Survival of Dental Implants Placed in Iliac, Fibula, and Radial Forearm Flaps: A Comprehensive Review.

Various donor sites have been extensively documented in the literature for bone free flaps in head and neck reconstruction. These include the radius, scapula, rib, ilium, femur, fibula, and metatarsal bone. Among them, the fibula, ilium, and scapula are the most commonly used and studied for placing endosseous implants and for rehabilitation purposes. Each donor site has its own advantages and disadvantages, which depend on factors such as whether the reconstruction is for the maxilla or mandible, the required volume and length of the bone and soft tissue, and the location, extent, and type of defect that needs to be reconstructed. The aim of this current review is to comprehensively assess the existing literature on the survival of implants in fibula, radial, and iliac flaps.

Modifying gummy smile: a minimally invasive approach.

AIM: Excessive gingival display is a problem that can be managed by variety of procedures. These procedures include non-surgical and surgical methods. The underlying cause of gummy smile can affect the type of procedure to be selected. Most patients prefer minimally invasive procedures with outstanding results. The authors describe a minimally invasive lip repositioning technique for management of gummy smile. MATERIALS AND METHODS: Twelve patients (10 females, 2 males) with gingival display of 4 mm or more were operated under local anesthesia using a modified lip repositioning technique. Patients were followed up for 1, 3, 6 and 12 months and gingival display was measured at each follow up visit. The gingival mucosa was dissected and levator labii superioris and depressor septi muscles were freed and repositioned in a lower position. The levator labii superioris muscles were pulled in a lower position using circumdental sutures for 10 days. Both surgeon's and patient's satisfaction of surgical outcome was recorded at each follow-up visit. RESULTS: At early stage of follow-up the main complaints of patients were the feeling of tension in the upper lip and circum oral area, mild pain which was managed with analgesics. One month postoperatively, the gingival display in all patients was recorded to be between 2 and 4 mm with a mean of (2.6 mm). Patient satisfaction records after 1 month showed that 10 patients were satisfied with the results. Three months postoperatively, the gingival display in all patients was recorded and found to be between 2 and 5 mm with a mean of 3 mm. Patient satisfaction records showed that 8 patients were satisfied with the results as they gave scores between. Surgeon's satisfaction at three months follow up showed that the surgeons were satisfied in 8 patients. The same results were found in the 6 and 12 months follow-up periods without any changes. Complete relapse was recorded only in one case at the third postoperative month. CONCLUSION: This study showed that the proposed lip repositioning technique is an acceptable minimally invasive procedure in managing gummy smile. CLINICAL SIGNIFICANCE: A non-invasive procedure to avoid other complicated surgical procedures.