Full-arch fixed overdenture in lower jaw - immediate solution for efficient mastication

Complete anodontia and alveolar ridge resorption are responsible for lack of retention and stabilization of conventional acrylic lower denture. Hybrid prostheses on 4 implants placed immediately in the first 7 days is therapeutic solution which allows patients better chewing and increased effective masticatory force. Aim: The study aims to assess the functional and subjective treatment outcomes of full-arch fixed overdenture hybrid rehabilitation. Material and Methods: 60 patients with hybrid prostheses over 4 implants were included in the study. The measurement of the masticatory force was done in the chewing center in the projection of the distally placed implant. Electro-gnathic-dynamometer measured the force of the muscle elevator and depressor of the mandible. Sensor was placed in plastic bite templates and the force value was registered three times. Results: The mean masticatory forces measured in the chewing center before implants and overdenture were 95.7 N. One month later with the prosthesis the value was increased to 185.6 N and after 18 months 186.2 N. Conclusion: There is significant increase in masticatory force in area of ​​the distal implant. This is indicating increased resistance to load and higher efficiency of the chewing process after the treatment. Keywords: overdenture, full-arch, hybrid prosthesi

Sophisticated graft materials and barrier membranes for oral surgery and dental implantology applications

The main aim of this review article is to evaluate the data bases presenting the different kinds of graft materials and barrier membranes applications which are dating in this new era and of it result and benefits from their usage. Regarding to the need of graft materials and barrier membranes applications, it is known that bone loss and jawbone defects from different etiology are common, so their usage and features are increasingly being examined and analyzed. Significant is the fact that bone graft materials are used as a scaffolds to replace the missing bone and for new bone growth. These materials can be derived from a patient’s own body like natural substitutes or can be of a synthetic origin. On the other hand, the different barrier membranes have a role to protect and stabilize graft material and to enable better regeneration. The materials which are acceptable for grafting procedures depend from clinical case and from specific features. Advances in technology and sophisticated materials for bone grafting offer numerous solutions and different treatment options for patients with bone deficiency. The new way of solving large bone defects proved as successful in cases treated with a bone graft combined with a barrier membrane

The subcrestal implant placement as factor for crestal bone stability in implant sites with vertically thin gingiva

This prospective comparative study aimed to determine the influence of the implant placement type (subcrestal or equicrestal) on bone level changes in platform-switched implants placed in sites with vertically thin gingiva (<3 mm) and restored with screw-retained or cement-retained restorations. Moreover, the effect of vertical gingival thickness on peri—implant bone loss was analyzed. The clinical significance of the study’s conclusions is in determining a modality of implant placement efficient in preserving stable crestal bone

Use of nonresorbable PTFE membranes in preservation of the alveolar ridge

One of the most frequently performed interventions in current oral surgical practice is the extraction of teeth. After the extraction, a biological remodeling phase of the alveolar ridge follows, resulting in resorption of the alveolar ridge both vertically and horizontally. To a large extent, this has the effect of installing a dental implant at this point. In order to maintain the width and height of the alveolar ridge, a large number of operative techniques for preserving the extraction wound are used. In our article, a preservation technique will be presented using the non-resorptive dPTFE membrane, which allows open healing of the extraction wound, and xenograft will be used as a substituted material. Also, the application procedures and fixation of these dPTFE membranes will be explained in detail, and the results of this technical procedure will be presente

The clinical outcomes of coronally advanced flap versus bilaminar technique for treatment of multiple gingival recessions: a split-mouth case report with five years follow-up

The aim of this split mouth case presenta9on was to compare the clinical outcomes in terms of complete root coverage (CRC) and buccal so< 9ssue thickness between the coronally advanced flap (CAF) alone and coronally advanced flap plus connec9ve 9ssue gra< (CAF+CTG) in a 5 years follow up. Material and Methods: A periodontally healthy 30 years old female patient presented with mul9ple gingival recessions in the both sides of the upper jaw due to inadequate oral hygiene habits. All recessions fell under Miller 1, Cairo RT-1 class. On the one side, the recessions were treated with coronally advanced envelope flap design (DeSan9s, Zucchelli), whereas on the contralateral side an autogenous connective tissue graft was also used in a bilaminar technique manner. The used connective tissue graft from the palatal donor site resulted from extraoral eepithelization of a gingival graft (DGG). The graft was adapted and stabilized to the root surfaces using resorbable 6.0 PGA suture. The flap on both sides was coronally advance

Free Gingival Graft versus Mucograft: Histological Evaluation

INTRODUCTION: The correction of the gingival recession is of esthetical and functional significance, but the tissue regeneration can only be confirmed by a histological examination.AIM: This study aims to make a comparison between the free gingival graft and the autograft.MATERIAL AND METHODS: This study included 24 patients with single and multiple gingival recessions. Twelve patients were treated with a free gingival graft and the other twelve with a micrograft. Six months after the surgical procedure, a micro-punch biopsy of the transplantation area was performed. The tissue was histologically evaluated, graded in 4 categories: immature, mature, fragmented and edematous collagen tissue. The elastic fibres were also examined and graded in three categories: with a normal structure, fragmented rare and fragmented multiplied.RESULTS: Regarding the type of collagen tissue that was present, there was a significant difference between the two groups of patients, with a larger number of patients treated with a micrograft showing a presence of mature tissue, compared to the patients treated with a free gingival graft. A larger number of patients in both of the groups displayed elastic fibres with a rare fragmented structure; 33.3% of the patients showed a normal structure; 50% demonstrated a normal structure.CONCLUSION: The patients treated with a free gingival graft showed a larger presence of fragmented collagen tissue and fragmented elastic fibres, whereas a mature tissue was predominantly present in the surgical area where a Geistlich Mucograft was placed

Management of patients with cystic fibrosis in oral and maxillofacial surgery

Cystic fibrosis, an autosomal recessive disease, is considered to be the most lethal inherited trait among Caucasians. The median age for the CF patient has significantly increased over the past 60 years. This study will review diagnosis, pathophysiology, and eventual systemic complications of CF and discuss relevant information for management of the CF patient for the oral and maxillofacial surgeon. The aim of this study is to prove the connection between the cystic fibrosis and the oral health of the patient. For this study, five patients with cystic fibrosis were treated at the clinic of oral surgery. They were evaluated thoroughly to prevent future complications. In preoperative assessment, the pulmonary status, nutritional status and blood glucose levels were identified. The usual doses of antibiotics, cardio tonic drugs, bronchodilators etc. were considered where it was necessary into the preoperative period. Depending on the nature, duration, and complications of the surgical procedure, patients were taken care of in the postoperative period. Every patient in our study went through the treatment successfully without specific complications with the appropriate procedures and protocols. With preoperative preparation and premedication, timing of the surgery, monitoring during the intervention and special post-operative care is necessary for creating specific protocol for surgical interventions on patients with cystic fibrosis. Patients with cystic fibrosis require consistent, regular follow-up. Keywords: Cystic fibrosis, premedication, protocol, surgery

Odontoma as an etiological factor for impaction of teeth

Odontoma is considered to be the most common odontogenic tumor of the oral cavity. Most odontoma are discovered during routine radiographic investigations and can cause disturbances in the teeth eruption. Here we report two cases, where the odontoma are the main etiological factor for tooth impaction. The aim of this study is to determine the necessity of the removal of the odontoma as a main etiological factor for tooth impaction in order to induce successful tooth eruption. In the first case, a radiography examination using orthopantomogram showed radio-opaque lesions mesial to the impacted right mandibular canine. The lesion was surgically removed under local anesthesia. After mucoperiosteal flap was raised, superficial bone was removed followed by the removal of the calcified structures. The flap was approximated and sutured. In the second case, a radiography examination using CBCT revealed presence of radio-opaque lesions next to the unerupted left maxillary canine. Surgery was performed under local anesthesia. After the primary canine was removed, the odontomas were removed in order to establish eruption path for the canine. The results of this study show that using the appropriate surgical protocols that eliminate odontogenic lesions can establish adequate environment for teeth to erupt. Diagnosis of odontoma at an early age and its surgical excision may prevent eruption disturbances. A careful follow-up of the case, implementing preventive and interceptive orthodontics, if necessary, prevents future malocclusion. Keywords: CBCT, Odontoma, Surgery, Tooth impactio

Clinical outcomes of guided tissue regeneration procedure utilized with two different surgical approaches - a comparative study

The guided tissue regeneration (Nyman et al. 1982) is a well-established surgical technique which main goal is to reconstruct the periodontal ligament with functional collagen fibers inserted into a newly formed cementum and alveolar bone. Teeth with periodontal disease resulting in deep infrabony pockets are successfully treated with this technique. Its main prognostic factors from clinical and biological standpoint include: blood clot stabilization, primary closure of the defect, space provision and exclusion from the gingival tissues. Several surgical techniques have been proposed for utilization of GTR. Lately these techniques have been aiming at minimal invasiveness for optimal wound closure and lesser postoperative morbidity. The aim of this presentation was to compare the clinical outcomes of two different techniques for GTR:modified papilla preservation flap (Cortelinni et al, 1995) vs. single flap approach. Results: The obtained data revealed significantly better results in CAL gain (3.6+/-1.3 mm vs. 2.1+/- 1.2 ), PD reduction (2.7+/- 0.8 vs. 1.4 +/-0.6) and REC ( 1.5 +/- 0.9 vs. 2.6 +/- 0.8) at baseline and one year post surgery in test group. Conclusion: Results from our analysis suggest that single flap approach as less invasive provides better clinical outcomes, although without big clinical relevance considering the small number of patients

Bone augmentation with xenograft and non resorptive membrane - case report

Introduction: Bone grafting is used where we have a defect, i.e. in the place where bone is missing, while enabling the formation of new bone through a process of tissue regeneration. With the progress of implantology, i.e. with the demand for implants, artificial bone is used more and more today. After tooth loss, bone resorption is irreversible, leaving the area without adequate bone volume for successful implant treatment. Bone grafting is the only solution to reverse dental bone loss and is a well-accepted procedure required in one in every four dental implants. Aim: The purpose of this poster presentation is to present the benefits of bone augmentation and non- resorptive membrane on a patient before placing dental implants. Case report: The patient was a 56-year-old man, healthy, without chronic diseases and without oral diseases, with good oral hygiene. For this purpose, we used plexus anesthesia after that we made an incision and flap to the place where we put the bone and membrane. We have used xenograft artificial bone and non-resorptive membrane from bottis. A xenograft is a bone substitute that has an origin other than human and bovine. They are usually distributed as a calcified matrix. Conclusion: In the past period, with the advancement of technology and new sophisticated materials for bone augmentation, problems with bone loss are being solved. Bone augmentation with artificial bone has a significant role in the repair of bone defects in the maxillofacial region. Key words: Augmentation, artificial bone, graft, membrane