Treatment of 3rd molar-induced periodontal defects with guided tissue regeneration.

Recent reports provide evidence of increased attachment levels when using guided tissue regeneration (GTR) techniques for the treatment of periodontal defects. Periodontal defects frequently occur at the distal aspect of mandibular 2nd molars which are next to mesioangular impacted 3rd molars that have oral communication. The purpose of this study was to determine whether the use of GTR can enhance probing attachment levels (PALs) following extraction of mesioangular impacted third molars. 12 patients with bilateral soft tissue impacted mandibular 3rd molars entered this split mouth study. After extractions, the previously exposed distal root surface of the 2nd molars were debrided. The defects on the randomly selected experimental sites were covered with expanded polytetraflouro-ethylene (e-PTFE) membrane and the tissue was replaced to cover the membrane. Membranes were removed after 6 weeks. Control sites were treated identically except no membrane was placed. GI, P1I, PD, PAL and BOP records were obtained at 0, 3 and 6 months. The use of barrier material did not provide statistically-significant differences in PAL when comparing experimental versus control sites. Nevertheless, PAL gain was consistently greater at 3 and 6 months when GTR techniques were used in sites with deep impactions.

Effect of methylprednisolone on swelling after orthognathic surgery.

The effectiveness of methylprednisolone for the reduction of postoperative facial edema was evaluated by the computed tomographic examination of 39 patients who underwent either a Lefort I osteotomy or a transoral vertical osteotomy. Results of the CT scans, which were performed preoperatively and at 24 and 72 hours postoperatively, showed that in the LeFort I osteotomy patients methylprednisolone reduced the degree of facial edema by 61% at 24 hours postoperatively and by 10% at 72 hours. In the transoral vertical osteotomy patients methylprednisolone reduced the degree of facial edema by 38% at 24 hours postoperatively and by 45% at 72 hours. It was concluded that methylprednisolone is effective for the control and management of postoperative facial edema following orthognathic surgery.

Use of the segmented LeFort I osteotomy to correct severe extrusion of maxillary posterior teeth or tuberosities.

The segmented LeFort I osteotomy technique is presented as a surgical alternative for the correction of severe posterior maxillary vertical excess prior to prosthodontic procedures. It allows the extruded maxillary dento-osseous segment to be retained and a normal plane of occlusion to be reestablished. The superior visibility, accessibility, and versatility afforded by the segmented LeFort I osteotomy technique make it particularly suited to the correction of severe posterior maxillary excess.

Cheilitis glandularis.

Cheilitis glandularis is an uncommon lesion affecting the lower lip. Its origin remains obscure, although it is hypothesized that chronic irritation secondary to prolonged solar exposure causes hypertrophy of the labial salivary glands and eventual enlargement and ectropion of the lower lip. Although carcinoma of the lower lip has been reported in association with it, cheilitis glandularis is still considered a benign process that is adequately managed with conservative surgery. A case is presented and its surgical management is described.