One surgical technique to improve the denture foundation area in flat ridge cases; including ridge augmentation and sulcus deepening

The insufficiency of the edentulous mandibular alveolar ridge, for accommodation of a stable and retentive prosthesis, is a relatively common dental dilemma. To overcome this problem, various ridge augmentation and vestibuloplasty procedures have been employed. Ten male patients, 50-70 years of age, were selected for this study. They all were complaining from the inability to use their lower complete dentures satifactorily; because of the presence of flat lower ridge and very shallow vestibule, mainly in the anterior region. After meticulous pre-operative assessment and preparation, a combined ridge augmentation and labial vestibuloplasty were performed in the anterior region of the mandible. For ridge augmentation, a subperiosteal tunnel was prepared over the crest of the ridge, and filled with hydroxylapatite granules. At the same visit, labial vestibuloplasty was performed. A supraperiosteal labial mucosal flap was reflected and sutured at a new position, as deep as possible in the vestibular sulcus. The supraperiosteal raw area left, between the inferior limit of the tunnel and the new created vestibular fornix, was covered as much as possible by fenestrating the alveolar mucosa, stretching it and suturing it to the periosteum. A pre-fabricated acrylic template, lined with a soft liner, was placed immediatly post-operatively; for one week; and a new complete denture was fabricated after one month. The patients were followed-up for 6 months. The healing process of the surgical site was uneventful, since we had made every effort to satisfy the necessary factors needed for the success of the implantation procedure; and infection and pain were carefully controlled by the post-operative antibiotics, the frequent irrigation of the operative site and the regular use of mouth washes. We could obtain a mean increase in the depth of the anterior labial sulcus of about 14.2 mm [507% of the pre-opeative depth], with a mean loss of only about 0.9 mm within 6 monthes [6.3%]. This loss was satistically insignificant

Evaluation of transosseous wiring versus screw-wire osteosynthesis in treatment of mandibular fractures

From this study, it was concluded that, screw-wire osteosynthesis is well tolerated and provides satisfactory mechanical stability of fixation in mandibular fractures. It has an area contact and can not be loosen quickly when compared with wire osteosynthesis. It is possible to treat most of mandibular fracture utilizing internal fixation with screw-wire osteosynthesis, especially when plating system is not the technique of choice, and the case is unfavorable mandibular fracture

Comparison between the healing of autogenous and heterogenous bone grafts [experimental study]

In the present study, 12 male adult dogs were randomly divided into two groups, each consisting of six dogs. Surgical bone defect was created in the inferior border of the mandible. For the first group, the defects received rib autogenous graft, and Kiel bone was placed in the second group. Histological sections, using H and E stain, were performed after each sacrifice of the 2 animals at 6-, 12- and 24-week intervals [two specimens at each interval]. The results were successful and promising with autogenous and heterogenous grafts. However, Kiel bone had higher advantages, besides high osteogenic potential in terms of eliminating a second operation, as in autografts, as well as time saving, ready availability, with ease of the shape selection

Computerized tomography as a guide for the diagnosis of internal derangement of TMJ

C.T. is a non-invasive method for providing detailed views of both the soft and hard tissues of the T.M.J. region. C.T. can provide an invaluable tool in the study, diagnosis, and treatment of various disorders of this nature. C.T. can evaluate the success of treatment aimed at reestablishing proper disk-condylar relationships. However, the major advantage of T.M.J. C.T. is the observation of the soft tissue of the articular disk. C.T. has been proved to be major adjunct in the treatment of patients with internal derangements of the T.M.J

Changes to the lower third profile after fenestrated mucosal flap vestibulopasty

Twenty patients with flat lower ridge were selected from the Outpatient Clinic, Faculty of Dentistry, Alexandria University, for this study. All the patients were operated with fenestrated mucosal flap technique. Cephalometric X-ray [soft tissue profile radiograph] was done for each patient, pre- and postoperatively. Tracing of the soft tissue profile was done by using indelible pencil and tracing paper. Two lines were drawn; the first was the tangent of the most prominent point of the mandibular bone, while the second was the tangent of the most prominent point of the chin. The distance between the two lines was measured pre- and postoperatively, and the difference was estimated

5 years follow-up for diffrent techniques of vestibuloplasty

The aim of this work was to evaluate the five years follow up of three different techniques of sulcus deepening: The secondary epithelization vestibuloplasty, the submucosal vestibuloplasty and the fenestrated mucosal flap vestibuloplasty. Seventy patients were selected for this study. They had no complaint from upper dentures, all of them lower denture satisfactory. The sulcus depth was measured from the crest of the ridge to the depth of the newly created sulcus at the midline, canine and molar regions, respectively, before the operation, and one, 2, 3, 4 and 5 years postoperatively, and the means were illustrated