Evaluation of the Safety and Clinical Efficacy of Allogeneic Bone Grafts in the Reconstruction of the Maxilla and Mandible.

INTRODUCTION: Loss of teeth caused by inflammatory processes or trauma is one of the causes of bone atrophy of the maxilla alveolar process and the alveolar part of the mandible. Often, restoring these deficiencies with dental implants requires additional reconstructive procedures. Methods using autogenous, allogeneic, xenogeneic, or synthetic bone grafts are commonly used. MATERIALS AND METHODS: Patients who had bone atrophy of the maxilla or mandible were qualified for deep-frozen transplantation, radiation-sterilized allogeneic bone from the Bank of Tissues in the form of cortico-spongy bone blocks and spongy bone granules. Bone blocks were stabilized with titanium screws, and the free spaces were additionally supplemented with chips from autogenous bone and covered with allogeneic pericardial transplants and platelet-rich fibrin (PRF). Four months after the bone reconstruction, titanium implants were placed, and then after the osseointegration period prosthetic restoration was performed. Clinical safety and efficacy were determined by analyzing the quantity and quality of the reconstructed bone tissue and the degree of resorption was assessed. RESULTS: The surgical procedures performed confirmed the safety and efficacy of biological material in the reconstruction of the jaw. In two cases, the treatment was not effective and the transplant was removed. In the remaining cases, titanium implants were successfully placed and loaded with prosthetic works. DISCUSSION: Implanting deeply frozen, radiation-sterilized bone is a safe and effective surgical procedure. As an appropriate technique for fixing the allogeneic bone block, additional use of autogenous bone chips and PRF allows one to obtain a good, long-lasting clinical result.

Prosthetic Rehabilitation of Patients After Surgical Treatment of Maxillary Tumors with Respect to Upper Airway Protection.

As a consequence of surgical treatment of maxillary tumors, a connection between oral and nasal cavities is formed, which leads to serious functional disorders, manifested by inability to normally ingest food, proper speech articulation, and to respiratory route disorders and upper airway inflammation. These morphological and functional disorders are intensified by adjunctive radio- or chemotherapy. The aim of this paper is to present different possible methods of rehabilitation, including application of interim obturators and individually planned prosthetic restorations to improve respiratory efficiency in patients after extensive maxillary resections. In the course of prosthetic treatment, cooperation with the laryngologist to consider every aspect of chronic paranasal sinusitis, accompanied by concurrent inflammation of oral, nasal, or laryngeal mucous membranes, was of paramount importance. Based on the quality of life questionnaire, used in this study, evident improvement in the masticatory efficiency, speech articulation, and respiration was observed. Particularly good effects were obtained in edentulous patients, in whom implant-prosthetic treatment was possible to apply. Comprehensive and multidisciplinary care of postoperative patients greatly contributes to their better quality of life and facilitates their return to prior living conditions, as well as to occupational and family lives.

Coronoid-condylar index in assessing of mandibular coronoid hyperplasia. Preliminary results.

PURPOSE: The purpose of this study was to define the coronoid-condylar index (CCI). MATERIALS AND METHODS: The material for studies comprised 26 patients. Thirteen patients were treated for bilateral coronoid hyperplasia. The remaining 13 patients were included in the control group. Based on 3D CT measurements, the coronoidcondylar index (CCI) was calculated and assessed statistically. RESULTS: In patients with coronoid hyperplasia mean CCI was 1.25, while in the control group it was 1.00. CONCLUSION: The proposed CCI can be used for the evaluation of anomalies of the mandibular coronoid processes.