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1.

Purpose

The aim of this study was to describe the surgical technique of immediate dental implant placement in calvarial grafts for augmentation of the severely resorbed maxilla and to assess the treatment results.

Methods

In 13 patients the maxilla was augmented with calvarial bone followed by simultaneous dental implant placement (total: 68 implants). In the frontal “knife edge” region, implants were inserted in the buccal plated area. In the maxillary sinus area, implants were inserted into alveolar bone that was plated buccally or palatally through the sinus window. After 4 months, the implants were retrieved and subsequently loaded. Per-operative and post-operative variables were scored. One bone biopsy sample was taken for histological analysis.

Results

The surgical procedure and wound healing was uneventful. During abutment connection after 4 months, all implants were fully osseointegrated with no signs of graft resorption. Radiographically, the mean (±SD) peri-implant bone loss after 1 year of functional loading was 0.23 ± 0.44 mm. No implants were lost. Histological examination revealed vital calvarial and maxillary bone with active remodeling.

Conclusion

Immediate dental implant placement in calvarial bone grafts to rehabilitate severely resorbed maxilla is technically feasible and seems to have a high success rate.  相似文献   

2.

Aim

The aim of the study was to compare postoperative sequelae and wound healing outcome following closure of surgical wound with either cyanoacrylate tissue adhesive or silk suture.

Methods

Subjects with mesio-angularly impacted mandibular third molar were allocated randomly into 2 equal groups. The control group had wound closure with silk suture and study group with cyanoacrylate tissue adhesive. Subjects were followed up for 7 postoperative days. Postoperative pain, swelling, trismus, bleeding, wound dehiscence and wound infection were evaluated.

Results

Sixty subjects in each group completed the study. No significant difference was observed in the mean postoperative pain, swelling, trismus, wound dehiscence and infection between the 2 groups. There was a statistically significant difference in postoperative bleeding between the 2 groups on postoperative day 1, with more bleeding in the control group.

Conclusions

This study shows that cyanoacrylate tissue adhesive compares favourably with silk suture as a wound closure material. In addition, cyanoacrylate tissue adhesive seems to have beneficial haemostatic effect on postoperative bleeding.  相似文献   

3.

Background

Promoting the directional attachment of gingiva to the dental implant leads to the formation of tight connective tissue which acts as a seal against the penetration of oral bacteria. Such a directional growth is mostly governed by the surface texture.

Material and methods

In this study, three different methods, mechanical structuring, chemical etching and laser treatment, have been explored for their applicability in promoting cellular attachment and alignment of human primary gingival fibroblasts (HGFIBs).

Results

The effectiveness of mechanical structuring was shown as a simple and a cost-effective method to create patterns to align HGIFIBs.

Conclusion

Combining mechanical structuring with chemical etching enhanced both cellular attachment and the cellular alignment.  相似文献   

4.

Objective

To evaluate the quality of life in patients with moderate or large cranial bone defects before and after late cranioplasty.

Methods

Authors performed a prospective clinical trial including all consecutive patients that filled inclusion criteria during a period of 1 year. All patients answered the quality of life SF-36 questionnaire in 5 different times. Besides authors gathered information about the primary trauma and demographic characteristics.

Results

A total of 70 consecutive patients were admitted to the hospital during the study period, and 62 were included in the project. Cranioplasty statistically improved patients' quality of life in all 8 domains after a 24 months follow-up.

Conclusion

Cranioplasty has a significant impact over the quality of life in brain trauma victims who survived the primary trauma and harbor a large cranial bone defect.  相似文献   

5.

Objective

We compared the clinical efficacy between the vacuum sealing drainage (VSD)-assisted irrigation technique and traditional abscess incision and drainage technique in the treatment of severe multiple-space infections in the oral, maxillofacial, and cervical regions.

Methods

Data of 73 patients with severe oral, maxillofacial, and cervical infections, who were admitted to the Oral and Maxillofacial Surgery Department at the First Affiliated Hospital of Fujian Medical University between June 2014 and May 2017, were retrospectively collected. Patients were divided into two groups based on the treatments. The cure duration, incision length, physician workload (frequency of dressing-change), and treatment costs were compared between the two groups.

Results

Of 73 patients, 38 were treated with the VSD-assisted irrigation technique, and 35 with the traditional technique. All patients were cured following treatment. The cure duration, surgical scar length, and physician workload were smaller for the former group than for the latter group (p < 0.05). There was no difference in the treatment costs between the two groups (p > 0.05).

Conclusion

VSD-assisted irrigation technique used in the treatment of severe multiple-space infection in the oral and maxillofacial cervical regions shows favorable clinical effects and enables short treatment duration, lesser pain-experience, and high clinical and therapeutic efficacy.  相似文献   

6.

Statement of problem

A palatogram aids prosthodontists and speech pathologists in evaluating the precise prosthetic treatment needed and the effectiveness of such treatment to improve speech intelligibility. Powder is commonly used to visualize tongue-palate contact, where wetted areas of powder in the oral cavity reveal such contact during palatography. However, discomfort and the risk of aspiration are among the shortcomings of this method, and an improved method is needed.

Purpose

The purpose of this in vitro study was to examine the feasibility of a new method of palatography that uses airborne-particle–abraded acrylic resin so that wet areas can be easily distinguished from dry areas.

Material and methods

Seventy-two specimens of heat-polymerized acrylic resin were prepared in 6 different resin colors. After the specimens had been airborne-particle abraded, CIELab color values for each specimen were measured using a colorimeter under dry and wet conditions and recorded. Color difference (ΔE) was then computed, and a paired Student t test, 1-way analysis of variance, and multiple comparison using the Tukey post hoc analysis were applied (α=.05).

Results

A significant color difference was found between the 2 conditions in all acrylic resin specimens examined. Mean ΔE ranged from 5.58 to 6.76.

Conclusions

The results indicated that an airborne-particle–abraded acrylic resin surface can show color differences made by wetting on palatograms.  相似文献   

7.

Introduction

The aim of this study was to investigate the effect of periodontal status at the time of nonsurgical root canal treatment (NSRCT) on the survival rate of endodontically treated teeth (ETT).

Methods

In this retrospective investigation, molars that received NSRCT in an advanced specialty education program in endodontics from 2009 through 2017 were initially recruited. After the application of inclusion and exclusion criteria, 315 teeth were included in the study. Inclusion criteria were ETT with an acceptable quality of NSRCT; ETT that received an adequate crown within 3 months after NSRCT; and ETT with complete periodontal charting before NSRCT including pocket depths, clinical attachment loss, and bone loss. The periodontal status of all included teeth was assessed based on American Academy of Periodontology guidelines. All included ETT were divided into 3 groups as follows: healthy group, mild periodontitis, and moderate periodontitis. The survival rate of ETT was analyzed using univariate Kaplan-Meier and log-rank tests for differences between groups (P < .05). A Cox regression model was used to assess the effect of independent variables on the survival rate.

Results

Teeth that were diagnosed with mild periodontitis were almost 2 times more likely to be extracted compared with ETT diagnosed with normal periodontium at the time of NSRCT (odds ratio [OR] = 1.9, P < .05). This increased risk of tooth loss was 3.1 (OR = 3.1, P < .05) for ETT diagnosed with moderate periodontitis. Smokers were twice as likely to have tooth loss compared with nonsmokers (OR = 2.2, P < .05).

Conclusions

Patients' periodontal health, being 1 of the prognostic determinants of the outcome of NSRCT, requires attention before and subsequent to NSRCT. This may improve the survival of ETT and help patients maintain their natural dentition.  相似文献   

8.

Objective

Cranioplasty is indicated to restore form and function of bone defects of the neurocranium. Autografts are the gold standard, alloplastic materials are used when autologous bone is unavailable or unsuitable, and increasing evidence supports the use of patient-specific implants (PSIs) for reconstruction. We reviewed our own patient data to assess pre- and intraoperative aspects, complications and costs in patients that were treated with PSIs from titanium or polyetheretherketone (PEEK) for skull bone reconstruction.

Methods

We retrospectively evaluated all patients receiving a PSI as at least a secondary reconstruction between 2004 and 2016 at Maastricht University Medical Center. These cases were analyzed for demographics, perioperative surgical and medical aspects, as well as costs.

Results

In total 30 patients received PSIs, of which 20 were included in this study. Duration of PSI placement was not statistically different between group I, where previously placed reconstruction material was still in situ, and group II, where no remaining previously placed reconstruction material was present (group I: 104 ± 27 mins, group II: 86 ± 36 mins; p = 0.27). Postoperatively, 2 patients experienced complications (10%). Costs of obtaining the PSIs were not significantly different between group I and group II (group I: mean EUR 7536 ± 2759, group II: mean EUR 8351 ± 2087, p = 0.51).

Conclusion

Treatment of skull bone defects in repeated reconstruction requires an optimal preoperative planning and intraoperative procedure. In this retrospective study comparing repeatedly reconstructed cases with and without remaining previously placed reconstruction material present at the surgical site, we could not find significant differences in the duration of the surgical procedure nor costs of obtaining the PSIs. The protocol followed at MUMC for preoperative planning, manufacturing, and surgery, represents the current state-of-the-art treatment.  相似文献   

9.
10.

Statement of problem

Clinicians are currently unable to quantify the psychosocial, functional, and esthetic effects of prosthetic interventions to replace teeth. Understanding the effects of treatment to replace teeth on oral health-related quality of life (OHRQoL) is important for informed consent. A systematic review of the evidence of OHRQoL improvements with prosthodontic tooth replacement and a comparison of outcomes between treatment modalities is therefore indicated.

Purpose

The purpose of this systematic review was to examine the OHRQoL of patients with partial edentulism after different dental prosthetic treatments.

Material and methods

Electronic database and manual searches were conducted to identify cohort studies and clinical trials reporting on the OHRQoL of individuals receiving implant-supported crowns (ISCs), implant-supported fixed dental prostheses (IFDPs), implant-supported removable dental prostheses (IRDPs), tooth-supported fixed dental prostheses (TFDPs), and removable partial dentures (RPDs). Two reviewers independently conducted article selection, data extraction, and quality assessment. Random-effects models were used to compare OHRQoL change scores (standardized mean change, 95% confidence intervals).

Results

Of the 2147 identified studies, 2 randomized controlled trials and 21 cohort studies met the inclusion criteria. Overall, studies were of low or moderate risk of bias. Pooled mean OHRQoL change ≤9 months was 15.3 for TFDP, 11.9 for RPD, and 14.9 for IFDP. Pooled standardized mean change OHRQoL change >9 months was 13.2 for TFDP and 15.8 for IFDP. Direct comparisons ≤9 months between TFDP against IFDP and RPD against IFDP significantly favored IFDP in both cases.

Conclusions

TFDP and IFDP had short- and long-term positive effects on OHRQoL. RPDs positively affected OHRQoL in the short term. IFDP showed greater short-term improvement in OHRQoL than RPD and TFDP.  相似文献   

11.

Background

Only some states provide coverage of nonemergency dental services for adult Medicaid enrollees. This study examined the association between coverage of Medicaid adult nonemergency dental services and dental services use and expenditures.

Methods

The authors analyzed data from the 2000 through 2015 Medical Expenditure Panel Survey Household Component for adults 21 years or older enrolled in Medicaid. The authors examined a range of outcomes such as dental visits, preventive and 5 other types of dental services, and total and out-of-pocket dental expenditures. Multivariate regression models were used to estimate the differences in outcomes for Medicaid enrollees between states that provided coverage of nonemergency dental services and states that did not, controlling for potentially confounding factors.

Results

Compared with Medicaid enrollees in states that did not provide coverage, enrollees in states that provided coverage of nonemergency dental services were approximately 9 percentage points more likely to have a dental visit, approximately 7 percentage points more likely to have any preventive dental service, and more likely to have all other types of dental services except oral surgery services. Among enrollees with any visit, out-of-pocket share of dental expenditures was approximately 19 percentage points lower among those in covered states than those in uncovered states.

Conclusions

Medicaid adult nonemergency dental benefits were associated with higher use of preventive and other types of dental services and lower out-of-pocket share of dental costs.

Practical Implications

Our results may help inform policy makers as they consider ways of improving dental health of adults through Medicaid.  相似文献   

12.
13.

Purpose

To compare mandibular distraction osteogenesis (MDO) to sagittal split ramus osteotomy (SSRO) to treat moderate-to-severe obstructive sleep apnea (OSA), and their surgical morbidities and skeletal stability.

Materials and methods

A randomized clinical trial was conducted on non-syndromic adult patients with apnea-hypopnea index (AHI) 15 or above to receive MDO or SSRO as part or whole skeletal advancement surgery. Post-operative 1 year OSA cure rate (AHI < 5/hour) and treatment success rate (50% reduction of AHI and AHI< 20/hour) were compared. Polysomnography were conducted pre-operatively and post-operatively up to 2 years. Surgical morbidities and skeletal stability were analyzed.

Results

Eighteen patients (9 in each group) were recruited. Patient recruitment was terminated after two major complications in the MDO group. The OSA cure rate and treatment success rate showed no statistical difference between MDO group or SSRO group at post-operative 1 year. Major complication rate was 44.4% in the MDO group and 0 in the SSRO group. No statistical difference was found in skeletal stability between the two groups.

Conclusion

Both MDO and SSRO were highly effective to treat moderate-to-severe OSA. MDO had a high major complication rate and was not superior than SSRO in airway function improvement and skeletal stability.  相似文献   

14.
15.

Purpose

Craniofacial anatomy, as measured by facial anthropometric data, varies significantly between races. South Asia, comprised of eight countries, represents a large proportion of the global population and is the fastest-growing region of the world. This systematic review presents the facial anthropometric data collected for populations from this region.

Materials and methods

This systematic review was conducted in accordance with PRISMA guidelines. A systematic review of the literature was conducted by an electronic search of the MEDLINE and Cochran databases, returning 1675 articles. Bibliographies of accepted articles were screened to identify further eligible studies.

Results

A total of 12 articles were considered eligible for the systematic review. Two studies were conducted in Bangladesh, 7 in India, and 3 in Nepal. No facial anthropometric data were found for populations from Afghanistan, Bhutan, Maldives, Pakistan, or Sri Lanka. Qualitative and quantitative parameters from the 12 studies were extracted.

Conclusion

There is a paucity of facial anthropometric data for South Asian populations. As South Asia has a significant prevalence of craniofacial anomalies and a burgeoning cosmetic facial surgery market, it is in the interest of both the craniofacial surgeon and the South Asian patient to collect baseline facial anthropometric data for this population.  相似文献   

16.

Aims

To evaluate the efficiency of reconstruction of long span mandibular defects using split rib bundle bone graft.

Materials and methods

Six hundred patients with long span mandibular defects (more than 6 cm long), following resection of aggressive mandibular tumours, were reconstructed with split rib bundle bone graft technique. Immediate reconstruction was performed in all patients. A reconstruction plate was used to support the graft. Two ribs were harvested from the right side of the chest, split into four halves and used to restore the continuity of the mandible. The inclusion criterion was post-surgical mandibular bony defects without soft tissue deficiency. Defects with a history of previous or need of future irradiation were excluded.

Results

The appearance of the patients was accepted in 550 patients. Functional reconstruction was done in 320 patients by osseointegrated dental implants (after 15 months), and removable prosthesis in 150 patients. Infection was minor in 31 patients, moderate in 47 patients and severe in 42 patients. Partial loss of graft, up to 25%, due to moderate infection was reported. Total or near total loss of graft due to severe infection was corrected by reoperation six months later.

Conclusions

This technique is simple, safe, and can be effectively used to reconstruct long-span mandibular defects with minimal complications in selected patients.  相似文献   

17.

Introduction

The aim of this study was to investigate the influence of various apical preparation designs for surgical endodontics on stress concentrations in the mesial root of the mandibular molar under different experimental conditions using finite element analysis.

Methods

We designed 2 apical preparation groups according to whether an isthmus was present or not. Each group contained 4 subgroups according to the size of the apical preparation. We constrained the displacement of all nodes at the base of the supporting bone and applied a force of 150 N to the vertical axis. We analyzed stress generation and concentrations numerically for the groups and subgroups.

Results

In the subgroups, the von Mises and maximum principal stresses reduced gradually according to the enlargement of the prepared cavity. However, when the preparation extended excessively in the isthmus preparation groups, the situation reversed (ie, both von Mises and maximum principal stresses increased).

Conclusions

Within the limitations of this study, the apical preparation design influenced the distribution of stress concentration. Unlike the overall pattern in which stress decreased as the amount of apical preparation increased, stress increased when the amount of residual dentin was extremely thin.  相似文献   

18.

Introduction

The aim of this study was to evaluate the efficacy of 2 hemostatic agents in periapical surgery and its relationship with patient- and tooth-dependent variables.

Methods

A prospective study was designed with 2 randomized parallel groups established according to the hemostatic agent used: aluminum chloride or electrocauterization. The surgeon and 2 independent blinded observers examined the initial and final bleeding and recorded it as 0 (no hemorrhage control), 1 (slight but apparent intermittent bleeding), or 2 (complete hemorrhage control). The following patient- and tooth-dependent variables were collected: sex, age, smoking habit, plaque index, and position.

Results

Sixty patients with a periapical lesion in the esthetic zone were enrolled in this study and divided into 2 groups of 30 patients. In the aluminum chloride group, complete hemorrhage control was achieved in 24 patients, and in the electrocauterization group, it was achieved in 18 patients (P < .05). A relationship between sex and the effectiveness of hemostasis was found; a female patient increases the possibility of achieving complete hemorrhage control.

Conclusions

Hemorrhage control was better in the aluminum chloride group than in the electrocauterization group as well as in female patients compared with male patients.  相似文献   

19.

Statement of problem

Antifungal agents incorporated into interim denture resilient liners have been suggested as an adjunct treatment for denture stomatitis (DS). However, before applying this protocol to humans, biocompatibility analysis of such drugs in animal models is required.

Purpose

The purpose of this animal study was to evaluate the in vivo biocompatibility of an interim resilient liner modified with minimum inhibitory concentrations (MICs) of antifungal drugs for Candida albicans biofilm.

Material and methods

Sixty Wistar rats were divided into 6 groups (n=5): PC=positive control/no protocol; IOD (intraoral device)=rats using an acrylic resin palatal device (PD); Tru=rats using a PD relined with Trusoft; and Ny (nystatin), Chx (chlorhexidine diacetate), and Ke (ketoconazole) groups=rats using a PD relined with Trusoft + drug MICs. The rats were sacrificed at 7 or 14 days of trial. Histopathological qualitative analysis was performed by comparing photomicrographs of histological sections of the intermolar region. Morphological changes in the epithelium and keratin were quantitatively analyzed by computerized planimetry, and data were analyzed by using 2-way ANOVA and the Tukey HSD test (α=.05).

Results

Quantitative analysis showed that only PD containing Ke significantly decreased the thickness and area of the keratin compared with the other groups (P<.001), which showed no differences between each other (P>.05). These results agreed with those of qualitative analysis.

Conclusions

Incorporation of MICs of Ny and Chx in Trusoft did not induce histopathological changes in the rat palatal mucosa, suggesting the in vivo biocompatibility of this DS treatment.  相似文献   

20.

Objectives

Present and overview the clinical finding, management and arthroscopic study of Synovial Chondromatosis (SC) cases in Temporomandibular Joint (TMJ) treated by our team.

Study design

During year 2008–2018, 16 TMJ SC cases were treated and reviewed. The clinical manifestations, radiographic data, arthroscopic study and pathologic findings were recorded and analyzed.

Results

Average age of first visit was 32.68. The ratio of male/female was 2/14, right/left was 7/9. The most common symptoms were pain, continuous crepitus and limited mouth opening (LMO). All cases were examined by computed tomography (CT) and magnetic resonance imaging (MRI) preoperative and proved by pathology postoperative. The diagnostic rates of CT and MRI were 12.5% and 93.75% respectively. 1 case could not be detected by both, but by arthroscopy. Particles in all cases occurred in the upper joint cavity and were all removed by arthroscopic technique. No recurrence was found after 3 years follow-up.

Conclusions

MRI and arthroscopic technique could be the first choice in the diagnosis and treatment of SC. Most cases were in stage 3 of the disease at the first visit. Low recurrence rate may be attributed to the improvement of intra-articular environment after surgery. Larger sample sizes are needed for further study.  相似文献   

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