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ABSTRACT: Intranasal ectopic eruption is an uncommon condition. Even if an intranasal tooth can be completely asymptomatic, sometimes a variety of nasal signs and symptoms may be associated, ranging from mild nasal congestion to recurrent epistaxis and purulent rhinorrhea. As a consequence, surgical removal is often required. Endoscopic extraction of the intranasal tooth has been reported to present several advantages with respect to traditional surgical approaches and thus recommended as routine treatment in such cases. However, when a tooth is impacted next to the nasal floor, an alternative approach could be needed. We suggest an alternative transoral approach to perform extraction of intranasal teeth, aimed at avoiding excessive bone removal to reach the nasal floor area and preventing the complications related to traditional intraoral buccal or palatal approach. It could represent a reliable alternative to traditional removal in the Oral Surgery Department.
The Journal of craniofacial surgery 09/2011; 22(5):1944-6. · 0.81 Impact Factor
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ABSTRACT: In this multicenter study, submerged implants were prospectively followed to evaluate their long-term prognosis in irradiated patients. In a total of 77 patients treated for oral or neck cancer, 188 implants were consecutively placed. After a healing period, the successfully integrated implants were restored with 69 removable and 38 fixed restorations. The implants cumulative survival and success rates were evaluated over a period of at least 36 months. In addition, cumulative success rates were calculated for implant subgroups divided per implant site (mandible or maxilla), radiation dosage, and the time interval between the last irradiation and implant placement. During the healing period, 20 implants did not successfully integrate, whereas 168 implants were classified as success (including both survival and success rates). The analysis of implant subgroups showed slightly more favorable cumulative success rate for mandibular implants (98.4%) compared with maxillary implants (57.1%) and clearly better success rate for a radiation dosage minor of 50-Gy doses. A time greater than 12 months as interval between last irradiation and implant placement seems not to promote better clinical results.
The Journal of craniofacial surgery 03/2011; 22(2):443-5. · 0.81 Impact Factor
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ABSTRACT: Severity of injury resulting from facial firearm wounds varies according to many factors. The correct management of these lesions can be complex, and each can present peculiarities.In this paper, we report a case of a patient affected by a limited mouth opening caused by a penetrating injury of the mandible angle by a large-caliber bullet retained in the contralateral medial pterygoid muscle. The limited mouth opening did not allow the performance of traditional intubation, and the bullet's location in the muscle tissue imposed a careful surgical approach without determining any displacement of it and consequently more damages.
The Journal of craniofacial surgery 01/2010; 21(1):124-5. · 0.81 Impact Factor
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ABSTRACT: The extraction of deeply included third molars may cause multiple periodontal defects at the distal root of the second molar. Platelet-rich plasma (PRP) is a material containing autologous growth factors, which may be used in repairing and preventing periodontal complications at the distal root of the second molar adjacent to the extracted third molar. We have previously analyzed the effects of autologous PRP on periodontal tissues after extraction of the third molar in 18 young patients. In the current study, we investigated the clinical effects of a resorbable collagen membrane of porcine origin (Bio-Gide; Geistlich Biomaterials, Wolhusen, Switzerland) associated with PRP on bone regeneration after surgical avulsion of the inferior third molars in mesio-horizontal inclusion in comparison with the use of PRP alone.
Inclusion criteria were the presence of a pocket distal to the mandibular second molar with a probing depth greater than or equal to 7.5 mm and a probing attachment level greater than or equal to 6 mm, and a postextraction defect presenting with the vestibular and lingual cortical bone intact.
We show that although clinical results from the comparison of PRP alone versus PRP and resorbable membrane can be considered similar, from a histologic point of view, the association of PRP to Bio-Gide membrane showed earlier signs of bone maturation but not a higher grade of bone regeneration.
Journal of oral and maxillofacial surgery: official journal of the American Association of Oral and Maxillofacial Surgeons 11/2009; 67(11):2369-73. · 1.58 Impact Factor
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Journal of oral and maxillofacial surgery: official journal of the American Association of Oral and Maxillofacial Surgeons 12/2008; 66(11):2349-55. · 1.58 Impact Factor
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ABSTRACT: Success in implant dentistry also comes from the implant macrodesign and nanostructure of its surface. Titanium implant surface treatments have been shown to enhance osseointegration, maximize bone healing, and bone-to-implant contact for predictable clinical results. The aim of the study, was to evaluate the geometric macrodesign and the surface nanostructure of a novel dental implant full contact covering (FCC) obtained by electrochemical procedures. FCC implants were analyzed by scanning electronic microscope, profilometer, and x-ray photoelectron spectroscopy and compared with commercial sandblasted and sandblasted, large-grit acid-etched dental implants. Sample analysis allowed to distinguish the different implant macrodesigns, the step and the profile of the coils that cover the fixture, and the surface characteristics. FCC implant showed novel macro-characteristic of crestal module, coils, and apical zone compared with sandblasted and sandblasted and acid-etched dental implants. Moreover, the FCC nanostructure surface showed roughness values statistically higher than the 2 other surfaces, with a more homogeneity in a peaks and valleys arrangement. Finally, the x-ray photoelectron spectroscopy analysis detected differences between the examined surfaces, with the presence of several contaminants according to the different treatment procedures. Research on new macrostructures and nano morphology should result in a better qualitative and quantitative osseointegration response, with a predictability of the clinical results and long-term success of the implants.
Implant dentistry 10/2008; 17(3):309-20. · 1.51 Impact Factor
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Carl E Misch,
Morton L Perel,
Hom-Lay Wang,
Gilberto Sammartino,
Pablo Galindo-Moreno,
Paolo Trisi,
Marius Steigmann,
Alberto Rebaudi,
Ady Palti,
Michael A Pikos,
D Schwartz-Arad,
Joseph Choukroun,
Jose-Luis Gutierrez-Perez, Gaetano Marenzi,
Dimosthenis K Valavanis
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ABSTRACT: The primary function of a dental implant is to act as an abutment for a prosthetic device, similar to a natural tooth root and crown. Any success criteria, therefore, must include first and foremost support of a functional prosthesis. In addition, although clinical criteria for prosthetic success are beyond the scope of this article, patient satisfaction with the esthetic appearance of the implant restoration is necessary in clinical practice. The restoring dentist designs and fabricates a prosthesis similar to one supported by a tooth, and as such often evaluates and treats the dental implant similarly to a natural tooth. Yet, fundamental differences in the support system between these entities should be recognized. The purpose of this article is to use a few indices developed for natural teeth as an index that is specific for endosteal root-form implants. This article is also intended to update and upgrade what is purported to be implant success, implant survival, and implant failure. The Health Scale presented in this article was developed and accepted by the International Congress of Oral Implantologists Consensus Conference for Implant Success in Pisa, Italy, October 2007.
Implant Dentistry 04/2008; 17(1):5-15. · 1.05 Impact Factor
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ABSTRACT: Ranulas have been managed by various surgical methods, and the optimal treatment is still controversial. The aim of this study was to analyze a group of 124 surgically treated patients with intraoral ranula to assess 3 different methods: sublingual gland removal combined with the ranula excision, conventional marsupialization, and a variant of the marsupialization technique usually performed in our departments. Recurrence rate was 0% after radical treatment, 25.8% after marsupialization, and 12% after modified marsupialization. We suggest that conservative methods should always be considered as treatment of superficial oral ranulas. The modification of the conventional marsupialization by suturing the edges of the pseudocyst before unroofing of the lesion was demonstrated to be a useful technical strategy that simplifies and accelerates the surgical procedures and probably contributed to preventing recurrences.
Journal of Craniofacial Surgery 02/2008; 19(1):286-90. · 0.82 Impact Factor
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ABSTRACT: The aim of this report is to demonstrate the outcome of implant rehabilitation in the anterior maxilla. Aesthetics in implantology results from the correct execution of many rehabilitation phases: presurgical planning, surgical and prosthetic phases, and case management. In the presurgical phase, preexisting anatomical conditions and prosthetic evaluations influence the choice of regenerative techniques. Correct presurgical planning, in order to realize surgical and prosthetic procedures, is the most important phase to obtain an aesthetic result. Only a successful anatomical correction of hard and soft tissues is able to assure a satisfying therapeutic achievement involving many operative steps and the rigorous observance of recovery timing. A guided bone regeneration technique with a staged approach was used in conjunction with implant replacement.
Implant Dentistry 01/2008; 16(4):349-55. · 1.05 Impact Factor
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ABSTRACT: The aim of this study was to identify a correct clinical, surgical, and prosthetic management of endosseous implants replacing missing teeth in the anterior maxilla, achieving predictable aesthetic outcomes. Placement of immediate post-extraction implants without incisions or flap elevation is one of the surgical treatment options able to improve the healing and regenerative potentials of the fresh socket.
Fifty-five patients (33 men, 22 women), ranging in age from 19 to 57 years (mean 29), were selected for this study. All the patients were not smokers, no bruxers, presented stable soft tissue conditions, an acceptable occlusion, and the absence of pathologies that would contraindicate bone healing. Patients were treated with implants made by 2 manufacturers: Institute Straumann, Walderburg, Switzerland and Friadent, Mannheim, Germany. A total of 87 implants were placed immediately after each failing tooth had been removed. The temporary restoration was placed 3 months after implant placement, and the final restoration was placed 4 months from the surgical procedure. The patients were evaluated clinically and radiographically at implant placement, and 2, 4, 18, and 24 months post-insertion.
At 24 months, only 3 implants were lost (2 in male patients;1 in female patient). All of these failed implants did not achieve osseointegration. The overall success rate was 96.6%, with an implant failure rate of 3.4%, all prior to restoration.
The immediate placement in the anterior maxilla fresh extraction sockets without incisions or flaps elevation is a surgical option that can ensure ideal peri-implant tissues healing, preserving the presurgical gingival and bone aspects. For a predictable aesthetic result, the most important aspect seems to be the height and thickness of the buccal bone wall, which remain after immediate placement of the fixture.
Implant Dentistry 04/2007; 16(1):54-65. · 1.05 Impact Factor
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ABSTRACT: Facial nerve injuries are rare complications after orthognathic surgery. A literature review shows that such damages can develop with various mechanisms and are usually transient. Two cases of delayed facial paralysis after mandibular osteotomy with spontaneous recovery are reported.
Journal of Craniofacial Surgery 12/2005; 16(6):1110-5. · 0.82 Impact Factor
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ABSTRACT: Gorham's disease is a rare disorder characterized by spontaneous and progressive osteolysis of one or more skeletal bones. The radiographic findings associated with Gorham's disease are particularly dramatic, as in some cases a complete resorption of the involved bone can occur, leading to the definition of phantom bone, vanishing bone, or disappearing bone disease.
A 24-year-old female patient with a previous diagnosis of periodontal disease and progressive mandibular alveolar bone loss was referred to our Oral Medicine section. The initial radiographic picture showed infrabony defects and horizontal bone loss.
After further extensive local and systemic evaluation, including histopathological, laboratory and imagine techniques investigations, the patient was diagnosed to be affected by Gorham's disease. Meanwhile the progression of the osteolytic process had caused the loosening of all the left mandibular teeth and a pathologic fracture. Appropriate medical therapy was successful in stabilizating the resorptive process, with no evidence of further progressive disease.
When Gorham's disease involves the mandible, the role of the periodontologist is extremely important in diagnosing promptly the disorder and preventing the functional and aesthetic consequences of advanced and extensive bone loss. Gorham's disease should be included among the pathologic entities mimicking periodontal disease on radiograph, such as inflammatory disease (e.g. osteomyelitis), endocrine disease (e.g. hyperparathyroidism), intra-osseous malignancies or metastases, lymphoma, histiocytosis X, mainly eosinophilic granuloma, infective process (e.g. tuberculosis and actinomycosis), odontogenic tumours.
Journal Of Clinical Periodontology 10/2005; 32(9):1022-6. · 3.00 Impact Factor
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ABSTRACT: The extraction of mesioangular impacted third molars may cause multiple periodontal defects at the distal root of the second molar. Platelet-rich plasma (PRP) is a material containing many autologous growth factors that may be used in repairing and preventing periodontal complications at the distal root of the second molar adjacent to the extracted third molar.
We analyzed the effects of autologous PRP on periodontal tissues after extraction of the third molar in 18 young patients (age, 21-26 years). Inclusion criteria were the presence of a pocket distal to the mandibular second molar with a probing depth>or=7.5 mm and a probing attachment level>or=6 mm.
We observed, at 12 weeks after surgery, a notable reduction in the probing depth and an improvement in the probing attachment level in those cases treated with PRP compared with the controls, as well as formation of new bone tissue in the bone defect.
We showed that PRP is effective in inducing and accelerating bone regeneration for the treatment of periodontal defects at the distal root of the mandibular second molar after surgical extraction of a mesioangular, deeply impacted mandibular third molar.
Journal of Oral and Maxillofacial Surgery 06/2005; 63(6):766-70. · 1.64 Impact Factor
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ABSTRACT: This article presents the use of stereolithography in oral implantology. Stereolithography is a new technology that can produce physical models by selectively solidifying an ultraviolet-sensitive liquid resin using a laser beam, reproducing the true maxillary and mandibular anatomic dimensions. With these models, it is possible to fabricate surgical guides that can place the implants in vivo in the same places and same directions as those in the planned computer simulation. A 70-year-old woman, in good health, with severe mandibular bone atrophy was rehabilitated with an over-denture supported by 2 Branemark implants. Two different surgical planning methods were considered: 1) the construction of a surgical guide evaluating clinical aspects, and 2) the surgical guide produced by stereolithographic study. The accuracy of surgical planning can reduce the problems related to bone density and dimensions. Furthermore, the stereolithographic study assured the clinicians of a superior location of fixtures in bone. Surgical planning based on stereolithographic technique is a safe procedure and has many advantages. This technologic advance has biologic and therapeutic benefits because it simplifies anatomic surgical management for improved implant placement.
Implant Dentistry 07/2004; 13(2):133-9. · 1.05 Impact Factor
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ABSTRACT: This study evaluated the effectiveness of a protocol using platelet-rich plasma (PRP) to prevent bleeding after dental extraction in patients treated with anticoagulant oral therapy.
Forty patients with mechanical heart-value replacement who were treated with anticoagulant oral therapy were selected for the study. Each patient was treated with PRP gel placed into residual alveolar bone after extraction without heparin administration after suspension of oral anticoagulant drugs (36 hours).
Only 2 patients reported hemorrhagic complications (5%). Sixteen patients (40%) had mild bleeding that was easy to control with hemostatic topical agents; this mild bleeding terminated completely 1 to 3 days after the surgical procedures. The remaining 22 patients (55%) presented with adequate hemostasis.
Oral surgery in heart surgical patients under oral anticoagulant therapy may be facilitated with PRP gel. Its use is an advanced and safe procedure. This biological and therapeutical improvement can simplify systemic management and help avoid hemorrhagic and/or thromboembolic complications.
Journal of Oral and Maxillofacial Surgery 12/2003; 61(11):1275-8. · 1.64 Impact Factor
