Stereoscopic Technique for Conversion of Radiographic Guide into Implant Surgical Guide

Purpose: The aim of this study was to develop and evaluate a new stereoscopic technique for conversion of radiographic guide into surgical guide for dental implant placement. Materials and Methods: Ten partially dentate patients requiring 18 implants for tooth replacement were recruited. Radiographic guides were modified with the addition of index rods for double computed tomography scanning. Implant positions were planned with implant planning software, and the stereoscopic angulations were measured. The radiographic guides were converted into surgical guides using either a generic bench drill (Group A, n = 9) or a milling machine (Group B, n = 9). Stereolithographic surgical guides were also made for three patients (Group S, n = 5). Differences between the planned and actual angulations were tested by pair‐sample t‐test. Difference of mean angle deviation among groups was tested by Brown–Forsythe test. Differences were considered significant if p < .05. Results: Eighteen implant sites were successfully treated with the converted surgical guides. The mean angle deviation of Group A (1.3 ± 0.6°) was significantly greater than Group S (0.4 ± 0.6°), while no differences were found between Group B (0.9 ± 0.3°) and Group S. The linear error was greatest in Group A with 1.5 mm at the head and 1.8 mm at the apex of the implant. Conclusions: The use of this new stereoscopic technique appears to be an acceptable alternative method for converting radiographic guide into surgical guide.     

The postural basis of malocclusion: A philosophical overview

Over the last 100 years, many theories have attempted to explain the cause of malocclusion. Most have stated that it is inherited, but, more recently, greater emphasis has been placed on the influence of the environment, especially the activity and the posture of the oral soft tissues. Unfortunately, it is not possible to measure long-term posture with any precision, and this has reduced its perceived importance. When some evidence is missing and much of the rest conflicting, there is merit in moving from the traditional "prove-it" attitude to philosophical reasoning to separate the probable from the improbable. We do not know to what extent posture and parafunction might be inherited, but there can be no doubt that facial and dental structures are, at times, strongly influenced by the soft tissues and that some malocclusions appear to have a postural basis. This article undertakes a philosophical examination of the conflicting strands of evidence that link oral posture with malocclusion, hoping to create a theory based solely on the restricted evidence that is broadly accepted by all sides in this age-old debate.     

Periodontal management of a patient with severe aplastic anemia: a case report

This article describes the periodontal management of a patient with severe aplastic anemia. A 51-year-old female patient was hospitalized with aplastic anemia and was referred for the management of her cyclosporine-induced gingival enlargement and bleeding from her gums. She also complained of pain in the palatal area and the mandibular anterior region. The patient was managed successfully with supra- and subgingival instrumentation, local drug delivery (LDD), electrosurgery, repeated oral hygiene instruction, and constant supervision. The treatment resulted in dramatic improvement in the patient's oral health and quality of life. This report highlights the importance of nonsurgical therapy followed by electrosurgery for the management of residual gingival enlargement.