Augmentation of the atrophic maxillary alveolar ridge with hydroxyapatite granules in a Vicryl (polyglactin 910) knitted tube and simultaneous open vestibuloplasty.

A modified technique for augmentation of the severely atrophic edentulous maxillary alveolar ridge is described. The augmentation was carried out using a knitted polyglactin 910 mesh tube filled with porous hydroxyapatite granules, the tube being inserted through the access achieved by an open vestibuloplasty. The results of an in-vivo animal study showed that the absorption of the mesh was complete between 49 and 70 days. The clinical study included 11 patients in all of whom there was severe maxillary ridge atrophy and major prosthetic problems; follow-up was for a mean of 25 months. The procedure was without significant complication and produced a mean immediate absolute augmentation of 5.5 mm and substantially increased vestibular depth. A gradual reduction of ridge height was found over time. Nevertheless all patients showed significantly increased ability to wear their dentures. The technique is presented as a safe and predictable alternative to the use of bone grafts and titanium implants in these severely atrophic cases.

[Oroantral communication and its treatment]. / La communication bucco-sinusale et son traitement.

The most frequent cause of an oroantral perforation is the extraction of an upper molar. In this article, this for a dental practitioner important entity is discussed in detail. After the etiopathology, clinical and roentgenological diagnosis is discussed. As 6.5% of perforations closes spontaneously, the question is raised wether all perforations should be surgically treated. Those different surgical techniques are then described and emphasis is thereby laid on the difference between a mere perforation and a fistula.

[Subcutaneous emphysema of the oral floor during cleaning of a bridge fixed on an IMZ implant. Case report]. / Emphysème sous-cutane du plancher buccal au cours du nettoyage d'un bridge sur implant IMZ. Présentation d'un cas.

A case of subcutaneous emphysema following intraoral elimination of plaque and tooth shading, on a bridge fixed on implants, is presented. An instrument that produces a cleaning spray with a water-air-powder mixture was used. A few minutes after this cleaning procedure there was facial swelling. The patient experienced difficulties in breathing and in swallowing; symptoms of unilateral hearing loss were also noticed. The emphysema lasted for three days. Etiology, diagnosis, differential diagnosis, complications and management are discussed.

[Are Ag-points, gutta percha and amalgam still useful as apical filling materials?]. / Zijn Ag-stiften, gutta percha en amalgaam nog te gebruiken voor apikale afsluiting.

Nowadays Ag-points, gutta percha and amalgam are widely used as orthograde or retrograde root canal filling materials. The biocompatibility of these materials however remains debatable. Ag-points are easy to manipulate and when used together with an appropriate cement, offer an adequate seal. Yet an important disadvantage is the susceptibility to corrosion resulting in argyrosis and inflammatory reaction. Tissue cultures proved these corrosion by products to be highly cytotoxic. Other investigations, reported that the inflammatory tissue response seen with gutta percha, may be due to small amounts of additives included in gutta percha. Equally, there is no unanimity concerning the biocompatibility of amalgam, and the extent of corrosion and inflammatory reaction is possibly related to the composition of the amalgam used. Nevertheless in vivo studies demonstrated that, when freshly mixed amalgam, gutta percha or Ag-points are implanted in the femur of rats, mature bone was formed in direct contact with these materials.

[The use of biocompatible materials in apicoectomy]. / Het gebruik van biocompatibele materialen voor de apicotomie.

The use of more biocompatible materials in comparison with silver, gutta-percha and amalgam was introduced a decade ago. First titanium was used, later followed by alumina. Both clinical as well as radiological results favor their use. Yet it appears that the system is mainly confined to the maxillary front teeth and mandibular canines.

[Are Ag-points, gutta percha and amalgam still applicable for apical sealing?]. / Zijn Ag-stiften, gutta percha en amalgaam nog te gebruiken voor apikale afsluiting.

Nowadays Ag-points, gutta percha and amalgam are widely used as orthograde or retrograde root-filling materials. The biocompatibility of these materials however remains debatable. Ag-points are easy to manipulate and when used together with an appropriate cement, offer an adequate seal. Yet an important disadvantage is the susceptibility to corrosion resulting in argyrosis and inflammatory reaction. Tissue cultures proved these corrosion by products to be highly cytotoxic. Other investigations, reported that the inflammatory tissue response seen with gutta percha, may be due to small amounts of additives included in gutta percha. Equally, there is no unanimity concerning the biocompatibility of amalgam, and the extent of corrosion and inflammatory reaction is possibly related to the composition of the amalgam used. Nevertheless in vivo studies demonstrated that, when freshly mixed amalgam, gutta percha or Ag-points are implanted in the femur of rats, mature bone was formed in direct contact with these materials.

[Biocompatible materials for use in apicotomy]. / Het gebruik van biocompatibele materialen voor de apicotomie.

The use of more biocompatible materials in comparison with silver, gutta-percha and amalgam was introduced a decade ago. First titanium was used, later followed by alumina. Both clinical as well as radiological results favor their use. Yet it appears that the system is mainly confined to the maxillary front teeth and mandibular canines.