ABSTRACT
Dentistry has a long, often well documented history. Evidence of tooth pullings has been discovered in crude carvings on the walls of caves that are over 10,000 years old. The ancient Egyptians, the Athenians, and the early inhabitants of Rome required oral health care; in addition to tooth extractions, they underwent tumor removal, tamponade for hemorrhage, reduction of jaw fractures with gold wire ligatures, cautery using white hot platinum loops, and an additional variety of remedies and nostrums. Pain relief was offered, with courses of treatment as varied as postural change, alteration of ambient temperature, and vegetable and organic medicines in poultices or via oral and rectal routes. Through the centuries, great surgeons and physicians introduced various methods of treatment: Hippocrates codified ethical standards; Maimonides established pragmatic rules for physicians; LeFort categorized facial fractures; Pasteur clarified the need for sterilization; Semmelweis standardized antiseptic conditions in the operating theater; Morton and Wells discovered safer methods of analgesia; Freud explored the theraupeutic uses of narcotics; Roentgen championed X-ray imaging; Curie pioneered the use of chemotherapy; and Barton and Nightingale were models of empathy and patient care. In more recent times, we have profited from the genius of Watson and Crick (DNA); Fleming (penicillin); Venable and Stuck (Chrome-cobalt--molybdenum alloy); Gershkoff and Goldberg (the subperiosteal implant); Chercheve, Branemark, Linkow, Misch, Tatum, and Niznick (innovative root forms, titanium and its alloys, and sinus floor grafting). The 20th century has brought to us phenomenal imaging, breathtaking intrauterine fetal surgery, wildly promising stem cell research, and astonishing CADCAM techniques. We've had great teachers and clinicians who have introduced us to new forms of therapy and advanced methods, including the role of the hemidesmasomes, the essential elements of bone grafting, the importance of microscopic analysis, and the benefits to patients of physical diagnosis by their dentists. To recognize and celebrate some of my heroes' contributions to the health and well-being of humankind, editorials will occasionally appear on these pages that explore their various contributions.
Subject(s)
Dental Service, Hospital/history , Education, Dental, Graduate/history , History, 20th Century , History, 21st Century , New York City , Pathology, Oral/historySubject(s)
Dental Implantation, Endosseous/methods , Absorbable Implants , Analgesics/therapeutic use , Dental Records , Dental Restoration Failure , Hemostasis, Surgical , Humans , Paresthesia/therapy , Postoperative Complications , Stress, Mechanical , Surgical Flaps , Surgical Wound Dehiscence/therapy , Suture TechniquesABSTRACT
Distraction osteogenesis is a process in which new bone is created in a defect of the alveolar ridge by stretching existing bone. The process was originally developed by a Russian orthopedist, Gavriel Ilizarov, for the correction of long-bone deformities. It was later adapted to the maxillofacial skeleton and alveolar ridge. Distraction osteogenesis involves surgically creating a mobile bone segment to which a distraction device is attached. By controlled movement, the bone segment, along with the soft tissues overlying it, are transported into a new position. After a suitable healing period, the distraction device is removed and dental implants can be placed. A case report is presented describing the use of alveolar distraction to augment a vertically deficient alveolar ridge.
Subject(s)
Alveolar Ridge Augmentation , Dental Implants , Mandible/surgery , Osteogenesis, Distraction , Adult , Dental Implantation, Endosseous , Humans , Jaw, Edentulous, Partially/surgery , Male , Mandibular Injuries/surgery , Osteogenesis, Distraction/instrumentation , Osteotomy , Wound HealingABSTRACT
A canine model was used to compare autogenous alveolar ridge augmentation bone grafting with allogeneic grafts. Defects were created by premolar extractions and measured by radiopaque markers. These markers were used for subsequent measurements made before and after grafting, and after animal sacrifice to evaluate the status of the grafted sites. The results were unexpected and disappointing.
Subject(s)
Alveolar Ridge Augmentation/methods , Bone Transplantation/methods , Graft Rejection , Analysis of Variance , Animals , Bone Resorption , Decalcification Technique , Dogs , Ilium/transplantation , Transplantation, Autologous , Transplantation, HomologousABSTRACT
The specimens retrieved from the experimental animals and described grossly in Part I were evaluated histologically. The disappointing results were more fully realized after microscopic examination that revealed far more critical information than was available from the purely clinical data obtained in Part I.
Subject(s)
Alveolar Ridge Augmentation/methods , Bone Transplantation/methods , Graft Rejection , Animals , Bone Resorption , Dogs , Ilium/transplantation , Mandible/pathology , Maxilla/pathology , Transplantation, Autologous , Transplantation, HomologousABSTRACT
Soft tissue healing plays a significant role in determining the outcome of implant and other osseous surgery. A variety of methods is required to accomplish primary soft tissue closure. These include the techniques of undermining; free grafting, both full and split thickness; and pedicle grafting. Preprosthetic surgery, which includes the correction of high muscle attachments and vestibular deficiencies, involves the use of broad spectrum grafting modalities in order to create an appropriate environment for the placement of implants.
