Τετάρτη 28 Δεκεμβρίου 2022

three-dimensional airway changes after fibula flap reconstruction for benign and malignant tumours in the anterior mandible

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Surgical treatment of tumours in the anterior mandible and surrounding tissues may result in defects which can be restored by a fibula free flap. The upper airway may change during this process. The purpose of this retrospective study was to evaluate upper airway changes after fibula free flap reconstruction. A total of 37 patients who underwent anterior mandibulectomy and fibula free flap reconstruction between 2012 and 2020 were recruited. Patients with benign and malignant tumours involving the anterior mandible were included. (Source: International Journal of Oral and Maxillofacial Surgery)
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Reconstruction using a submental island flap combined with mylohyoid muscle as a reliable surgical strategy after rim mandibulectomy for the management of stage 3 medication-related osteonecrosis of the mandible

alexandrossfakianakis shared this article with you from Inoreader
The purpose of this study was to evaluate the clinical outcomes of patients with stage 3 mandibular medication-related osteonecrosis of the jaw (MRONJ) treated using a submental island flap in combination with mylohyoid muscle reconstruction after rim mandibulectomy. The medical records of 12 patients treated between January 2019 and April 2022 were analysed retrospectively. Primary wound healing was assessed as the maintenance of full mucosal coverage without signs of infection at 6 months postoperatively. (Source: International Journal of Oral and Maxillofacial Surgery)
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Individual “alveolar phenotype” limits dimensions of lateral bone augmentation

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Abstract

Aim

Alveolar ridge resorption following tooth extraction often renders a lateral bone augmentation inevitable. Some patients, however, suffer from severe early (during graft healing, Eres) and/or late (during follow-up, Lres) graft resorption. This study explored the hypothesis that the "individual phenotypic dimensions" may partially explains the degree of such resorptions.

Material & methods

Patients who underwent a guided bone regeneration (GBR) were screened for inclusion according to the following criteria: (1) a relatively symmetrical maxillary arch, (2) an intact contra-lateral alveolar bone dimension, (3) the presence of a pre-operative cone-beam CT (CBCT), (4) a CBCT taken immediately after GBR, and (5) at least one CBCT scan ≥6 months after surgery. CBCT scans from different timepoints were registered and imported into Mimics software (Materialise, Leuven, Belgium). Bone dimensions of the contra-lateral site of the augmentation, representing the "individual phenotypical dimension of the alveolar crest" (IPD) were super-imposed on the augmented site and registered accordingly. As such, Eres and Lres could be measured over time, in relation to the IPD (in 2D; per millimetre apically from the alveolar crest, in the centre of the GBR), as well as in 3D (the entire GBR, 2 mm away from the mesial, distal, and apical border for standardisation).

Results

A total of 17 patients (23 augmented sites) were included. After Eres, the outline of the augmentation was in general located ±1 mm outside the IPD, but ≥1,5 years after GBR, it further moved towards the IPD (85% within 0.5 mm distance).

Conclusions

Within the limitations of this study the results indicate that the dimensions of a lateral bone augmentation are defined by the "individual phenotypic bone boundaries" of the patient.

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Clinical reproducibility of different centric relation recording techniques in edentulous individuals: an observational cross sectional study

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Abstract

Purpose

To assess the reproducibility of four different centric relation (CR) recording techniques, and time spent performing each technique in edentulous individuals.

Materials and Methods

Four techniques were assessed: extraoral gothic arch tracing (EOGA), intraoral gothic arch tracing (IOGA), deglutition (D), and frontal manipulation with tongue elevation (FMTE). Twelve subjects participated in the study; four technique records were performed on each volunteer by the same operator. Each record was repeated three times, in the same period of the day, with a 30 min interval between each technique. The reproducibility of each technique was assessed by the tri-dimensional displacement of the position of the condylar housing (mandible condyle) to the wall of the condylar guide (glenoid cavity) in the semi-adjustable articulator (anteroposterior, mediolateral, and superior-inferior). The time spent on each technique was timed in seconds (from the beginning of each technique until the wax occlusion fixation). The analysis of variance and the Tukey test were performed for anteroposterior displacement (two-way) and for time spent on CT recording techniques (one-way) (α &l t; 0.05). Regarding mediolateral and superior-inferior displacements, the non-parametric Kruskal-Wallis was performed for the comparison between recording methods, while the Mann-Whitney test was performed for the comparison between sides (α < 0.05).

Results

The factor recording technique interfered with the anteroposterior displacement (ANOVA: α < 0.001; F = 11.396). The technique D (right side: 3.78 ± 0.69 mm; left side: 3.45 ± 0.74 mm) showed a statistically significant difference compared to the other techniques (EOGA: right side: 3.00 ± 0.00 mm; left side: 3.00 ± 0.00 mm; FMTE: right side: 2.81 ± 0.52 mm; left side: 2.82 ± 0.79 mm; IOGA: right side: 2.90 ± 0.65 mm; left side: 3.12 ± 0.44 mm). The time spent on the recording technique influenced the results (ANOVA: α < 0.001; F = 21.118). The IOGA (340.40 ± 163.41 seconds) and EOGA (285.93 ± 133.84 seconds) required more time compared to the D (86.00 ± 34.33 seconds) and FMTE (101.33 ± 36.72 seconds) techniques.

Conclusion

Graphic recordings showed better reproducibility and accuracy of the position of the centric relation.

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Esthetic and clinical outcomes after immediate placement and restoration: Comparison of two implant systems in the anterior maxilla—A cross‐sectional study

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Abstract

Aim

To assess the esthetic and clinical performance of a novel self-tapping implant system for single-tooth restorations in the esthetic zone after immediate placement and provisionalization.

Materials and Methods

This cross-sectional study included 52 patients contributing a total of 52 immediately placed and restored implants with ≥12 months after functional loading, comparing two different implant systems: Straumann® BLX (Institut Straumann AG, Basel, Switzerland; 25 patients) and Ankylos® (Dentsply Sirona, Hanau, Germany; 27 patients). As the primary outcome measure, peri-implant tissue esthetics were assessed by means of pink esthetics score (PES) rated by three independent clinicians. Moreover, as secondary outcome measures, the peri-implant tissue health was assessed by means of bleeding on probing, probing depth, and suppuration. Apart from that, the modified plaque index, keratinized mucosa width, and the presence of mucosal recessions were also assessed. When clinical signs suggested the possibility of peri-implantitis, radiographs were indicated to assess progressive bone loss.

Results

The mean PES ratings were 12.10 ± 1.10 for Ankylos versus 11.2 ± 1.86 for BLX, both achieving good esthetic results without significant differences (p = 0.143). There were no differences among most clinical parameters (plaque, bleeding on probing, probing depth, peri-implant mucosal recession), although peri-implant mucositis was present in one-third of the cases. The inter-rater agreement on esthetics was not significant (p < 0.250).

Conclusion

Within the limitations of the present study, it was concluded that the use of either BLX or Ankylos implant systems was associated to comparable peri-implant health and good pink esthetic outcomes during immediate implantation and restoration protocols, for at least 12 months.
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