Orthodontic reduction of a displaced alveolar fracture: a case study.

A 42-year-old woman had sustained a severe dental trauma with an alveolar fracture after an epileptic attack. A tooth block 31, 32, 33 and 34 was dislocated about 7 mm in buccal direction. Panoramic X-rays and CT-scan disclosed the alveolar fracture without total disjunction of the fragment. An orthodontic appliance was used to reduce the fracture with gentle forces during a 5-month period. Normal function was established and the teeth remained vital.

Septa within the sinus: effect on elevation of the sinus floor.

Elevation of the sinus floor allows the correct number and length of oral implants to be placed. The sinus membrane is dissected blindly, usually by a crestal approach, but several internal configurations of the maxillary sinus or intrasinus septa can cause problems. We studied 150 sinuses from 40 male cadavers, and 35 randomised male patients by anatomical dissection and computed tomography. Forty-six subjects (61%) had no bony septa or had septa less than 4mm. Twenty-nine (39%) had bony septa of which seven were incomplete, one had a complete bony septum in each maxillary sinus, and 20 had symmetrical bony septa. We present the results of a study of bony intramaxillary sinus septa and the potential problems they can cause during elevation of the sinus floor.

Vascular connections of the lateral wall of the sinus: surgical effect in sinus augmentation.

PURPOSE: There are several vascular vessels that supply the maxillary sinus, such as the posterior superior alveolar artery, the anterior superior alveolar artery, and the infraorbital artery (IOA). These vessels have to be taken into consideration during a sinus augmentation because of the potential risk of bleeding during the procedure. The objective of this investigation was to study variations in maxillary sinus artery connections with the potential surgical effect during a sinus floor elevation by the lateral wall. MATERIALS AND METHODS: The first part of the study was done in 32 anatomical specimens embedded in 10% formaldehyde solution and aged between 55 and 70 years (mean, 61.3 years). The second part of the study was a radiographic study using computerized tomographic (CT) scan images in 35 randomized patients treated in odontology and maxillofacial surgery departments. RESULTS: Results were recorded for 134 sinuses. In most cases, there was no vessel visible or no vessel present with a diameter less than 0.5 mm after dissection or CT-scan analysis: 120 sinuses (89.5%). In 14 cases (10.5%) there were vessels in the lower two thirds of the anterolateral wall. In 10 sinuses (71.4% of the 14 cases), there was an intraosseous or intrawall artery and in 2 sinuses (14.3%) they were in the intrasinusal position. In 8 of the 14 sinuses (57.1%, about 6% of overall sinuses) the diameter was between 1 and 2.5 mm. CONCLUSION: Knowledge of the arterial supply is essential for surgical treatment in the sinus area. A CT scan is recommended and the radiologist must be advised to search for intraosseous or extraosseous vessels in the lower two thirds of the maxillary sinus.