1/14. The role of orthognathic surgery in the treatment of severe dentoalveolar extrusion.BACKGROUND: When mandibular molars are not replaced after extraction, the long-term problem of inadequate interarch space for either a fixed or removable prosthesis can occur. In the past, practitioners needed to decide whether to shorten the teeth, extract the supererupted maxillary molars to recapture space or leave the area unrestored. The authors present another option. CASE DESCRIPTION: A 61-year-old man was referred to a periodontist by his general dentist for placement of mandibular implants in the posterior sextant. Extreme supereruption of the maxillary dentoalveolar segment prevented restoration of the opposing edentulous area. An oral and maxillofacial surgeon performed a segmental osteotomy of the posterior right maxilla to gain needed interarch space. After the osteotomy was stabilized, the periodontist placed implants that were subsequently restored with a fixed prosthesis. CLINICAL IMPLICATIONS: The role of orthognathic surgery in treatment planning should not be overlooked in the comprehensive management of severe extrusion. It offers patients the opportunity to gain both function and esthetics that might otherwise be impossible.- - - - - - - - - - ranking = 1keywords = extraction (Clic here for more details about this article) |
2/14. Dental blood supply in the segmentally resected mandible.There are approximately 30,000 new cases of oral and pharyngeal carcinoma treated in the united states each year. A large number of these patients go on to receive segmental resection of the mandible, and have natural teeth remaining on the surgical side. To the best of our knowledge, there has not been a thorough discussion of the blood supply to these remaining teeth. Radiographic evidence of periapical pathology in these teeth is unusual, despite the compromised vascular supply. The purpose of this article is to report a case and review the literature on blood supply to teeth after segmental mandibulectomy. Microscopic examination was conducted on the pulpal tissue of a premolar retained on the side of, and anterior to, a segmental mandibular resection. Although abnormal, the pulp tissue showed evidence of a vascular supply 4 yr after mandibular surgery. A literature review was performed, and a discussion is given to explain the continued vascularity of the dentition through collateral and retrograde circulation. Despite the compromised dental circulation on the surgical side, unless radiographic evidence of periapical pathology occurs, endodontic therapy or extraction is not necessary. Due to the compromised nature of the circulation however, these teeth may be more susceptible to caries or restorative dental procedures that may lead to pulpal necrosis.- - - - - - - - - - ranking = 1keywords = extraction (Clic here for more details about this article) |
3/14. The Royal london Space Planning: an integration of space analysis and treatment planning: Part II: The effect of other treatment procedures on space.The Royal london Space Planning process is carried out in 2 stages. The first stage, assessing the space required to attain the treatment objectives, was described in Part I of this report, published earlier. In Part II, the process of integrating space analysis with treatment planning continues with consideration of the effects other treatment procedures have on space. These procedures include tooth enlargement or reduction, tooth extraction, the creation of space for prosthetic replacement, and mesial and distal molar movement. The effects of favorable and unfavorable growth are also considered. A brief case report is presented to demonstrate use of the Royal london Space Planning.- - - - - - - - - - ranking = 1keywords = extraction (Clic here for more details about this article) |
4/14. Alveolar ridge preservation using a bioactive glass particulate graft in extraction site defects.This article describes the application of a bioactive glass particulate graft and placement of an expanded polytetrafluoroethylene barrier into extraction sites to preserve the residual ridge and to develop the site prior to fixed prosthetic replacement. Extraction site development can enhance and facilitate the position and shape of the pontics while maximizing the natural contour of the soft tissues.- - - - - - - - - - ranking = 5keywords = extraction (Clic here for more details about this article) |
5/14. Immediate implant placement and provisionalization in edentulous, extraction, and sinus grafted sites.The incorporation of restorative procedures during implant placement, as well as during the creation of natural emergence profiles and lifelike ceramic restorations, has become the focus of implantology over the last few years. Recent publications have provided guidelines for success with the immediate restoration procedure and have presented basic surgical protocols for the implant team. Enhancement of the healing phase through the local delivery of growth factors to the surgical site, as well as through advancements in bone grafting materials, has allowed the implant surgeon to accomplish multiple surgical procedures during the initial surgical visit. In addition, advancements in surgical stent designs have allowed the restorative dentist to adequately communicate to the surgeon during surgery the parameters required in the final restoration to replace the natural tooth system with form, function, and esthetics. This article presents the results of more than 400 immediate restored implants placed in edentulous sites, fresh extraction sockets, and sinus grafted sites. Also highlighted are guidelines for surgical success, as well as a description of a surgical stent design that communicates requirements for restorative success to the surgeon, while also serving as an esthetic provisional restoration.- - - - - - - - - - ranking = 5keywords = extraction (Clic here for more details about this article) |
6/14. Implant treatment and the role of platelet rich plasma.Implant supported restorations have become and continue to be a very popular clinical option for patients who are either partially or completely edentulous. This article, the third in a series dealing with implant dentistry, describes the role of platelet rich plasma as an adjunct to help with the healing process following tooth extraction, socket preservation, and, ultimately, replacement with implant supported restorations. A clinical case is used to illustrate surgical options available in the restoration of the posterior partially edentulous maxilla.- - - - - - - - - - ranking = 1keywords = extraction (Clic here for more details about this article) |
7/14. Localized edentulous ridge augmentation with upside down osteotomy prior to implant placement.Localized bone defects may be seen following the extraction of teeth with periapical lesion or advanced periodontal disease, or as a result of trauma. When these regions are considered for treatment with implants, localized ridge augmentation will be necessary. Autogenous bone grafts are used exclusively for ridge augmentation. This case report represents the treatment of a localized edentulous ridge with an upside down osteotomy technique at the symphysis region prior to implant placement. Systemically healthy 21-year-old female patient, who was missing a lower right incisor tooth, was scheduled for an implant treatment. However, the crestal width was only 1 mm. The augmentation was planned and the region was treated with an upside down osteotomy technique. Nine months after the augmentation procedure, the computed tomography (CT) examination of the area revealed that the width of the crest was 7 mm, and the height of the crest was in good relation with the cementoenamel junction of the adjacent teeth. Flipping a bone block graft, which was harvested from the edentulous area, upside down may provide a successful result in partially edentulous ridges, in both maxilla and mandible.- - - - - - - - - - ranking = 1keywords = extraction (Clic here for more details about this article) |
8/14. Fixed prosthetics with a connective tissue and alloplastic bone graft ridge augmentation: a case report.Augmentation of the partially edentulous ridge can significantly improve the final prosthodontic rehabilitation. For enhancing soft tissue contours in the anterior region, the subepithelial connective tissue graft is the treatment of choice. The combination of connective tissue grafts with alloplastic bone graft material can optimize the ridge augmentation and reduce post extraction defects. The aim of this clinical report is to describe the use of subepithelial connective tissue in conjunction with an alloplastic bone graft for augmentation of a maxillary anterior ridge prior to prosthetic rehabilitation.- - - - - - - - - - ranking = 1keywords = extraction (Clic here for more details about this article) |
9/14. Using a fixed provisional prosthesis during post-extraction healing and implant placement.Most dental patients insist on the use of provisional prostheses throughout healing and osseointegration when replacing extracted teeth with implants in esthetically sensitive areas. Removable appliances of some kind are normally used for this purpose, but patients often consider them to be too cumbersome. This can lead to decreased case acceptance and compliance with the use of the provisional restoration, which can compromise the final result of treatment. Custom fixed solutions to this problem exist, but they tend to be more complicated, less practical, and more expensive than other options now available. The Monodont bridge, a new system of prefabricated components for the creation of provisional fixed partial dentures, can be more esthetic, more retentive, more functional, more cost-effective, and more universally applicable than any other available techniques. This can raise patient tolerance of provisional prostheses and thus increase case acceptance, while fostering a more predictable esthetic result with regard to soft tissue contours and emergence profile.- - - - - - - - - - ranking = 4keywords = extraction (Clic here for more details about this article) |
10/14. Rigid endosseous implant utilized as anchorage to protract molars and close an atrophic extraction site.A two-stage endosseous implant, placed in the retromolar area of the mandible was utilized as rigid anchorage to translate two molars 10-12 millimeters mesially into an atrophic endentulous ridge. Despite substantial anchorage demand over a three year period, the endosseous implant remained rigid ("osseointegrated"). At the end of treatment the implant and adjacent, intravitally labeled bone were recovered. Microradiographic and polarized light analyses revealed that about 80 percent of the endosseous portion of the implant was in direct contact with mature lamellar bone. Bone labels demonstrated a remarkably high remodeling rate (about 30 percent/year) for cortical bone within 0.5 millimeter of the interface. Continuous remodeling may be the long-term mechanism whereby loaded implants resist bone fatigue and maintain "osseointegration." Clinical use of orthodontic implants, placed outside the dental arches, requires careful attention to soft tissue management.- - - - - - - - - - ranking = 4keywords = extraction (Clic here for more details about this article) |
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