Comparison of implant primary stability between maxillary edentulous ridges receiving intramembranous origin block grafts

Purpose: The purposes of the present study were: to compare the resonance frequency analysis (RFA) values of implant placed in either ramus or calvaria block grafts; and to determine if implant diameter influences RFA implant stability quotient (ISQ) value. Material and Methods: This was a retrospective study that included 16 consecutives healthy patients treated with autogenous onlay block grafts for horizontal bone reconstruction in maxilla. Ten ramus and ten calvaria block graft treated patients were selected and compared. Results: Totally, 59 implants were placed, 35 (59.3%) were placed on the calvaria bone grafts and the remaining 24 (40.7%) were on the ramus bone graft. Of all the implants studied, 13 (22%), 35 (59.3%), and 11 (18.6%) were 10 mm, 11.5 mm and 13 mm in length respectively. Regarding the diameter, 4 (7%) were 3.3 mm, 3 (5%) were 3.5 mm, 20 (34%) were 3.7 mm and 32 (54%) were 4 mm. Mean ISQ value obtained by RFA was 73.06 ± 6.08, being 72.19 ± 6 and 74.47 ± 6.06 for the calvaria and ramus treated group respectively. No significant differences were noted between the two groups (p= 0.154). Implants were pooled and divided by their diameter. Mean ISQ value obtained for 3.3 mm was 80 ± 5.09, while for 4.0 mm was 72.5 ± 7.19. Again, no significant differences were found among the groups (p= 0.138). Conclusion: For RFA ISQ value, the bone graft origins (calvaria or ramus) or implant diameters did not influence the outcome

Giant cell granuloma of the maxilla: global management, review of literature and case report

Giant cell granuloma is a relatively rare benign entity but can be locally aggressive. Histologically characterized by intense proliferation of multinucleated giant cells and fibroblasts. Affects bone supported tissues. Definitive diagnosis is given by biopsy. Clinically manifest as a mass or nodule of reddish color and fleshy, occasionally ulcerated surface. They can range from asymptomatic to destructive lesions that grow quickly. It is a lesion to be considered in the differential diagnosis of osteolytic lesions affecting the maxilla or jaw. Its management passed from conservative treatment with intralesional infiltration of corticosteroids, calcitonin or interferon, to the surgical resection and reconstruction, for example with microvascular free flaps. Keywords: giant cell granuloma, intralesional injection, microvascular free flap, fibula

Costochondral graft with green-stick fracture used in reconstruction of the mandibular condyle : experience in 13 clinical cases

Since its publication in 1920 by Gillies, costochondral grafts have been used by surgeons to replace an injured mandibular condyle and to reconstruct the temporomandibular joint. This procedure is currently applied in cases of congenital dysplasia, developmental defects, temporomandibular ankylosis, neoplastic disease, osteoarthritis and post-traumatic dysfunction. Over the years, various procedures for the reconstruction with this type of graft have been described. In 1989, Mosby and Hiatt described a technique for setting the graft securely, reducing the space between the graft and the mandibular area. In 1998, Monje and Martín-Granizo developed a variation of this method, enabling a precise adaptation of the costochondral graft to the remaining mandibular ramus. The aim of this study is to evaluate the functional and anatomic results of the costochondral graft treatment by green-stick fracture for reconstruction of the TMJ in the 10 years following the description of this technique. We carry out a retrospective study of thirteen cases of temporomandibular pathology (tumors, ankylosis and hypoplasia) treated during a period of ten years from 1998 to 2008. In all these cases, the technique described by Monje and MartínGranizo was used: removal of the sixth rib, fixation to a titanium mini-plate using screws, making an internal corticotomy in order to obtain a green-stick fracture of the outer cortex, providing adequate adaptation of the graft to the mandibular ramus. The graft was then set in place, attaching it with titanium screws. This technique was successful in achieving optimal ossification, a good interincisal opening and satisfactory cosmetic results. In conclusion, according to our experience, the green-stick fracture for the adaptation of costochondral grafts to the remaining mandibular ramus has presented outstanding results in the surgical treatment of temporomandibular pathology

Características del hueso neoformado tras procedimientos de elevación del seno maxilar: análisis mediante micro-tomografía computarizada, histología y tomografía computarizada de cono

La elevación de senos constituye una técnica predecible para restaurar un volumen óseo suficiente previamente a la colocación de implantes dentales en el sector maxilar posterior. Actualmente la elección del material de injerto más adecuado constituye un tema en controversia. El presente trabajo analiza y compara la morfología de la microestructura trabecular del hueso neoformado tras elevación de seno maxilar en dos grupos (Combinación de hueso autólogo y hueso bovino inorgánico particulado (HBIP) (grupo1) y, por otra parte, HBIP (grupo2)) encontrando mayor porcentaje de hueso y densidad mineral en el grupo 2. La conectividad trabecular y la proporción de trabéculas en forma de placa también fueron mayores en este grupo. Se hallaron correlaciones numerosas entre las diferentes variables micromorfométricas analizadas. La microarquitectura del hueso formado fue diferente a la del hueso nativo adyacente para los dos grupos, encontrando relación entre ambos tipos de hueso en el grupo1. El incremento de altura ósea determinado mediante TC-haz de cono fue óptimo en ambos grupos, siendo mayor en el grupo1. En cuanto a la estabilidad implantaria determinada mediante AFR, no se ha objetivado relación de ninguno de los parámetros óseos microestructurales con la misma. El análisis histológico reveló que las partículas de HBIP residuales se habían integrado en tejido óseo, sin signos de inflamación. Todos estos datos orientan hacia una mayor calidad ósea que soporte cargas oclusales en el grupo2, evitando los inconvenientes derivados de la extracción de hueso autólogo.Rehabilitation of the posterior area of the maxilla with dental implants is difficult in cases of ridge atrophy, with insufficient bone quality and quantity due to alveolar bone loss, pneumatization of maxillary sinuses, or a combination of them. Sinus floor augmentation has proven to be a predictable technique to provide an optimal bone volumen previous to placement of dental implants. Different grafting materials have been proposed to promote bone formation. Our study analyses and compares the morphology of the trabecular microstructure of newly formed bone after sinus augmentation in 2 groups (Combination of autolologous bone and Cancellous Porous Bovine Bone (CPBB) (Group 1) and, on the other hand, CPBB as a unique graft (group 2), finding higher bone percentage and bone mineral density in group 2. Trabecular conectivity and proportion of plate-trabeculae were also better en this group. Correlations between different micromorphometric parameters were found. Newly-formed bone structure was different from native bone, finding relations between two types of bone in group 1. Bone height determined by Cone-beam-CT was optimal in both groups, being higher in group 2. Implant stability determined by RFA had not relation with micro-CT parameters. Histologic analisys revealed bone around CPBB particles, without inflammation. All these microstructural data favour group 2, with a better osseous quality to load osseointegrated implants, avoiding disadvantages of autologous bone harvesting

Oral Rehabilitation With Dental Implants for Teeth Involved in a Maxillary Fibrous Dysplasia

Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/141275/1/cap0208.pd

Oral Rehabilitation With Dental Implants for Teeth Involved in a Maxillary Fibrous Dysplasia

Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/141275/1/cap0208.pd