Use of long implants with distal anchorage in the skull base for treatment of extreme maxillary atrophy : the remote bone anchorage concept

The objectives of this study are to present a new concept of the bone anchorage using long implants in remote bone sites and to discuss four cases treated with this method. Our patients were treated with long implants with a distant anchorage in the skull bone. The planning procedure, the construction of the drill guide, and the surgical protocol are described. In the clinical cases described, all four patients were rehabilitated with the remote bone anchorage concept using long implants anchored in the skull base. Patients were followed for 5 - 12 years and the implants remained present and stable in these time periods. The skull base implant is a new concept of bone anchorage using long implants. It can be a solution for complicated clinical situations (often failed bone reconstructions and implant placements) or an alternative for bone grafting and maxillary augmentation procedures. There is effective implant retention in the skull base, an anatomical area that is often overlooked for implant placement

Avulsie van bovenfrontelementen in het definitieve gebit, schade na reïmplantatie: een paradigmashift.

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Coronectomy of deeply impacted lower third molar : incidence of outcomes and complications after one year follow-up

Objectives: The purpose of present study was to assess the surgical management of impacted third molar with proximity to the inferior alveolar nerve and complications associated with coronectomy in a series of patients undergoing third molar surgery. Material and Methods: The position of the mandibular canal in relation to the mandibular third molar region and mandibular foramen in the front part of the mandible (i.e., third molar in close proximity to the inferior alveolar nerve [IAN] or not) was identified on panoramic radiographs of patients scheduled for third molar extraction. Results: Close proximity to the IAN was observed in 64 patients (35 females, 29 males) with an impacted mandibular third molar. Coronectomy was performed in these patients. The most common complication was tooth migration away from the mandibular canal (n = 14), followed by root exposure (n = 5). Re-operation to remove the root was performed in cases with periapical infection and root exposure. Conclusions: The results indicate that coronectomy can be considered a reasonable and safe treatment alternative for patients who demonstrate elevated risk for injury to the inferior alveolar nerve with removal of the third molars. Coronectomy did not increase the incidence of damage to the inferior alveolar nerve and would be safer than complete extraction in situations in which the root of the mandibular third molar overlaps or is in close proximity to the mandibular canal

Proliferation of epithelial rests of Malassez following auto-transplantation of third molars: a case report

<p>Abstract</p> <p>Introduction</p> <p>Auto-transplantation of third molars is frequently undertaken in order to restore a perfect occlusion and to improve mastication following a substantial loss of molars. However, little is known about the precise role of the periodontal membrane during this procedure. Therefore, we investigated if the epithelial rests of Malassez persist in the periodontal ligament of auto-transplanted teeth and, if so, whether these may show signs of a neuro-epithelial relationship.</p> <p>Case presentation</p> <p>We report a case of a 21-year-old Caucasian woman who underwent an auto-transplantation of two third molars. After two years, renewed progressive caries of the auto-transplanted teeth led to the removal of the auto-transplanted elements. The periodontal ligament was removed and studied with a light and transmission electron microscope.</p> <p>Conclusion</p> <p>In this report we examined the ultrastructure of the periodontal ligament after auto-transplantation in order to see if the periodontal ligament recovers completely from this intervention. We observed fully developed blood vessels and a re-innervation of the epithelial rests of Malassez which were proliferating following auto-transplantation. This proliferation might be critical in the remodelling of the alveolar socket in order to provide a perfect fit for the transplanted tooth. In order to minimalise the damage to the epithelial rests of Malassez, the extraction of the tooth should be as atraumatic as possible in order to provide an optimal conservation of the periodontal ligament which will be beneficial to the healing-process.</p

Complications of osteotomies

The authors wish to present a review of the literature on complications in orthognathic surgery. They are classified into non-specific, general complications and into complications which are specific, according to the region the osteotomy is performed in. Though the list of possible complications is very extensive, one should realise that they are often based on single case-reports and that orthognathic surgery in general should be considered as a group of safe technical, surgical procedures

Bioactive glass particles of narrow size range : a new material for the repair of bone defects

A clinical trial to treat dental osseous lesions with bioactive glass granules of narrow size range (300 to 360 microns) has been conducted since early spring 1990. This study followed an animal study in which the osseous tissue repair properties of bioactive glass granules of narrow size range and hydroxyapatite granules were compared for up to 2 years of implantation. The therapeutic response to the bioactive glass material exceeded the response to the hydroxyapatite as evidenced by very extensive osteoconduction, as well as the capacity to cause differentiation of osteoprogenitor cells to osteoblasts. The clinical study was started by virtue of the bioactive glass granules of narrow size range eliciting expeditious bone tissue formation throughout a defect. In this clinical study 87 patients and 106 defects were treated. The indications selected were apical resection areas, cystic defects, extraction sites, and defects of the alveolar ridge due to surgery or resorption. After insertion, the particles remained well in place and only small changes in the contours of the restored defects were seen, at the most up to 2 months postinsertion. At 3 months the application sites had fully solidified. Radiographic analysis indicated that the material integrated into the bone tissue, and at 6 months any difference between glass particles and bone tissue had nearly disappeared. The few initial cases with limited clinical results were caused by factors unrelated to the glass granules, mostly the surgical technique. By adapting the surgical technique, no unfavorable clinical results were subsequently experienced

Using Cellular automata for the analysis of the dynamics of a landscape unit: discussions about the study of a suburban area in the East of Liège

peer reviewe

The extremely displaced praemaxilla in bilateral cleft-lip-palate patients

Ten patients with an extremely displaced premaxilla were treated with early repositioning and stabilisation with bone grafts. One group ( 5 pts) had severe maxillary hypoplasia with teh premaxilla locked behind the lower front teeth. The age at repositioning varies between 8.1 and 13.3 yrs and teh patients were followed until adulthood. (fu 9.2 yrs). The second group (5 pts) had a protruded and caudally displaced premaxilla. These patients were treaded because o unacceptable esthetics. The ages varied from 2 to 9 yrs and follow up varies from 2.6 to 5.6 yrs. Growth analysis and comparison to existing data on growth in CLP patients evealed that early repositioning satbilisation and bone grafting had no adverse effects on maxillary growth. By both procedures however facial appaerance and profile greatly improved

Surgical treatment of exophthalmos and exorbitism: a modified technique

A modified surgical technique for the treatment of exophthalmos caused by Graves' disease or meningioma is presented. It is based on the orbital expansion as presented by Tessier (1969). It consisted of a lateral marginotomy with extension to the superior and inferior orbital rim and removal of the great wing of the sphenoid bone. The osteotomised orbital rim segment was advanced and stabilised by interposition of a calvarial bone graft. Concomitant lipectomy was carried out when indicated. Seven patients were operated on. No major complications occurred. The advantages of the method are discussed