ABSTRACT
Aim: This study is aimed to investigate the success rate and clinical outcome of placed implants in reconstructed alveolar ridges using iliac cortico-cancellus bone graft compared to normal nonaugmented alveolar ridge. Materials and Methods: In this clinical trial study, 30 patients who were selected and assigned in case and control groups. The case group included patients with severe alveolar bone loss, who needed bone grafting. The control group included patients with sufficient alveolar ridge and no need for bone grafting. The prosthesis was placed on implants after 3 to 8 months. Plaque index, bleeding, pocket depth, mobility, pain, pus secretion and bone loss were evaluated after 24 month. Data were analyzed by SPSS 13. P-value less than 0.05 was considered as significant. Results: Out of 30 patients, two were excluded due to their requirements. Totally 97 implants were placed in patients, which included 52 implants in control group and 45 implants in case group. All of the implants were successfully osseointegrated and loaded. There was no significant difference between the success of inserted implants between both groups (P=0.05). The mesial and distal bone losses were significantly more in patients without iliac bone graft (P=0.05). There was no statistically significant difference between measured outcomes including plaque, bleeding, pocket depth, mobility, pain, and pus secretion (P=0.05). Conclusion: Inserted implant in free non-vascularized iliac bone graft has high rate of success comapred to non-augmented alveolar ridges and has shown to be a reliable method for reconstruction of severe atrophic jaws.
ABSTRACT
Aims: Expanding mandibular arch for correcting transverse deficiency is a challenging problem in orthodontics. It is believed that mandibular symphyseal distraction osteogenesis (MSDO) is an attractive solution for this problem. The aim of the present study is to review available data regarding stability of MSDO and its effect on temporomandibular joint and teeth and their surrounding tissues, in a systematic approach. Study Design: The study is a systematic review of available evidence. Place and Duration of Study: Department of Orthodontics of Dental school at Shahid Beheshti University of Medical Sciences. From January 2014 to January 2015. Methodology: Electronic searching was done in Medline, Embase and CENTRAL databases. Published clinical studies and case series in English language which had used tooth borne, bone borne or hybrid distractors and had follow up period of 1 year or more were included. Review article, case reports, and letters were not included. Presence of samples with syndromic problems or mandibular cleft and simultaneous other surgical procedures in mandible were reasons for excluding articles. Data were extracted from selected articles. Risk of bias was assessed in articles. Results: A total of 77 articles were found, from which, 10 met the inclusion criteria. 5 articles had assessed stability and none had reported instability. The effect of MSDO on temporomandibular joint was evaluated in all of the included studies, all of them stating that MSDO would not cause permanent changes in temporomandibular joint status. Gingivitis, root injury, mobility, pseudopocket and irresponsiveness to cold stimulus were reported in 6 studies. Risk of bias was assessed to be high in the included studies. Conclusion: Within the limits of this review it is concluded that MSDO would be a stable procedure and it may not cause temporomandibular joint disorder, provided that proper technique is used. Risk of injury to tooth is not so common; however, great care should be taken in order to prevent these injuries. Well-designed randomized clinical trials are highly recommended to clarify these issues.