Evaluation of osseous regeneration in alveolar distraction osteogenesis with histological and radiological aspects.

PURPOSE: Alveolar distraction osteogenesis is used for reconstruction of defects caused by trauma, periodontal disease, or congenital anomalies of the dentoalveolar region. PATIENTS AND METHODS: Alveolar distraction osteogenesis was performed on 10 patients with various vertical alveolar defects in the mandible. Panoramic radiographs and computed tomography (CT) scans were obtained preoperatively. At the end of 12 weeks, panoramic radiographs and dental CT scans were taken and the bony specimens were harvested from the distracted areas by trephine bur for histologic evaluation. After a year, the status of the distraction areas was assessed by radiographs and dental CT scans. Densities of the newly formed bone were evaluated at the twelfth week and the first year by dental CT scans. RESULTS: At the twelfth week, tubular bone was longitudinally oriented and osteoblastic activation was increased; the osseous density in the distraction chamber was higher than the original medullary bone density, which increased from the twelfth week to the first year. The regenerated bones were more dense (866.81) than the pre-existing medullary bone (309.66), and less dense than the pre-existing cortical bone (1641.12) at the twelfth week. Bone densities were seen to have increased gradually by the end of the first year (1089.99). CONCLUSION: Alveolar distraction osteogenesis can be used successfully for reconstruction of alveolar bone deficiencies caused by trauma or periodontal defects.

Endoscopic retrieval of dental implants from the maxillary sinus.

Endoscopic sinus surgery has been performed for various indications in maxillofacial surgical practices. It has been utilized for assessment of antral pathologies, removal of foreign bodies, orthognathic procedures, and treatment of facial fractures. In the cases presented, 3 dental implants which were displaced into maxillary sinuses were removed by endoscopic sinus surgery. Transantral endoscopic surgery is a reliable, minimally invasive method for retrieving displaced objects from the maxillary antrum with minimal complications.

Alternative bone expansion technique for immediate placement of implants in the edentulous posterior mandibular ridge: a clinical report.

PURPOSE: The aim of this study was to evaluate the effectiveness of a split-crest bone augmentation technique performed for immediate implant placement in thin edentulous posterior mandibular ridges. MATERIALS AND METHODS: In the present study, 125 implants were placed in posterior mandibular ridges of 30 patients. The mandibular buccal walls were split, expanded, and grafted with a combination of platelet-rich plasma and Cerasorb. The split segments were held in place by cortical bone screws. Before loading, periodontal status was checked, implant stability was evaluated with the Periotest, and panoramic radiographs and computerized tomography scans were obtained. Second-stage surgery (cover screw removal and healing abutment placement) was performed after 3 to 4 months. RESULTS: All implants osseointegrated successfully and underwent loading after 4 months. Optimal healing occurred 3 to 4 months earlier than the usual 6 to 9 months required, and no lip paresthesia was noted. DISCUSSION: Although onlay-inlay grafts, sandwich osteotomies, guided bone regeneration, piezoelectricity, and alveolar distraction have been indicated for augmentation in the posterior mandibular region, each of these techniques involves risks and complications. The crest-splitting bone expansion technique enables single-stage immediate implant placement and lateral ridge augmentation in thin crests and may prevent neurosensorial deficiencies. CONCLUSIONS: The split-crest surgical technique is a valid reconstructive procedure for sharp posterior mandibular ridges. If performed using platelet-rich plasma and Cerasorb, it can shorten the osseointegration period.