1,721,382 research outputs found
THE PRE-IMPLANT "WINDOW-OSTEOTOMY" TECHNIQUE FOR THE ATROPHIC POSTERIOR MANDIBLE.
No full textThis article presents a technique used for the implant-bone prosthetic rehabilitation of a partially edentolous posterior mandible with a mean high <6 mm in the molar zone. The procedure allowed clinicians to insert 2 fixtures via a lateral approach with intraoperative verification of the position of the inferior alveolar nerve
Large defect rehabilitation of upper jaw with zygomatic/oncologic implants. Preliminary results of a prospective study
Full text linkBackground
The maxilla reconstruction with bone free flap after a resection for cancer or malformation may be required for a functional rehabilitation of the patient. A secondary dental implant placement into the reconstructed bone may be needed for the restoration of masticatory functions. The implants placed in free flap may have, on a long term, a higher number of perimplatitis and a lower survival rate than those placed in native bone. An alternative method for these rehabilitations could be represented by the employment of zygomatic implants for fixed bridges support. This effectiveness of this technique, already reported in literature and used for severe maxilla atrophy treatment too, has been proved by several long- term clinical studies. The use of three-dimensional diagnostic systems could allow a surgical and prosthetic virtual planning and a guided implant placement through the aid of a navigation system. These devices may help the surgeon with positioning the implant and consequently reduce the working time.
Aim/Hypothesis
The primary objective of this project is to evaluate the survival rate and the surgical and prosthetic problems of zygomaticoncologic implant placed in upper jaw where this is affected by a large anatomical defect. The secondary aim is to evaluate the quality of life.
Material and methods
Ten patients with a large anatomic defect due to resection for cancer or malformation were recruited in our protocol starting from September 2013, following the Ethical Committee approval. The patients were scheduled in base of the extent of the resection and the residual bone: (1) Full maxillary resection, treated with four zygomaticoncologic implants. (2) Hemimaxillectomy, treated with two zygomaticoncologic implants on the resected side and on the other side: (A) contralateral side dentate, one zygomaticoncologic implant behind the dental roots; (B) edentulous contralateral side, standard implants; (C) edentulous atrophic contralateral side, two zygomatic implants. In all cases the simultaneous use of standard implants was allowed. Four patients were treated up today: two hemimaxillectomy, one total maxillectomy and one anatomical defect due to palatal cleft. The implant placement was performed in two cases under the navigation guide. Three patients were immediate loaded with a fixed prosthesis and one delayed. Survival rate, early and late surgicalprosthetic complications were reported. Evaluation record of quality of life was filled pre and post surgery and in every follow-up at 3 and 6 months.
Results
After a follow-up period of 6 months no complications occurred with an implant survival rate of 100%. The quality of life in these patients resulted improved by 40%.
Conclusion and clinical implications
The results seem to be encouraging but long terms results are needed to confirm the reliability of the technique. This procedure may reduce the extent of intervention and minimize morbidity and procedure cost. Therefore there is a need to investigate the possibility to simplify the rehabilitation procedure using fixed bridges supported by zygomatic implants
Aggressive Central Giant Cell Granuloma of the Mandible Treated With Conservative Surgical Enucleation and Interferon-α-2a: Complete Remission With Long-Term Follow-Up
No full textCentral giant cell granuloma (CGCG) is a benign tumor of the jaws. Aggressive lesions present a strong tendency toward recurrence after surgical enucleation; thus, en bloc resection and microvascular bone free flap transfer are usually performed. However, in young patients, aggressive surgical treatment is a not always suitable solution. This report describes the case of a young female patient who developed an aggressive recurrence of CGCG after its diagnosis and enucleation from the mandible. Surgical enucleation with subcutaneous injection of interferon-α-2a was performed. The patient was evaluated every 6 weeks, and after 6 months radiographic evidence of complete bone regeneration was obtained. No sign of recurrence was seen after 8 years of follow-up. A review of the literature proved that interferon treatment is an effective strategy to avoid extensive surgery in patients with aggressive CGCG
Giant pleomorphic adenoma of the parotid gland: an unusual case presentation and literature review
Full text linkPleomorphic adenoma is the most common type of all salivary gland tumours. Although uncommon, cases of giant pleomorphic adenomas
have been described in the medical literature, the majority involving the parotid gland. This paper describes an unusual case of a giant adenoma
arising in the parotid gland. The patient underwent surgical resection of the giant tumour, which was one of the largest pleomorphic
adenoma reported in recent literature. This case has prompted us to evaluate the behaviour of those benign tumours, which suggested that
aesthetic and social morbidity is sufficient to justify, when possible, early tumour excision, despite the relatively low risk of malignant
transformation. Management of this unusual tumour is discussed, and the literature on giant parotid tumours is reviewed
Tumor Infiltration Depth as Predictor of Nodal Metastasis in Early Tongue Squamous Cell Carcinoma: Study on an Italian Cancer Population
No full textA retrospective longitudinal study was conducted to identify the cutoff value of infiltration depth for predicting the risk of lymph node metastasis of the neck in a well-defined population of surgically treated patients affected by stage T1 to T2 oral squamous cell carcinoma of the tongue
Reconstruction of extended and morphologically varied alveolar ridge defects with the titanium mesh technique: Clinical and dental implants outcomes
No full textA sample of 24 patients with varied morphologic defects were treated with 34 titanium meshes and particulate bone and rehabilitated at least 8 to 9 months thereafter with the placement of 88 implants. Of the 34 meshes, 4 had to be removed before implant placement (11.76% total failure) and 20 were exposed due to soft tissue dehiscence (58.82% of complications): 4 (11.77%) prematurely (within 4 to 6 weeks) and 16 (47.05%) delayed (after 4 to 6 weeks), with no compromise in implant placement. None of the 88 implants was lost (100% implant survival), and 15 demonstrated increased bone loss, yielding a cumulative implant success rate of 82.9%. This technique appears useful in treating extended and morphologically varied alveolar defects
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