Osteotomía segmentaria con injerto interposicionado en región anterior de la mandíbula: reporte de un caso / Segmental osteotomy with interpositional graft in anterior mandible: report of a case

La pérdida de dientes por lo general resulta en defectos de la cresta alveolar, dificultando la colocación de implantes. La corrección de estos defectos es un desafío para los cirujanos orales. La técnica de osteotomía segmentaria con injerto óseo interposicionado también conocida como osteotomía en «sándwich¼ ha demostrado ser efectiva para estos problemas. Se describe un caso clínico con la utilización de esta técnica para el aumento óseo vertical en la región anterior mandibular y la colocación de implantes (AU)

The loss of teeth usually results in defects of the alveolar ridge, making it diffi cult to place implants. The correction of these defects is a challenge for oral surgeons. The segmental sandwich technique with interpositional bone graft has proven to be predictable for these problems. We describe a clinical case with the use of this technique for vertical bone augmentation in the mandibular anterior region and the placement of dental implants (AU)

Combined application of roll flap and combination onlay-interpositional graft to enhance esthetics of maxillary anterior fixed partial denture: A case report

In the maxillary anterior region, reconstruction of the localized alveolar ridge defect is very important in enhancing the esthetics of fixed partial denture. A 40-year-old female patient presented with a chief complaint of the inconvenience and unesthetic problem of 3-unit maxillary anterior prosthesis due to alveolar ridge resorption. After removal of old prosthesis, intraoral examination revealed moderate (buccolingually 4 mm) ridge deficiency in missing tooth region, leading to the diagnosis of Class I alveolar ridge defect. One of the reconstruction techniques to overcome this problem might be a technique that combines two types of soft tissue augmentation techniques. The purpose of this paper was to demonstrate the new combined technique of roll flap and combination onlay-interpositional graft utilized to acquire sufficient dimension of recipient area by one time of operation and to present the esthetic improvement of fixed partial denture by using this procedure in case of maxillary anterior localized ridge defect.

Treatment of Unilateral TMJ Ankylosis in a Pediatric Patient with Temporalis Fascia Flap A Case Report.

The definite cause of temporomandibular joint (TMJ) ankylosis is still an unknown fact. TMJ ankylosis may result from, infection, trauma or insufficient surgical treatment of the mandibular condyle region. Different techniques have been described so far for the treatment of TMJ ankylosis, but no technique has successfully given uniform results. Relapse causing limited mouth opening, infection, open bite, reankylosis are the complications. Many authors agree that aggressive physiotherapy immediately after the surgical procedure, interpositional graft as spacer and wide bone resection are the basic principles in treating TMJ ankylosis. In this article, we discussed a case of unilateral TMJ ankylosis, in a 9-year-old boy, treated with the intre-positional gap arthroplasty with superficial temporalis fascia flap.

O uso de rhBMP-2/beta-TCP para técnica de enxerto vertical interposicional: relato de caso com quatro anos de acompanhamento / The use of rhBMP-2/beta-TCP for interpositional vertical graft technique: a case report with 4 years of follow-up

A reconstrução óssea de mandíbulas atróficas para o posicionamento de implantes dentários ainda é um grande desafio na Implantodontia atual. Para um ganho ósseo vertical, a técnica de enxerto interposicional com a utilização de enxerto de osso autógeno, ou algum substituto ósseo, apresentou excelentes resultados. Neste relato de caso, um paciente com 58 anos de idade e ausências entre os elementos 34 e 38 apresentava 3 mm de altura entre a crista óssea e o nervo alveolar inferior pelo exame de TCFC, impossibilitando o posicionamento de implantes sem enxertos prévios para ganho em altura e espessura. Com a utilização de rhBMP-2 como osteoindutor, associada ao beta-TCP como osteocondutor, foi possível regenerar o local com pouca morbidade e com ganho ósseo satisfatório (8 mm) para o posicionamento dos implantes. Após sete meses da consolidação do enxerto, implantes de diâmetro estreito (3,3 mm) foram posicionados e o paciente foi reabilitado sem complicações ou intercorrências durante todo o tratamento. Os autores sugerem que essa técnica tem um grande potencial para reconstruções de regiões atróficas, com um excelente ganho ósseo vertical, pouca morbidade e grande previsibilidade de resultados.

Bone reconstruction of atrophic mandibles for correct implant positioning is a great challenge on contemporary dentistry. Also, the interpositional graft technique using autogenous or bone substitute materials for vertical augmentation has presented excellent outcomes. This case report presents a 58 years-old patient with tooth loss from 34 to 38 regions having 3 mm from the bone crest to the inferior alveolar nerve canal according to the CBCT exam preventing implant placement without previous grafts for horizontal and vertical augmentation. With the aid of rhBMP-2 (osteoinductive) and beta-TCP (osteoconductive) materials it was possible to regenerate the area with less morbidity and satisfactory bone gain (8 mm) for implant placement. Seven months after graft healing narrow diameter implants (3.3 mm) were positioned and the patient rehabilitated without complications during the course of treatment. The authors suggest that this technique has a great potential for reconstruction of atrophic sites with excellent vertical bone gain, less morbidity, and great outcome predictability.

Clinical Application of Great Saphenous Vein Graft in the Oral and Maxillofacial Reconstruction

Técnica modificada de injerto de tejido conectivo interposicionado y sobrepuesto en implantología y rehabilitación oral: reporte de dos casos clínicos / Description of two clinical cases showing surgical possibilities of correction or ridges reconstruction, using connective yissue graft and gingival sculping

Se describen dos reportes de casos clínicos mostrando posibilidades quirúrgicas de corrección o reconstrucción para rebordes usando tejido conectivo y posterior modelado gingival.

Description of two clinical cases showing surgical possibilities of correction or ridges reconstruction, using connective tissue graft and gingival sculping.

Anterior Interpositional Grafting for Scaphoid Nonunion with Dorsal Instability Rattern / 대한정형외과학회잡지

In thirteen adult male patient with scaphoid nonunion associated with DISI(Dorsal intercalated Segment Instability) defined as scapholunate angle is greater than 70 degrees of the radiolunate angle is greater than 10 degrees, anterior interpostitional bone grafting has been performed. Surgical procedure: 1) Closed reduction of lunate(reduction of DISI) by volar flexing of the wrist and holding the position by Kirschner wire inserted obliquely through the radial styloid to lunate. 2) Radical curettage of nonunion site and intraoperative measurement of the gap in the scaphoid through volar approach. 3) A bicortical wedge shaped graft from the iliac crest was then impacted between the fragments. 4) Temporary K-wire fixation of the grafted scaphoid from the scaphoid tubercle to prevent distortion of nonunion site and loss of fixation. 5) A Herbert screw was then inserted. Results: Mean patient age was 24.5 years, and mean duration of nonunion before surgery was 19.4 months. Mean follow-up time was 22.6 months. The nonunion involved the middle one-third of scaphoid in 11 patients and distal one-third in 2 patients. The mean postoperative grip strength was 39.4kg by Dynamometer(PC-5303J). The mean postoperative range of motion was volar flexion 50.5 degrees; dorsiflexion 47.3 degrees. The scaphlunate angle decreased from a mean of 78.8 preoperatively to 52.9 degrees postoperatively. The radiolunate angle was decresed from a mean of 16.8 degrees prope- ratively to a mean of 1.8 degrees postoperatively. Union was obtained in all 13 cases, According to Herbert and Fisher's formulation, 2 excellent, 10 good and 1 fair results were obtained from our study. The results of the series suggest that treatment of scaphoid nonunion associated with DISI by this method is an effective method that reconstitutes scaphoid anatomy and promotes excellent wrist function.