RESUMO
PURPOSE: The present retrospective cohort study compared the subjective inferior alveolar nerve (IAN) function after distraction osteogenesis (DOG) and bilateral sagittal split osteotomy (BSSO) in mandibular advancement surgery. MATERIALS AND METHODS: Treatment consisted of correction of a retrognathic mandible using DOG (30 patients) or BSSO (35 patients). Subjective IAN function was recorded using a questionnaire 1 year after surgery. A total of 130 IANs were evaluated. RESULTS: In 37 nerves (28.5%), an IAN disturbance was observed. In this group of 37 nerves, BSSO had been performed in 26 (70.3%) and DOG in 11 (29.7%). After eliminating confounders (eg, age, amount of advancement, gender), no significant difference (odds ratio 0.652, 95% confidence interval 0.221 to 1.920) was found. Age was significantly related to subjective IAN disturbances for women but not for men. This was seen in women older than 22 years and increased for women older than 36 years to an odds ratio of 22.8 (95% confidence interval 2.580 to 201.488). Satisfaction also correlated with age, independent of gender. CONCLUSION: No difference was found in subjective IAN disturbances after 1 year between DOG and BSSO for lengthening the mandible.
Assuntos
Avanço Mandibular/métodos , Nervo Mandibular/fisiologia , Osteogênese por Distração/métodos , Osteotomia Sagital do Ramo Mandibular/métodos , Adolescente , Adulto , Fatores Etários , Queixo/inervação , Estudos de Coortes , Fatores de Confusão Epidemiológicos , Feminino , Seguimentos , Humanos , Lábio/inervação , Masculino , Mandíbula/cirurgia , Pessoa de Meia-Idade , Procedimentos Cirúrgicos Ortognáticos/métodos , Satisfação do Paciente , Retrognatismo/cirurgia , Estudos Retrospectivos , Fatores Sexuais , Distúrbios Somatossensoriais/etiologia , Tato/fisiologia , Adulto JovemAssuntos
Mandíbula/cirurgia , Osteogênese por Distração/métodos , Osteotomia/métodos , Feminino , Humanos , MasculinoRESUMO
We have evaluated the survival of dental implants in extremely atrophic edentulous maxillas after autogenous bone grafting. We compared two techniques: the Le Fort I down-grafting procedure and conventional raising of the sinus floor with onlay bone grafting. Twenty-seven consecutive patients had their atrophic maxillas reconstructed, 10 of whom were treated with a Le Fort I osteotomy with down-grafting and interpositioning of bone, and 17 by raising the sinus floor and onlay grafts. All implants were placed 5-6 months after grafting. There was no difference in the survival of implants between the two groups. The choice of grafting technique will therefore be based primarily on the interarch relations and the need for soft tissue support.
Assuntos
Aumento do Rebordo Alveolar/métodos , Transplante Ósseo/métodos , Implantação Dentária Endóssea , Maxila/cirurgia , Seio Maxilar/cirurgia , Procedimentos Cirúrgicos Pré-Protéticos Bucais/métodos , Osteotomia de Le Fort/métodos , Perda do Osso Alveolar/cirurgia , Placas Ósseas , Substitutos Ósseos , Distribuição de Qui-Quadrado , Falha de Restauração Dentária , Feminino , Humanos , Arcada Edêntula/cirurgia , Masculino , Doenças Maxilares/cirurgia , Pessoa de Meia-Idade , Osteotomia de Le Fort/instrumentaçãoRESUMO
OBJECTIVE: The purpose of this study was to evaluate the potential benefit of an ultrasonic device in apical surgery on the outcome of treatment. STUDY DESIGN: A randomized prospective design was used in a standardized treatment protocol. Patients were allocated to treatment with an ultrasonic device (P-Max Newtron) or treatment with a bur in an otherwise similar protocol. One year after treatment the results were evaluated by 2 oral and maxillofacial surgeons who were blinded for the therapy. RESULTS: Out of a total group of 399 patients who were included in the study, adequate follow-up could be obtained in 290 patients. The overall success rate in the ultrasonic group was 80.5% and in the group treated with a bur 70.9% (P = .056). In molars, the difference in success rate was significant (P = .02). CONCLUSION: The use of an ultrasonic device in apical surgery improved the outcome of treatment. In molars this effect was significant.
