Positional changes of the lower and upper anterior teeth after surgical correction of mandibular prognathism

Background/Aim. To establish the influence of surgical corrections of mandibular prognathism upon the position of the lower and upper anterior teeth (incisors). Methods. The changes in position of the lower and upper anterior teeth (incisors) after the surgical correction of mandibular prognathism were analyzed by means of x-ray craniometry in 183 patients (female: n = 110, male: n = 73) in which the correction had been made in accordance with the principles of sagital osteotomy of the mandibular ramus. There were 4 angular and 2 linear parameters determined in the pre- and postoperative tele-xray-pictures. The changes of these parameters were tested by means of the parametric statistic tests. Results. The performed surgical procedures did not cause statistically significant changes in the angular parameters. The changes of both linear parameters were thought highly statistically significant. Conclusion. Under the influence of the performed surgical procedures no changes were found in the position of anterior teeth (incisors) in relation to SN and the mandibular plane. They were actually moved along with the medium fragment of the lower jaw and that fragment was moved linearly backwards along the occlusal plane with a practically insignificant rotation in the cranial direction

Primena modifikovane metode po Friesu u rekonstrukciji donje usne posle uklanjanja malignih tumora

Background/aim: Lip carcinoma makes about 1/4 of all oral carcinomas. Primary treatment of the lower lip carcinoma means radical excision of the full thickness of the lower lip tissue together with the tumor. The reconstruction of the defect accomplished after the removal of the lower lip tumor is a challenge for the surgeon and requires a detailed preoperative planning, the right choice of the method for reconstruction and the knowledge of the adequate surgical techniques needed. The aim of this study was to present a ten-year clinical results and experience concerning the reconstruction of lower lip defects longer than 4 cm by means of the modified Fries method in patients treated for the lower lip carcinoma. Methods. The reconstruction of the lower lip by means of the modified Fries method was performed in 37 patients. The following parameters were analyzed: sex, age, the time elapsed from the occurrence of the first symptoms until the first consultation with the doctor, the size of tumors, the size of the postexcision defect, TNM classification, the application of side diagnostic procedures, pathohistological diagnosis of postoperative complications. The sensibility of the lower lip region was monitored, as well as the obtained esthetic effects. Results. The results classified according to the mentioned parameters were processed, analyzed and displayed in detail. Clinical experience concerning the application of this reconstruction technique was presented and analyzed. Conclusion. The modified Fries technique can successfully be applied in the reconstruction of the lower lip defects longer than 4 cm because its application leads to satisfactory functional and acceptable esthetic results.Uvod/cilj: Karcinomi usana čine približno oko 1/4 svih karcinoma usne duplje. Primarno lečenje karcinoma donje usne podrazumeva radikalnu eksciziju pune debljine tkiva donje usne zajedno sa tumorom. Nadoknada defekta nastalog nakon uklanjanja tumora donje usne predstavlja izazov za hirurga i zahteva detaljno preoperativno planiranje, pravilan izbor načina rekonstrukcije i poznavanje odgovarajućih hirurških tehnika. Cilj rada je da se kroz desetogodišnju retrospektivnu studiju prikažu naši klinički rezultati i iskustva u nadoknadi velikih defekata donje usne modifikovanom metodom po Friesu kod bolesnika lečenih od karcinoma donje usne. Metode. Od 256 bolesnika lečenih zbog tumora donje usne u periodu od 1992. do 2001. godine, kod 37 je primenjena rekonstrukcija modifikovanom metodom po Friesu. Analizirani su sledeći parametri: pol i godine starosti bolesnika, vreme proteklo od pojave prvih simptoma do javljanja lekaru, veličina tumora, veličina postekscizionog defekta, TNM klasifikacija, primena pomoćnih dijagnostičkih procedura, patohistološka dijagnoza, postoperativne komplikacije. Beležena su opažanja bolesnika u vezi senzibiliteta predela donje usne. Procenjivani su i ostvareni estetski efekti. Rezultati. Detaljno su obrađeni, analizirani i prikazani rezultati po navedenim parametrima. Izneta su naša klinička iskustva u primeni ove tehnike rekonstrukcije. Analizirane su njene prednosti i mane. Zaključak. Modifikovana tehnika po Friesu može se uspešno primeniti u rekonstrukciji defekata donje usne većih od 4 cm do potpunog nedostatka donje usne, jer se njenom primenom ostvaruju zadovoljavajući funkcionalni i prihvatljivi estetski rezultati

The effect of injectable platelet-rich fibrin use in the initial treatment of chronic periodontitis

Introduction/Objective. The objective of the study was to investigate whether there are differences in therapeutic effect between initial treatments of chronic periodontitis [scaling and root planning (SRP)] alone and SRP in conjunction with injectable platelet-rich fibrin (I-PRF) application, comparing clinical parameters after three months. Methods. Twenty-four patients with chronic periodontitis who had at least two sites with probing pocket depth (PPD) ≥ 5 mm on contralateral side participated in the study. Using a split-mouth design, the patients were treated with SRP + I-PRF (study group) or SRP only (control group). The clinical parameters, clinical attachment level (CAL), gingival margin level (GML), PPD, bleeding on probing, and plaque index, were recorded on both sides. Results. Compared to baseline, both treatment modalities demonstrated an improvement in investigated clinical parameters. The mean value of CAL was reduced from 1.97 ± 0.75 (0.25–3.31) to 1.07 ± 0.44 (0.12–1.78) in the study group, whereas it decreased from 1.81 ± 0.66 (0.42–2.96) to 1.48 ± 0.55 (0.22–2.30) in the control group. Similarly, the corresponding values for GML and PPD showed statistically significant difference between the groups (p = 0.040 and p = 0.006, respectively). Conclusion. Regardless the limited number of patients in the study, initial periodontal therapy in conjunction with injectable platelet-rich fibrin proved to display significant improvement in all clinical parameters compared to initial periodontal therapy alone

Promene gornje usne posle hirurške korekcije progenije

The aim of this study was to establish and estimate the effects of surgical correction of mandibular prognathism on the height and position of the upper lip. The changes of the upper lip were analyzed on 115 patients between 16 and 30 year of age (71 females and 44 males) who were subject to surgical correction of mandibular prognathism using the sagittal split ramus osteotomy. The lateral cephalometric radiographs were taken of each patient before and six months after the surgical procedure. The soft tissue cephalometric analysis included the measurements of six linear and two angular parameters. The obtained data were statistically processed and evaluated. Statistical analysis revealed the significant changes in two linear cephalometric parameters after surgical procedure - the incisal step and the length of the upper lip. The changes in the length and position of the upper lip after surgical correction of mandibular prognathism by means of sagittal split ramus osteotomy seem to be minor and clinically insignificant. Only the length of the upper lip was significantly changed. It became longer. The upper lip advancement amounted approximately 15% of the complete mandibular set-back during operation.Cilj istraživanja je bio da utvrdi i proceni efekte hirurške korekcije mandibularnog prognatizma na dužinu i položaj gornje usne. Promene gornje usne su kefalometrijski analizirane kod 115 osoba (f=71; m=44) kod kojih je mandibularni prognatizam korigovan metodom sagitalnih osteotomija grane donje vilice. Svakom pacijentu su načinjena po dva profilna telerendgenska snimka glave, jedan pre i jedan nakon hirurške intervencije. Kefalometrijska analiza mekog profila lica je obavljena merenjem i poređenjem šest linearnih i dva angularna parametra. Dobijene vrednosti su statistički obrađene i evoluirane. Primenjene hirurške korektivne procedure rezultirale su statistički značajnim promenama kod dva linearna parametra (incizalna stepenica i dužina gornje usne). Promene gornje usne posle hirurške korekcije mandibularnog prognatizma pomoću sagitalnih klizajućih osteotomija grane donje vilice su minimalne i gotovo neznačajne. Značajno se menja jedino dužina gornje usne - postaje duža. Gornja usna se pomera za 15% ukupnog pomeranja struktura donje vilice

Promene položaja donjih i gornjih sekutića posle hirurške korekcije mandibularnog prognatizma

Background/Aim. To establish the influence of surgical corrections of mandibular prognathism upon the position of the lower and upper anterior teeth (incisors). Methods. The changes in position of the lower and upper anterior teeth (incisors) after the surgical correction of mandibular prognathism were analyzed by means of x-ray craniometry in 183 patients (female: n = 110, male: n = 73) in which the correction had been made in accordance with the principles of sagital osteotomy of the mandibular ramus. There were 4 angular and 2 linear parameters determined in the pre- and postoperative tele-xray-pictures. The changes of these parameters were tested by means of the parametric statistic tests. Results. The performed surgical procedures did not cause statistically significant changes in the angular parameters. The changes of both linear parameters were thought highly statistically significant. Conclusion. Under the influence of the performed surgical procedures no changes were found in the position of anterior teeth (incisors) in relation to SN and the mandibular plane. They were actually moved along with the medium fragment of the lower jaw and that fragment was moved linearly backwards along the occlusal plane with a practically insignificant rotation in the cranial direction.Uvod/Cilj. Utvrditi uticaj hirurške korekcije mandibularnog prognatizma na položaj donjih i gornjih sekutića. Metode. Promene položaja donjih i gornjih sekutića posle hirurške korekcije mandibularnog prognatizma analizirane su rendgenkraniometrijski kod 183 osobe (ž = 110; m = 73) kod kojih je korekcija izvršena po principima sagitalnih osteotomija ramusa mandibule. Na preoperativnim i postoperativnim telerendgenogramima određivana su četiri angularna i dva linearna parametra. Promene tih parametara testirane su pomoću parametrijskih statističkih testova. Rezultati. Sprovedene hirurške procedure nisu izazvale statistički značajne promene angularnih parametara. Promene oba linearna parametra bile su visoko statistički značajne. Zaključak. Pod uticajem sprovedenih hirurških korektivnih procedura ne dolazi do promene položaja sekutića u odnosu na SN i mandibularnu ravan, već se oni pomeraju zajedno sa središnjim fragmentom donje vilice. Taj fragment se kreće translatorno unazad duž okluzalne ravni, sa praktično zanemarljivom rotacijom u kranijalnom pravcu

Use of the modified fries technique in the reconstruction of the lower lip after the removal of a malignant tumor

Background/aim: Lip carcinoma makes about 1/4 of all oral carcinomas. Primary treatment of the lower lip carcinoma means radical excision of the full thickness of the lower lip tissue together with the tumor. The reconstruction of the defect accomplished after the removal of the lower lip tumor is a challenge for the surgeon and requires a detailed preoperative planning, the right choice of the method for reconstruction and the knowledge of the adequate surgical techniques needed. The aim of this study was to present a ten-year clinical results and experience concerning the reconstruction of lower lip defects longer than 4 cm by means of the modified Fries method in patients treated for the lower lip carcinoma. Methods. The reconstruction of the lower lip by means of the modified Fries method was performed in 37 patients. The following parameters were analyzed: sex, age, the time elapsed from the occurrence of the first symptoms until the first consultation with the doctor, the size of tumors, the size of the postexcision defect, TNM classification, the application of side diagnostic procedures, pathohistological diagnosis of postoperative complications. The sensibility of the lower lip region was monitored, as well as the obtained esthetic effects. Results. The results classified according to the mentioned parameters were processed, analyzed and displayed in detail. Clinical experience concerning the application of this reconstruction technique was presented and analyzed. Conclusion. The modified Fries technique can successfully be applied in the reconstruction of the lower lip defects longer than 4 cm because its application leads to satisfactory functional and acceptable esthetic results

Surgical management of squamous cell carcinoma of the lip: Analysis of a 10-year experience in 223 patients

Background: The most common type of lip carcinoma is squamous cell carcinoma (SCC), accounting for approximately 90% of all oral malignancies. Currently, surgery and/or radiotherapy are considered the standards of care for SCC of the lip. Materials and Methods: We retrospectively analyzed medical records of patients diagnosed with SCC of the lip at the Clinic for Maxillofacial surgery at University of Belgrade (Belgrade, Serbia) during a period between 1991 and 2000. Results: A total of 223 patients with SCC of the lip were diagnosed and treated during a 10-year period. The overall male-to-female ratio was 5 to 0. The most frequently affected site was the lower lip (92.8%,). Mean diameter of the tumor was 30.1 mm (range, 5 to 80 full Neck lymph node metastases at presentation was detected in 26.5% of patients, who subsequently underwent neck dissection. We observed a linear trend in the association between the size of the tumor and the clinical stage of the neck (chi(2) = 15.1; df = 1; P lt .0001). Different surgical techniques were used for reconstruction of the lip defect after tumor removal. After a median follow-up of 56 months (range, 15 to 78 months), local recurrence occurred in 10.8% of patients while regional metastases developed in 4.5% of patients. Mortality from SCC of the lip was only 2.2%. Conclusion: SCC of the lip generally has a favorable outcome. Recently, there have been no major advances in lip reconstruction but rather continued improvement on accepted techniques. Early detection is essential for the successful treatment of SCC of the lip, which requires a multidisciplinary approach

Real-time thermographic analysis of low-density bone during implant placement: a randomized parallel-group clinical study comparing lateral condensation with bone drilling surgical technique

Objectives: To compare the effect of two surgical techniques, lateral condensation and bone drilling, on changes in temperature of the adjacent low-density bone during implant placement into posterior maxilla and to investigate the influence of the host factors - age, gender, region of implantation, bone density, and thickness of the cortical bone at the recipient sites. Material and methods: Local bone temperature was measured thermographically during implant placement into posterior maxilla following lateral bone condensing (test group) or bone drilling (controls). The main study outcomes were baseline bone temperature prior to implantation and maximum bone temperature recorded during implantation. Early implant success was evaluated after 6 months of healing. Results: A total of 40 implants were randomly allocated to test and control groups and placed into maxillary premolar and/or molar region of 18 participants of both genders and average age of 51.74 years. All recorded bone temperatures were below the threshold for thermal necrosis. Although both groups showed significant increase in bone temperature during implant placement procedure (P lt = 0.0005), it was significantly higher for bone condensing compared with drilling (P lt = 0.0005; 3.79 +/- 1.54 degrees C; 1.91 +/- 0.70 degrees C respectively). No host factor was singled out as a significant predictor of bone temperature changes, although trend of higher increase was observed in young patients, regardless of gender, during implant placement procedure into maxillary first premolar region with bone density type 3 and cortical layer thicker than 1 mm. Early implant success rate after 6 months follow-up was 100%. Conclusion: Although both surgical techniques, bone condensing and bone drilling, can be considered safe regarding their thermal effect on the bone of posterior maxilla, bone drilling is associated with fewer local bone heating during implantation. Host factors do not affect the bone thermal changes significantly