Management of Compromised Ridges: A Case Report

Complete denture therapy is an age old form of dental treatment. Ridge atrophy poses a clinical challenge towards the fabrication of a successful prosthesis. Extreme resorption of the maxillary and mandibular denture bearing areas results in sunken appearance of cheeks, unstable and non retentive dentures with associated pain and discomfort. This article describes the step by step rehabilitation procedure of a patient with atrophic ridges using a hollow maxillary complete denture with cheek plumpers attached to it and the recording of neutral zone to ensure a stable mandibular denture.     

Customized Cheek Plumper with Friction Lock Attachment for a Completely Edentulous Patient to Enhance Esthetics: A Clinical Report

Prosthetic rehabilitation of a completely edentulous patient should never be restricted to the replacement of missing teeth. The ultimate aim of complete denture treatment should be restoration of the full range of oral functions and esthetics. Slumped cheeks are always a concern for esthetically demanding complete denture patients. This article describes a simple, scientific, cost‐effective technique to improve facial esthetics in a completely edentulous patient with the help of a cheek plumper. The technique used here implements the concept of neutral zone to precisely determine the amount of space available for the cheek plumper. The simple friction lock attachments that retained the cheek plumpers on the prosthesis were also fabricated after determining the space available in the appropriate areas. Thus an effort was made to keep the cheek plumpers unobtrusive yet effective to ensure complete integration of the prosthesis into the stomatognathic system.     

Magnet Retained Cheek Plumper to Enhance Denture Esthetics: Case Reports

Handicap due to the loss of teeth in patients can be severe due to the impairment of masticatory function and facial disfigurement leading to negative psychological impact on the individual. To combat this, apart from the regular measures of positioning the teeth to obtain lip support, excellent denture esthetics can be achieved by providing additional support to the slumped tissues. This clinical report highlights a technique to provide support for sunken cheeks using detachable acrylic cheek plumpers, retained using iron–neodymium close-field magnets. The use of these magnets is a modification from the conventional technique of supporting the slumped tissues.     

Neutral zone. An anatomic space which is often neglected while fabricating removable complete dentures

When designing complete dentures, consideration should not only be given to the occlusal concept but also to the occlusal system as a whole. An important part of that system is the position of the artificial teeth. This prosthetic part of the occlusal system is directly related to the tongue, the floor of the mouth, the cheeks and the lips. The artificial teeth of the mandibular dentures have to be positioned in the so-called 'neutral zone' of the edentulous mandible. The neutral zone is the stress-free area between the tongue on one side and, on the other side, the mimic muscles, which are responsible for the movement of the lips and cheeks. Moreover, the maxillary posterior artificial teeth and the supporting acrylic surfaces of the maxillary denture have an important function in providing support for the upper lip and cheeks in order to prevent a 'denture look' appearance.     

Frequent, low-dose, improved-contrast radiographic images with the use of narrow x-ray beams.

Conventional dental radiography uses 60 mm-wide x-ray beams that irradiate the cheeks. To reduce the dose of radiation, months or years can separate serial films and prevent short-term assessment of disease activity. A technique that uses a 13 mm narrow x-ray beam that avoids the cheeks was compared with a wide x-ray beam by using a contrast phantom, a cheek substitute, and a serially sectioned dry mandible. Phantom contrast was measured densitometrically at 50 kVp, 65 kVp, and 90 kVp with wide x-ray beam and narrow x-ray beam and with and without cheek scatter. The narrow x-ray beam without cheek scatter technique resulted in better contrast (0.06 to 0.04 OD) than the wide x-ray beam with cheek scatter (0.05 to 0.02 OD). A posterior interdental crest was irradiated and a trabecular rod was removed. The bone detail was best in the images produced with the narrow x-ray beam without cheek scatter. The area of the narrow x-ray beam was 4.35% of the area of the wide x-ray beam with approximately 5% of the dose. Short-interval (weekly), very-low-dose radiography should be possible with improved contrast to assess alveolar bone changes.     

Morphologic evidence of muscle influence on dental arch width.

Tests on hypotheses to explain changes in arch width during correction of distoclusion with the activator appliance used in this study showed that statistically significant increases occurred in both maxillary and mandibular arch widths during treatment. The increase was substantially larger in the maxilla than in the mandible. The arch width showed no statistically significant decrease after completion of treatment. The activator designed for this study affected orofacial muscle balance. The findings suggest that there were changes in the influence of tongue and cheek muscles on the maxilla. Available experimental as well as clinical data support the assumption that the tongue had taken a higher and more anterior position in the palatal area and that the tension of the cheek muscles was reduced relative to the posterior part of the maxillary dental arch.     

Changes in lip, cheek, and tongue pressures after rapid maxillary expansion using a diaphragm pressure transducer

The purpose of this study was to investigate the changes in pressures that are exerted to maxilla by the tongue, lip, and cheek before and after expansion and during the retention period. Twelve patients (five males, seven females) with maxillary transverse deficiencies were randomly selected. The first pressure measurements were made before expansion using a diaphragm pressure transducer. The second measurements were made right after the maxillary expansion procedure, which lasted about 20 days. The expansion devices were replaced with retention devices, and measurements were made at the end of the first, second, and third months of retention. Pressure values on the buccal side of upper first molar and incisor increased significantly right after expansion but started decreasing during retention. The values at the end of the third month of retention were similar to the preexpansion values (P < .05). Tongue pressures on the lingual side of the upper first molar and upper incisor decreased significantly with expansion but started increasing after the expansion procedure. Even at the end of the third month of the retention period, the values were not similar to the preexpansion values (P < .05). These values show that the cheeks and lips almost adapt to the new position of dental arches at the end of the third month, whereas tongue adaptation took comparatively longer.     

上颌第一磨牙近中颊根MB2根管研究

目的：观测上颌第一磨牙近中颊根MB2的存在率,根管口的位置及形态。方法：采用牙体硬组织切片机对拔除的上颌第一磨牙进行连续横断切片,并在显微镜下观测其近中颊根第二根管存在情况,根管口位置及根管形态。结果：220个上颌第一磨牙中有81个存在近中颊根第二根管,存在率为36．81％,近颊根第二根管口横切面形态为圆形或卵圆形,近颊第二根管口与近颊第一根管口,远颊根管口和腭根管口的位置关系呈斜四边形。结论：上颌第一磨牙近中颊根第二根管存在率较高,其开髓形状应为斜四边形。     

螺旋扩大器快速打开腭中缝后口颌系统横向变化的研究

目的 探讨支架半托式螺旋扩大器快速打开腭中缝后,口颌系统中牙齿、颌骨、肌肉的变化.方法 20例上颌骨发育不足伴上颌牙弓狭窄患者在快速打开腭中缝前后拍摄后前位头颅定位片,进行测量分析,同时测量颊肌压力变化.结果 上颌中切牙冠间距和根间距分别增大了（4.34±1.18） mm和（3.74±1.75） mm;上颌第一磨牙间距和上颌骨宽度分别增大了（7.83 ±1.49） mm和（5.07±1.07） mm;上颌尖牙间宽度增大了（6.79±1.82） mm;牙槽嵴间距、前鼻嵴间距和鼻腔宽度分别增大了（4.32±0.98） mm、（3.69±0.83） mm和（2.08±0.72） mm;双侧上颌第一磨牙处颊肌压力分别增大了（857.01±300.96） Pa和（772.06±296.93）Pa.结论 支架半托式螺旋扩大器可以快速打开腭中缝,牙齿、颌骨、颊肌压力均发生了显著变化.     

Extensibility characteristics of human cheek--visco-elastic properties

Using a hydraulic bellows system mounted on a maxillary partial denture, continuous force-displacement data were taken in an edentulous area in the maxillary bicuspid-molar region on ten adults. Both loading and unloading force-displacement curves showed three segments. Two visco-elastic properties - hysteresis and relaxation - were consistently evident. The maximum difference in force-magnitude of the hysteresis loop was 1.02 g. A pre-conditioning phenomenon of the cheek tissue, evidence by a reduction of the area of the hysteresis loop, was observed in a series of repeated runs. The significance of the study was that: (1) in some individuals, the cheek could be displaced, by expansion of the molars, up to 1 mm into a second stable position; and (2) the relaxation phenomenon suggests a limited adjustive capacity in cheek stiffness.     

上唇系带附着异常及其治疗方法研究进展

上唇系带位于面部美学区,将唇、颊黏膜连接到牙槽黏膜、牙龈和骨膜,以便能够适应正常的唇活动。其附着异常与母乳喂养困难、菌斑堆积、儿童龋病、牙周疾病的发生和进展、上颌中切牙间隙等密切相关。因此,及时对异常附着的上唇系带进行治疗至关重要。文章对上唇系带的发育与解剖结构、上唇系带附着异常的临床诊断与分类方法、上唇系带附着异常与上颌中切牙间隙的关系以及上唇系带附着异常的治疗方法等几方面内容做一综述。     

�ϴ�ϵ�������쳣�������Ʒ����о���չ

??The maxillary frenum locates in the facial aesthetic area?? which is a mucous membrane fold that attaches the lip and the cheek to the alveolar mucosa?? the gingiva?? and the underlying periosteum and adapt to the mobility of lip. Its abnormal adhesion is closely related to the breastfeeding difficulties?? plaque accumulation?? child caries??the development of periodontal disease and maxillary midline diastema.  Therefore??it is important to treat abnormal adhesion of maxillary labial frenum timely. This article reviews the development and anatomic structure of maxillary labial frenum??the clinical classification and diagnostic methods of the abnormal adhesion of maxillary libial frenum??the relationship between abnormal adhesion of the maxillary labial frenum and maxillary midline diastema and its therapies.     

Cheek and tongue pressures in the molar areas and the atmospheric pressure in the palatal vault in young adults.

The pressures acting on the maxillary and mandibular posterior teeth from the tongue and cheeks were measured in 24 adults aged 22-29 years. In addition, the pressure in the palatal vault was recorded. The pressure at two maxillary (buccal and lingual) and two mandibular (buccal and lingual) measuring points, and in the palatal vault was recorded simultaneously. Repeated recordings of the pressures at rest, and during chewing and swallowing were made. The pressures at rest were of similar magnitude (about 2 g/cm2) at the buccal and lingual sides of the mandibular posterior teeth. The median resting pressure at the maxillary posterior teeth was 2.7 g/cm2 on the buccal side and 1.0 g/cm2 on the lingual side. The difference in the maxilla was significant, but not in the mandible. It was concluded that the equilibrium of tooth position is maintained by the pressure from the cheeks and the tongue. During chewing and swallowing the pressures on the lingual side of the teeth were greater than those on the buccal side. At rest about half of the subjects had a negative pressure at the palatal vault, but no correlations between the resting pressure at the palatal vault and the resting pressures on the teeth were found.     

A histological study of the effect of developmental stage of tooth-germ on transplantation to hamster cheek pouch

Seventeen out of 27 maxillary second molar tooth-germ isografts from 2-day old donor animals continued development after transplantation to hamster cheek pouch. The grafts were examined histologically at 2, 6, and 24 weeks after transplantation; mature molar teeth had formed after 6 weeks in the cheek pouch. These transplants exhibited less growth disturbance than tooth-germ isografts from 5-day old donor animals. The genesis of abnormal dentine formation and enamel hypoplasia in the transplants is discussed in the context of other studies on tooth development. It is concluded that the developmental stage of the tooth germ at the time of the transplantation strongly influences its subsequent growth in the cheek pouch.     

Maxillary reconstruction for a huge odontogenic keratocyst

A range of different entities may be responsible for cystic lesions in the maxillary region. However, sometimes an accurate diagnosis cannot be made based on clinical or radiologic presentation. In this case, the surgeon should evaluate the clinical situation so that a comprehensive surgical plan that addresses the patient's complaints can be made. We present a 25-year-old female patient with a huge maxillary cyst causing obvious cheek protrusion. For cosmetic concern, she received surgical excision of the cystic lesion and reconstruction of anterior maxillary defect. No recurrence was seen at 18 months' follow-up, and the patient was quite satisfied with the aesthetic result. We reported the case to provide an effective procedure for benign maxillary cysts that result in cosmetic concerns with simple excision and reconstruction.     

A case of maxillary Schneider's papilloma

A very rare case of bilateral maxillary Schneider's papilloma is described in a patient aged 61 years treated with cytostatics and observed during 8 years. The neoplasm destroyed the maxilla, infiltrated the nasal cavity, ethmoid bone, cheeks, lower eyelid, temple, and facial nerve rami on the left side, and began penetrating into the left orbit and right sphenopalatine fossa. The general condition of the patient was good.     

Management of an unusual maxillary dentoalveolar fracture: a case report

The purpose of this case report was to describe the management of a trauma-induced maxillary dentoalveolar fracture of the right maxilla in an 8-year-old boy. The child presented with swelling of the right maxillary region, difficulty in chewing and closing the mouth, and a sutured laceration on the cheek. Complete palatal displacement of the fractured fragment involving the deciduous canine and molars was observed clinically and confirmed by radiological examination. The fracture was reduced and stabilized using a custom-fabricated, open-cap acrylic splint with modified interdental wiring under general anesthesia.     

血管化复合组织瓣修复全上颌骨缺损的临床进展

上颌骨、软腭、颊等组成的面中份结构不仅支撑面部外形、决定个人的面容,同时参与完成咀嚼、吞咽、语音和维持正常视觉等重要功能。因此,上颌骨重建是头颈部缺损修复中最复杂、最有争议的临床课题之一,其中以保留眶内容物的全上颌骨缺损（James Brown Ⅲb类）重建尤为困难。本文对保留眶内容物全上颌骨缺损的血管化复合组织瓣的修复重建目标、方法选择以及相关问题作一综述。     

骨性Ⅲ类错(牙合)正颌术后颊部宽度变化的三维研究

目的 探讨骨性Ⅲ类错(牙合)患者正颌术后颊部宽度变化的规律.方法 20例完成正颌手术的骨性Ⅲ类错(牙合)患者,男性9例,女性11例,平均年龄(25.06±5.33)岁,其中9例接受双侧下颌升支矢状劈开截骨(Bilateral sagittal split ramus osteotomy,BSSRO)后退术,11例接受Lefort-Ⅰ型截前移骨术和BSSRO后退术,分别在术前2周(T1)、术后6个月(T2)进行面部激光扫描检查,手术前后软组织面型的三维图像在同一坐标系中完成测量,分析颊部宽度的变化.结果 在经过外眦连线中点的冠状截面上,20例患者术后单侧颊部软组织宽度增加(3.58±2.21) mm,不同性别之间无显著性差异;下颌后退组单侧颊部增宽(1.74±0.76) mm,双颌手术组单侧颊部增宽(5.00±1.86) mm,两组之间存在显著性差异(P=0.001).结论 骨性Ⅲ类错(牙合)接受单纯下颌后退或者双颌手术后,颊部宽度均有增加的趋势.     

鼻内窥镜微创手术治疗牙源性上颌窦炎的临床观察

目的探讨慢性牙源性上颌窦炎应用鼻内窥镜手术的治疗效果。方法回顾性分析41例慢性牙源性上颌窦炎患者的临床资料，其中采用柯-陆氏手术治疗24例，采用鼻内窥镜下联合进路中鼻道上颌窦造口术17例，比较两种方法的治疗效果。结果采用柯一陆氏术式者面颊肿胀、面颊麻木、上牙槽酸痛的发生率分别是100．0％、37．5％、33.3％，鼻内窥镜手术组未见上述表现；柯-陆氏术式第一次手术拔牙率37．5％(9／24)，5例再次手术者均拔除患牙，总拔牙率58．3％(14．／24)，鼻内窥镜手术组拔牙率35．3％(6／17)，11例经根管治疗的牙齿保存良好；柯-陆氏手术组3年内复发率为37．5％(9／24)，而鼻内窥镜手术组术后3～6个月鼻道窦口复合体完全恢复通畅，随访1～3年未见复发。结论鼻内窥镜微创手术能最大限度减少上颌窦粘膜及骨质的损伤，利于术后恢复，在保留鼻窦正常生理功能、保存牙齿及减少复发率等方面明显优于传统的柯一陆氏手术。