Reconstruction of Extensive Bucco-Palatal Defects Using Twin Block Grafts: A Clinical Report of the Sandwich Technique in Two Cases.

INTRODUCTION: Three-dimensional alveolar ridge defects in the anterior maxilla necessitate bone augmentation before implant placement. Bone volume, contour, and the overlying soft tissue form have to be optimized for an ideal outcome. A large three-dimensional defect needs osteogenic bone to predictably reconstruct the defect. Autogenous bone in the form of block and particulate is the graft of choice in such situations. CASE SERIES: Two cases are presented here with severe three-dimensional alveolar ridge deficiency in the maxillary right lateral incisor and maxillary canine areas, respectively. Both cases had a three-dimensional bone and contour deficiency. Restorative-driven positioning of the implant necessitated augmentation of the buccal and palatal aspects of the defects. The defects were grafted with autogenous corticocancellous bone blocks harvested from the mandibular symphysis. In both sites, one block was placed on the buccal side and the other on the palatal side, "sandwiching" the host bone and the remainder of the gap filled with particulate autogenous bone. Implants were placed in both cases 5 months after the grafting, and the final restorations were placed 5 months subsequently. The implants and the grafts successfully integrated at the sites with stable bone and soft tissue levels. At the 3-year follow-up, both implants showed stable bone and soft tissue levels. CONCLUSION: Autogenous corticocancellous block grafts used in a sandwich technique reconstructed the lost bone volume, but also facilitated implant placement and optimal restorative outcomes.

Magnet and Semi Precision Attachment in an Implant Retained Partial Denture for the Rehabilitation of an Irradiated Marginal Mandibulectomy Patient: A Case Report.

Surgical treatment of malignancies in the oral cavity (mandible, tongue, floor of the mouth, alveolus, buccal sulcus) often results in an unfavourable anatomic condition for prosthodontic rehabilitation. Hence, maxillofacial prosthetic rehabilitation becomes a mightier task when resection is accompanied by radiation therapy. In selected cases, implant therapy comes to rescue. The following report throws light on the case of prosthetic rehabilitation of a patient who underwent right marginal mandibulectomy and right partial glossectomy, with the aid of a single implant, semi precision attachment and magnet supported partial denture.

Evaluation of soft tissue marginal stability achieved after excision with a conventional technique in comparison with laser excision: A pilot study.

BACKGROUND: Soft tissue excision around natural teeth is carried out to increase the clinical crown lengths, expose the caries apical to the gingival margins and to correct irregular and un-esthetic soft-tissue contours. AIMS: The study was carried out with an aim to evaluate the stability of the soft tissue margins after excision either with a laser or scalpel. MATERIALS AND METHODS: A total of 20 patients indicated for soft tissue excision for correcting soft tissue discrepancies were selected. The patients with thick gingival biotype were included in the study. They were grouped randomly into excision by laser or scalpel methods. The change in the soft tissue positions from the time of excision to 1-month follow-up were evaluated immediate postoperatively, after 2 weeks and after 1-month postrestoration. RESULTS: The soft tissues remained stable in the laser group at 1-month follow-up, in contrast to the scalpel group and were found to be statistically significant, (Student's t-test) (P < 0.05). CONCLUSION: The soft tissue margins are more stable and stay at the point they were excised with lasers when compared with scalpel.

Rehabilitation of a missing ear with an implant retained auricular prosthesis.

Burns can leave a patient with a severely debilitating disability even after treatment. The objectives of burn rehabilitation are to minimize the adverse effects caused by the injury while rehabilitating the patient's physical and psychological well-being, maximizing social integration. Long-term success of maxillofacial prostheses mainly depends on the retention. Extra oral implant retained prostheses have proved to be a predictable treatment option for maxillofacial rehabilitation. Replacement of a severely deformed external ear with burned tissues may be satisfactorily accomplished by a cosmetic prosthesis anchored by implants integrated in the skull. The use of such implants is now a well-recognized method for creating a stable result in maxillofacial rehabilitation. This case report describes a safe, simple and economical method for the rehabilitation of a patient with missing right auricle using an implant supported silicone prosthesis. The implant was placed in the mastoid region of the temporal bone. Reconstruction of the ear was done with auricular silicone prosthesis, retained using magnets incorporated in an autopolymerizing resin shim to decrease the weight of the prosthesis on a single implant. This method eliminates the need of tedious laboratory procedures and exact casting and fitting requirements of a metal substructure while minimizing the overall weight and cost of the prosthesis while maintaining adequate support, esthetics and retention of the prosthesis.

Measurement of gingival thickness using digital vernier caliper and ultrasonographic method: a comparative study.

BACKGROUND: The measurement of the thickness of the gingival tissues has been done using different techniques. Trans-gingival probing with a graduated probe, use of vernier calipers, ultrasonography and cone-beam computed tomography (CBCT), have all been tried, but no one technique has been shown to be consistent and better than the others. The present study was done to evaluate and compare the gingival thickness as measured with a digital vernier caliper and ultrasonography. METHODS: A total of 30 systemically healthy, non-smokers were included in the study. The gingival measurements were made and recorded from the maxillary and mandibular lateral incisor areas at 2 locations: (a) at a point apical to the free gingival groove; and (b) at a point immediately coronal to the muco-gingival junction. RESULTS: The mean gingival thickness ranged from 0.56 to 1.02 mm. Males had a significantly thicker gingiva as compared to females (P < 0.10). Significant differences were not observed when the measurements made using the digital vernier caliper and those made with ultrasonography were compared. CONCLUSIONS: The thickness of the gingiva was in the range of 0.56-1.02 mm. A digital vernier caliper and ultrasonography both can be used to assess the gingival thickness with equal accuracy.

Rehabilitation of geriatric hemiglossectomy patient with implant-supported overdentures. Clinical report.

Carcinomas of the tongue constitute approximately 5% to 10% of oral carcinomas. Rehabilitation of these patients postsurgery is challenging because the motor control of the tongue is lost and postsurgical scarring reduces the vestibular depth needed to support and retain a denture. Implant-supported overdentures are a viable option to rehabilitate such patients. The restoration provides enhanced function and wearer comfort.

Implant-retained nasal prosthesis for a patient following partial rhinectomy: a clinical report.

Prosthetic rehabilitation of facial defects has always perplexed maxillofacial prosthodontists. Facial defects lead to functional and cosmetic deficiencies. Early rehabilitation improves patients' quality of life. Osseointegrated rehabilitation of the maxillofacial prosthetic patient presents the potential for overcoming many of the disadvantages associated with conventional retentive methods. This paper presents the clinical report of a patient who had undergone partial rhinectomy due to basal cell carcinoma. Following post-surgical healing, the patient was rehabilitated with a temporary acrylic resin nasal prosthesis retained by eyeglass frame. Later a silicone nasal prosthesis supported by an implant-retained framework was fabricated as a definitive replacement.

Comparison of cyanoacrylate and silk sutures on healing of oral wounds--an animal model study.

Cyanoacrylates are tissue adhesives used for closure of surgical wounds. N-butyl cyanoacrylate is a biocompatible tissue adhesive used for closure of surgical wounds. In the present study evaluation and comparison the healing of oral wounds was done when closed with N-butyl cyanoacrylate and silk sutures in a rabbit model. It was found clinically that the sites treated with cyanoacrylate had less inflammation and healed better at 7 days as compared to the sutured sites. At 7 days the histological picture correlated with the clinical findings and the amount of inflammation was less on the cyanoacrylate site. At 21 days both the sites appeared similar clinically and histologically. It is concluded that N-butyl cyanoacrylate tissue adhesive results in faster initial wound healing as compared to silk sutures and can be used for closure of oral wounds.