ABSTRACT
BACKGROUND: Partial edentulism in growing children due to aplasia or trauma poses a difficult situation to manage. We present a case of horizontal ridge augmentation in a growing patient who had trauma in childhood when it was too early to place implants. METHODS AND RESULTS: This patient had a history of trauma, at age 13, that resulted in mandibular fracture and loss of teeth #23-27. The definitive restorative treatment plan was postponed due to the patient's continued growth. At age 18, horizontal bone augmentation was performed in a severely resorbed anterior mandible. After 7 months of healing, 7-8 mm ridge augmentation was achieved, and three implants were placed. Soft tissue augmentation by free gingival graft was performed at implant second stage surgery 4 months later. CONCLUSIONS: When considering the timing of implant placement in adolescents, the clinician walks a fine line between waiting as long as possible to place the implants and racing against continued resorption of the edentulous alveolar ridge. 70/30 mineralized/demineralized cortical bone allograft and injectable platelet-rich fibrin mix combined with tenting screws and resorbable membranes are useful measures for horizontal ridge augmentation in growing patients. KEY POINTS: Why is this case new information? There are insufficient data available when considering implant treatment in younger patients. The present case was managed with a variation of the sausage technique described by Urban. The use of allograft, I-PRF, and tenting screws replaced the use of autogenous bone and resulted in exceptional results. What are the keys to the successful management of this case? Delaying treatment until after the critical growth period has passed. Adequate flap release, tension-free primary flap closure, and space maintenance through the use of tenting screws and tacking the membranes using tacking pins provided support for the grafted site. What are the primary limitations to success in this case? The continued growth may cause infra occlusion of the implant-supported bridge.
Subject(s)
Alveolar Ridge Augmentation , Dental Implants , Platelet-Rich Fibrin , Adolescent , Child , Humans , Dental Implantation, Endosseous , Alveolar Ridge Augmentation/methods , Wound HealingABSTRACT
This report describes the case of a male aged 28 years who presented with a chief complaint of discomfort and swelling in the mandibular right molar area. An incisional biopsy was performed with a preliminary differential diagnosis of periodontal abscess, fibrotic lesion, or odontogenic tumor. Subsequent excision of the lesion was performed and histologic analysis confirmed the diagnosis of myofibroma.
Subject(s)
Mandibular Neoplasms/diagnosis , Myofibroma/diagnosis , Adult , Diagnosis, Differential , Humans , Male , Mandibular Neoplasms/pathology , Mandibular Neoplasms/surgery , Mouth Mucosa/pathology , Myofibroma/pathology , Myofibroma/surgery , Odontogenic Tumors/diagnosis , Periodontal Abscess/diagnosisABSTRACT
Cemental separations and tears are secondary etiological factors that may lead to rapid periodontal destruction if the lesion communicates with the oral cavity and allows bacterial invasion. Although many cemental tears that occur on proximal surfaces can be diagnosed radiographically, separations on the facial or lingual surface that cannot be detected on radiographs may present a diagnostic dilemma. This article describes a case of lingual cemental separation on a maxillary incisor, with subsequent successful surgical correction utilizing an osseous graft.
