
AS participated in its design and coordination, carried out the data selection, and drafted the manuscript, and is the corresponding author. FW participated in its design and coordination and helped in drafting the manuscript. MH participated in its design a...
Semper W, Kraft S, Mehrhof J, Nelson K. Impact of abutment rotation and angulation on marginal fit: theoretical considerations. Int J Oral Maxillofac Implants. 2010;25:752–8.
Wiltfang J, Jätschmann N, Hedderich J, Neukam FW, Schlegel KA, Gierloff M. Effect of deproteinized bovine bone matrix coverage on the resorption of iliac cortico-spongeous bone grafts—a prospective study of two cohorts....
Chiapasco M, Zaniboni M. Clinical outcomes of GBR procedures to correct peri-implant dehiscences and fenestrations: a systematic review. Clin Oral Implants Res. 2009;20:113–23.
Felice P, Pellegrino G, Checchi L, Pistilli R, Esposito M. Vertical augmentation with interpositional blocks of anorganic bovine bone vs. 7-mm-long implants in posterior mandibles: 1-year results of a randomized clinical...
Verdugo F, Castillo A, Moragues MD, Pontón J. Bone microbial contamination influences autogenous grafting in sinus augmentation. J Periodontol. 2009;80:1355–64.
Wiltfang J, Schultze-Mosgau S, Merten HA, Kessler P, Ludwig A, Engelke W. Endoscopic and ultrasonographic evaluation of the maxillary sinus after combined sinus floor augmentation and implant insertion. Oral Surg Oral Med Oral Pathol O...
von Arx T, Buser D. Horizontal ridge augmentation using autogenous block grafts and the guided bone regeneration technique with collagen membranes: a clinical study with 42 patients. Clin Oral Implants Res. 2006;17:359–66.
Levin L, Nitzan D, Schwartz-Arad D. Success of dental implants placed in intraoral block bone grafts. J Periodontol. 2007;78:18–21.
Andersson L. Patient self-evaluation of...
Aghaloo TL, Moy PK. Which hard tissue augmentation techniques are the most successful in furnishing bony support for implant placement? Int J Oral Maxillofac Implants. 2007;22:49–70.
Margonar R, dos Santos PL, Queiroz TP, Marcantonio E. Rehabilitation of atrophic maxilla using the combination of autogenous and allogeneic bone grafts followed by protocol-type prosthesis. J Craniofac Surg. 2010;2...
Schwartz-Arad D, Dori S. Intraoral autogenous onlay block bone grafting for implant dentistry. Refuat Hapeh Vehashinayim. 2002;19:35–9. 77.
Misch CM. Ridge augmentation using mandibular ramus bone grafts for the placement of dental implants: presentation of a technique. Pract Periodontics Aesthet Dent. 1996;8:127–35.
Altiparmak N, Soydan SS, Uckan S. The effect of conventional surgery and pi...
Jensen AT, Jensen SS, Worsaae N. Complications related to bone augmentation procedures of localized defects in the alveolar ridge. A retrospective clinical study. Oral Maxillofac Surg. 2016;20(2):115–22 [Epub ahead of print].
Buser D, Dula K, Hirt HP, Schenk RK. Lateral ridge augmentation using autografts and barrier membranes: clinical study with 40 partially edentulous patients. J Oral Maxill...
The results of the clinical study proves the reliability and low comorbidity of autologous bone grafts in preprosthetic alveolar ridge reconstructions prior to implant insertion. The high graft success rate (95.6%) and the low early implant failure rate (0.38%) in a surveillance of all patients treated in three following years with this technique showing no exclusion and no dropout of any case for...
Data on risk factors based on the original examination and documentation are difficult to assess the adverse effects of variable factors on the surgical prognosis because of the multifactorial genesis of surgical complications [73]. Factors such as gender, age, or smoking habit could be associated with postoperative complications after two-stage dentoalveolar reconstruction with autologous bone gr...
The results of the present study have to take into account the absence of a control group with patients undergoing bone augmentation procedures with bone substitutes (allogen, alloplastic, exogen). Without a comparative group of grafting surgeries using alternative bone material, only limited statements can be made.
However, the excellent surgical outcome of autologous surgical methods providing ...
The use of autologous bone in this study has shown excellent graft survival and success rate (95.6%). This is equal to the results from the studies on implants inserted in reconstructed sites [6, 8, 24]. The early implant survival rate of 99.7% found in the present material is very high comparable to that in the previous systematic reviews after staged horizontal ridge augmentation [9, 10, 22, 62,...
Of the sinus floor elevations performed in this study, 84.8% were defined absolutely successful. Only two of our 72 patients having sinus lift operations could not finally be treated with dental implants. These results are comparable to other studies considering the sinus graft to be a safe treatment modality with few complications [6, 8, 51,52,53]. Raghoebar et al. reported incidences of sinus co...
Postoperative morbidity after mandibular bone harvesting procedures was reported to be mainly related to temporary or permanent neural disturbances involving the inferior alveolar nerve and its branches [19]. In this study, only the incidence of the temporary hypoesthesia of the mandibular and lingual nerve after harvesting from the retromolar area could be detected. It was 10.4 and 2.8%, respecti...
Systematic reviews have failed to find evidence that one particular grafting technique is superior to others [10]. Intraoral bone grafts from the mandibular symphysis, mandibular ramus, and maxillary tuberosity provide a good treatment modality for ridge augmentation, and the amount of bone available for harvesting is sufficient for defects up to the width of three teeth [42]. Harvesting of retrom...
Several grafting procedures have been described to create sufficient volume of bone for implant placement [8, 9]. Autologous bone grafts can be harvested by an intraoral approach (mandibular ramus, mandibular symphysis, zygomatic buttress) or from distant sites (iliac crest, calvaria, and etc.) [17, 36, 37]. However, bone harvesting potentially causes donor site morbidity which is a major issue fo...
The surgical outcome after augmentation and implantation procedures is presented in Fig. 5.
The average healing period until implant placement after bone harvesting was 4.53 months. Initially, 546 implants in 279 patients were planned. After the healing period, it was possible to place 525 implants in 436 successfully augmented areas in 259 patients. Three hundred implants were inserted in the maxilla and 225 in the mandible. The remaining 21 implants planned for 20 patients could not b...
Regarding intraoperative complications, all sinus membrane perforations were covered with a resorbable collagen membrane (Bio-Gide®, Geistlich Biomaterials, Baden-Baden, Germany) which applied as sealant to overlap the site of perforation prior to insertion of the graft material. These patients were advised to avoid physical stress, blowing their noses, or sneezing for a period of 3 weeks, and n...
No permanent damage to any trigeminal nerves was evident in any of our entire cohort. All cases of postoperative hypoesthesia of the mental, lingual, or infraorbital nerve were just a temporary nature. At the time of implant surgery, none of these patients reported any persisting neural disturbances (Fig. 4).
In eleven patients, hypoesthesia of the mental area was mentioned, and three of them al...
Thirty-eight patients underwent a total of 116 augmentation procedures harvesting from the iliac crest. In 20 patients, a bone graft augmentation of the maxilla and the mandible in combination with bilateral sinus floor augmentations was performed. Eighteen patients had augmentations only in the maxilla, involving bone grafting and sinus lift elevations. Totally, 76 sinus lifts with bone material ...
A total of 104 retromolar bone graft procedures in 86 patients were conducted. Twenty-two harvesting procedures were performed for augmentation of the maxilla and 82 for the mandible. Seven retromolar bone grafts (93.2%) in seven single-tooth gap dental regions by seven patients had been lost. Therefore, seven implants could not be inserted in augmented alveolar sites after graft failure. Three of...
In six patients, a partial graft resorption was detected at the time of implantation and an additional simultaneous augmentation with bone chips harvested with the Safescraper device (C.G.M. S.p.A., Divisione Medicale META, Italy) was then necessary in order to ensure the osseointegration of the implants. Two out of these six cases had grafts from the crista zygomatico-alveolaris, two from the ram...
A total of 112 sinus floor elevations were performed. In all of the cases, implants were inserted in a two-stage procedure. The donor site for harvesting the bone for the sinus elevations was in 76 procedures in the iliac crest area, and in 36 procedures, the bone was harvested with a bone scraper device from the lateral sinus wall at the site of sinus lifting.
The distribution and number of tran...
Two hundred seventy-nine patients—250 men and 29 women—underwent 456 augmentation procedures involving autologous bone grafts prior to implant placement. The patients ranged in age from 18.5 to 71.5 years (average 43.1 years) at the moment of augmentation surgery.
Of those patients, 162 (58.1%) were younger than 40 years of age and 117 (41.9%) were older than 40 years of age. Caries or pe...
Early and late implant loss was documented in this study, defining the clinical success of osseointegration. Early implant failures were assessed before the acquisition of osseointegration, i.e., before the placement of prosthodontic restorations. Early implant failure could occur from the time of placement, during the healing phase and before abutment connection. The implant inserted after re-aug...
Medical history of patient
Age of patient at the time of bone harvesting and augmentation
History of periodontal disease
Smoking habits
Donor site
Jaw area and dental situation of the recipient site
Intraoperative complications
Postoperative complications after augmentation
Management of complications
Bone graft stability and clinical resorption prior to implant placement
Complications a...
In addition to the bone already gained with the bone scraper device from the sinus wall during the antrostomy, bone was harvested with the same device from the maxillary buccal buttress, if more volume was needed. By taking this approach, the collection of enough bone for the augmentation of at least two implantation sites was feasible with a mean surgical time of 5 to 10 min for harvesting. In c...
Grafting from the iliac crest was always performed under general anesthesia in a two-team approach. The iliac crest was exposed and autogenous grafts from the anterosuperior inner edge of the iliac wing were harvested with an oscillating saw and/or a chisel, keeping a safe distance of around 2 cm from the anterosuperior iliac spine. After harvesting the bone grafts, the corticocancellous bone blo...
A standardized two-stage surgical protocol was used, and all sites were treated in a similar fashion. In the first intervention, a bone block harvested from the donor site was fixed with osteosynthesis titanium screws to the recipient site as an onlay graft to achieve a horizontal and/or vertical enlargement of the alveolar ridge. Placement of the bone graft was always guided by an augmentation te...
For this retrospective cohort study, we reviewed the records of all patients without exclusion criteria who were referred to the department of oral and plastic maxillofacial surgery at the military hospital of Ulm, Germany, between January 2009 and December 2011 for alveolar ridge augmentations prior to implant insertions using autologous bone grafts harvested from different donor sites and unilat...
In our military outpatient center exclusively, autologous bone transplantations harvested from different donor sites were used intraorally (crista zygomatico-alveolaris, ramus mandible, symphysis mandible, anterior sinus wall) and extraorally (iliac crest) to reconstruct severe horizontal and/or vertical alveolar ridge atrophy prior to implant placement. The aim of this study was to assess the cli...
Although the iliac crest is most often used in jaw reconstruction, a significant bone resorption has been mentioned [12]. This disadvantage, and the fact that dental implants do not always require a large amount of bone, has increased the use of autologous block bone grafts from intraoral sources [13]. Bone grafts from intraoral donor sites offer several benefits like surgical accessibility, proxi...
Oral implantation has a significant role in the rehabilitation of patients. Bone reconstruction techniques have been advanced in order to optimize the esthetic and functional outcome. However, the restoration of the oral function of atrophic alveolar crests still remains a challenge in oral implantology. Bone augmentation procedures are often indicated to allow implant placement in an optimal thre...
This review demonstrates the predictability of autologous bone material in alveolar ridge reconstructions prior to implant insertion, independent from donor and recipient site including even autologous bone chips for sinus elevation. Due to the low harvesting morbidity of autologous bone grafts, the clinical results of our study indicate that autologous bone grafts still remain the “gold standar...
This study assessed the clinical outcomes of graft success rate and early implant survival rate after preprosthetic alveolar ridge reconstruction with autologous bone grafts.
A consecutive retrospective study was conducted on all patients who were treated at the military outpatient clinic of the Department of Oral and Plastic Maxillofacial Surgery at the military hospital in Ulm (Germany) in the ...
Fig. 6. Postoperative intraoral finding and radiograph
Fig. 6. Postoperative intraoral finding and radiograph
Fig. 5. High p53, p63, and Ki-67 reactivity are also observed in the basal cell layer (immunohistological staining, bar 400 μm)
Fig. 5. High p53, p63, and Ki-67 reactivity are also observed in the basal cell layer (immunohistological staining, bar 400 μm)
Fig. 4. Immunohistological findings show a negative staining mosaic pattern for keratin 13 (k13) and positive staining for keratin 17 (k17) (immunohistological staining, bar 400 μm)
Fig. 4. Immunohistological findings show a negative staining mosaic pattern for keratin 13 (k13) and positive staining for keratin 17 (k17) (immunohistological staining, bar 400 μm)
Fig. 3. Pathological microscopic examination reveals thickened squamous epithelia with slight nuclear atypism and disorders of the epithelial rete pegs accompanied by moderate grade inflammatory cell infiltration (HE staining, bar: 400 μm)
Fig. 3. Pathological microscopic examination reveals thickened squamous epithelia with slight nuclear atypism and disorders of the epithelial rete pegs a...
Fig. 2. Panoramic radiograph shows slight vertical bone resorption around the implants in the right side of the mandible
Fig. 2. Panoramic radiograph shows slight vertical bone resorption around the implants in the right side of the mandible
Fig. 1. Well-circumscribed gingival swelling on the lingual side of the right side of the mandible
Fig. 1. Well-circumscribed gingival swelling on the lingual side of the right side of the mandible
Antibody
Sorce
Clone
Staining
Keratin 13
DAKO
DE-K13
...
Noguchi, M., Tsuno, H., Ishizaka, R. et al. Primary peri-implant oral intra-epithelial neoplasia/carcinoma in situ: a case report considering risk factors for carcinogenesis.
Int J Implant Dent 3, 47 (2017). https://doi.org/10.1186/s40729-017-0109-z
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Received: 15 March 2017
Accepted: 25 October 2017
Published: 16 November 2017
DOI: https://doi.org/10.1186...
Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were...
Written informed consent was obtained from the patient for publication of this case report and any accompanying images.Makoto Nogchi, Hiroaki Tsuno, Risa Ishizaka, Kumiko Fujiwara, Shuichi Imaue, and Kei Tomihara declare that they have no competing interests.Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Written informed consent was obtained from the patient for publication of this case report and any accompanying images.
Makoto Nogchi, Hiroaki Tsuno, Risa Ishizaka, Kumiko Fujiwara, Shuichi Imaue, and Kei Tomihara declare that they have no competing interests.
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Correspondence to
Makoto Noguchi.
Department of Oral and Maxillofacial Surgery, Graduate School of Medicine and Pharmaceutical Sciences for Research, University of Toyama, 2630 Sugitani Toyama city, Toyama, 9300194, Japan
Makoto Noguchi, Hiroaki Tsuno, Risa Ishizaka, Kumiko Fujiwara, Shuichi Imaue & Kei Tomihara
Department of Diagnosis Pathology, Graduate School of Medicine and Pharmaceutical Sciences for Research, Univers...
Vasilescu F, Ceauşu M, Tänsen C, et al. P53, p63 and ki-67 assessment in HPV-induced cervical neoplasia. RJME. 2009;50:357–61.
Ndiaye C, Mena M, Alemany L, et al. HPV DNA, E6/E7 mRNA, and p16INK4a detection in head and neck cancers: a systematic review and meta-analysis. Lancet Oncol. 2014;15:1319–31.
Nagy K, Sonkodi I, Szöke I, et al. The microflora associated with human oral carcinoma. ...
Sah JP, Johnson NW, Batsakis JG. Oral cancer. London: Informa Healthcare; 2011. p. 3–32.
Japan Society for Oral Tumors. General rules for clinical and pathological studies on oral cancer. 1st ed. Tokyo: Kanehara-shuppan Co; 2010. p. 44–7.
Laprise C, Shahl HP, Madathil SA, et al. Periodontal diseases and risk of oral cancer in Southern India: results from the HeNCe Life Study. Int J Cancer. 2...
Deoxyribonucleic acid
Human papilloma virus
Oral intra-epithelial neoplasia/carcinoma in situ
Squamous cell carcinoma
In our case, the persistence of peri-implant mucositis or peri-implantitis around the dental implant was implicated as being a plausible risk factor for carcinogenesis. Regular follow-up to ensure the maintenance of oral hygiene after dental implant therapy has again been shown to be important for preventing peri-implantitis, a plausible risk factor for carcinogenesis.
The latest evidence implies that the human papilloma virus (HPV) may be responsible for carcinogenesis in the oral cavity [12, 13]; however, its role is debatable. The interaction of the HPV’s E6 and E7 oncoproteins with cell cycle proteins disturbs the cell cycle mechanism and subsequent alteration in the expression of proteins such as p53, p63, and Ki-67 [14]. In our case, the immunohistochemi...
OIN/CIS can sometimes be difficult to distinguish pathologically from epithelial dysplasia on hematoxylin- and eosin-staining sections; this has proved challenging for oral pathologists [9]. Recently, it has been reported that combined immunohistochemistry for k13 and k17 was useful for the differential diagnosis [9, 10]. K13 is a marker for cellular differentiation toward prickle cells in normal ...
A 65-year-old woman was referred to our clinic with a tumor in the right lower gingiva. Her medical history included breast cancer without metastatic lesion, diabetes mellitus, hyperlipidemia, and hypertension. She had taken orally aspirin, amlodipine, pravastatin, and bepotastine for 2 years. She drank alcohol socially, but she had no history of tobacco smoking habit.
About 10 years prior to h...
Oral cancer ranks sixth among the malignancies in terms of worldwide prevalence, with more than 90% being pathologically squamous cell carcinoma (SCC) [1]. Oral SCC generally develops via multistep carcinogenesis. The squamous epithelium goes into irreversible change, including epithelial dysplasia and oral intra-epithelial neoplasia/carcinoma in-situ (OIN/CIS) [2], finally resulting in the develo...
In this case, prolonged peri-implant mucositis or peri-implantitis may have been a plausible risk factor for carcinogenesis.
Major risk factors for oral squamous cell carcinoma (SCC) are tobacco smoking, a betel quid chewing habit, and heavy alcohol consumption. However, around 15% of oral SCCs cannot be explained by these risk factors. Although oral SCC associated with dental implants is quite rare, there has been a recent gradual accumulation of reports about it. Here, we report a case of primary peri-implant oral int...
Fig. 1. Treatment strategies for OAF closure
Fig. 1. Treatment strategies for OAF closure
Author year
No. of participants
Method
Autogenous soft tissue flaps
Lin et al. 1991
16
...
Parvini, P., Obreja, K., Sader, R. et al. Surgical options in oroantral fistula management: a narrative review.
Int J Implant Dent 4, 40 (2018). https://doi.org/10.1186/s40729-018-0152-4
Download citation
Received: 14 August 2018
Accepted: 02 November 2018
Published: 27 December 2018
DOI: https://doi.org/10.1186/s40729-018-0152-4
Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were m...
Not applicable.
Not applicable.
Puria Parvini, Karina Obreja, Robert Sader, Jürgen Becker, Frank Schwarz, and Loutfi Salti declare that they have no competing interests.
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Correspondence to
Karina Obreja.
Department of Oral Surgery and Implantology, Carolinum, Johann Wolfgang Goethe-University, Frankfurt, Germany
Puria Parvini, Karina Obreja, Frank Schwarz & Loutfi Salti
Department for Oral, Cranio-Maxillofacial and Facial Plastic Surgery, Medical Center of the Goethe University Frankfurt, Frankfurt am Main, Germany
Robert Sader
Department of Oral Surgery, Universitätsklinikum Düsseldorf,...
Not applicable
No funding to declare.
All data generated or analyzed during this study are included in this published article.
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Misch CM. Harvesting of ramus bone in conjunction with third molar removal for onlay grafting before placement of dental implants. J Oral Maxillofac Surg. 1999;57:1376–9.
Nkenke E, Radespiel-Tröger M, Wiltfang J, Schultze-Mosgau S, Winkler G, Neukam FW. Morb...
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Singh J, Prasad K, Lalitha RM, Ranganath K. Buccal pad of fat and its applications in oral and maxillofacial surgery: a review of published literature (February) 2004 to (July) 2009. Oral Surg Oral Med O...
Awang MN. Closure of oroantral fistula. Int J Oral Maxillofac Surg. 1988;17:110–5.
Hynes W. Fistula in the hard palate following cleft surgery. Br J Plast Surg. 1957:377–84.
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Salins PC, Kishore SK. Anteriorly based...
Yilmaz T, Suslu AE, Gursel B. Treatment of oroantral fistula: experience with 27 cases. Am J Otolaryngol. 2003;24:221–3.
Borgonovo AE, Berardinelli FV, Favale M, Maiorana C. Surgical options in oroantral fistula treatment. Open Dent J. 2012;6:94–8.
Güven O. A clinical study on oroantral fistulae. J Craniomaxillofac Surg. 1998;26:267–71.
Amaratunga NADES. Oro-antral fistulae- a study of c...
Buccal fat pad
Bone graft transplantation
Connective tissue grafts
Free mucosal graft
Guided tissue regeneration
Oroantral fistula
Platelet-rich fibrin
By reviewing the literature, we can conclude that in selecting the surgical approach to close an oroantral fistula, different parameters have to be taken into account, including location and size of fistula as well as its relationship to the adjacent teeth, height of the alveolar ridge, persistence, sinus inflammation and the general health of the patient.
A small oroantral fistula of less than 5...
Logan and Coates described a procedure that provided closure of OAF in immunocompromised patients [74].
The oroantral fistula was de-epithelialized under local anesthesia, and the patient wore an acrylic surgical splint continuously for an 8-week period. The acrylic surgical splint covered the fistula and the edentulous area including the hard palate. The investigators reported complete healing o...
Use of guided tissue regeneration has been documented by Waldrop and Semba [71]. This method uses an absorbable gelatin membrane, allogenic bone graft material, and a nonresorbable expanded polytetrafluoroethylene (ePTFE) membrane. After flap reflection, an absorbable gelatin membrane is placed over the OAF with its edges on the bony margins of the perforation, which serve as a barrier for the bon...
The use of a bioabsorbable root analog made of β-tricalcium phosphate for closure of oroantral fistulas was proposed by Thoma et al. [68]. The root replicas were fabricated chair side, using a mold of the extracted tooth [10]. The investigators reported that the healing was uneventful. However, fragmentary roots or overly large defects prevent replica fabrication or accurate fitting of the analog...
Polymethylmethacrylate has been introduced as an alternative technique for closing OAFs [64]. After 24 h of immersion in a sterilizing solution, the polymethylmethacrylate plate is placed over the defect. Mucoperiosteal flaps are then replaced without attempting to cover the acrylic plate. The polymethylmethacrylate plate is removed as soon as the edges become exposed. One of the common disadvant...
Various synthetic materials have been used for OAF closures. Use of gold foil and gold plate for the closure of OAFs was reported for the first time by Goldman and Salman, respectively [59, 60]. It is a simplified technique for the closure of oroantral fistulas. The technique consists of elevating the mucoperiosteum to expose the bony margins of the fistula. Then, the opening is covered with an ov...
Multiple techniques have been described for the closure of OAFs using lyophilized fibrin glue of human origin [53]. In this technique, the fibrin glue is prepared and injected into the socket, together with the collagen sheet. Stajčić et al. stressed the importance of inserting the syringe above the floor of the antrum to protect the clot from airflow [53]. The technique is simple with few posto...
An autogenous bone graft and platelet-rich fibrin (PRF) membrane as a treatment strategy for closure of OAF has also been proposed [50]. PRF is a product of centrifuged blood. The biochemical components of PRF are well-known as factors acting synergistically in the healing process. This includes platelet-derived growth factor (PDGF), whose components are the reason why PRF has anti-inflammatory pr...
Recently, auricular cartilage graft has been used for the closure of OAFs. A full-thickness flap is raised at the defect site [47]. A semicircular incision is then made posteriorly over the conchal cartilage. The conchal cartilage with overlying perichondrium is exposed with a blunt dissection. The harvested auricular graft is then adapted on the defect site and sutured with the surrounding tissue...
A retromolar bone graft is a viable procedure for OAF closure. However, harvesting of a retromolar bone can occasionally be combined with removal of the third molar, which may affect acceptance of the procedure by patients [44]. When compared to chin bone grafts, the significant disadvantage of the retromolar donor area is the confined amount of bone available [45]. The incision is made medial to ...
The tongue is an excellent donor site for soft tissue defects of the oral cavity, due to its pliability, position, and abundant vascularity. Tongue flaps can be created from the ventral, dorsal, or lateral part of the tongue [36]. The surgical design of the flap is dictated by the location of the defect. A lateral tongue flap has been described as a suitable method for the closure of large OAF [37...
Free mucosal grafts (FMG) or connective tissue grafts (CTG) are suitable for the closure of small to moderate size defects in the premolar area as well as small to medium size-persistent defects. In contrast to the techniques described so far, the harvested grafts are not directly vascularized. The flap initially receives its nutrients within the first three postoperative days by diffusion alone, ...
The palatal straight advancement flap is of limited use due to the inelastic nature of the palatal tissue, which reduces its lateral mobility. For the same reason, it is suitable for the closure of minor palatal or alveolar defects [17].
The palatal hinged flap has been used successfully to close small fistula of the hard palate, i.e., those less than 2 cm in diameter in a one-stage operation [1...
Môczáir [14] described closing alveolar fistulas by the buccal sliding flap, shifting the flap one tooth distally. This technique produces only a negligible change in the depth of the buccal vestibule. A drawback of this approach is that it requires a large amount of dentogingival detachment in order to facilitate the shift, which may result in gingival recession and periodontal disease.
The fi...
A narrative literature review of articles and case reports for oroantral fistula has been conducted in the PubMed databases of published English literature. Articles published until April 2018 were reviewed. In addition to 262 articles on the closure of oroantral, 4 articles on the closure of antrooral fistula in humans, and 5 articles in animals, citations were referenced to identify further rele...
Radiologically, in the computed tomography (CT) or cone beam computed tomography (CBCT), the oroantral fistula might show as sinus floor discontinuity, opacification of the sinus, or communication between the oral cavity and the sinus. In addition, focal alveolar atrophy and associated periodontal disease may be observed [6]. In chronic OAF, there is generalized mucosal thickening. Recent studies ...
An oroantral fistula (OAF) can be defined as an epithelialized pathological unnatural communication between the oral cavity and the maxillary sinus [1]. The term oroantral fistula is used to indicate a canal lined by epithelium that may be filled with granulation tissue or polyposis of the sinus membrane [2]. They can arise as late sequelae from perforation and last at least 48–72 h. An oroantr...
Fig. 3. Treatability refers to OPG/CBCT and to residents in oral surgery and orthodontics
Fig. 3. Treatability refers to OPG/CBCT and to residents in oral surgery and orthodontics
Fig. 2. Accuracy of diagnostic answers given by residents in orthodontics (R right, F false, NS not sufficient)
Fig. 2. Accuracy of diagnostic answers given by residents in orthodontics (R right, F false, NS not sufficient)
Fig. 1. Accuracy of diagnostic answers from residents in oral surgery (R right, F false, NS not sufficient)
Fig. 1. Accuracy of diagnostic answers from residents in oral surgery (R right, F false, NS not sufficient)
Variable
p value
Odds ratio (95% CI)
Specialisation: oral surgery vs orthodontics
4 year
0.045*
...
Question pertaining to
OPG (%)
CBCT (%)
p value
Odds ratio (95% CI)
Contact to nerve
...
Question pertaining to
OS (%)
ORTH (%)
p value
Odds ratio (95% CI)
Contact to nerve
...
Case
Age (years)
Sex
Pathology
Time between OPG and CBCT
1
...
Resident
Age (years)
Sex
Specialisation
Experience as a dentist (years)
1
...
Radic, J., Patcas, R., Stadlinger, B. et al. Do we need CBCTs for sufficient diagnostics?-dentist-related factors.
Int J Implant Dent 4, 37 (2018). https://doi.org/10.1186/s40729-018-0147-1
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Received: 06 July 2018
Accepted: 08 October 2018
Published: 16 November 2018
DOI: https://doi.org/10.1186/s40729-018-0147-1
Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were m...
The study was approved by the cantonal ethics committee of the canton of Zurich (KEK 2016-00070).
Not applicable
Josipa Radic, Raphael Patcas, Bernd Stadlinger, Daniel Wiedemeier, Martin Rücker and Barbara Giacomelli-Hiestand declare that they have no competing interests.
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Correspondence to
Barbara Giacomelli-Hiestand.
Clinic of Cranio-Maxillofacial and Oral Surgery, Centre of Dental Medicine, University of Zurich, Plattenstrasse 11, 8032, Zurich, Switzerland
Josipa Radic, Bernd Stadlinger, Martin Rücker & Barbara Giacomelli-Hiestand
Clinic for Orthodontics and Paediatric Dentistry, Centre of Dental Medicine, University of Zurich, Plattenstrasse 11, 8032, Zurich, Switzerland
Raphael Patcas
Statistical S...
Ren H, Chen J, Deng F, Zheng L, Liu X, Dong Y. Comparison of cone-beam computed tomography and periapical radiography for detecting simulated apical root resorption. Angle Orthod. 2013;83(2):189–95. https://doi.org/10.2319/050512-372.1 published Online First: Epub Date]|.
Tantanapornkul W, Okouchi K, Fujiwara Y, Yamashiro M, Maruoka Y, Ohbayashi N, et al. A comparative study of cone-beam comput...
Hasani A, Ahmadi Moshtaghin F, Roohi P, Rakhshan V. Diagnostic value of cone beam computed tomography and panoramic radiography in predicting mandibular nerve exposure during third molar surgery. Int J Oral Maxillofac Surg. 2017;46(2):230–5. https://doi.org/10.1016/j.ijom.2016.10.003 published Online First: Epub Date]|.
Alqerban A, Jacobs R, Fieuws S, Willems G. Comparison of two cone beam comp...
Mason C, Papadakou P, Roberts GJ. The radiographic localization of impacted maxillary canines: a comparison of methods. Eur J Orthod. 2001;23(1):25–34.
Maverna R, Gracco A. Different diagnostic tools for the localization of impacted maxillary canines: clinical considerations. Prog Orthod. 2007;8(1):28–44.
Neves FS, Passos CP, Oliveira-Santos C, Cangussu MC, Campos PS, Nascimento RJ, et al. C...
Three-dimensional
Cone beam computed tomography
Digital Imaging and Communications in Medicine
Orthopantomography
Odds ratio
Resident in orthodontics
Resident in oral surgery
This study analysed (i) whether pathologies are accurately diagnosed in three different imaging modalities (OPG, CBCT, 3D model). Diagnostic accuracy was decent with OPG and was improved with CBCT. Next, the study assessed (ii) whether each case was classified as treatable on the basis of the present imaging modality. This result was influenced by the professional background, which influenced whet...
Certain limitations affect the generalizability of this study’s results. First, only nine cases were assessed with a limited range of pathologies (five retained teeth (canines and molars), two tooth resorptions, one odontoma and one supernumerary tooth). Moreover, the assessment was performed by a small amount of residents of the local university. The fact that all residents shared a similar aca...
In 81.6% of the cases, further imaging was requested after the OPG. Caution should be applied in the interpretation of this number, as the residents’ decision was theoretical and did not imply additional costs or radiation exposure. Nevertheless, it is striking that in the majority of the cases, further imaging was requested. One possible explanation might be the diagnostic difficulty of the cho...
Moreover, another valuable and novel observation is the divergence seen in the importance of printed 3D models. For residents in oral surgery, printed 3D models caused more uncertainties and led to a decrease of diagnostic accuracy (if assessed in sequential order after OPG and CBCT). In contrast, residents in orthodontics seemed to benefit of an additional assessment of printed 3D models, which r...
The aim of this study was twofold: (i) to analyse the diagnostic accuracy of pathologies in three different imaging modalities of the same case and (ii) to analyse the need for further imaging in order to enable treatment. Further, aspects like the impact of specialisation, gender and dental experience were analysed. In contrast to the plethora of scientific literature available dealing with CBCT ...
Overall, the majority of the questions were answered correctly, independently to the imaging modality. The percentages of correct answers given by OS were 66.3% for OPG, 83.4% for CBCT and 76.4% for 3D model; and differed slightly to those given by ORTH with 63.7% for OPG, 78.0% for CBCT and 78.7% for 3D model (Figs. 1 and 2). Both OS and ORTH alike answered to around 20% of the questions that th...
Statistical analysis and plots were performed using the statistical software R [12]. To evaluate the differences in the proportions of correct diagnostic answers between OS and ORTH and between different imaging modalities, Fisher’s exact tests were used and odds ratios (OR) including confidence intervals (CI) were computed for every question separately. Likewise, Fisher’s exact tests were app...
Each resident was shown the region of interest to which the questions related to
Allowed setup change of OPG: zoom
Allowed setup change of CBCT: brightness, contrast, zoom, scroll in all three levels (coronal, axial and sagittal
3D model: no restrictions
The OPGs of this study were taken either in-house (CRANEX D, Kw73, 10 mA) or extramural. All CBCTs were taken at the Centre of Dental Medici...
Fourteen residents were recruited for this survey [7 residents in oral surgery (OS) and 7 residents in orthodontics (ORTH), respectively; m = 6, f = 8]. Their characteristics are listed in Table 1. Every resident assessed individually nine separate patient cases, each containing a distinct dentoalveolar pathology, as defined in the study planning process (Table 2).
For each patient case...
Finally, the request for a CBCT should always be guided by the pursuit of improved diagnostic accuracy and the prospect of an enhanced treatment plan. Preferably, the indications for a CBCT should be based entirely on case-related factors. Yet, dentist-related factors might influence the request for a CBCT as well.
The aim of this study was therefore (i) to assess whether pathologies are accurate...
Along with the clinical examination, radiological imaging is essential for a complete diagnosis in dental medicine [1, 2]. Orthopantomography (OPG), a two-dimensional panoramic radiograph, is widely used across all dental disciplines including oral surgery and orthodontics [3,4,5] to address basic diagnostic queries. An OPG contains an abundance of information on the teeth, mandible, maxilla, incl...
The aim of this study was to assess the diagnostic accuracy of various dentoalveolar pathologies based on panoramic radiography (OPG), cone beam computed tomography (CBCT) and printed 3D models in consecutive order; and to evaluate the impact of specialisation of residents in oral surgery (OS) versus residents in orthodontics (ORTH).
Fourteen residents were recruited to evaluate nine selected cas...
Fig. 8. PPD on natural teeth. No significant differences appreciable
Fig. 8. PPD on natural teeth. No significant differences appreciable
Fig. 7. PPD on dental implants. No significant differences appreciable
Fig. 7. PPD on dental implants. No significant differences appreciable
between 1 month and 3 months, the test group values decrease during all the duration of the study
Fig. 6. BoP on natural teeth. While the control group shows a mild increase between 1 month and 3 months, the test group values decrease during all the duration of the study
Fig. 5. BoP on dental implants. It can be observed how the values keep decreasing after 1 month only in the test group
Fig. 5. BoP on dental implants. It can be observed how the values keep decreasing after 1 month only in the test group
Fig. 4. PI on natural teeth. After 1 month, the test group showed mild reduction while control a light improvement
Fig. 4. PI on natural teeth. After 1 month, the test group showed mild reduction while control a light improvement
Fig. 3. PI on dental implants. Test values keep reducing after 1 month while control maintains the same level
Fig. 3. PI on dental implants. Test values keep reducing after 1 month while control maintains the same level
Fig. 2. Patients’ population flow chart
Fig. 2. Patients’ population flow chart
Fig. 1. Electric toothbrush heads: on the left is the one designed for natural teeth, and on the right is the one designed for dental implants
Fig. 1. Electric toothbrush heads: on the left is the one designed for natural teeth, and on the right is the one designed for dental implants
Baseline
1 month
3 months
T0
T1
T2
BoP implants, t...
Allocca, G., Pudylyk, D., Signorino, F. et al. Effectiveness and compliance of an oscillating-rotating toothbrush in patients with dental implants: a randomized clinical trial.
Int J Implant Dent 4, 38 (2018). https://doi.org/10.1186/s40729-018-0150-6
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Received: 12 April 2018
Accepted: 24 October 2018
Published: 10 December 2018
DOI: https://doi.org/10.11...
Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were m...
Not applicable
This study was conducted in compliance with the principles of the Declaration of Helsinki, and the approval of the ethics committee required for the study was obtained from the Ethics Committee of the IRCCS Ospedale Maggiore Policlinico di Milano, Fondazione Ca’ Granda. The procedures to be performed were explained in detail, and the patients signed the consent form.
Not applica...
Center for Edentulism and Jaw Atrophies, Maxillofacial Surgery and Dentistry Unit, Fondazione IRCCS Cà Granda – Ospedale Maggiore Policlinico, University of Milan, Via Commenda 10, 20122, Milan, Italy
Giuseppe Allocca, Diana Pudylyk, Fabrizio Signorino & Carlo Maiorana
Oral Surgery, Maxillofacial Surgery and Dentistry Unit, Fondazione IRCCS Cà Granda – Ospedale Maggiore Policlinico, Un...
Not applicable
The authors declare no funds for the research.
Mean data of PI, BoP, and PPD collected from 80 periodontal charts are shown in Table 1.
Berglundh T, Lindhe J. Dimension of the periimplant mucosa. Biological width revisited. J Clin Periodontol. 1996;23(10):971–3 PubMed PMID: 8915028.
Berglundh T, Lindhe J, Ericsson I, Marinello CP, Liljenberg B, Thomsen P. The soft tissue barrier at implants and teeth. Clin Oral Implants Res. 1991;2(2):81–90 PubMed PMID: 1809403.
Berglundh T, Abrahamsson I, Welander M, Lang NP, Lindhe J. Morp...
Quirynen M, De Soete M, van Steenberghe D. Infectious risks for oral implants: a review of the literature. Clin Oral Implants Res. 2002;13(1):1–19 PubMed PMID: 12005139.
Roos-Jansåker AM, Renvert S, Egelberg J. Treatment of peri-implant infections: a literature review. J Clin Periodontol. 2003;30(6):467–85 PubMed PMID: 12795785.
Ho HP, Niederman R. Effectiveness of the Sonicare sonic toothb...
Pjetursson BE, Lang NP. Prosthetic treatment planning on the basis of scientific evidence. J Oral Rehabil. 2008;35(Suppl 1):72–9. https://doi.org/10.1111/j.1365-2842.2007.01824.x PubMed PMID: 18181936.
Jung RE, Pjetursson BE, Glauser R, Zembic A, Zwahlen M, Lang NP. A systematic review of the 5-year survival and complication rates of implant-supported single crowns. Clin Oral Implants Res. 2008...
Bleeding on probing
Plaque index
Pocket probing depth
The oscillating-rotating toothbrush can be used for the plaque and bleeding control around both natural teeth and dental implants. It has also been shown how the toothbrush head designed for dental implant can be effective in plaque removing of the peri-implant tissues.
At the end of the present study, electric toothbrush groups showed plaque and bleeding values lower (PI and BoP on teeth) or at least without significative differences (BoP on implants) than the control group. These data may suggest how the use of electric toothbrush, associated to the dedicate heads, can be an effective method for plaque and bleeding reduction.
This 3-month study aimed to demonstrate the efficacy of an electric toothbrush in reducing plaque and gingival inflammation around dental implants and natural teeth. To better understand the different data collected around two different anatomical structures, we decided to collect data separately. Analyzing our results, it is possible to observe how the mean values for probing, bleeding, and plaqu...
The difference between the BoP recorded on dental implant sites at baseline and the end of the study showed statistical significance for both the test and control groups (P
Seventy-eight patients successfully completed the study (45 women and 33 men aged from 31 to 76 years old) (Fig. 2). Two patients of test group did not show up both at the first and second controls. No patients were excluded or showed complications or adverse reaction. Results are shown in Table 1. The average number of implants per patients was 4.8 ± 3.4 in the control group and 4.4 ±...
Mean scores of all clinical indices for each subject were calculated separately for dental implants and natural teeth. The final data analysis was performed for those subjects who completed the study. The Student’s t test and the Mann-Whitney U test were used to evaluate whether any statistically significant differences were present between the two groups at each time point, and the Wilcoxon sig...
The study was conducted between September 2015 and June 2017 at Implantology Department of Policlinic Hospital, University of Milan, Milan. It was designed as a monocentric randomized clinical study according to the STROBE criteria. Eighty patients who underwent dental implant rehabilitation were selected for this study. At the screening visit, subjects were asked to read and sign a written inform...
Dental implants became one of the most accepted treatments for the rehabilitation of partial or complete edentulism [1]. However, inflammatory processes may still occur due to the presence of the implant itself [2]. It is well known that peri-mucositis and peri-implantitis are strictly related to the presence of plaque on the surface of the implant-prosthetic complex, which lead respectively to th...
The aim of this randomized clinical trial was to assess the efficacy of an oscillating-rotating toothbrush in reducing plaque and inflammation around dental implants.
Eighty patients presenting dental implants were enrolled in this study and assigned randomly to two different groups: 40 patients in the test group and 40 in the control one. Each patient in the test group received an oscillating-ro...
Figure 2. Clinical image of patient 4: a region 21 before implant placement. b, c Implant placement using the GBR procedure with a synthetic bone substitute material composed of HA + β-TCP
Figure 1. Schematic representation of the technical characteristics of the investigated C-Tech Esthetic Line implant system (provided by the manufacturer)
Patient
Implant-localization (region)
Implant loss (+/−)
Buccal width of keratinized peri-implant gingiva (mm)
Buccal thickness of keratinized peri-implant gingiva (mm)
Pink Esthetic Score (PES)
Probing depth (mm) at four sites (mb, db, mo, do)
Bleeding on Probing (+/−) at four sites (mb, db, mo, do)
Peri-implant bone loss (mm)
Presence of peri-implant osteolysis (+/−)
...
Patient
Gender (m/f)
Age (years)
Implant localization (region)
Implant diameter (mm)
Implant length (mm)
Augmentation material
Prosthetic rehabilitation
1
f
50
32
3.5
13
HA + β-TCP
r.p
34
4.3
11
HA + β-TCP
r.p
42
3.5
13
HA + β-TCP
r.p
44
4.3
11
HA + β-TCP
r.p
2
m
61
36
3.5
11
HA + β-TCP
...
Abbreviations
β-TCP:
β-tricalcium phosphate
BOP:
Bleeding on probing
F.P.:
Fixed prosthetics
GBR:
Guided bone regeneration
HA:
Hydroxyapatite
MNGCs:
Multinucleated giant cells
PES:
Pink Esthetic Score
R.P.:
Removable prosthetics
References
Gurgel BC, Montenegro SC, Dantas PM, Pascoal AL, Lima KC, Calderon PD. Frequency o...
Comparing the present results to the aforementioned study with the same implant system on immediately placed implants, it seems that the GBR augmentation procedure has no influence on the long-term stability of the implants. In both studies with different placement modalities and protocols, comparable clinical and radiological results were achieved. This leads to the assumption that the inve...
The tissue reaction, however, did not only differ in bone substitute materials of different origin but also in bone substitute materials of the same origin. In an in vivo trial, two xenogeneic bone substitute materials processed with different techniques were implanted subcutaneously in CD-1 mice for up to 60 days. Both bone substitute materials showed good integration within the peri-impla...
Discussion
In the present retrospective study, C-Tech bone level implants placed simultaneously with a GBR procedure around the implant shoulder were investigated clinically and radiologically after at least 3 years of loading to assess peri-implant tissue conditions and document peri-implant tissue stability.
A total of 47 implants were placed in the upper (23 implants) and lower jaw (24...
Results
Altogether, 47 implants were placed in the upper and lower jaws of a total of 20 patients. In all implants, lateral augmentation in a GBR process was performed simultaneously with implant placement due to reduced horizontal or vertical height of the alveolar crest. A total of 23 implants were placed in the upper jaw and 24 implants in the lower jaw. The implant diameter varied between 3...
C-Tech implant system
In the present retrospective study, bone level implants (C-Tech Esthetic Line implants) were investigated clinically and radiologically. The bone level implant system has a Morse-locking conical implant-abutment connection with platform switching and an indexing hex that allows subcrestal implant placement and aims to prevent peri-implant bone loss. The surface of the implan...
Methods
Patient population
In the present retrospective study, 47 dental implants (C-Tech Esthetic Line implants) from 20 patients (11 female, 9 male) with a mean age of 58.5 years (45–75 years) were analyzed clinically and radiologically. Implant placement and follow-up investigation was performed at the HL Dentclinic in Baden-Baden, Germany. The study was approved by the ethics commissio...
Regarding the stability of peri-implant hard and soft tissue, biological or anatomical factors are not the only elements that could be proven to have an impact. Technical factors such as the implant-abutment connection are also known to be key factors for long-term stable hard- and soft-tissue health [11]. Regarding the implant-abutment connection, which seems to be the key issue, located on the i...
However, in most patients, the local bone amount is reduced due to atrophy, inflammatory processes, or resectional defects. Therefore, in the past few years, different techniques have been described to enlarge the local bone amount in prospective implant sites [7]. Besides methods such as GBR or the sinus augmentation technique, different augmentation materials have been investigated and establish...
Background
The prevalence of peri-implantitis has grown in the past few years and has become a major issue in implant dentistry. Long-term stable and healthy soft- and hard-tissue conditions should be achieved in combination with esthetically and functionally satisfying results. However, the rising number of placed implants in the past decades has come with an increase in the prevalence of ...
Investigation of peri-implant tissue conditions and peri-implant tissue stability in implants placed with simultaneous augmentation procedure: a 3-year retrospective follow-up analysis of a newly developed bone level implant system
Abstract
Background
Guided bone regeneration (GBR) has been proven to be a reliable therapy to regenerate missing bone in cases of atrophy of the alveolar crest. T...
Figure 17. The appearance of the case shown in Fig. 16 with the polythene “washer” removed at 2 weeks post-surgery, providing access to the zygomatic oncology implants
Figure 15. Facial appearance 18 months following treatment
Figure 15. Facial appearance 18 months following treatment
Figure 14. Intra-oral view of perforated flap 3 weeks following radiotherapy
Figure 13. Panoramic dental radiograph showing the position of the zygomatic implants and the seating of the initial fixed prosthesis
Figure 12. Provisional acrylic fixed dental prosthesis fitted at 4 weeks post-surgery
Figure 11. Intra-oral view of the soft tissue flap at 3 weeks post-operatively with overgrowth of flap over the zygomatic oncology implants
Figure 10. Radial forearm flap inset and sutured into the maxillary defect and perforated by the zygomatic oncology implant abutments
Figure 10. Radial forearm flap inset and sutured into the maxillary defect and perforated by the zygomatic oncology implant abutments
Figure 9. Inter-occlusal registration using the pre-fabricated maxillary denture prosthesis relined with silicone putty over the implant abutment protection caps
Figure 8. Abutment level impression utilising light-cured acrylic tray material
Figure 7. Conventional zygomatic implant insertion on the non-defect side of the maxilla following extraction of the remaining teeth and an alveoloplasty
Figure 6. Zygomatic oncology implants sited in the residual zygomatic bone on the defect side of the maxilla
Figure 5. Left-sided maxillary resection (Brown class 2b)
Figure 4. Panoramic dental radiograph showing dental status at presentation
Figure 3. Staging CT scan confirming maxillary destruction but preservation of the orbital floor
Figure 2. Staging MRI scan showing destructive lesion left maxilla
Figure 1. Clinical view of left-sided maxillary tumour at presentation
Table 1 Patient-reported quality of life outcomes following ZIP flap procedure
From: The zygomatic implant perforated (ZIP) flap: a new technique for combined surgical reconstruction and rapid fixed dental rehabilitation following low-level maxillectomy
Domain
Score
Activity
100 (“I am as active as I have ever been”)
Anxiety
100 (“I am not anxious about ...
References
Okay DJ, Genden E, Buchbinder D, Urken M. Prosthodontic guidelines for surgical reconstruction of the maxilla: a classification system of defects. J Prosthet Dent. 2001;86(4):352–63.
Rohner D, Bucher P, Hammer B. Prefabricated fibular flaps for reconstruction of defects of the maxillofacial skeleton: planning, technique, and long-term experience. Int J Oral Maxillofac Impl...
Conclusions
The ZIP flap technique represents an innovative approach to the management of patients presenting with low-level malignant maxillary tumours. It provides effective closure of the resulting maxillary defect restoring speech and swallowing functions and also establishing a high-quality fixed dental rehabilitation in a rapid timescale, thus facilitating a more timely return to function...
Immediate/early loading of zygomatic [8] and dental implants [9] have been well demonstrated already within the literature with very high implant survival rates. In the oncology setting, Boyes-Varley et al. [4] lost no zygomatic/oncology implants in their series of 20 patients restored with implant-retained obturators, 6 of whom received radiotherapy post-operatively. The case reported...
The use of soft tissue flaps to close a typical hemi-maxillectomy defect is an effective way of dealing with the oro-nasal communication, but in isolation, this technique works against dental rehabilitation as the bulk of the flap provides a very poor moveable foundation for a subsequent removable prosthesis. The move towards the use of composite reconstruction (especially the fibula flap) h...
Discussion
In order to reduce intra-operative time, the soft tissue free flap is harvested at the same time as the implant placement and prosthodontic procedures. On raising a skin island, it is appropriate to make it a little over-sized for the required defect to ensure that tension and possible dehiscence at the surgical margins during healing is reduced.
In low-level maxillectomy (Brown...
Procedural modifications to the ZIP flap technique
In order to address some of the issues highlighted in this early case, the technique was modified slightly to try and prevent flap overgrowth and prosthesis fracture in the early stages. In order to prevent flap overgrowth over the zygomatic oncology implant abutments, the use of a polythene washer was instituted on subsequent cases treated in th...
The radial forearm free flap (RFFF) was then disconnected from the arm and inset into the maxillary defect after creating a tunnel down into the left neck for the pedicle. The flap was carefully perforated over the zygomatic implant abutment protection caps using a short incision just through the skin layer followed by blunt dissection to allow the abutment and cap to perforate the flap ensuring a...
The ZIP flap technique
The patient underwent tracheostomy, a limited left-sided selective neck dissection for node sampling and vessels preparation. The maxillary tumour was excised in a standard manner via an intra-oral approach with preservation of the left orbital floor (Fig. 5). The resection extended to the maxillary alveolar midline in the incisor region with extension posteriorly just into...
Case presentation
A 66-year-old male patient presented with an enlarging mass in the left maxilla (Fig. 1). The mass had been present for a few weeks. An incisional biopsy revealed squamous cell carcinoma. Staging scans were undertaken (Fig. 2) which demonstrated a T4N0M0 maxillary alveolus tumour in close proximity to the left orbital floor with obliteration of the maxillary antrum and destruc...
Background
The surgical management and prosthodontic rehabilitation of the maxillectomy patient is complex with a variety of options available to the head and neck cancer team ranging from simple prosthodontic obturation [1] to reconstruction using pre-fabricated or digitally planned composite flaps [2] with or without the placement of osseointegrated implants [3]. The primary aims of treatment...
The zygomatic implant perforated (ZIP) flap: a new technique for combined surgical reconstruction and rapid fixed dental rehabilitation following low-level maxillectomy
Abstract
This aim of this report is to describe the development and evolution of a new surgical technique for the immediate surgical reconstruction and rapid post-operative prosthodontic rehabilitation with a fixed dental prost...
Item
Mean ± SD pre-operative
Mean ± SD post-operative
Mean ± SD in the last time
Have you felt pain in your mouth?
0.9 ± 1.1
1.2 ± 1.0
0.3 ± 0.6
Have you had difficulties with your mouth opening?
0.2 ± 0.6
0.5 ± 0.9
0.1 ± 1.0
Have you had painful gums?
0.9 ± 1.0
1.0 ± 1.1
0.5 ± 0.8
Have you had a ...
Item
Mean ± SD before sinus lift
Mean ± SD after sinus lift
p value
Have you felt tense because of problems with your teeth, mouth or dentures?
1.8 ± 1.1
0.8 ± 1.0
Item
Mean ± SD before sinus lift
Mean ± SD after sinus lift
p value
Have you had difficulty chewing any foods?
1.6 ± 1.2
0.4 ± 0.7
Figure 5. Total score for physical and psychological disabilities before (gray) and after (hatched) sinus augmentation according to indications
Figure 4. Total score for functional limitations before (gray) and after (hatched) sinus augmentation according to indications
Figure 3. Total score for complaints due to surgical procedure pre-operative, post-operative, and recently
Figure 2. Cumulative survival rate according to Kaplan–Meier and sinus augmentation procedure
Figure 1. Flow chart of patients included in the study
Figure 1. Flow chart of patients included in the study
References
Al-Nawas B, Schiegnitz E. Augmentation procedures using bone substitute materials or autogenous bone—a systematic review and meta-analysis. Eur J Oral Implantol. 2014 Summer;7 Suppl 2:S219-34.
Derks J, Hakansson J, Wennstrom JL, Tomasi C, Larsson M, Berglundh T. Effectiveness of implant therapy analyzed in a Swedish population: early and late implant loss. J Dent Res. 2015;94(...
The authors concluded that in clinical decision-making regarding donor site for bone graft harvesting, patients and clinicians should consider expected decrease in HRQoL if deciding to use extra-oral donor sites. Therefore, the authors recommended to prefer intra-oral donor sites whenever possible. In a recent study of Nickenig et al., OHIP-G 21 was evaluated in 8689 patients with variou...
In this prospective study, health-related quality of life questionnaire was given to 76 patients evaluating patient perception of recovery in the four areas pain, oral function, general activity, and other symptoms. The results showed that average and maximal pain peaked on post-operative day 1 and improved on post-operative days 4 and 5. Difficulty in mouth opening was greatest on pos...
Discussion
The clinical and radiological outcomes of sinus augmentation procedures have been published in several studies. However, little data on the physical and psychological impact of this procedure on the patient is available yet. The present study evaluated pre-operative and post-treatment OHRQoL self-assessment scores of patients treated with dental implants after sinus augmentation ...
In the subcategory physical and psychological disabilities, all questions had significant better values after the sinus lift (p
Results
Survival analysis
After an average time in situ of 41.2 ± 27 months (3.4 years; range 0–96 months), 40 of the 863 implants were lost. These results indicated an in situ rate of 95.4%. One-year and five-year survival rate according to Kaplan–Meier were 95.4 and 94.4%. In patients receiving an external sinus lift an in situ rate of 95.1% and in patients with an internal sinus...
Methods
Study design and subjects
This retrospective study addresses the oral health-related quality of life after maxillary sinus augmentation. Therefore, all patients that received an implantation after maxillary sinus augmentation in the Department of Oral and Maxillofacial Surgery of the University Medical Centre Mainz, Germany, between July 2002 and December 2007 were included in this stu...
Background
Rehabilitation of completely and partial edentulous patients with dental implants has proved to be a safe and predictable procedure. However, reduced bone height and the proximity of the maxillary sinus are challenging limitations for dental implant placement in the posterior maxilla. Besides the use of short and tilted implants, one of the most frequently used surgical techniques fo...
Abstract
Background
The aim of this study was to measure the oral health-related quality of life (OHRQoL) after maxillary sinus augmentation to determine the physical and psychological impact of this procedure for the patient.
Methods
Three hundred sixteen patients treated with an external or internal maxillary sinus augmentation and a total of 863 implants in the Department of Oral and Maxi...
Figure 9. a Mandibular implant-fixed prosthesis inserted into the mouth.
Figure 8. Periapical radiographs of the implants. a Postoperative, 1 year. b Postoperative, 16 years
Figure 7. a Intraoral photograph. b Gold Dolder bar and screws; marked wear of a prosthetic screw (arrow)
Figure 6. a Mandibular implant-supported overdenture inserted into the mouth. b Panoramic radiograph after insertion of the prosthesis
Figure 3. Photomicrographs of the biopsy specimen showing the intermingling of (a), (b), and (c). a Moderately differentiated epidermoid tumor cells with a duct-like structure (hematoxylin and eosin [H&E], original magnification × 100). b Intermediate cells (H&E, original magnification × 100). c Clear cells (H&E, original magnification × 100)
Figure 4. a Intraoperative photograph of resection of the alveolar ridge and bilateral upper neck dissection. b Transplantation of a lateral tongue flap to cover the alveolar ridge defect. c Surgical specimen
Figure 2. Panoramic radiograph showing notable alveolar bone resorption in the left mandibular premolar region and slight resorption in the right mandibular canine region (arrows)
Figure 1. Intraoral photograph showing diffuse tumor formation on the alveolar gingiva (arrows)
We inserted an implant-supported overdenture on a gold bar retainer splinting four implants. However, the patient was not satisfied with this prosthesis because of the mucosal pain and discomfort that developed over time. In such cases, prosthetic loading of atrophic mucosa is often not well tolerated. As such, we proposed replacement with an implant-fixed prosthesis. Initially, the patient ...
Conclusions
Prosthetic rehabilitation of edentulous patients after surgical management of oral cancer is difficult and therefore often avoided. However, adequate prosthetic rehabilitation is a pivotal factor for patients to regain oral function. In terms of the masticatory rehabilitation of these patients, the application of a removable prosthesis unsupported by implants may be difficult or...
However, she was not satisfied with the prosthesis; she experienced denture discomfort and developed a decubital ulcer in the tongue flap area, and she gradually ceased use of the denture. The patient was followed for more than 10 years on a regular basis to examine recurrence or metastasis of the gingival carcinoma. Mild erythema and swelling of the mandibular and implant-surrounding mucosa secon...
Case presentation
A 16-year-old female patient developed slight tenderness of the gingiva in the left mandibular premolar region, and her dentist referred her to our clinic in April 1992. Oral examination showed erythematous granular swellings that bled easily on the alveolar gingiva involving the area extending from the right second premolar to the left second molar (Fig. 1). The lesion showed...
Background
Surgical treatment of oral cancer may lead to significant disability, including facial deformity, loss of hard and soft tissue, and impaired function of speech, swallowing, and mastication. Bone resection because of surgical treatment of a large mandibular tumor can cause long-term defects. Rehabilitation with a removable prosthesis can be difficult or impossible due to the distorted...
Dental implant treatment in a young woman after marginal mandibulectomy for treatment of mandibular gingival carcinoma: a case report
Abstract
Dental implants play an important role in postoperative rehabilitation after surgical treatment of oral cancer through the provision of prosthetic tooth replacement. Two major implant prosthesis designs are available: fixed implant-supported prostheses ...
Figure 21. A dental class I occlusion was established only on the right side (lateral aspect)
Figure 20. The left side could not be restored to an ideal class I relationship from the original class II due to the pontic prosthesis
Figure 19. A full-mouth frontal aspect
Figure 18. OPT after prosthodontic finalization
Figure 17. Implants were used for implant-retained prostheses (abutment-cemented crowns), and a three-unit fixed partial denture pontic (crowns 25–27) was placed
Figure 16. After orthodontic treatment was completed, the prosthodontic phase took place
Figure 15. All implants received immediate healing screws
Figure 14. Implants placement after site preparation
Figure 13. Implant site preparation: OP5, IM2, OT4, and IM3 (correctly in sequence)
Figure 12. The total width flap was sutured
Figure 11. A mesiobuccal root surface exposure of element 16 required bone regeneration through Bio Oss and bone chip application
Figure 10. A triangular-shaped corticotomy was performed with inserts OT7 0.55 mm and OT7 special 0.35 mm to accelerate orthodontic tooth movements
Figure 9. A microsurgical corticotomy was mandatory to assist orthodontic tipping and intrusion of elements 16 and 17
Figure 8. Orthodontic bracket placement: left side view
Figure 7. Ortodontic bracket placement: right side view
Figure 6. Orthodontic bracket placement: frontal view
Figure 5. The panoramic radiography and cephalometric analysis revealed a partially edentulous mandible
Figure 4. The panoramic radiography and cephalometric analysis revealed a partially edentulous mandible
Figure 3. Some metal ceramic crowns in the upper left maxillary arch with a very poor esthetic appearance
Figure 2. Initial lateral intraoral aspect
Figure 1. Initial frontal intraoral aspect
A number of reports have indicated that orthodontic treatment can improve the periodontal situation in patients with pathologic migration by providing good function and improved esthetics after realignment.
It is generally recommended that orthodontic treatment should be preceded by periodontal therapy. In fact, orthodontic treatment when there is an inflammation/periodontal...
Discussion
The management of an anterior deep bite requires adequate treatment planning, especially if the clinical condition is associated with posterior DVO (vertical occlusion dimension) reduction due to multiple missing teeth. A multidisciplinary planning approach, including orthodontics, oral and periodontic surgery, and restorative dentistry, has an important role in t...
This was a preliminary stage before the first surgical corticotomy (performed with a piezo device).
A microsurgical corticotomy was mandatory to assist orthodontic tipping and intrusion of elements 16 and 17. This surgical procedure was performed by a piezo approach (Fig. 9).
A total width flap was elevated to make the cortical subapical and longitudinal bone cut possible. The ...
Case presentation
Diagnosis and etiology
A young female patient was referred to our dental clinic to resolve a malocclusion disorder due to missing teeth. She was unsatisfied with the functional aspect of her dentition. She had a second upper right molar very damaged by caries (17) (Figs. 1 and 2); it was also extruded due to missing antagonist teeth (I and II l...
A piezo surgery with corticotomies and implant placement as part of a multidisciplinary approach to treat malocclusion disorder in an adult patient: clinical report
Abstract
This clinical report illustrates a multidisciplinary approach for the rehabilitation of a young adult patient affected by a bilateral edentulous space and an anterior deep bite. The patient required orthodontics and surgic...
Pada dasarnya, membersihkan implant gigi sama seperti membersihkan gigi yamak Anda. Gampangnya, menyikat gigi, flossing, dan kumur-kumur pakai obat kumur setiap hari.
Tapi, karena gigi implant adalah gigi palsu buatan manusia, tetap ada yang butuh diperhatikan lebih daripada gigi jati. Partikel-partikel makanan dan bakteri bisa nyelip di derah sekeliling implant. Ini bisa marakken pembentukan pla...
Semua pasien yang baru masuk senden bisa punya kondisi kebersihan mulut yang buruk. Dalam kondisi semacam ini, layanan oral hygiene (kebersihan mulut) bisa diperlukan bila memang diperlukan, sekurang-kurangnya empat jam sekali, bisa lebih sering.
Indikasi untuk layanan oral hygiene meliputi pasien dengan karakteristik sebagai berikut:
Pasien yang mengalami demam tinggi atau hyper-pyrexia.
P...
Pasien mudah didiagnosis menderita gingivostomatitis primer dengan melihat gambaran klinis gejala umum yang pilah dan yang diikuti dengan:erupsi vesikel oralulkus oral simetris yang dangkalgingivitis marginal akutpasien tidak punya sejarah herpes kambuhanKarena infeksi virus HSV 1 mudah dikenali, maka tes laboratorium jarang digunakan. Tes laboratorium digunakan apabila infeksi virus HSV tidak ...
Cedera pada bagian mulut bisa dikarnakan oleh radiasi. Cedera karena radiasi dihasilkan dari efek ionisasi gelombang elektromagnetik atau partikel energi pada sel. Terapi radiasi umumnya digunakan untuk mengatasi kanker ganas pada kepala dan leher. Dalam proses menghilangkan jaringan yang sakit, jaringan oral yang normal di dalam atau dekat bidang yang sama juga dapat rusak tetapi biasanya pada t...