Pleomorphic adenoma rehabilitative treatment in growing up patient: a 20-years follow-up

OBJECTIVE: Although tumors of minor salivary glands are rare, the pleomorphic adenoma is the most common pathology among the benign neoplasm and can be found with high prevalence in the junction between hard palate and soft palate. Most of the maxillary tumors are surgically treated through either a total or partial maxillectomy. However, surgical defects lead to both clinical and psychologic disorders for the patient. A postoperative obturator prosthesis is a good option in patients who underwent maxillectomy. It allows to restore both masticatory and speaking functions, as well as aesthetic appearance. When reconstruction of the surgical site is possible, an implant-supported prosthesis can be considered to guarantee a better function and aesthetic's rehabilitation. CASE REPORT: This clinical report presents the prosthetic rehabilitation of a patient who underwent maxillectomy because of a pleomorphic adenoma of hard palate minor salivary glands. The patient was treated with a palatal obturator prosthesis first and with an implant-supported prosthesis after surgical site's reconstruction and complete healing. CONCLUSIONS: The rehabilitation of the patient after maxillectomy through both these devices was an excellent option and provided clinical benefits, improving the patient's quality of life, allowing the patient's reinsertion into societ

Immediate implant loading: a comparison of trabecular metal and tapered screw-vent dental implants

Aims: The aim of the present study is to compare osteointegration and marginal bone loss of immediately loaded Trabecular Metal® and Tapered Screw-Vent® Dental Implants (Zimmer Dental Inc., Carlsbad, CA, USA). Methods: Eighty-seven (87) patients were selected and randomly divided into Group A and Group B. Twenty-six (26) patients were enrolled in Group A, and were rehabilitated using Zimmer Trabecular Metal Dental Implants®. Sixty-one (61) patients were enrolled in Group B, and were rehabilitated using Zimmer Tapered Screw-Vent Dental Implants®. Results: The mean value of marginal bone loss after one year was 0.44 ± 0.40 mm for Group A and 0.95 ± 0.62 mm for Group B (p<.003). Mean marginal bone loss after 18 months was 0.46 ± 0.42 mm for group A and 0.97 ± 0.65 mm for group B (p<.003). No TM implant was lost (Group A), whereas one TSV implant (Group B) was lost before osseointegration and was not included in the statistical analysis. Conclusion: Both Trabecular Metal and Tapered Screw-Vent dental implants showed satisfying levels of osteointegration and marginal bone loss; however, statistical analysis revealed a value significantly lower of marginal bone loss for TM. Thus, it may be deduced that when implants are immediately loaded, the average loss of marginal bone around the TM implants is lower than that of the Tapered Screw-Vent implants

Obturator prostheses in post-oncological maxillofacial patients: our experience

Background: Surgical procedures for tumors of the paranasal sinus, palatal epithelium, minor salivary glands or osteosarcoma of the upper jaw require a partial or total maxillectomy of the upper jaw. When the surgical procedure and/or radiation therapy result in a communication, the solution is necessarily prosthetical, through a palatal obturator that recreates a partition between the oral and nasal cavities. Methods: Authors selected 32 post-oncological patients with the upper maxilla completely edentulous prosthetically rehabilitated with a palatal obturator. Results: No serious complications or adverse reactions were reported during the fabrication of surgical or definitive obturators. All patients stated to benefit the palatal obturator in terms of quality of life. Conclusion: Prosthetic rehabilitation of edentulous maxillectomy with oral communication is a demanding challenge for the prosthodontist. The goals of prosthetic rehabilitation include separation of oral and nasal cavities to allow adequate deglutition and articulation of teeth, restore midfacial soft tissue contour and a satisfactory esthetic outcome. When, for any reason, the patient is not a suitable candidate for an implant-retained overdenture, a total removable prosthesis should ensure the most comfort in terms of swallowing, phonation and aesthetics

Prosthetic rehabilitation with use of palatal augmentation prosthesis in patients affected by functional limitations of the tongue

In this study six patients with oral carcinoma were subsequently subjected to surgery. Following surgical operation, patients highlight functional and psychosocial problems such as dysphagia, dysarthria and difficulties in everyday life. These issues are much greater as the tongue is affected by the tumor. The removal of part or all of the tongue, generally associated to teeth loss, is related to the severity of functional problems for the patient such as chewing, phoning and swallowing. To improve their clinical conditions, patients underwent prosthetic rehabilitation through the use of the Palatal Augmentation Prosthesis (PAP). The use of this device showed satisfactory results under all considered profiles. Subsequently, lingual pressure measurements were made both in static and dynamic phase before and after the use of the PAP. The use of this device experienced significant clinical improvements, evaluated also by two questionnaires: the first one, on general satisfaction with the PAP and specific satisfaction regarding comfort, mastication, phonetics, aesthetics, ease of cleaning and self-esteem and the second one, about the OHIP-14 items, referring to seven dimensions of impact; also phonetic tests for speech evaluation - with the help of a speech therapist - have been performed

Evaluation of highly porous dental implants in postablative oral and maxillofacial cancer patients: a prospective pilot clinical case series report

The aim of this study was to evaluate the clinical efficacy of new porous tantalum trabecular metal (PTTM)-enhanced titanium dental implants used for the prosthodontic rehabilitation of postablative cancer patients. First-year interim results of a prospective clinical case series are presented