Italian Oral Surgery最新文献

Objectives

In this article, the authors describe their use of a heterologous equine collagen bone substitute for a maxillary sinus lift, and they assess the efficacy of this biomaterial when utilized with autologous bone.

Materials and methods

Maxillary sinus lift is a common surgical procedure in dentistry practices. A wide array of biomaterials and bone substitutes are available for this purpose. Their efficacy varies in terms of the amount of de novo bone production observed at a given point in time. Nonetheless, histomorphometric analyses are not usually performed during routine clinical practice. The authors performed a sinus lift procedure in a 66-year-old male with the aid of an equine collagen graft. Eight months later, at the time of implant placement, two biopsies were collected for the histomorphometric analysis.

Results and conclusions

The histomorphometric analysis revealed spongy bone tissue undergoing remodeling, and 42% of the tissue was newly formed bone. There was no evidence of an inflammatory reaction.

Objectives

To examine the existing possibilities of controlling anxiety in the dental office practice. While pain control is not a problem with the current techniques of regional anesthesia and with the modern local anesthetics, control anxiety and fear is still a limit to the treatment of categories of patients such as children, disabled, psychiatric patients however, who have a strong emotional component. The use of sedation and anxiolysis also reduces the risk of medical complications in dental treatment of patients “at risk” for systemic diseases.

Materials and methods

The technique of inhalation analgesia and sedation with nitrous oxide and oxygen is described in detail, after analyzing the current classification of sedation: pharmacokinetics and toxicity of two gases, indications and contraindications, operative technique in the adult and pediatric dental patient using dedicated equipment, possible adverse effects and complications. The scientific literature on the safety aspects of the methodology and forensic in dentistry is then revised.

Results

The review confirms the efficacy and the absolute safety of the sedative technique inhaled nitrous oxide and oxygen, provided that it is not associated with other hypnotic or sedative drugs. The dental practitioner is considered suitable for inhaled conscious sedation in outpatient environment, even at a higher rate of 50% nitrous oxide. Although the technique does not present risks of cardiovascular and respiratory, current legislation requires dental practitioner adequate training in cardiopulmonary resuscitation (BLS-D).

Conclusions

The inhaled sedation with nitrous oxide and oxygen sedation technique is considered the first choice in dental outpatient environment, as it ensures fast action and equally rapid elimination of the effects, safety and clinical efficacy.

Aims

To present a case in which a removable partial prosthesis with resin-bonded attachments was used to replace an existing partial prosthesis that was esthetically unacceptable to the patient.

Materials and methods

The palatal surfaces of the upper teeth were prepared and an impression was taken. A framework with attachments was created and an impression was taken to create the removable prosthesis. Maxillo-mandibular relationships were assessed, and an impression of the edentulous ridges was taken.

Results and conclusion

The 16-month follow-up visit revealed successful rehabilitation. The use of resin-bonded attachments to retain a removable partial prosthesis is a viable option when reduction of biological and economic costs is an issue.

Objectives

The aim of this report is to present a case of maxillary radicular cyst and describe the surgical approach used to treat it.

Materials and methods

The patient, who was in good general health, presented with extruded lower and upper front teeth and a fixed prosthesis on elements 11 and 21. The orthopantomographic analysis revealed an osteolytic lesion in the upper jaw involving elements 13 through 22. The lesions was completely excised and the residual cavity filled with allograft bone.

Results and conclusions

The involved dental elements were subjected to root canal therapy and prepared for insertion of a permanent fixed zirconium and ceramic rehabilitation device. Treatment was planned around the possibility that the affected teeth might not be salvageable, and the lesioned areas were prepared to receive osteointegrated rehabilitation devices. After an evaluation period of 10 months, the clinical and radiological examinations revealed no contraindications to the final application of the prostheses.

Objectives

The aim of this report is to describe the surgical removal of a central osteoma located distally to tooth 47.

Materials and methods

The case report illustrates the technique used to remove a mandibular osteoma located distally to the second right molar. Thanks to the use of piezoelectric surgery, the approach to this lesion was minimally invasive. The lesion was excised and the surgical site cleaned.

Results

The radiographic control six months after surgery showed signs of healing with ossification of the residual bone gap.

Conclusions

The minimally invasive surgical approach and use of piezoelectric surgery are methods that dental surgeons should consider for cases in which there is a high risk of injury to surrounding neurovascular structures.

Objectives

Odontomas are benign, odontogenic tumors that manifest as self-limiting lesions; they are also included among the hamartomatous lesions. The authors report a case of an asymptomatic, intraosseous, central, compound odontoma.

Materials and methods

The report provides a detailed account of all phases of the diagnosis and surgical treatment of this tumor and highlights the usefulness of computed tomography in the diagnostic and surgical phases.

Results and conclusions

Surgical enucleation of compound odontomas produces positive results and reduces the risk of recurrence.

Objectives

To underline the possibility of performing the All-on-Four technique as a less invasive method and at the same time functional in rehabilitation of edentulous end atrophic arches.

Materials and methods

A number of studies in the medium term have demonstrated that All-on-Four technique can be an effective treatment for the rehabilitation of completely edentulous atrophic arches with fixed, screwed immediate prosthesis.

The principles of the technique consists in the placement of only four implants in the interforaminal region of the mandible and between the antero-mesial walls of maxillary sinuses in the superior jaw. The distal implants are tilted to avoid anatomical structures such as the maxillary sinus and the inferior alveolar nerve.

Results and conclusion

By this approach it is possible to avoid bone grafts and regenerative techniques with obvious advantages in biological terms and morbidity for the patient ensuring, at the same time, a good prognosis in the medium term.

The following paper describes the clinical protocol and surgical treatment of this technique.