ABSTRACT
Objective@#To investigate the changes of the lateral cephelometric landmarks of soft tissue and hard tissue of patients with maxillary alveolar protrusion and advanced periodontitis treated with immediate implants and cross-arch fixed prostheses.@*Methods@#From January 2013 to October 2016, consecutive patients with advanced periodontitis and maxillary alveolar protrusion in need of immediate implants and cross-arch fixed prostheses were included in this study. All the patients were treated with provisional cross-arch fixed prostheses supported with 4 to 6 immediate implants after extraction of all the residual teeth and reduction of excessive alveolar bone. After 6 months, a final cross-arch fixed prosthesis was delivered. The lateral cephalometric landmarks of soft tissue and hard tissue at the time of pre-operation and final prosthesis delivery were analyzed. The change of patients' facial aesthetics was assessed using visual analogue scale (VAS).@*Results@#Ten patients were included in the study. All the patients underwent full arch rehabilitation of both jaws supported by a total of 89 dental implants. In the maxillae, the average number of inserted implants were 4.5. The mean height of alveolar bone reduction was (6.3±1.8) mm. Both the distance of U1-NA (the upper incisor to nasion-A point line) and U1-PP (the upper incisor to palatal plane) were significantly reduced by (5.5±2.7) mm and (1.6±1.2) mm, respectively. The angle of U1-SN (between upper incisor to sella-nasion line) was reduced by 9.6°±8.1°palatally. The nasolabial angles were significantly increased by 10.5°±6.4°. Both the patients and dentists considered that the facial aesthetics was improved greatly after the treatment.@*Conclusions@#With the reduction of excessive alveolar bone and the realignment of artificial teeth, the treatment of immediate implants and cross-arch fixed prostheses could improve the facial aesthetics of the patients with advanced periodontitis and maxillary alveolar protrusion.
ABSTRACT
Introducción: la prótesis Inmediata es una alternativa de tratamiento protésico que sustituye inmediatamente los dientes extraídos. Generalmente se confecciona para reponer dientes anteriores, evitando el deterioro psíquico del paciente; en ocasiones, se hace necesario realizar además de las exodoncias de los dientes afectados, técnicas de cirugía preprotésica, como la Tuberoplastia o la Alveolectomía. Objetivo: mostrar que es posible realizar el tratamiento de rehabilitación con prótesis inmediata luego de una amplia resección quirúrgica. Presentación del caso: se presentó el caso de una paciente femenina de 58 años de edad, trabajadora activa, con antecedentes de buena salud. Refiriendo rechazo al período de desdentamiento. Al examen intrabucal presentaba incisivos centrales superiores con fractura oblicua mesial y movilidad de grado III por trauma, protrusión dentoalveolar marcada del sector anterosuperior, con resalte aumentado y reducción del espacio interalveolar en el sector posterior. Fue diagnosticada como desdentada parcial superior clase I, subclase I de Kennedy, y desdentada parcial Inferior clase I de Kennedy. Se decidió rehabilitar a la paciente por prótesis inmediata total superior, realizando previa Alveolectomía correctora y Tuberoplastia bilateral en una misma intervención quirúrgica. Resultados: con el tratamiento quirúrgico-aparatológico elegido se lograron excelentes resultados, mostrando las bondades de este tratamiento. Conclusiones: se obtuvo en la paciente buen resultado estético, funcional y psíquico.
Introduction: the Immediate Denture is a prosthetic treatment option. It substitutes the extracted teeth immediately. It is generally made to restore Front teeth, avoiding the patient's psychic trouble, sometimes becomes necessary to practice previous prosthetic surgery technics, such as reduction of hyperplastic tuberosities or Alveolectomy besides to make the exodontics of affected teeth. Objective: to show that it is possible to carry out the rehabilitation treatment with immediate prosthesis after a surgical wide resection. Case presentation: we presented a 58 year-old feminine patient, active worker with antecedents of good health. Besides she refereed she couldn't see herself without teeth. To the clinical exam it presents upper central incisors with mesial oblique fracture and III mobility grade, for trauma. Also shows marked dental and alveolar protrusion of the upper front sector, with increased overjet and overbite. And reduction of the interalveolar space in posterior area. Being diagnosed as upper partial toothless Kennedy's class I, subclass I, and inferior partial toothless Kennedy's class I.We decided to rehabilitate the patient for immediate complete upper denture carrying out previous Alveolectomy proofreader and bilateral reduction of hyperplastic tuberosities at the same surgical intervention. Results: with this prosthetic- surgical treatment excellent results were achieved showing the kindness of this treatment. Conclusions: an esthetic, functional and psychic good result was obtained for the patient.
ABSTRACT
Myofibroblastic sarcoma is a rare tumor that mostly develops in the soft tissues of the head and neck. Within the oral cavity, a tongue lesion is the most common. A myofibroblastic sarcoma tends to recur locally instead of metastasizing. We encountered a myofibroblastic sarcoma of the mandible of a 9-year-old male and performed mass excision and additional marginal alveolectomy. So far, there is neither recurrence nor metastasis. We report this case because of the uncommon location of this tumor type and its surgical approach compared to other forms of sarcomas.
Subject(s)
Child , Humans , Male , Alveolectomy , Head , Mandible , Mouth , Myofibroblasts , Neck , Neoplasm Metastasis , Recurrence , Sarcoma , TongueABSTRACT
Objective: To present a modified option to surgical crown lengthening for repair of biologic width loss. Methods: The alternative to the traditional method involves reshaping the fractured root surface in combination with conservative removal of the supporting alveolar bone to rebuild the biological width. Although these teeth were considered as not suitable for the traditional methods, 7 teeth from 7 patients with fracture surface located lower than alveolar bone crest were treated by this modified method of surgical crown lengthening. Restoration was accomplished on these teeth two month later. Periodontal index such as tooth mobility, plaque index, probing depth and bleeding index were recorded and followed up. Results: The mean follow-up period was 17 months (ranged from 10 to 31 months). Result of surgery and restoration of these 7 teeth was satisfactory. The gingival tissue remained healthy and esthetic with good function. Conclusion: This modified surgical crown lengthening can be used as an alternative to the traditional method to save more fractured teeth.