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Sample records for mandibular implant overdentures

  1. Stud attachments for the mandibular implant-retained overdentures: Prosthetic complications. A literature review

    PubMed Central

    Daou, Elie E.

    2013-01-01

    A plethora of attachment systems for mandibular two-implant overdentures is currently available often without evidence-based support. Technical aspects are now parameters considered when choosing the appropriate attachment. Despite the increasing use of the Locator attachments, studies regarding their properties remain scarce. Peer reviewed articles published in English up to 2011, were identified through a MEDLINE search (Pubmed and Elsevier) and a hand search of relevant textbooks and annual publications. Emphasis was made on the technical complications as well as the loss of retention related to the attachments in implant-retained overdentures, primarily the Locator attachment. The evaluation of the long-term outcome of implant overdentures and complications associated with different attachment systems may provide useful guidelines for the clinician in selecting the type of attachment system and overdenture design. PMID:23960557

  2. Masticatory efficiency and oral health-related quality of life with implant-retained mandibular overdentures

    PubMed Central

    Sun, Xu; Zhai, Jun-Jiang; Liao, Jian; Teng, Min-Hua; Tian, Ai; Liang, Xing

    2014-01-01

    Objectives: To evaluate masticatory efficiency (ME) and oral health-related quality of life (OHRQoL) in patients rehabilitated with implant-retained mandibular overdentures. Methods: In this randomized controlled clinical trial, 50 edentulous patients visiting the Implant Center and Department of Prosthodontics, West China College of Stomatology, Sichuan University, Chengdu, China between June 2010 and June 2012 were selected and received 2 implant-retained mandibular overdenture treatments. All patients were rehabilitated with maxillary complete dentures. The ME and OHRQoL were determined both one month before the mandibular complete denture was anchored to the osseointegrated implants, and 6 months after anchoring. Paired t-tests were used to compare means of ME, and oral health impact profile-49 (OHIP-49) domains scores between pre- and post-implant. Linear regression models were utilized to seek correlations between ME and OHIP domains scores. Results: The ME increased from pre- to post-implant retained mandibular overdentures significantly (p<0.001). The total OHIP score and 4 subscales scores were changed significantly from pre- to post-implant; namely, functional limitation, psychological discomfort, physical disability, and physical pain. The total OHIP score, functional limitation, physical disability, and physical pain subscale scores were related to ME. Conclusion: Implant-retained mandibular over dentures can significantly improve patients’ ME and OHRQoL. The improvement in OHRQoL is mainly because of the improved ME. An improved chewing experience, and pain relief also contributes to improvement of OHRQoL. PMID:25316463

  3. Clinical and Radiographic Evaluation of Median Lingualized Occlusion in Implant Retained Mandibular Complete Overdenture

    PubMed Central

    Ismail, Hussien A; Yousief, Salah A; Mahrous, Ahmed I; Shaban, Ahmed Abdelwahed; Azzeghaiby, Saleh Nasser; Aljehani, Dareen

    2015-01-01

    Background: The purpose of this study was to evaluate clinically and radiographically median lingualized occlusion in implant-retained mandibular complete overdenture. Materials and Methods: Ten completely edentulous male patients were participated in this study. Each patient received two implants in the intraforaminal area of the edentulous mandible that were left unloaded for 4 months. Patients were received conventional maxillary complete denture and implant mandibular overdenture with ball and socket attachment. The posterior teeth were set according to median lingualized occlusion scheme. All patients were evaluated clinically and radiographically immediately after denture insertion, 6 and 12 months of overdenture insertion. Results: The results revealed significant differences in probing depth, gingival index, plaque index, and marginal bone height between the different follow-up periods. With the limitation of this study, and according to the results of the mean marginal bone loss and the other peri-implant parameters after 1 year of loading. Conclusion: The implant retained overdenture with the median lingualized occlusal scheme may be recognized as being acceptable according to the general implant success rates and criteria. PMID:26225096

  4. Treatment of edentulism using Astra Tech implants and ball abutments to retain mandibular overdentures.

    PubMed

    Cooper, L F; Scurria, M S; Lang, L A; Guckes, A D; Moriarty, J D; Felton, D A

    1999-01-01

    The goal of this study was to provide evidence to support simplified treatment of mandibular edentulism using denture fabrication and implant placement to circumvent the need for second-stage surgeries or prosthodontic superstructures. A 5-year prospective clinical trial is reported, which involved treatment of mandibular edentulism using the single-stage surgical placement of a TiOblast microthreaded titanium screw implant with immediate replacement of a relieved mandibular overdenture and eventual retention of the overdenture with reduced ball abutments. Fifty-eight patients were treated; 116 implants were placed using a single-stage surgical approach, with a duplicate mandibular denture as the tomographic/surgical template. Mandibular dentures were relieved and relined with a tissue conditioning material and placed immediately after implant surgery. After 3 months, Conical Seal Design ball abutments were placed and attachments were secured in the overdentures by heat-polymerizing laboratory reline methods. Five of the 116 consecutively placed implants failed at 2 to 4 months, providing an immediate implant survival rate of 95.69% at the time of attachment connection. Pain and inflammation were not common to all failures, and infection was not reported in any of the 5 failures. The immediate placement of implants by a single-stage surgical procedure in the parasymphyseal region of the mandible, followed by placement of a relined mandibular denture, results in predictable and asymptomatic healing of implants that display the clinical and radiographic features of osseointegration. Encouraging results at the immediate observation period (attachment connection) must be tempered by the need for prudent and detailed clinical and radiologic evaluation over the 5-year trial period. PMID:10531736

  5. Narrow-implant-retained overdenture in an atrophic mandibular ridge: a case report with 6-year follow-up.

    PubMed

    Araujo, Carlos Roberto Garcia; Martins-Junior, Paulo Antonio; Araujo, Roberto Carlos de; Sa, Marcos Augusto de; Wassall, Thomaz; Ferreira, Anderson Jose

    2015-01-01

    When atrophic jaws compromise oral rehabilitation with conventional implants, narrow-diameter implants can be used. This case report describes treatment of an edentulous 75-year-old diabetic woman with a severely resorbed mandibular ridge. Her mandibular dentition was restored with an overdenture supported by 3 narrow implants and 1 mini implant. Her maxillary dentition was restored with a conventional complete denture. A 6-year clinical and radiographic follow-up confirmed that the narrow implants had provided effective stability for the overdenture, providing improvements in phonetics and masticatory ability at a low cost. PMID:26545281

  6. Implant-supported overdenture with prefabricated bar attachment system in mandibular edentulous patient.

    PubMed

    Ha, Seung-Ryong; Kim, Sung-Hun; Song, Seung-Il; Hong, Seong-Tae; Kim, Gy-Young

    2012-11-01

    Implant-supported overdenture is a reliable treatment option for the patients with edentulous mandible when they have difficulty in using complete dentures. Several options have been used for implant-supported overdenture attachments. Among these, bar attachment system has greater retention and better maintainability than others. SFI-Bar® is prefabricated and can be adjustable at chairside. Therefore, laboratory procedures such as soldering and welding are unnecessary, which leads to fewer errors and lower costs. A 67-year-old female patient presented, complaining of mobility of lower anterior teeth with old denture. She had been wearing complete denture in the maxilla and removable partial denture in the mandible with severe bone loss. After extracting the teeth, two implants were placed in front of mental foramen, and SFI-Bar® was connected. A tube bar was seated to two adapters through large ball joints and fixation screws, connecting each implant. The length of the tube bar was adjusted according to inter-implant distance. Then, a female part was attached to the bar beneath the new denture. This clinical report describes two-implant-supported overdenture using the SFI-Bar® system in a mandibular edentulous patient. PMID:23236580

  7. Training needs for general dentistry residents to place and restore two-implant-retained mandibular overdentures.

    PubMed

    Malmstrom, Hans; Xiao, Jin; Romanos, Georgios E; Ren, Yan-Fang

    2015-01-01

    Implant therapy is rapidly becoming a standard of care for replacing missing dentition. Predoctoral dental curricula include some training in the implant restorative phase but offer limited exposure to the surgical phase, so it is important for postdoctoral general dentistry residency programs to provide competency training in all phases of implant therapy. The aim of this study was to determine the training needed for general dentistry residents to achieve competence in this area, specifically by defining the number of clinical experiences necessary in both the surgical and prosthetic phases of implant-retained mandibular overdenture construction (IRMOD). Fifteen Advanced Education in General Dentistry (AEGD) residents at one academic dental institution placed two implants in a total of 50 patients with edentulous mandibles and subsequently restored them with IRMOD. The supervising faculty member and the residents evaluated the competency level on a five-point scale after each implant placement and prosthetic case completion. According to the faculty evaluations, the residents achieved surgical competence after placing two implants in four to six cases and prosthetic management competence after restoring two to four cases of IRMOD. All 50 patients were satisfied with the treatment outcomes of IRMOD. This study concluded that general dentistry residents could potentially achieve competence in both the surgical and prosthetic phases of implant therapy while enrolled in an AEGD program. PMID:25576555

  8. Implant-supported mandibular overdentures in very old adults: a randomized controlled trial.

    PubMed

    Müller, F; Duvernay, E; Loup, A; Vazquez, L; Herrmann, F R; Schimmel, M

    2013-12-01

    The purpose of this study was (1) to investigate denture satisfaction following the conversion of existing mandibular complete dentures to implant overdentures (IOD) in very old edentulous patients who depend on help for activities of daily living and (2) to evaluate secondary end points, such as functional, structural, nutritional, and patient-centered aspects. For this randomized clinical trial, 2 interforaminal short implants were placed in the intervention group (n = 16, 85.0 ± 6.19 yrs) to retain mandibular IODs; the control group (n = 18, 84.1 ± 5.55 yrs) received conventional relines. During the first year, no implant was lost; however, 2 patients died. IODs proved more stable, and participants in the intervention group demonstrated significantly higher denture satisfaction as well as an increased oral health-related quality of life compared to the control group. Maximum voluntary bite force improved significantly with IODs, yet the chewing efficiency was not different between groups. Masseter muscle thickness increased with IODs, mainly on the preferred chewing side. Body mass index decreased in both groups, but the decline tended to be smaller in the intervention group; blood markers and the Mini Nutritional Assessment did not confirm this tendency. These results indicate that edentulous patients who depend on help for activities of daily living may benefit from IODs even late in life. PMID:24158342

  9. Effect of attachment type on load distribution to implant abutments and the residual ridge in mandibular implant-supported overdentures

    PubMed Central

    Matsudate, Yoshiki; Abue, Masaru; Hong, Guang; Sasaki, Keiichi

    2015-01-01

    This study aimed to investigate the effect of attachment type on the load transmitted to implants and the residual ridge in a mandibular two-implant-supported overdenture in a model study. Ball attachments, locator attachments, and round-bar attachments were selected and examined. Static and dynamic vertical loads of 100?N were applied in the right first molar region. The load on the implants was measured by piezoelectric three-dimensional force transducers, and the load on the residual ridge beneath the denture base was measured using a tactile sheet sensor. The load on the implants with ball attachments was significantly higher than that with the other two attachments. The load on the residual ridge with round-bar attachments was significantly higher than that with the other two attachments. Our findings indicate that the three-dimensional load on implants and the residual ridge beneath the denture base is significantly associated with the type of attachment used in implant-supported overdentures. PMID:25798201

  10. The Effect of Inter-Implant Distance on Retention and Resistance to Dislodging Forces for Mandibular Implant-Tissue-Supported Overdentures

    PubMed Central

    Tabatabaian, Farhad; Saboury, Abolfazl; Sobhani, Zahra Sadat; Petropoulos, Vicki C

    2014-01-01

    Objectives: The effect of inter-implant distance on retention and resistance of implant-tissue-supported overdentures is lacking in the literature. An in vitro study was performed to evaluate this effect for mandibular implant-tissue-supported overdentures retained by two ball attachments. Materials and Methods: An acrylic cast of an edentulous mandible was fabricated. Three pairs of implants were symmetrically placed at both sides of the midline. The inter-implant distance was 10, 25, and 35 millimeters in positions A, B and C, respectively. A framework simulating the overdenture was fabricated on the cast. Six attachment housings were placed within the overdenture. For each sample, two ball abutments were screwed onto the implant pairs and two pink nylon inserts were seated in their respective attachment housings. The samples were tested in three groups of 15 (A, B, and C). The testing machine applied tensile dislodging forces and peak loads were measured in three directions: vertical, oblique, and anterior-posterior. A one-way ANOVA followed by Tukey’s HSD was used to determine groups that were significantly different. Tests were carried out at 0.05 level of significance. Results: Peak loads for the anterior-posteriorly directed dislodging forces were significantly the highest for group C (P<0.05); 21.25 N±3.05 N, while there were no statistically significant differences among groups with vertically and obliquely directed forces (P>0.05). Conclusion: Inter-implant distance did not affect the vertical retention and oblique resistance of mandibular implant-tissue-supported overdentures; however, it affected anterior-posterior resistance. PMID:25628676

  11. Immediate loading and implant-bar overdenture.

    PubMed

    Chang, John; Millstein, Philip

    2014-10-01

    Immediate loaded implants may be used with an implant-bar overdenture to provide fixed splinting. This is a relatively new system that provides for immediate implant placement and restoration. PMID:24787132

  12. A 5-year randomized trial to compare 1 or 2 implants for implant overdentures.

    PubMed

    Bryant, S R; Walton, J N; MacEntee, M I

    2015-01-01

    The hypothesis of this 5-y randomized clinical trial was that there would be no significant difference in the satisfaction of edentulous participants with removable complete overdentures attached to 1 or 2 mandibular implants. Secondary aims were to test changes in satisfaction between and within the groups from baseline to 5 y and differences between the groups in implant survival and prosthodontic maintenance over 5 y. Each of the 86 participants (mean age, 67 y) was randomly allocated to receive either 1 implant in the midline (group 1) or 2 implants in the canine areas (group 2) attached to a mandibular overdenture opposing a maxillary complete denture. Satisfaction was self-assessed by participants on a visual analog scale at baseline prior to implants, as well as at 2 mo and 1, 3, and 5 y with implant overdentures, whereas implant survival and prosthodontic maintenance were assessed by clinical examination. After 5 y, 29 participants in group 1 and 33 in group 2 were available, with most dropouts due to death. Satisfaction with the implant denture after 5 y was significantly (P < 0.001) higher than at baseline in both groups and remained with no significant difference (P = 0.32) between the groups. No implants failed in group 1 but 5 failed before loading in 4 participants in group 2. Most participants required maintenance or occasionally denture replacement, and although differences between the groups were not statistically significant, group 1 experienced almost twice as many fractured dentures usually adjacent to the implant attachment. We conclude that there were no significant differences after 5 y in satisfaction or survival of implants with mandibular overdentures retained by 1 implant or 2 implants. Additional research is required to confirm long-term treatment effectiveness of single-implant dentures and the implications of prosthetic maintenance with implant overdentures (ClinicalTrials.gov: NCT02117856). PMID:25348544

  13. Implant and root supported overdentures - a literature review and some data on bone loss in edentulous jaws

    PubMed Central

    2014-01-01

    PURPOSE To present a literature review on implant overdentures after a brief survey of bone loss after extraction of all teeth. MATERIALS AND METHODS Papers on alveolar bone loss and implant overdentures have been studied for a narrative review. RESULTS Bone loss of the alveolar process after tooth extraction occurs with great individual variation, impossible to predict at the time of extraction. The simplest way to prevent bone loss is to avoid extraction of all teeth. To keep a few teeth and use them or their roots for a tooth or root-supported overdenture substantially reduces bone loss. Jaws with implant-supported prostheses show less bone loss than jaws with conventional dentures. Mandibular 2-implant overdentures provide patients with better outcomes than do conventional dentures, regarding satisfaction, chewing ability and oral-health-related quality of life. There is no strong evidence for the superiority of one overdenture retention-system over the others regarding patient satisfaction, survival, peri-implant bone loss and relevant clinical factors. Mandibular single midline implant overdentures have shown promising results but long-term results are not yet available. For a maxillary overdenture 4 to 6 implants splinted with a bar provide high survival both for implants and overdenture. CONCLUSION In edentulous mandibles, 2-implant overdentures provide excellent long-term success and survival, including patient satisfaction and improved oral functions. To further reduce the costs a single midline implant overdenture can be a promising option. In the maxilla, overdentures supported on 4 to 6 implants splinted with a bar have demonstrated good functional results. PMID:25177466

  14. Tissue-supported dental implant prosthesis (overdenture): the search for the ideal protocol. A literature review

    PubMed Central

    Laurito, Domenica; Lamazza, Luca; Spink, Michael J.; De Biase, Alberto

    2012-01-01

    Summary Aims The success of maxillary and mandibular tissue supported implant prostheses varies in the literature, and the ideal protocol may be elusive from given the numerous studies. The oral rehabilitation option is an alternative to conventional dentures and should improve function, satisfaction, and retention. The purpose of this review article is to clarify these questions. Methods The search of literature reviews English non-anecdotal implant overdentures articles from 1991 to 2011. Results The results display an aggregate comprehensive list of categorical variables from the literature review. Overall success of maxillary and mandibular implant overdenture was respectively, 86.6% and 95.8%. Conclusion The literature indicates that the implant overdenture prosthesis provides predictable results – enhanced stability, function and a high-degree of satisfaction compared to conventional removable dentures. PMID:22783448

  15. Two Years Retrospective Evaluation of Overdenture Retained by Symphyseal Single Implant Using Two Types of Attachments

    PubMed Central

    Ismail, Hussien Abdelfattah; Mahrous, Ahmed I; Banasr, Fahad H; Soliman, Tarek A; Baraka, Yasser

    2015-01-01

    Background: This study was aimed to evaluate complete mandibular overdentures retained by a symphyseal single implant using ball and magnet attachments in both clinical and radiographic evaluation. Materials and Methods: Ten dental press fit titanium implants were installed in the lower jaws of completely edentulous patients according to two-stage surgical protocol. For each patient, one implant was installed in the symphyseal midline region, and left submerged and unloaded for 4 months. The patients were then divided into two equal groups. The first group received mandibular overdentures retained by ball and socket attachment. The second group received mandibular overdentures retained by magnet attachment. Both groups were supplied with conventional maxillary complete dentures. All patients were evaluated immediately after denture insertion, 6 months, and 12 months and after 24 months of overdenture insertion. Results: The study showed insignificant difference regarding the clinical condition and the marginal bone height changes in both groups during the follow-up period. Conclusion: Single implant retained overdenture with ball and socket or magnetic attachments was easy in construction, required less home care to maintain gingival health and give satisfactory clinical results. PMID:26124591

  16. The effectiveness of 2-implant overdentures - a pragmatic international multicentre study.

    PubMed

    Rashid, F; Awad, M A; Thomason, J M; Piovano, A; Spielberg, G P; Scilingo, E; Mojon, P; Müller, F; Spielberg, M; Heydecke, G; Stoker, G; Wismeijer, D; Allen, F; Feine, J S

    2011-03-01

    The purpose of this multicentre observational study was to determine patient satisfaction with either conventional dentures or mandibular 2-implant overdentures in a 'real world' setting. Two hundred and three edentulous patients (mean age 68·8 ± 10·4 years) were recruited at eight centres located in North America, South America and Europe. The patients were provided with new mandibular conventional dentures or implant overdentures supported by two implants and ball attachments. At baseline and at 6 months post-treatment, they rated their satisfaction with their mandibular prostheses on 100-mm visual analogue scale questionnaires. One hundred and two (50·2%) participants had valid baseline and 6-month satisfaction data. Although both groups reported improvements, the implant overdenture group reported significantly higher ratings of overall satisfaction, comfort, stability, ability to speak and ability to chew. These results suggest that edentulous patients who choose mandibular implant overdentures have significantly greater improvements in satisfaction, despite their relatively higher cost, than those who choose new conventional dentures. PMID:20704639

  17. Comparison of Three Attachments in Implant-Tissue Supported Overdentures: An In Vitro Study

    PubMed Central

    Tabatabaian, F.; Alaie, F.; Seyedan, K.

    2010-01-01

    Objective: Retention and resistance of the implant-tissue supported overdenture may be affected by the type of attachment. The aim of this research was to compare the retention and resistance of Nobel Biocare Ball (NBB), Nobel Biocare Bar and Clip (NBBC) and Sterngold ERA Red (ERAR) attachments on an implant-tissue supported overdenture model. Materials and Methods: The attachment samples were divided into 3 groups of NBB, NBBC, and ERAR (5 samples in each group). Two parallel Nobel Biocare Branemark implants were placed symmetrically at the symphysis region of a mandibular test model. A metallic overdenture was fabricated precisely adapted to the model and attached to a Zwick testing machine (crosshead speed of 51 mm/min). Dislodging tensile forces were applied in three vertical, oblique, anterior-posterior directions and two situations, at the beginning and after 100 times of insertion/removal of the overdenture, for each sample. The maximum dislodging force was measured. A One-way ANOVA test was employed followed by Tukey’s test. Results: ERAR was the most retentive and resistant in both situations. NBB and NBBC showed the same anterior-posterior resistance at the beginning. All test groups represented a large amount of retention and resistance loss after the insertion/removal of the overdenture, while NBBC showed a higher loss of anterior-posterior resistance than NB. Conclusion: A highest level of retention and resistance was seen in ERAR. The retention and resistance were affected by the wear of attachments. PMID:21998784

  18. A finite element study on stress distribution of two different attachment designs under implant supported overdenture

    PubMed Central

    El-Anwar, Mohamed I.; Yousief, Salah A.; Soliman, Tarek A.; Saleh, Mahmoud M.; Omar, Wael S.

    2015-01-01

    Objective This study aimed to evaluate stress patterns generated within implant-supported mandibular overdentures retained by two different attachment types: ball and socket and locator attachments. Materials and methods Commercial CAD/CAM and finite element analysis software packages were utilized to construct two 3D finite element models for the two attachment types. Unilateral masticatory compressive loads of 50, 100, and 150 N were applied vertically to the overdentures, parallel to the longitudinal axes of the implants. Loads were directed toward the central fossa in the molar region of each overdenture, that linear static analysis was carried out to find the generated stresses and deformation on each part of the studied model. Results According to FEA results the ball attachment neck is highly stressed in comparison to the locator one. On the other hand mucosa and cortical bone received less stresses under ball and socket attachment. Conclusions Locator and ball and socket attachments induce equivalent stresses on bone surrounding implants. Locator attachment performance was superior to that of the ball and socket attachment in the implants, nylon caps, and overdenture. Locator attachments are highly recommended and can increase the interval between successive maintenance sessions. PMID:26644755

  19. Biomaterial aspects: A key factor in the longevity of implant overdenture attachment systems

    PubMed Central

    Daou, Elie E.

    2015-01-01

    Background: New attachment systems are released for mandibular two-implant overdentures often without evidence-based support. Biomaterial aspects are now the parameters considered when choosing the appropriate attachment. Studies regarding their properties remain scarce. Purpose: The purpose of this review was to help the clinician in selrcting the most adapted stud attachments according evidence-based dentistry. Materials and Methods: An electronic search was conducted using specific databases (PubMed, Medline, and Elsevier libraries). Peer-reviewed articles published in English up to July 2014 were identified. Emphasis was given on the biomaterial aspects and technical complications. No hand search was added. Results: The electronic search generated 115 full-text papers, of which 84 papers were included in the review. The majority were clinical and in vitro studies. Some review articles were also considered. Papers reported survival and failures of overdenture connection systems. Emphasis was laid on attachment deformation. Conclusion: Implant overdentures long-term follow-up studies may provide useful guidelines for the clinician in selecting the type of attachment system and overdenture design. Locator attachments are more and more used, with lesser complications reported. PMID:26312224

  20. Magnet-retained implant-supported overdentures: review and 1-year clinical report.

    PubMed

    Ceruti, Paola; Bryant, S Ross; Lee, Jun-Ho; MacEntee, Michael I

    2010-01-01

    Open-field aluminum-nickle-cobalt magnets have been used in prosthodontics for many years, but success has been limited because these magnets are susceptible to corrosion by the saliva and because their retentive force is weak relative to the initial retention offered by mechanical attachments. More recently, magnets have been made from alloys of the rare earth elements samarium and neodymium, which provide stronger magnetic force per unit size. In addition, a new generation of laser-welded containers has improved protection from salivary corrosion. The current resurgence of interest in this type of attachment appears justified because, unlike mechanical attachments, magnets have potential for unlimited durability and might therefore be superior to mechanical ball or bar attachments for the retention of removable prostheses on implants. To date, no long-term prospective trials have been conducted to confirm the clinical durability of this new generation of magnets for retaining dentures on either teeth or implants. The aim of this study was to document initial clinical experiences and levels of satisfaction among edentulous patients treated with mandibular implant-supported overdentures retained using a new generation of rare-earth magnetic attachments. At the outset, all but one of the 17 patients had had several years of experience with implant-supported overdentures. During the first year, the mean overall satisfaction among these 17 patients increased from less than 70 to over 90 out of 100 (standardized visual analogue scale). No unusual difficulties were encountered in rendering the treatment or maintaining the attachments. This report offers preliminary evidence of the excellent potential of these magnets for retaining mandibular implant-supported overdentures. PMID:20943036

  1. Rehabilitation with implant-supported overdentures in total edentulous patients: A review

    PubMed Central

    Segura-Andrés, Gustavo; Faus-López, Joan; Agustín-Panadero, Rubén

    2013-01-01

    Objectives: The main aim of this review article is to discuss implant-supported overdentures (ISOs) as treatment in edentulous patients. Besides, we will try to discuss among the different treatment options in such patients and to analyze their validity when ISOs are compared with other clinical modalities. At the same time, we will try to suggest clinical guidelines supported by current clinical studies. Material and methods: We performed a Medline search and review of pertinent articles on the mentioned subject from 1986 to 2011. As a searching strategy, we used the following words: implant-supported overdentures, attachment systems, Locator attachment, cantilever, fixed prosthesis. Results and conclusions: Implant-supported overdentures constitute an accurate and predictable treatment option and achieve a higher patients’ satisfaction. This type of treatment constitutes a cheaper treatment than fixed prostheses and in some patients, with loss of lip support or with an interoclusal space larger than 15 mm, the choice of implant-supported overdentures seems to prevent future aesthetic or phonetic problems. Key words:Overdentures, implant occlusion, implant rehabilitation, total edentulous rehabilitation, fixed prosthesis. PMID:24455093

  2. Telescopic Overdenture and Implant Supported Fixed Partial Denture: A Pragmatic Treatment Approach

    PubMed Central

    Dede, Do?u Ömür; Cenk Durmu?lar, M.; ?ah?n, Onur; Köro?lu, Ay?egül; ???sa?, Özer

    2015-01-01

    This case report presents a patient who had been rehabilitated with a telescopic overdenture and implant supported fixed partial denture (ISFPD). The treatment process was as follows: (1) fabricating telescopic crowns and overdenture prosthesis for the lower jaw and a temporary complete denture for the upper jaw, (2) using the temporary denture as diagnostic and surgical guide to optimize dental implant placement, and (3) fabricating ISFPD for the upper jaw. Using the patient's existing or temporary denture not only serves as an alternative surgical guide to calibrate the dental implant locations but also helps to finish the restoration at desired dimension, size, and anatomic form. PMID:26106491

  3. Accessory mandibular foramen during dental implant placement: case report and review of literature.

    PubMed

    Pancer, Brooke; Garaicoa-Pazmiño, Carlos; Bashutski, Jill D

    2014-04-01

    Accurate knowledge of vital anatomical structures, such as the inferior alveolar nerve, mental nerve, and mental foramen, is critical to achieve favorable results during oral surgical procedures and dental implant placement. Although uncommon, variations in mandibular foramina have been reported and if unnoticed and, as a result, injured, may lead to patient morbidity, neurosensory disturbances, and other undesired complications. We present a case report of identification of an accessory mandibular foramen (AMF) encountered during placement of 2 dental implants for a mandibular implant-retained overdenture and demonstrate appropriate management. In addition, we propose a more reasonable terminology for such accessory foramina so as to facilitate communication through common terminology among health care providers. As conventional radiography (periapical and panoramic films) may not allow for proper identification of such anatomical variations, cone-beam computed tomography may be useful in the diagnosis of AMF during treatment planning of dental implants in the mandible. PMID:24637530

  4. 21 CFR 874.3695 - Mandibular implant facial prosthesis.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ...2012-04-01 false Mandibular implant facial prosthesis. 874...NOSE, AND THROAT DEVICES Prosthetic Devices § 874.3695 Mandibular implant facial prosthesis. (a) Identification. A mandibular implant facial prosthesis is a...

  5. [Immediate implant-support and overdenture retained by conical crowns: three cases report].

    PubMed

    Huang, Jian-sheng; Zhu, Xiao-bin

    2009-08-01

    Completed denture or immediate completed dentures were manufactured before operation to three patients with edentulous mandible and maxillary or severe chronic periodontitis. The remnant teeth of patients were extracted. Four Ankylos implants were implanted in mandible, and six implants were implanted in maxillary. SynCone conical bases were placed into implants, prefabricated conical crowns were inserted into conical bases, and temporary dentures were completed. After 3-12 months, temporary dentures were replaced by overdenture with casting frame. Except that one implant had been lost and was replaced by a new implant after 1 month of treatment, the rest implants had no obvious frontal resorption in 12-24 months of follow-up. PMID:19769275

  6. Oral health impact on daily performance in patients with implant-stabilized overdentures and patients with conventional complete dentures.

    PubMed

    Melas, F; Marcenes, W; Wright, P S

    2001-01-01

    This cohort study (n = 83) investigated whether patients with implant-stabilized overdentures would demonstrate less impact on daily life, would have less difficulty in the mastication of different types of food, and would generally be more satisfied than patients with conventional complete dentures. The groups were comparable for gender, age of dentures, and duration of edentulism. The patients were interviewed using a questionnaire, which included the Oral Impacts on Daily Performances (OIDP) sociodental indicator. Patients with implant-stabilized overdentures were more satisfied with the comfort of their dentures, could eat a wide range of food items with less difficulty, and experienced less impact on daily life than patients with conventional complete dentures. The findings of this study support the need to consider implant-stabilized overdentures in the treatment of edentulous patients. PMID:11669253

  7. Intra-oral welding of implants for an immediate load with overdentures.

    PubMed

    Hruska, A R; Borelli, P

    1993-01-01

    Different clinical applications of the Hruska intra-oral welding machine have been described in previous articles (Hruska, 1986, 1987, 1988, 1989a,b). These applications were related to over 100 cases of the use of non-submergible implants. This paper will describe a revised application of this machine as used with the currently popular multiform submergible implants widely used in the United States. The intra-oral welding is performed immediately after suture placement, with one or more connecting titanium wires serving as the splinting medium. This permits the patient to leave the office with a stable and retentive overdenture resting securely on the newly created splint performed the same day of surgery. This avoids the potentially troublesome problem of allowing the overdenture to be supported by the recently altered soft tissues. In addition, the patient otherwise would not have the use of a denture during the bone-healing period, which creates an alteration in psychological as well as physiological status. The disadvantages of immediate loading are counteracted by the splinting and load-sharing. This encourages the bone around the implants to reorganize and remodel according to Wolff's law, as demonstrated by De Angelis (1970) and Dalin and Olsson (1974). Different studies (Sutter et al., 1983a,b; Schroeder, 1985; Jennings, 1991) have shown that the ankylotic connection between one-stage titanium ITI implants and bone (so-called osseointegration) occurs and is maintained under load. PMID:7902447

  8. The Effects of Denture Cleansing Solutions on the Retention of Attachments of Implant Supported Overdentures

    PubMed Central

    Derafshi, Reza; Mohaghegh, Mina; Saki, Maryam; Safari, Anahita; Rabee Haghighi, Mohammad

    2015-01-01

    Statement of the Problem Implant-retained overdenture can improve the stability of dentures and prevent bone loss. Overdenture-wearing patients need special hygiene care. Purpose The aim of this study was to evaluate the effects of various denture cleansers on the retention of Dio orange O-rings. Method and Materials In this experimental study, 40 Dio orange O-rings were divided into 4 groups (10 O-rings each) and each group was soaked for equivalent of 6 months in the following solutions: 5.25% NaOCl (1:10 dilution), Corega cleanser tabs, Professional cleanser tabs and water (as the control group). After 6 months, O-rings were tested for 2inch/minutes of tensile force. The peak load-to-dislodgement was recorded. Data were imported to SPSS18 and were analyzed by One-Way ANOVA and Tukey HSD test (p? 0.05). Results Denture cleansing solutions have significant effects on the reduction of retentive value of O-rings (p? 0.001). Corega tabs caused the reduction of 15.7% (9.91±0.53 N) in the retentive value of O-rings and Professional tabs caused 15% (10.00±0.86 N). NaOCl caused significant decrease (48%) in retentive value of O-rings (6.10±0.91 N in comparison with the control group (11.76±1 N). Conclusion This in-vitro study demonstrated that the retention of O-rings was affected when soaked in cleansing solutions. NaOCl caused more reduction in retentive value compared to effervescent cleansers and would not be recommended for cleansing O-rings. These results should be interpreted clinically and the role of other factors in the retention of O-rings should be considered in order to recommend the best cleanser for O-ring overdentures. PMID:26106638

  9. Transition from a fixed implant dental prosthesis to an implant overdenture in an edentulous patient: a clinical report.

    PubMed

    Ali, Bolouri; Bhavani, Venkatachalam

    2014-09-01

    The lack of planning before implant placement and restoration in edentulous patients can lead to a number of problems. Prosthodontists are often faced with the challenge of re-treating patients who have only recently been treated. Although many reports discuss retreatment by fabricating all new prosthetic components, few discuss salvaging parts of the patient's existing prosthesis. This report details the treatment of an edentulous patient who presented with an implant-retained fixed dental prosthesis in the maxillary arch and no opposing prosthesis. The transition from an implant-retained fixed dental prosthesis to a removable implant- and tissue-supported overdenture that uses the patient's existing computer-aided design/computer-aided manufacturing milled titanium substructure is described. PMID:24582133

  10. Maxillary Overdentures Supported by Four Splinted Direct Metal Laser Sintering Implants: A 3-Year Prospective Clinical Study

    PubMed Central

    Mangano, Francesco; Shibli, Jamil Awad; Anil, Sukumaran

    2014-01-01

    Purpose. Nowadays, the advancements in direct metal laser sintering (DMLS) technology allow the fabrication of titanium dental implants. The aim of this study was to evaluate implant survival, complications, and peri-implant marginal bone loss of DMLS implants used to support bar-retained maxillary overdentures. Materials and Methods. Over a 2-year period, 120 implants were placed in the maxilla of 30 patients (18 males, 12 females) to support bar-retained maxillary overdentures (ODs). Each OD was supported by 4 implants splinted by a rigid cobalt-chrome bar. At each annual follow-up session, clinical and radiographic parameters were assessed. The outcome measures were implant failure, biological and prosthetic complications, and peri-implant marginal bone loss (distance between the implant shoulder and the first visible bone-to-implant contact, DIB). Results. The 3-year implant survival rate was 97.4% (implant-based) and 92.9% (patient-based). Three implants failed. The incidence of biological complication was 3.5% (implant-based) and 7.1% (patient-based). The incidence of prosthetic complication was 17.8% (patient-based). No detrimental effects on marginal bone level were evidenced. Conclusions. The use of 4 DMLS titanium implants to support bar-retained maxillary ODs seems to represent a safe and successful procedure. Long-term clinical studies on a larger sample of patients are needed to confirm these results. PMID:25580124

  11. Clinical outcome of double crown-retained implant overdentures with zirconia primary crowns

    PubMed Central

    Buergers, Ralf; Ziebolz, Dirk; Roediger, Matthias

    2015-01-01

    PURPOSE This retrospective study aims at the evaluation of implant-supported overdentures (IODs) supported by ceramo-galvanic double crowns (CGDCs: zirconia primary crowns + galvano-formed secondary crown). MATERIALS AND METHODS In a private practice, 14 patients were restored with 18 IODs (mandible: 11, maxilla: 7) retained by CGDCs on 4 - 8 implants and annually evaluated for technical and/or biological failures/complications. RESULTS One of the 86 inserted implants failed during the healing period (cumulative survival rate (CSR) implants: 98.8%). During the prosthetic functional period (mean: 5.9 ± 2.2 years), 1 implant demonstrated an abutment fracture (CSR-abutments: 98.2%), and one case of peri-implantitis was detected. All IODs remained in function (CSR-denture: 100%). A total of 15 technical complications required interventions to maintain function (technical complication rate: 0.178 treatments/patients/year). CONCLUSION Considering the small sample size, the use of CGDCs for the attachment of IODs is possible without an increased risk of technical complications. However, for a final evaluation, results from a larger cohort are required. PMID:26330981

  12. 21 CFR 874.3695 - Mandibular implant facial prosthesis.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... (CONTINUED) MEDICAL DEVICES EAR, NOSE, AND THROAT DEVICES Prosthetic Devices § 874.3695 Mandibular implant... made of materials such as stainless steel, tantalum, titanium, cobalt-chromium based...

  13. 21 CFR 874.3695 - Mandibular implant facial prosthesis.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... (CONTINUED) MEDICAL DEVICES EAR, NOSE, AND THROAT DEVICES Prosthetic Devices § 874.3695 Mandibular implant... made of materials such as stainless steel, tantalum, titanium, cobalt-chromium based...

  14. 21 CFR 874.3695 - Mandibular implant facial prosthesis.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... (CONTINUED) MEDICAL DEVICES EAR, NOSE, AND THROAT DEVICES Prosthetic Devices § 874.3695 Mandibular implant... made of materials such as stainless steel, tantalum, titanium, cobalt-chromium based...

  15. 21 CFR 874.3695 - Mandibular implant facial prosthesis.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... (CONTINUED) MEDICAL DEVICES EAR, NOSE, AND THROAT DEVICES Prosthetic Devices § 874.3695 Mandibular implant... made of materials such as stainless steel, tantalum, titanium, cobalt-chromium based...

  16. 21 CFR 874.3695 - Mandibular implant facial prosthesis.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... (CONTINUED) MEDICAL DEVICES EAR, NOSE, AND THROAT DEVICES Prosthetic Devices § 874.3695 Mandibular implant... made of materials such as stainless steel, tantalum, titanium, cobalt-chromium based...

  17. Retentive bar overdenture fabrication with preformed castable components: a case report.

    PubMed

    Williamson, R T

    1994-06-01

    Overdenture bar attachment therapy is a rarely chosen treatment option in today's aggressive environment of implant treatment. However, overdenture therapy preserves the sensation of proprioception, preserves the edentulous ridge, maintains the border seal, and provides the patient with good speaking ability and chewing efficiency. The use of preformed components for impression posts, plastic burnout post patterns, plastic burnout bar patterns, attachable screw attachments, and nylon retention clips, which are quickly replaced clinically and induce minimal wear on the bar, have made the fabrication of the overdenture bar attachment easier, quicker, and more precise. This article details the fabrication of a canine splint bar for a bar and clip-retained mandibular overdenture that opposes a complete maxillary denture. PMID:7938426

  18. Flapless implant surgery to overcome anatomic challenges in the anterior mandible for overdenture therapy: a clinical report.

    PubMed

    Bidra, Avinash S

    2014-03-01

    Implant surgery in the atrophic anterior mandible presents a number of anatomic challenges owing to the vascular and neurologic structures related to this region. Flapless implant surgery is known to be a conservative surgical approach that has a number of advantages and disadvantages for both the clinician and the patient. This clinical report describes the use of flapless implant surgery for a 2-implant overdenture in an 89-year-old patient with a severely atrophic mandible and significant anatomic constraints. The insertion of the sublingual artery into the lingual cortex close to the level of the crest of the ridge and the presence of the mental foramen at the ridge crest precluded conventional flap surgery. To overcome these anatomic challenges, a conventional surgical guide was used with careful preoperative treatment planning for a successful flapless implant surgery and subsequent overdenture therapy. The anatomic challenges, surgical and prosthetic treatment planning, choice of simple versus complex interventions, and indications and contraindications of flapless surgery are discussed. PMID:24286637

  19. 21 CFR 874.3695 - Mandibular implant facial prosthesis.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 21 Food and Drugs 8 2012-04-01 2012-04-01 false Mandibular implant facial prosthesis. 874.3695 Section 874.3695 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES EAR, NOSE, AND THROAT DEVICES Prosthetic Devices § 874.3695 Mandibular...

  20. 21 CFR 874.3695 - Mandibular implant facial prosthesis.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Mandibular implant facial prosthesis. 874.3695 Section 874.3695 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES EAR, NOSE, AND THROAT DEVICES Prosthetic Devices § 874.3695 Mandibular...

  1. 21 CFR 874.3695 - Mandibular implant facial prosthesis.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 21 Food and Drugs 8 2013-04-01 2013-04-01 false Mandibular implant facial prosthesis. 874.3695 Section 874.3695 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES EAR, NOSE, AND THROAT DEVICES Prosthetic Devices § 874.3695 Mandibular...

  2. 21 CFR 874.3695 - Mandibular implant facial prosthesis.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 21 Food and Drugs 8 2014-04-01 2014-04-01 false Mandibular implant facial prosthesis. 874.3695 Section 874.3695 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES EAR, NOSE, AND THROAT DEVICES Prosthetic Devices § 874.3695 Mandibular...

  3. 21 CFR 874.3695 - Mandibular implant facial prosthesis.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 21 Food and Drugs 8 2011-04-01 2011-04-01 false Mandibular implant facial prosthesis. 874.3695 Section 874.3695 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES EAR, NOSE, AND THROAT DEVICES Prosthetic Devices § 874.3695 Mandibular...

  4. 21 CFR 874.3695 - Mandibular implant facial prosthesis.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ...CONTINUED) MEDICAL DEVICES EAR, NOSE, AND THROAT DEVICES Prosthetic Devices § 874.3695 Mandibular implant facial prosthesis...device is made of materials such as stainless steel, tantalum, titanium, cobalt-chromium based alloy,...

  5. 21 CFR 874.3695 - Mandibular implant facial prosthesis.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ...CONTINUED) MEDICAL DEVICES EAR, NOSE, AND THROAT DEVICES Prosthetic Devices § 874.3695 Mandibular implant facial prosthesis...device is made of materials such as stainless steel, tantalum, titanium, cobalt-chromium based alloy,...

  6. 21 CFR 874.3695 - Mandibular implant facial prosthesis.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ...CONTINUED) MEDICAL DEVICES EAR, NOSE, AND THROAT DEVICES Prosthetic Devices § 874.3695 Mandibular implant facial prosthesis...device is made of materials such as stainless steel, tantalum, titanium, cobalt-chromium based alloy,...

  7. Comparison of changes in retentive force of three stud attachments for implant overdentures

    PubMed Central

    Kim, Su-Min; Choi, Jae-Won; Jeon, Young-Chan; Jeong, Chang-Mo; Yun, Mi-Jung; Lee, So-Hyoun

    2015-01-01

    PURPOSE The aim of this study was to compare the changes in retentive force of stud attachments for implant overdentures by in vitro 2-year-wear simulation. MATERIALS AND METHODS Three commercially available attachment systems were investigated: Kerator blue, O-ring red, and EZ lock. Two implant fixtures were embedded in parallel in each custom base mounting. Five pairs of each attachment system were tested. A universal testing machine was used to measure the retentive force during 2500 insertion and removal cycles. Surface changes on the components were evaluated by scanning electron microscopy (SEM). A Kruskal-Wallis test, followed by Pairwise comparison, was used to compare the retentive force between the groups, and to determine groups that were significantly different (?<.05). RESULTS A comparison of the initial retentive force revealed the highest value for Kerator, followed by the O-ring and EZ lock attachments. However, no significant difference was detected between Kerator and O-ring (P>.05). After 2500 insertion and removal cycles, the highest retention loss was recorded for O-ring, and no significant difference between Kerator and EZ lock (P>.05). Also, Kerator showed the highest retentive force, followed by EZ lock and O-ring, after 2500 cycles (P<.05). Based on SEM analysis, the polymeric components in O-ring and Kerator were observed to exhibit surface wear and deformation. CONCLUSION After 2500 insertion and removal cycles, all attachments exhibited significant loss in retention. Mechanism of retention loss can only be partially explained by surface changes. PMID:26330977

  8. Implant-supported overdentures with different bar designs: A retrospective evaluation after 5-19 years of clinical function

    PubMed Central

    Rinke, Sven; Rasing, Hajo; Gersdorff, Nikolaus; Buergers, Ralf

    2015-01-01

    PURPOSE This retrospective study evaluated the outcome of implant-retained overdentures (IODs) after 5-19 years of clinical function. MATERIALS AND METHODS A retrospective analysis of patient files was performed referring to 27 patients who received 36 IODs with 3 different bar designs (group A=prefabricated round bars, n=7; group B=one-piece anterior milled bars, n=20; and group C=two bilaterally placed milled bars, n=9) in the mandible (n=24) and/or in the maxilla (n=12). The analysis focused on the survival and success rates (according to Kaplan-Meier) of the implants and prostheses. Technical complication rates for each type of restoration were analyzed and compared via one-way ANOVA and the Chi-squared test. The prevalence of peri-implantitis (radiographic bone loss ?3.5 mm) was evaluated by digital analysis of panoramic radiographs taken post-operative (baseline) and after 5-19 years of clinical function (follow-up). RESULTS The mean observational time was 7.3 years. The survival rates of the prostheses and implants were 100% and 97.7%, respectively. Technical complications occurred more frequently in group A (mean: 3.5 during observational time) than in the other two groups (B: 0.8; C: 1.0). However, this difference was not statistically significant (P=0.58). Peri-implantitis was diagnosed for 12.4% of the implants in 37% of the patients. CONCLUSION Bar-retained IODs are an adequate treatment option for edentulous jaws. These restorations may exhibit high implant/prosthesis survival rates (>97%), and a limited incidence of technical complications after a mean observational period of >7 years. Nevertheless, peri-implantitis was identified as a frequent and serious biological complication for this type of reconstruction. PMID:26330982

  9. Interforaminal hemorrhage during anterior mandibular implant placement: An overview

    PubMed Central

    Kusum, Chandan Kumar; Mody, Pranav V.; Indrajeet; Nooji, Deviprasad; Rao, Suhas K.; Wankhade, Bhushan Ganesh

    2015-01-01

    Implant surgery in mandibular anterior region may turn from an easy minor surgery into a complicated one for the surgeon, due to inadequate knowledge of the anatomy of the surgical area and/or ignorance toward the required surgical protocol. Hence, the purpose of this article is to present an overview on the: (a) Incidence of massive bleeding and its consequences after implant placement in mandibular anterior region. (b) Its etiology, the precautionary measures to be taken to avoid such an incidence in clinical practice and management of such a hemorrhage if at all happens. An inclusion criterion for selection of article was defined, and an electronic Medline search through different database using different keywords and manual search in journals and books was executed. Relevant articles were selected based upon inclusion criteria to form the valid protocols for implant surgery in the anterior mandible. Further, from the selected articles, 21 articles describing case reports were summarized separately in a table to alert the dental surgeons about the morbidity they could come across while operating in this region. If all the required adequate measures for diagnosis and treatment planning are taken and appropriate surgical protocol is followed, mandibular anterior region is no doubt a preferable area for implant placement. PMID:26288617

  10. Interforaminal hemorrhage during anterior mandibular implant placement: An overview.

    PubMed

    Kusum, Chandan Kumar; Mody, Pranav V; Indrajeet; Nooji, Deviprasad; Rao, Suhas K; Wankhade, Bhushan Ganesh

    2015-01-01

    Implant surgery in mandibular anterior region may turn from an easy minor surgery into a complicated one for the surgeon, due to inadequate knowledge of the anatomy of the surgical area and/or ignorance toward the required surgical protocol. Hence, the purpose of this article is to present an overview on the: (a) Incidence of massive bleeding and its consequences after implant placement in mandibular anterior region. (b) Its etiology, the precautionary measures to be taken to avoid such an incidence in clinical practice and management of such a hemorrhage if at all happens. An inclusion criterion for selection of article was defined, and an electronic Medline search through different database using different keywords and manual search in journals and books was executed. Relevant articles were selected based upon inclusion criteria to form the valid protocols for implant surgery in the anterior mandible. Further, from the selected articles, 21 articles describing case reports were summarized separately in a table to alert the dental surgeons about the morbidity they could come across while operating in this region. If all the required adequate measures for diagnosis and treatment planning are taken and appropriate surgical protocol is followed, mandibular anterior region is no doubt a preferable area for implant placement. PMID:26288617

  11. Implant-supported overdenture manufactured using CAD/CAM techniques to achieve horizontal path insertion between the primary and secondary structure: A clinical case report

    PubMed Central

    Agustín-Panadero, Rubén; Peñarrocha-Oltra, David; Gomar-Vercher, Sonia; Ferreiroa, Alberto

    2015-01-01

    This report describes the case of an edentulous patient with an atrophic maxilla and severe class III malocclusion. Prosthetic rehabilitation was performed using CAD/CAM techniques for manufacturing an implant-supported overdenture with horizontal insertion. A vestibulo-lingual insertion overdenture is a precision prosthesis with a fixation system affording a good fit between the primary and secondary structure. Both structures exhibit passive horizontal adjustment. This treatment option requires the same number of implants as implant-supported fixed dentures. The horizontal assembly system prevents the prosthesis from loosening or moving in response to axial and non-axial forces. The technique was used to rehabilitate a patient presenting an atrophic upper maxilla, with the insertion of 8 implants. No complications were reported at follow-up 3, 6 and 12 months after fitting of the prosthesis. This system offers solutions to the clinical and laboratory complications associated with hybrid prostheses, concealing emergence of the chimneys and improving implant-prosthesis hygiene. PMID:26140179

  12. Implant-supported overdenture manufactured using CAD/CAM techniques to achieve horizontal path insertion between the primary and secondary structure: A clinical case report.

    PubMed

    Agustín-Panadero, Rubén; Peñarrocha-Oltra, David; Gomar-Vercher, Sonia; Ferreiroa, Alberto; Peñarrocha-Diago, Miguel

    2015-06-01

    This report describes the case of an edentulous patient with an atrophic maxilla and severe class III malocclusion. Prosthetic rehabilitation was performed using CAD/CAM techniques for manufacturing an implant-supported overdenture with horizontal insertion. A vestibulo-lingual insertion overdenture is a precision prosthesis with a fixation system affording a good fit between the primary and secondary structure. Both structures exhibit passive horizontal adjustment. This treatment option requires the same number of implants as implant-supported fixed dentures. The horizontal assembly system prevents the prosthesis from loosening or moving in response to axial and non-axial forces. The technique was used to rehabilitate a patient presenting an atrophic upper maxilla, with the insertion of 8 implants. No complications were reported at follow-up 3, 6 and 12 months after fitting of the prosthesis. This system offers solutions to the clinical and laboratory complications associated with hybrid prostheses, concealing emergence of the chimneys and improving implant-prosthesis hygiene. PMID:26140179

  13. Maxillary implant-retained partial overdenture with Dolder bar attachment: a clinical report.

    PubMed

    Kim, Hyeongil; Buhite, Robert J; Monaco, Edward A

    2015-03-01

    This article describes a technique for maintaining a maxillary Kennedy III partial removable dental prosthesis design in a patient who had non-restorable failing abutments by replacing the abutments with dental implants. Two implants were placed immediately after extraction of the abutment teeth in the anterior maxilla. After the implants were fully integrated, a Dolder bar attachment was fitted onto the implants. A new maxillary partial removable dental prosthesis was fabricated using the implants and the remaining natural teeth as abutments to restore function and esthetics. With the aid of dental implants, this Kennedy III maxillary removable dental prosthesis design could provide additional retention and support by promoting cross-arch stability and tissue, implant and tooth support. The patient's satisfaction was significantly increased. PMID:25928972

  14. Telescopic overdenture for oral rehabilitation of ectodermal dysplasia patient

    PubMed Central

    Gupta, Charu; Verma, Mahesh; Gupta, Rekha; Gill, Shubhra

    2015-01-01

    Reduced number of teeth with underdeveloped alveolar ridges poses a greatest prosthetic challenge in rehabilitation of ectodermal dysplasia patients (ED). Furthermore, surgical risks and financial constraints may preclude the implant supported prosthesis, the most desirable treatment option in an adult ED patient. Long edentulous span does not permit fixed dental prosthesis (FDP) as well. Telescopic denture by incorporating the best of both fixed and removable prosthesis can be a viable treatment alternative for ED patients with compromised dentition and limited finances. A 21-year-old young girl presented with chief complaint of esthetics and mastication due to missing upper and lower teeth. A provisional diagnosis of ED was made based on familial history, physical, and oral examination. This clinical report describes management of an adult ED patient by means of telescopic overdenture prosthesis in mandibular arch and FDP in maxillary arch which restored esthetics, function, and social confidence of the patient in a cost effective manner. PMID:26604583

  15. Mandibular reconstruction using free vascularized iliac crest grafts and dental implants

    PubMed Central

    MOLDOVAN, IULIU; JUNCAR, MIHAI; DINU, CRISTIAN; ONISOR-GLIGOR, FLORIN; ROTAR, HORATIU; BRAN, SIMION; BACIUT, GRIGORE

    2015-01-01

    Background and aim The mandible is frequently affected by tumor masses present in the oral cavity and is included in the tumor ablation procedure, with major functional and esthetic consequences for the patient. A method of high current interest in mandibular reconstruction is based on the use of free vascularized iliac crest grafts, followed by reconstruction using dental implants. Methods This study presents the case of four patients benefiting from this treatment method, and monitors the treatment stages and their clinical evolution after mandibular reconstruction and dental implant placement. Results The postoperative evolution of the patients was favorable, with the integration of the iliac crest grafts and dental implants. After prosthetic loading, the masticatory as well as the esthetic function of the patients was restored to a standard close to the initial one. Conclusions This mandibular reconstruction method proved to be effective, with a high degree of reliability and a significant improvement of the patients’ quality of life.

  16. 21 CFR 874.3695 - Mandibular implant facial prosthesis.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ...in the functional reconstruction of mandibular deficits. The device is made of materials such as stainless steel, tantalum, titanium, cobalt-chromium based alloy, polytetrafluoroethylene, silicone elastomer, polyethylene, polyurethane, or...

  17. An Alternative Technique for Fabrication of Frameworks in an Immediate Loading Implant Fixed Mandibular Prosthesis

    PubMed Central

    Paleari, André Gustavo; Presoto, Cristina Dupim; Vasconcelos, Juliano Alencar; Nunes Reis, José Maurício dos Santos; Pinelli, Lígia Antunes Pereira; Tavares da Silva, Regina Helena Barbosa; Quishida, Cristiane Campos Costa

    2015-01-01

    The oral rehabilitation of edentulous patients with immediate loading has become a safe procedure with high predictability. The success is related to immediate fabrication of a passive fit framework to attach the implants. Based on these considerations, this case report shows an alternative technique for mandibular rehabilitation using implants immediately loaded, where the framework was fabricated using cylinders with internal reinforcement and precast pieces, electrowelding, and conventional welding providing esthetics and function to the patient in a short period of time. PMID:25628899

  18. An alternative technique for fabrication of frameworks in an immediate loading implant fixed mandibular prosthesis.

    PubMed

    Paleari, André Gustavo; Presoto, Cristina Dupim; Vasconcelos, Juliano Alencar; Nunes Reis, José Maurício Dos Santos; Pinelli, Lígia Antunes Pereira; Tavares da Silva, Regina Helena Barbosa; Quishida, Cristiane Campos Costa

    2015-01-01

    The oral rehabilitation of edentulous patients with immediate loading has become a safe procedure with high predictability. The success is related to immediate fabrication of a passive fit framework to attach the implants. Based on these considerations, this case report shows an alternative technique for mandibular rehabilitation using implants immediately loaded, where the framework was fabricated using cylinders with internal reinforcement and precast pieces, electrowelding, and conventional welding providing esthetics and function to the patient in a short period of time. PMID:25628899

  19. Experimental findings on customized mandibular implants in Göttingen minipigs - a pilot study.

    PubMed

    Markwardt, J; Sembdner, P; Lesche, R; Jung, R; Spekl, K; Mai, R; Schulz, M C; Reitemeier, B

    2014-01-01

    Reconstructing continuity defects of the mandible is still challenging for surgeons. The currently applied conventional titanium bridging plates have considerable rates of complications. Now, a new technology enables an individual shape-identical creation of a mandibular implant in a form-board design by the method of LaserCUSING using pure titanium. This technology has been successfully performed in previous examinations to individually reconstruct mandibular continuity defects. This pilot study evaluated the surgical procedure in 10 female Göttingen mini pigs. First, a computed tomography scan from a mini pig cranium was performed. A three-dimensional model of the mandible was designed by data conversion. Based on the data, a customized mandibular implant resembling the natural shape was virtually created and manufactured. Then, a continuity defect of the left mandible was created in a standardized way. The implants were inserted into the defect and the wounds were allowed to heal for 21, 35, 56 and 180 days. During the healing period, no signs of inflammation or infection were observed. After the sacrifice of the minipigs the mandibles were resected. Histological microsections using Donath's sawing and grinding technique were manufactured and stained with Masson Goldner trichrome staining. The histomorphological results showed a pronounced ossification at the outer and inner surface of the implants. This animal study describes a promising approach to optimize customized implants for the application in humans. PMID:24189298

  20. Evaluation of Hi-Tec Implant Restoration in Mandibular First Molar Region- A Prospective Clinical Study

    PubMed Central

    Sreeram, Roopa Rani. S.; Prasad, L Krishna; Chakravarthi, P Srinivas; Devi, Naga Neelima; Sreeram, Sanjay Krishna

    2015-01-01

    Background and Aims Missing teeth lead to loss of structural balance, inefficient function, poor aesthetics and psychological effects on human beings, which needs restoration for normal contour, function and aesthetics. Several natural or synthetic substitutes are being used for replacement of missing tooth since centuries. Implants are the latest modality of replacement. So, the study was aimed to assess clinical success rate of Hi-Tec implant; which is economical and new in market. Results of the study will help clinician for appropriate implant selection. Materials and Methods The study included 10 patients from 19 to 31 years and needed restoration of missing mandibular first molar. Restoration had done using Hi Tec Single-tooth implants with metal-ceramic single crown prosthesis after three months of osseointegration. The implants were evaluated clinically (bleeding on probing, probing depth, implant mobility- periotest) and radiographically (marginal bone loss and peri-implant radiolucency) for six years. The observers were blinded for the duration of the study to prevent bias. Results All the patients had uneventful post-surgical healing. No bleeding on probing, Implant mobility, peri-implant radiolucency with minimal marginal bone loss and constant probing depths were observed well within the normal range during follow-up periods. Conclusion Two stage single-tooth Hi Tec implant restoration can be used as a successful treatment modality for replacing mandibular first molar in an economic way. However, these results were obtained after 6 years of follow up with a smaller sample size, so long term multi center studies with a larger sample size is recommended for the predictability of success rate conclusively. PMID:26436053

  1. Design and finite element analysis of a novel sliding rod microscrew implantation device for mandibular prognathism

    PubMed Central

    Li, Yanfeng; Lv, Yuan; Lu, Yongjin; Zeng, Pan; Zeng, Xianglong; Guo, Xiaoqian; Han, Weili

    2015-01-01

    Tooth distalization is an effective approach for mandibular prognathism. Current distalization devices are bulky and clinically complicated. Here, we designed a novel molar distalization device by using a sliding rod and a microscrew and performed a mechanical analysis and finite element model (FEM) analysis of force distribution and displacement of the upper canine, first and second premolar and first molar. A 2D FEM was constructed using the Beam3 element and a 3D FEM was constructed of the mandibular teeth, the periodontal membrane, and the alveolar bones using the UG software. The upper first molar was divided into 12 points on the dental surface to facilitate stress analysis. Force analysis using the ANSYS WORKBECNH revealed that, both horizontally and vertically, the traction force causing distalization of the first molar decreased when the spring coil moved down the L shaped sliding rod. The 3D FEM force analysis revealed distomedial displacement of the upper first molar when the sliding rod microscrew implantation device caused distalization of the molar. These findings support further exploration for the use of the sliding rod microscrew implants as an anchorage for group distal movement of the teeth of patients with mandibular prognathism. PMID:26379860

  2. Remedy for Repeated Implant Retained Denture Fracture-A Challenging Case Report

    PubMed Central

    Reddy M, Ramu; Metta, Kiran Kumar; Charry N, Sudheer; B, Chittaranjan

    2014-01-01

    The most common site of fracture in a maxillary or a mandibular complete denture is along an anteroposterior line that coincides with the labial notch in in the denture which used to provide the frenum relief. Osseointegrated implants have been a boon to the patients who are completelly edentulous and are not satisfied with the conventional removable complete denture approach.Implant supported dentures have proven to provide superior retention and support for removable complete dentures. Nevertheless, fracture of the denture bases is a common complication of implant-supported mandibular overlay dentures,ecspecially when the artificial denture is opposing natural dentition. This article describes and illustrates a method of reinforcing implant-supported mandibular overdentures to overcome this problem. PMID:25584333

  3. Accuracy of vertical height measurements on direct digital panoramic radiographs using posterior mandibular implants and metal balls as reference objects

    PubMed Central

    Vazquez, L; Nizamaldin, Y; Combescure, C; Nedir, R; Bischof, M; Dohan Ehrenfest, DM; Carrel, J-P; Belser, UC

    2013-01-01

    Objectives: Conventional panoramic radiography, a widely used radiographic examination tool in implant treatment planning, allows evaluation of the available bone height before inserting posterior mandibular implants. Image distortion and vertical magnification due to projection geometry is well described for rotational panoramic radiographs. To assess the accuracy of vertical height measurements on direct digital panoramic radiographs, implants and metal balls positioned in the posterior mandible were used as radio-opaque reference objects. The reproducibility of the measuring method was assessed by the inter- and intraobserver agreements. Methods: Direct digital panoramic radiographs, performed using a Kodak 8000C (Eastman Kodak Company, Rochester, NY), of 17 partially edentulous patients (10 females, 7 males, mean age 65 years) were selected from an X-ray database gathered during routine clinical evaluation of implant sites. Proprietary software and a mouse-driven calliper were used to measure the radiological length of 25 implants and 18 metal reference balls, positioned in mandibular posterior segments. The distortion ratio (DR) was calculated by dividing the radiological implant length by the implant's real length and the radiological ball height by the ball's real height. Results: Mean vertical DR was 0.99 for implants and 0.97 for balls, and was unrelated to mandibular sites, side, age, gender or observer. Inter- and intraobserver agreements were acceptable for both reference objects. Conclusions: Vertical measurements had acceptable accuracy and reproducibility when a software-based calibrated measurement tool was used, confirming that digital panoramic radiography can be reliably utilized to determine the pre-operative implant length in premolar and molar mandibular segments. PMID:23360688

  4. Scapular Free Vascularised Bone Flaps for Mandibular Reconstruction: Are Dental Implants Possible?

    PubMed Central

    Gander, Thomas; Grätz, Klaus; Rostetter, Claudio; Zweifel, Daniel; Bredell, Marius

    2015-01-01

    ABSTRACT Objectives Free fibula flap remains the flap of choice for reconstruction of mandibular defects. If free fibula flap is not possible, the subscapular system of flaps is a valid option. In this study, we evaluated the possibility of dental implant placement in patients receiving a scapular free flap for oromandibular reconstruction. Material and Methods We retrospectively reviewed 10 patients undergoing mandible reconstruction with a subscapular system free-tissue (lateral border of the scapula) transfer at the University Hospital Zürich between January 1, 2010 and January 1, 2013. Bone density in cortical and cancellous bone was measured in Hounsfield units (HU). Changes of bone density, height and width were analysed using IBM SPSS Statistics 22. Comparisons of bone dimensions as well as bone density were performed using a chi-square test. Results Ten patients were included. Implantation was conducted in 50%. However, all patients could have received dental implants considering bone stock. Loss of bone height and width were significant (P < 0.001). There was a statistical significant increase in bone density in cortical (P < 0.001) and cancellous (P = 0.004) bone. Conclusions Dental implants are possible after scapular free flap reconstruction of oromandibular defects. Bone height and width were reduced, while bone density increased with time. PMID:26539286

  5. Implant-supported fixed restoration of post-traumatic mandibular defect accompanied with skin grafting: A clinical report

    PubMed Central

    Noh, Kwantae; Choi, Woo-Jin

    2013-01-01

    Traumatic defects are mostly accompanied by hard and soft tissue loss. This report describes the surgical and prosthetic treatment of a patient with post-traumatic mandibular defect. A split-thickness skin graft was performed prior to implant placement and prefabricated acrylic stent was placed to hold the graft in place. The esthetic and functional demands of the patient were fulfilled by implant-supported screw-retained fixed prosthesis using CAD-CAM technology. PMID:23508120

  6. Clinical results of alveolar ridge augmentation with mandibular block bone grafts in partially edentulous patients prior to implant placement.

    PubMed

    Cordaro, Luca; Amadé, David Sarzi; Cordaro, Massimo

    2002-02-01

    A group of 15 partially edentulous patients who needed alveolar ridge augmentation for implant placement, were consecutively treated using a two-stage technique in an outpatient environment. A total of 18 alveolar segments were grafted. During the first operation bone blocks harvested from the mandibular ramus or symphysis were placed as lateral or vertical onlay grafts and fixed with titanium osteosynthesis screws after exposure of the deficient alveolar ridge. After 6 months of healing the flap was re-opened, the screws were removed and the implants placed. Twelve months after the first operation implant-supported fixed bridges could be provided to the patients. Mean lateral augmentation obtained at the time of bone grafting was 6.5 +/- 0.33 mm, that reduced during healing because of graft resorption to a mean of 5.0 +/- 0.23 mm. Mean vertical augmentation obtained in the 9 sites where it was needed was 3.4 +/- 0.66 mm at bone grafting and 2.2 +/- 0.66 mm at implant placement. Mean lateral and vertical augmentation decreased by 23.5% and 42%, respectively, during bone graft healing (before implant insertion). Mandibular sites showed a larger amount of bone graft resorption than maxillary sites. All the 40 implants placed were integrated at the abutment connection and after prosthetic loading (mean follow-up was 12 months). No major complications were recorded at donor or recipient sites. Soft tissue healing was uneventful, and pain and swelling were comparable to usual dentoalveolar procedures. A visible ecchymosis was present for 4 to 7 days when the bone was harvested from the mandibular symphysis. From a clinical point of view this procedure appears to be simple, safe and effective for treating localised alveolar ridge defects in partially edentulous patients. PMID:12005140

  7. The Value of SPECT/CT in Monitoring Prefabricated Tissue-Engineered Bone and Orthotopic rhBMP-2 Implants for Mandibular Reconstruction

    PubMed Central

    Zhou, Miao; Peng, Xin; Mao, Chi; Tian, Jia-he; Zhang, Shu-wen; Xu, Fang; Tu, Jing-jing; Liu, Sheng; Hu, Min; Yu, Guang-yan

    2015-01-01

    Bone tissue engineering shows good prospects for mandibular reconstruction. In recent studies, prefabricated tissue-engineered bone (PTEB) by recombinant human bone morphogenetic proteins (rhBMPs) applied in vivo has found to be an effective alternative for autologous bone grafts. However, the optimal time to transfer PTEB for mandibular reconstruction is still not elucidated. Thus, here in an animal experiment of rhesus monkey, the suitable transferring time for PTEB to reconstruct mandibular defects was evaluated by 99mTc-MDP SPECT/CT, and its value in monitoring orthotopic rhBMP-2 implants for mandibular reconstruction was also evaluated. The result of SPECT/CT showed higher 99mTc-MDP uptake, indicating osteoinductivity, in rhBMP-2 incorporated demineralized freeze-dried bone allograft (DFDBA) and coralline hydroxyapatite (CHA) implants than those without BMP stimulation. 99mTc-MDP uptake of rhBMP-2 implant peaked at 8 weeks following implantation while CT showed the density of these implants increased after 13 weeks’ prefabrication. Histology confirmed that mandibular defects were repaired successfully with PTEB or orthotopically rhBMP-2 incorporated CHA implants, in accordance with SPECT/CT findings. Collectively, data shows 99mTc-MDP SPECT/CT is a sensitive and noninvasive tool to monitor osteoinductivity and bone regeneration of PTEB and orthotopic implants. The PTEB achieved peak osteoinductivity and bone density at 8 to 13 weeks following ectopic implantation, which would serve as a recommendable time frame for its transfer to mandibular reconstruction. PMID:26340447

  8. Influence of ridge inclination and implant localization on the association of mandibular Kennedy class I removable partial denture.

    PubMed

    Cunha, Lígia Del' Arco Pignatta; Pellizzer, Eduardo Piza; Verri, Fellippo Ramos; Falcón-Antenucci, Rosse Mary; Goiato, Marcelo Coelho

    2011-05-01

    The aim of this study was to evaluate the tendency of displacement of the supporting structures of the distal extension removable partial denture (DERPD) associated to the implant with different inclinations of alveolar ridge and implant localizations through a two-dimensional finite-element method. Sixteen mandibular models were fabricated, presenting horizontal, distally descending, distally ascending, or descending-ascending ridges. All models presented the left canine and were rehabilitated with conventional DERPD or implant-retained prosthesis with the ERA system. The models were obtained by the AutoCAD software and transferred to the finite-element software ANSYS 9.0 for analysis. A force of 50 N was applied on the cusp tips of the teeth, with 5 points of loading of 10 N. The results were visualized by displacement maps. For all ridge inclinations, the assembly of the DERPD with distal plate retained by an anterior implant exhibited the lowest requisition of the supporting structures. The highest tendency of displacement occurred in the model with distally ascending ridge with incisal rest. It was concluded that the association of the implant decreased the displacement of the DERPD, and the anterior positioning of the implant associated to the DERPD with the distal plate preserved the supporting structures for all ridges. PMID:21558932

  9. Edentulous maxillary arch fixed implant rehabilitation using a hybrid prosthesis made of micro-ceramic-composite: case report.

    PubMed

    Geckili, Onur; Bilhan, Hakan; Ceylan, Gulsum; Cilingir, Altug

    2013-02-01

    The prosthetic treatment of patients with an edentulous maxilla opposing mandibular natural teeth is one of the most challenging endeavors that face clinicians. Occlusal forces from the opposing natural teeth may cause fractures in the maxillary prosthesis and also result in advanced bone loss of the edentulous maxilla. With the presence of extreme gagging reflex, the treatment may become more complicated. This article describes and illustrates the 2-stage surgical and prosthetic treatment of a patient with an edentulous maxilla opposing natural teeth. In the beginning, the patient was treated with 4 implants and a maxillary implant-supported overdenture. The extreme gagging reflex and the occlusal forces from the mandibular natural teeth obligated the team a second stage surgical and prosthetic treatment, which included increasing the number of implants after bilateral sinus lifting in the posterior maxilla and fabricating a maxillary fixed hybrid prosthesis made of micro-ceramic composite that yielded a satisfactory result. PMID:20932120

  10. All-on-4 concept implantation for mandibular rehabilitation of an edentulous patient with Parkinson disease: A clinical report.

    PubMed

    Liu, Fang-Chun; Su, Wei-Chia; You, Chia-Hsun; Wu, Aaron Yu-Jen

    2015-12-01

    Parkinson disease (PD) is a progressive neurologic disorder. Compromised voluntary and involuntary muscle control of the orofacial-pharyngeal muscles of patients with PD may lead to difficulty in mastication, dysphagia, and tremor of the mouth and chin. All of these problems represent major challenges for the clinician with respect to the oral rehabilitation. This clinical report describes the use of the All-on-4 concept implantation for mandibular rehabilitation with a fixed detachable dental prosthesis in an edentulous patient with PD. The treatment steps, outcome, and limitations are discussed. PMID:26409584

  11. Finite element analysis of dental implant loading on atrophic and non-atrophic cancellous and cortical mandibular bone - a feasibility study.

    PubMed

    Marcián, Petr; Borák, Libor; Valášek, Ji?í; Kaiser, Jozef; Florian, Zden?k; Wolff, Jan

    2014-12-18

    The first aim of this study was to assess displacements and micro-strain induced on different grades of atrophic cortical and trabecular mandibular bone by axially loaded dental implants using finite element analysis (FEA). The second aim was to assess the micro-strain induced by different implant geometries and the levels of bone-to-implant contact (BIC) on the surrounding bone. Six mandibular bone segments demonstrating different grades of mandibular bone atrophy and various bone volume fractions (from 0.149 to 0.471) were imaged using a micro-CT device. The acquired bone STL models and implant (Brånemark, Straumann, Ankylos) were merged into a three-dimensional finite elements structure. The mean displacement value for all implants was 3.1 ±1.2 µm. Displacements were lower in the group with a strong BIC. The results indicated that the maximum strain values of cortical and cancellous bone increased with lower bone density. Strain distribution is the first and foremost dependent on the shape of bone and architecture of cancellous bone. The geometry of the implant, thread patterns, grade of bone atrophy and BIC all affect the displacement and micro-strain on the mandible bone. Preoperative finite element analysis could offer improved predictability in the long-term outlook of dental implant restorations. PMID:25468296

  12. Comprehensive Comparison of the 5-Year Results of All-on-4 Mandibular Implant Systems With Acrylic and Ceramic Suprastructures.

    PubMed

    Ayna, Mustafa; Gülses, Aydin; Açil, Yahya

    2015-12-01

    The objective of the present study was to evaluate the comprehensive 5-year results of fixed mandibular dentures fabricated from metal-acrylic or metal-ceramics according to the All-on-4 protocol. Twenty-seven patients who received immediately loaded All-on-4 fixed mandibular dentures in 2006 were included in the study, and they were evaluated up to 5 years after denture integration. Endpoints were chosen in accordance with the 2007 Pisa consensus and included bone resorption, the Oral Health Impact Profile (OHIP), the sulcus fluid flow rate (SFFR), and prosthodontic complications. The initial situation in both groups was largely identical. Bone loss remained under 2 mm after 5 years in all implants and showed no group difference. The SFFR showed a gradual increase in both groups, and acrylic-bearing implants showed a substantially and significantly higher flow rate from the third year onward. The subjective improvement as expressed by the OHIP score was immediate and dramatic, and it showed no group differences. All acrylic restorations showed some extent of abrasion, and veneer fractures occurred in 4 patients (28.6%). Besides a single fracture of a fixation screw, there were no prosthetic complications in patients with ceramic suprastructures. According to bone loss and subjective outcome, acrylic and ceramic suprastructures appeared to be equivalent after 5 years; however, sulcus flow and prosthodontic complications suggest that the economic advantage of acrylic dentures may be specious. The rational choice of implant suprastructures requires comprehensive, long-term observation. Short-term economic benefits might be cancelled out in the long term. PMID:24712706

  13. Bar attachments for overdentures with nonparallel abutments.

    PubMed

    Evans, D B; Koeppen, R G

    1992-07-01

    Bar attachments are easily fabricated and provide increased retention and support for overdentures. Nonparallel root abutments can preclude the routine use of bar attachments unless modifications are made in the design. This article reviews several existing techniques to successfully fabricate bar attachments in overdenture patients with nonparallel abutments. In addition, three alternative methods are presented for placing bar attachments on abutments with divergent roots. PMID:1403922

  14. Influence of implant inclination associated with mandibular class I removable partial denture.

    PubMed

    de Freitas Santos, Ciandrus Moraes; Pellizzer, Eduardo Piza; Verri, Fellippo Ramos; de Moraes, Sandra Lúcia Dantas; Falcón-Antenucci, Rosse Mary

    2011-03-01

    The aim of this study was to use two-dimensional finite element method to evaluate the displacement and stress distribution transmitted by a distal extension removable partial denture (DERPD) associated with an implant placed at different inclinations (0, 5, 15, and 30 degrees) in the second molar region of the edentulous mandible ridge. Six hemimandibular models were created: model A, only with the presence of the natural tooth 33; model B, similar to model A, with the presence of a conventional DERPD replacing the missing teeth; model C, similar to the previous model, with a straight implant (0 degrees) in the distal region of the ridge, under the denture base; model D, similar to model C, with the implant angled at 5 degrees in the mesial direction; model E, similar to model C, with the implant angled at 15 degrees in the mesial direction; and model F, similar to ME, with the implant angled at 30 degrees in the mesial direction. The models were created with the use of the AutoCAD 2000 program (Autodesk, Inc, San Rafael, CA) and processed for finite element analysis by the ANSYS 8.0 program (Swanson Analysis Systems, Houston, PA). The force applied was vertical of 50 N on each cusp tip. The results showed that the introduction of the RPD overloaded the supporting structures of the RPD and that the introduction of the implant helped to relieve the stresses of the mucosa alveolar, cortical bone, and trabecular bone. The best stress distribution occurred in model D with the implant angled at 5 degrees. The use of an implant as a support decreased the displacement of alveolar mucosa for all inclinations simulated. The stress distribution transmitted by the DERPD to the supporting structures was improved by the use of straight or slightly inclined implants. According to the displacement analysis and von Mises stress, it could be expected that straight or slightly inclined implants do not represent biomechanical risks to use. PMID:21415633

  15. Metastatic Breast Cancer in Medication-Related Osteonecrosis Around Mandibular Implants

    PubMed Central

    Favia, Gianfranco; Tempesta, Angela; Limongelli, Luisa; Crincoli, Vito; Piattelli, Adriano; Maiorano, Eugenio

    2015-01-01

    Patient: Female, 66 Final Diagnosis: Breast cancer metastasis in medication-related osteonecrosis of the jaw Symptoms: — Medication: — Clinical Procedure: Clinical and radiological examination • surgical treatment Specialty: Dentistry Objective: Rare co-existance of disease or pathology Background: Many authors have considered dental implants to be unrelated to increased risk of medication-related osteonecrosis of the jaw (MRONJ). Nevertheless, more recently, more cases of peri-implant MRONJ (PI-MRONJ) have been described, thus becoming a challenging health problem. Also, metastatic cancer deposits are not infrequently found at peri-implant sites and this may represent an additional complication for such treatments. We present the case of a breast cancer patient with PI-MRONJ, presenting a clinically and radiologically undetected metastasis within the necrotic bone, and highlight the necessity of an accurate histopathological analysis. Case Report: A 66-year-old female patient, who had received intravenous bisphosphonates for bone breast cancer metastases, came to our attention for a non-implant surgery-triggered PI-MRONJ. After surgical resection of the necrotic bone, conventional and immunohistochemical examinations were performed, which showed breast cancer deposits within the necrotic bone. Conclusions: Cancer patients with metastatic disease, who are undergoing bisphosphonate treatment, may develop unusual complications, including MRONJ, which is a site at risk for hosting additional metastatic deposits that may be clinically and radiologically overlooked. Such risk is increased by previous or concomitant implant procedures. Consequently, clinicians should be prudent when performing implant surgery in cancer patients with advanced-stage disease and consider the possible occurrence of peri-implant metastases while planning adequate treatments in such patients. PMID:26371774

  16. Reconstruction of mandibular vertical defects for dental implants with autogenous bone block grafts using a tunnel approach: clinical study of 50 cases.

    PubMed

    Restoy-Lozano, A; Dominguez-Mompell, J L; Infante-Cossio, P; Lara-Chao, J; Espin-Galvez, F; Lopez-Pizarro, V

    2015-11-01

    The objective of this study was to evaluate the outcomes of mandibular vertical defect reconstruction with autologous bone and the use of a sub-periosteal tunnel approach in preparation for dental implant insertion. Forty-three consecutive patients with an atrophic posterior mandible were reconstructed using this method. Two thin laminae of cortical bone, obtained by splitting blocks harvested from the retromolar area, were fixed in a box-like framework containing cancellous and particulate bone. The goal was to achieve an alveolar ridge width of ?5.5mm and an effective bone height (EBH) of ?10.5mm for dental implant insertion (?3.4mm diameter, ?9.5mm length). Fifty reconstruction procedures were performed. The mean EBH was 7.1±1.3mm pre-treatment and 12.3±1.1mm post-treatment (mean increase 5.2±1.4mm). Complete graft loss was recorded in two cases; the remaining complications were minor. After a mean consolidation period of 3.5 months, 96 dental implants were placed. No failure of osseointegration was observed at follow-up (mean 32.9 months). The average bone height reduction was 0.9mm (graft vertical resorption 17.4%). Reconstruction of posterior mandibular vertical defects using two autogenous cortical bone blocks with particulate bone between them, combined with a tunnelling technique, provided good healing with no wound dehiscence and minimum resorption of the grafted bone, favouring a substantial vertical bone gain. PMID:26116063

  17. 21 CFR 872.3960 - Mandibular condyle prosthesis.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... MEDICAL DEVICES DENTAL DEVICES Prosthetic Devices § 872.3960 Mandibular condyle...prosthesis is a device that is intended to be implanted in the human jaw to replace the mandibular...mandibular condyle prosthesis intended to be implanted in the human jaw for temporary...

  18. 21 CFR 872.3960 - Mandibular condyle prosthesis.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... MEDICAL DEVICES DENTAL DEVICES Prosthetic Devices § 872.3960 Mandibular condyle...prosthesis is a device that is intended to be implanted in the human jaw to replace the mandibular...mandibular condyle prosthesis intended to be implanted in the human jaw for temporary...

  19. 21 CFR 872.3960 - Mandibular condyle prosthesis.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... MEDICAL DEVICES DENTAL DEVICES Prosthetic Devices § 872.3960 Mandibular condyle...prosthesis is a device that is intended to be implanted in the human jaw to replace the mandibular...mandibular condyle prosthesis intended to be implanted in the human jaw for temporary...

  20. Reconstruction of the extremely atrophied mandible with iliac crest onlay grafts followed by two endosteal implants: a retrospective study with long-term follow-up.

    PubMed

    Boven, G C; Meijer, H J A; Vissink, A; Raghoebar, G M

    2014-05-01

    Treatment outcomes of implant-retained lower dentures on two endosseous implants placed in severely atrophied mandibles after reconstruction with iliac crest onlay grafts were assessed in a retrospective observational study. All consecutive patients treated between 2000 and 2007 were recalled in 2012 (n=40). Survival of the implants, the condition of hard and soft peri-implant tissues, and patient satisfaction were scored. One implant was lost after 5.5 years. The mean mandibular symphysis height was 8.9±2.2, 16.4±2.7, 15.7±2.7, and 15.4±2.5mm at intake, after augmentation, after implantation, and at the last recall visit, respectively. Mean radiographic peri-implant bone loss was 0.6±0.7mm. Mean clinical index scores were very low. Patient satisfaction was high. Surgical complications related to the donor site were seroma (n=1), haematoma (n=2), and sensory disturbance of the lateral femoral cutaneous nerve (n=1); all had resolved before placement of the implants. Eleven patients reported postsurgical sensory disturbances of the mental nerve, of whom five still experienced some sensory disturbance at the last recall visit. Augmentation of the extremely resorbed mandible with an iliac crest onlay graft followed by placement of two implants 4 months later provides a solid basis for a bar-retained overdenture with favourable clinical and radiographic results. PMID:24411276

  1. Effect of difference in occlusal contact area of mandibular free-end edentulous area implants on periodontal mechanosensitive threshold of adjacent premolars.

    PubMed

    Terauchi, Rie; Arai, Korenori; Tanaka, Masahiro; Kawazoe, Takayoshi; Baba, Shunsuke

    2015-01-01

    Implant treatment is believed to cause minimal invasion of remaining teeth. However, few studies have examined teeth adjacent to an implant region. Therefore, this study investigated the effect of occlusal contact size of implants on the periodontal mechanosensitive threshold of adjacent premolars. A cross-sectional study design was adopted. The Department of Oral Implantology, Osaka Dental University, was the setting where patients underwent implant treatment in the mandibular free-end edentulous area. The study population comprised of 87 patients (109 teeth) who underwent follow-up observation for at least 3 years following implant superstructure placement. As variables, age, sex, duration following superstructure placement, presence or absence of dental pulp, occlusal contact area, and periodontal mechanosensitive threshold were considered. The occlusal contact area was measured using Blue Silicone(®)and Bite Eye BE-I(®). Periodontal mechanosensitive threshold were measured using von Frey hair. As quantitative variables for periodontal mechanosensitive threshold, we divided subjects into two groups: normal (?5 g) and high (?5.1 g). For statistical analysis, we compared the two groups for the sensation thresholds using the Chi square test for categorical data and the Mann-Whitney U test for continuous volume data. For variables in which a significant difference was noted, we calculated the odds ratio (95 % confidence interval) and the effective dose. There were 93 teeth in the normal group and 16 teeth in the high group based on periodontal mechanosensitive threshold. Comparison of the two groups indicated no significant differences associated with age, sex, duration following superstructure placement, or presence or absence of dental pulp. A significant difference was noted with regard to occlusal contact area, with several high group subjects belonging to the small contact group (odds ratio: 4.75 [1.42-15.87]; effective dose: 0.29). The results of this study suggest an association between implant occlusal contact area and the periodontal mechanosensitive threshold of adjacent premolars. Smaller occlusal contact application resulted in an increased threshold. It appears that prosthodontic treatment should aim not only to improve occlusal function but also to maintain oromandibular function with regard to the preservation of remaining teeth. PMID:26609505

  2. A 5-Year Implant Follow-Up in Maxillary and Mandibular Horizontal Osseous Onlay Grafts and Native Bone.

    PubMed

    Sbordone, Carolina; Toti, Paolo; Martuscelli, Ranieri; Guidetti, Franco; Sbordone, Ludovico; Ramaglia, Luca

    2015-10-01

    The purpose of this study is to analyze marginal bone levels (MBLs) around dental implants positioned in the upper and lower jaw with or without horizontal onlay grafting procedures, and to survey implant survival with a follow-up of 5 years. Seventeen patients were surveyed in the present retrospective chart review. A total of 27 dental implants positioned in pristine bone and 21 in horizontally grafted bone were enrolled. MBLs were recorded for 4 aspects during a radiologic survey of 5 years. Significant differences were searched for among times and surgical procedures with paired and unpaired comparison tests, respectively, and survival rates were calculated for the 2 groups. In the maxilla, no statistically-significant differences between pristine and augmented groups were obtained; the time comparisons for pristine implants showed an affection of palatal, mesial, and distal sides, whereas the resorption around implants placed into horizontally grafted bone of anterior maxilla seemed to be limited just to buccal and distal aspects. Comparisons with the pristine horizontal procedure revealed that just the buccal sides were involved. The analysis of time comparisons attested to a continuous alveolar bone remodeling during the entire time of the survey for the pristine group. Given the extremely unfavorable resorption at the buccal aspect of the augmented areas, clinicians should reserve dental implant positioning into horizontal bone graft to selected patients, in whom it may represent one of the last opportunities of rehabilitation with a fixed prosthesis. PMID:24593180

  3. 21 CFR 872.3960 - Mandibular condyle prosthesis.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 21 Food and Drugs 8 2014-04-01 2014-04-01 false Mandibular condyle prosthesis. 872.3960 Section... (CONTINUED) MEDICAL DEVICES DENTAL DEVICES Prosthetic Devices § 872.3960 Mandibular condyle prosthesis. (a) Identification. A mandibular condyle prosthesis is a device that is intended to be implanted in the human jaw...

  4. 21 CFR 872.3960 - Mandibular condyle prosthesis.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Mandibular condyle prosthesis. 872.3960 Section... (CONTINUED) MEDICAL DEVICES DENTAL DEVICES Prosthetic Devices § 872.3960 Mandibular condyle prosthesis. (a) Identification. A mandibular condyle prosthesis is a device that is intended to be implanted in the human jaw...

  5. 21 CFR 872.3960 - Mandibular condyle prosthesis.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 21 Food and Drugs 8 2012-04-01 2012-04-01 false Mandibular condyle prosthesis. 872.3960 Section... (CONTINUED) MEDICAL DEVICES DENTAL DEVICES Prosthetic Devices § 872.3960 Mandibular condyle prosthesis. (a) Identification. A mandibular condyle prosthesis is a device that is intended to be implanted in the human jaw...

  6. 21 CFR 872.3960 - Mandibular condyle prosthesis.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 21 Food and Drugs 8 2011-04-01 2011-04-01 false Mandibular condyle prosthesis. 872.3960 Section... (CONTINUED) MEDICAL DEVICES DENTAL DEVICES Prosthetic Devices § 872.3960 Mandibular condyle prosthesis. (a) Identification. A mandibular condyle prosthesis is a device that is intended to be implanted in the human jaw...

  7. 21 CFR 872.3960 - Mandibular condyle prosthesis.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 21 Food and Drugs 8 2013-04-01 2013-04-01 false Mandibular condyle prosthesis. 872.3960 Section... (CONTINUED) MEDICAL DEVICES DENTAL DEVICES Prosthetic Devices § 872.3960 Mandibular condyle prosthesis. (a) Identification. A mandibular condyle prosthesis is a device that is intended to be implanted in the human jaw...

  8. Onlay grafts in combination with endosseous implants in severe mandibular atrophy: one year results of a prospective, quantitative radiological study.

    PubMed

    Verhoeven, J W; Ruijter, J; Cune, M S; Terlou, M; Zoon, M

    2000-12-01

    In taking an overall view of the radiographs made of patients that underwent simultaneous onlay-grafting and implant placement in the anterior mandible, changes are seen in the grafts. The impression arose that a number of stages could be distinguished in this process of remodelling of the graft. The purpose of the present study was to objectivate the existence of those stages in the first year after bone-grafting by densitometric and height measurements of the onlay grafts using standardized extraoral radiographs (OLCR) and densitometric analysis in a group of 8 patients. OLCRs were taken at regular intervals in the first year after surgery. The measurements were performed in three fixed fields, both ventrally and dorsally of each implant. Generally the densitometric measurement fields were located at the (upper) cortex, the upper spongiosa and the lower spongiosa of the onlay graft. The OLCRs were also used for measurements of the height of the complete graft and of the thickness of the cortex of the graft, using a gauged caliper. The results indicate the following remodelling of the structure of the onlay grafts: 1) decrease in the thickness and the radiographic density of the (upper) cortex of the onlay graft predominantly in the first 6-month period; 2) no significant changes in the radiographic density of the upper spongeous part of the graft; 3) a decrease of approximately 25% in the overall height of the graft, particularly during the first 6-month period; 4) an increase in the radiographic density of the lower part of the spongeous bone in the second 6-month period. It is concluded that the remodelling of the graft has a predictable pattern in time: the first half year being dominated by bone resorption, mainly confined to the cortex of the graft, whereas the second half year is characterized by an increase in bone density in the (remaining) cortex as well as the lower spongeous parts of the graft. PMID:11168252

  9. Cemented and screw-retained implant-supported single-tooth restorations in the molar mandibular region: A retrospective comparison study after an observation period of 1 to 4 years

    PubMed Central

    Peñarrocha-Diago, Miguel; Pradíes, Guillermo; Sola-Ruiz, María-Fernanda; Agustín-Panadero, Rubén

    2015-01-01

    Objectives: The aim of this study was to evaluate the survival and compare the appearance of different mechanical and biological complications, in screw-retained and cemented-retained single-tooth implant-supported restorations localized in the molar mandibular region, over a period of 1 to 4 years. Material and Methods: A retrospective study was carried out with a total of eighty implant-supported restorations, which were placed in eighty patients for prosthetic rehabilitation of a mandibular molar. Forty patients were rehabilitated with a cemented-retained restoration and the other forty with a screw-retained restoration. The presence of the following complications was recorded for both types of prostheses: Fractures of the ceramic veneering, loosening screws, mucositis and peri-implantitis. Debonding of the restoration was analyzed in the cemented-retained restoration group. The clinical survival of crowns was analyzed with a Kaplan-Meier test and the clinical complications were compared, using a Student t test and Log-rank test. Results: 27 patients registered some complication. The average rate of complications was 37,5% for cemented-retained restorations and 30% for screw-retained restorations. The complications more common in the cemented-retained restoration were the presence of mucositis (14,87%), while in the screw-retained restorations was the loosening screw (20%). Student t test and Log-Rank test found significant differences (p=0,001) between the screw loosening and presence of mucositis. Conclusions: The cemented-retained restorations seem to prevent screw loosening, but the presence of cement seem to increase the complications around the soft tissues, however in the screw-retained restorations the presence of mucositis and peri-implantitis are lower than cemented-retained restorations. The incidence of fracture of ceramic veneering was similar in both groups. Key words:Screw-retained restorations, cemented-retained restorations, screw loosening, peri-implant diseases and fracture ceramic veneering. PMID:25810850

  10. Feasibility of purely endoscopic intramedullary fixation of mandibular condyle fractures.

    PubMed

    Frake, Paul C; Goodman, Joseph F; Joshi, Arjun S

    2015-01-01

    The investigators of this study hypothesized that fractures of the mandibular condyle can be repaired using short-segment intramedullary implants and purely endoscopic surgical technique, using a basic science, human cadaver model in an academic center. Endoscopic instrumentation was used through a transoral mucosal incision to place intramedullary implants of 2 cm in length into osteotomized mandibular condyles. The surgical maneuvers that required to insert these implants, including condyle positioning, reaming, implant insertion, and seating of the mandibular ramus, are described herein. Primary outcome was considered as successful completion of the procedure. Ten cadaveric mandibular condyles were successfully repaired with rigid intramedullary internal fixation without the use of external incisions. Both insertion of a peg-type implant and screwing a threaded implant into the condylar head were possible. The inferior portion of the implant remained exposed, and the ramus of the mandible was manipulated into position on the implant using retraction at the sigmoid notch. The results of this study suggest that purely endoscopic repair of fractures of the mandibular condyle is possible by using short-segment intramedullary titanium implants and a transoral endoscopic approach without the need for facial incisions or punctures. The biomechanical advantages of these intramedullary implants, including improved strength and resistance to mechanical failure compared with miniplates, have been recently established. The combination of improved implant design and purely endoscopic technique may allow for improved fixation and reduced surgical- and implant-related morbidity in the treatment of condylar fractures. PMID:25534058

  11. The central single implant in the edentulous mandible: improvement of function and quality of life. A report of 2 cases.

    PubMed

    Wolfart, Stefan; Braasch, Katja; Brunzel, Simone; Kern, Matthias

    2008-01-01

    Implant-retained overdentures are a reliable treatment option for edentulous patients, especially when only few implants can be placed. Internationally, 2 implants are considered adequate to retain an overdenture in the edentulous mandible. However, for many patients, 2 implants can be cost-prohibitive. By means of 2 clinical cases, it is shown that the insertion of a single implant in the middle of the mandible might stabilize the prosthesis and improve the oral health quality of life and the chewing function. A ball attachment with a screw-activated matrix was used to retain the overdenture. Early clinical results are promising. However, before this method can be recommended for general clinical application, long- term clinical results are needed. PMID:19107261

  12. The Reverse Zygomatic Implant: A New Implant For Maxillofacial Reconstruction.

    PubMed

    Dawood, Andrew; Collier, Jonathan; Darwood, Alastair; Tanner, Susan

    2015-01-01

    This case report describes the rehabilitation of a patient who had been treated with a hemimaxillectomy, reconstruction with a latissimus dorsi vascularized free flap, and radiotherapy for carcinoma of the sinus some years previously. Limited jaw opening, difficult access through the flap to the bony site, and the very small amount of bone available in which to anchor the implant inspired the development and use of a new "reverse zygomatic" implant. For this treatment, site preparation and implant insertion were accomplished using an extraoral approach. The implant was used along with two other conventional zygomatic implants to provide support for a milled titanium bar and overdenture to rehabilitate the maxilla. Two years later, the patient continues to enjoy a healthy reconstruction. The reverse zygomatic implant appears to show promise as a useful addition to the implant armamentarium for the treatment of the patient undergoing maxillectomy. PMID:26574864

  13. An accelerated clinical chairside technique for casting overdenture attachment copings.

    PubMed

    Scherer, Michael D; Campagni, Wayne V

    2011-11-01

    An accelerated technique for casting a direct-pattern post and core restoration for use in fixed prosthodontics has been previously described. Similar techniques for use in removable prosthodontics show potential for clinical use, specifically for the fabrication of radicular stud overdenture attachments and their corresponding copings. The procedure uses a chairside technique and readily available components to fabricate a direct, acrylic resin pattern combining the elements of a cast coping with a fixed radicular attachment. This pattern can subsequently be invested, cast, finished and polished, luted, and attached to the removable prosthesis in a single clinical appointment. PMID:22024184

  14. Pathological mandibular fracture: A severe complication of periimplantitis

    PubMed Central

    Rodriguez-Campo, Francisco; Naval-Parra, Beatriz; Sastre-Pérez, Jesús

    2015-01-01

    Nowadays, dental implant treatment is a very common option for patients even in medical compromised conditons. Some complications related to them have been described. Periimplantitis (PI) is one of the biggest concerns complications of these kind of treatments, probably has a multifactorial aethiology. Usually the consequences of PI are the loss of the implants and prostheses, expenses of money and time for dentists and patients. Very often PI implies the necesity of repeating the treatment . Pathological mandibular fracture due to PI is a severe but infrequent complication after dental implant treatment, especially after PI. In this study we present three cases of mandibular pathologic fractures among patients with different medical and dental records but similar management: two of them had been treated years ago of oral squamous cell carcinoma with surgery and radiotherapy, the other patient received oral bisphosphonates for osteoporosis some years after implantation. We analized the causes, consequences and posible prevention of these fractures as well as the special features of this kind of mandibular fractures and the different existing treatments. Key words:Periimplantitis, pathological mandibular fracture, mandibular atrophy, bicortical implants. PMID:26155355

  15. Corrosion of ferromagnetic alloys used for magnetic retention of overdentures.

    PubMed

    Vrijhoef, M M; Mezger, P R; Van der Zel, J M; Greener, E H

    1987-09-01

    Three ferromagnetic casting alloys intended for use with magnetically retained overdentures (compositions in wt%: #1, Pd 50, Co 47, Ga 2, Pt 1; #2, Pd 60, Co 37, Ga 2, Pt 2; #3, Pd 49, Co 46, Ga 2, Pt 2) were investigated. A 0.9% saline solution and an artificial saliva (Meyer) were used for evaluation of the electrochemical corrosion behavior of these alloys, utilizing standard potentiodynamic techniques. All alloys investigated possessed a good corrosion resistance in the potential range of the oral environment (from -100 to 300 mV versus SCE). In addition, alloys #1 and 3 appeared to be susceptible to pitting above +300 mV (SCE), while #2 was resistant to pitting and was found to passivate in 0.9% saline solution. PMID:3305638

  16. Osseointegrated implants--principles and practice: 2. Prosthetic rehabilitation with osseointegrated implants.

    PubMed

    Watson, R M; Davis, D M; Coward, T

    1989-11-01

    In this series of three articles the authors describe some of the principles and practice of osseointegrated implants. Part 1 gave a detailed description of the surgical techniques required to establish osseointegrated implant fixtures (with special reference to the Branemark system), and gave guidance on patient selection and treatment planning. Part 2 now considers prosthetic rehabilitation techniques with osseointegrated implants for complete dentures, complete overdentures, partial bridges, and single tooth replacement cases. Part 3 will conclude the series by presenting a number of case studies. PMID:2700969

  17. Maxillary palatal ramp prosthesis: A prosthodontic solution to manage mandibular deviation following surgery

    PubMed Central

    (Bhattacharya), Sampa Ray; Majumdar, Dibyendu; Singh, Dilip K.; Islam, M. D. Rabiul; Ray, Pradip K.; Saha, Nilanjana

    2015-01-01

    Mandibular resection following surgical treatment for neoplastic lesions of the oral cavity leads to numerous complications including altered mandibular movements, disfigurement, difficult in swallowing, impaired speech and articulation, and deviation of the mandible towards the resected site. Various prosthetic methods are employed to reduce or minimize mandibular deviation and improve and restore the lost functions and esthetic, like maxillomandibular fixation, implant supported prosthesis, removable mandibular guide flange prosthesis, and palatal based guidance restoration. This clinical report describes the rehabilitation of a patient following segmental mandibulectomy using palatal ramp prosthesis. PMID:25821361

  18. Retention force and fatigue strength of overdenture attachment systems.

    PubMed

    Botega, D M; Mesquita, M F; Henriques, G E P; Vaz, L G

    2004-09-01

    This study evaluated retention force and fatigue resistance of two overdenture attachment systems. Twenty samples (O-ring and Bar-Clip) from two manufacturers (Conexão Sistemas de Prótese and Lifecore Biomedical) were prepared and divided into four groups: (i) Conexão/O-ring; (ii) Conexão/Bar-Clip; (iii) Lifecore/O-ring and (iv) Lifecore/Bar-Clip, with five samples in each group. They were submitted to mechanical fatigue test using a servohydraulic machine performing 5500 cycles of insertion and removal (f=0.8 Hz), immersed in artificial saliva. Retention force values were obtained three times (0, 3000 and after 5500 cycles) simulating the clinical service, using a tensile strength at 1 mm min(-1) and load cell of 1 kN. Data were analysed with analysis of variance and Tukey's test at 5% level. Results showed that Conexão/Bar-Clip specimens had significantly higher retention values than Lifecore/Bar-Clip (44.61 and 18.44 N, respectively), Conexão/O-ring specimens had significantly lower values than Lifecore/O-ring (13.91 and 19.75 N, respectively). Conexão/Bar-Clip values were always significantly higher than those of Conexão/O-ring group (44.61 and 13.91 N, respectively). Lifecore (O-ring and Bar-Clip) presented similar values (19.75 and 18.44 N, respectively). The systems evaluated showed satisfactory retention force values, before and after fatigue testing. Conexão/Bar-Clip specimens presented the highest values. A 5-year simulation of insertion and removal did not decrease retention values or fracture components. PMID:15369470

  19. Measuring mandibular motions

    NASA Technical Reports Server (NTRS)

    Dimeff, J.; Rositano, S.; Taylor, R. C.

    1977-01-01

    Mandibular motion along three axes is measured by three motion transducers on floating yoke that rests against mandible. System includes electronics to provide variety of outputs for data display and processing. Head frame is strapped to test subject's skull to provide fixed point of reference for transducers.

  20. Irradiated mandibular autografts

    SciTech Connect

    Hamaker, R.C.; Singer, M.I.; Shockley, W.W.; Pugh, N.; Shidnia, H.

    1983-09-15

    The cosmetic and functional disability associated with mandibular resection has been a major problem to the patient with direct invasion of the mandible by oral cancer. Marginal resections with combined postoperative radiation therapy have frequently been substituted for the more preferred segmental resections and resultant deformities. Presented are 15 cases of oral cavity cancer involving resection of the mandible, immediate radiation to 10,000 rad, and primary reconstruction as irradiated mandibular autografts. The longest following is 4 years and 3 months, with a success rate of 66%. Morbidity is minimal as compared to autogenous bone grafting. Tumor size, previous radiation, or use of regional flaps have not been a factor in the success of this method in reconstruction of the mandible primarily.

  1. [Subcondylar mandibular fracture].

    PubMed

    Marsot-Dupuch, K; Pierard, E

    1992-01-01

    Mandibular fractures are frequent lesions which are classified into 6 groups according to the site of the fracture. Condylar fractures are primarily due to a direct blow to the symphysis menti. Medical imaging must be able to identify the type of fracture, its intra- or extra-articular site and the associated displacement of the condyle, the fundamental element in deciding treatment. The action of the masticatory muscles on one of the bone fragments may be responsible for an unstable fracture, leading to disturbances of consolidation (pseudarthrosis). Anterior bilateral fractures can be life-threatening due to ptosis of the tongue. PMID:1642427

  2. Reoperative mandibular trauma: management of posttraumatic mandibular deformities.

    PubMed

    Vega, Luis G

    2011-02-01

    Mandibular fractures are one the most common maxillofacial injuries. Diagnostic errors, poor surgical technique, healing disorders, or complications may lead to the establishment of posttraumatic mandibular deformities. Nonunion, malunion/malocclusion, or facial asymmetry can be found early during the healing process or as long-term sequelae after the initial mandibular fracture repair. Although occasionally these problems can be solved in a nonsurgical manner, reoperations play an important role in the management of these untoward outcomes. This article discusses the reoperative techniques used for the management of these deformities. PMID:21272766

  3. Experience with mandibular reconstruction using transport-disc-distraction osteogenesis.

    PubMed

    Pingarrón-Martín, Lorena; Otero, T González; Gallo, L J Arias

    2015-06-01

    The goal of transport-disc-distraction osteogenesis (TDDO) is to restore bone continuity by using in-situ bone. It may be useful following trauma, gunshot injuries, or tumor ablation, especially when there may be contraindications at the donor site or for prolonged surgery. To the best of the authors' knowledge, this is the first time TDDO has been used for mandibular reconstruction reporting additional procedures, which include osseointegrated dental implants rehabilitation and orthognathic surgery. A retrospective study is performed analyzing all mandibular reconstruction cases that may be suitable for distraction from January 2006 to December 2011. A thorough description of the documented cases includes details about sex, gender, complications, duration of hospitalization, etiology, size, and location of the defect. Eight cases of mandibular reconstruction were included. Six cases correspond to mandibular ameloblastoma. The remaining two cases were mandibular gunshot comminuted fractures. Range of the defects was from 45 to 60 mm. Length of the transport disc was 15 to 20 mm. Protocolized technique consisted of 5 days of latency period, 19 to 45 days of activation term (average 30 days), and 8 to 12 weeks for consolidation. Mean distraction length achieved was 40.45 mm. We can conclude that TDDO is an alternative to conventional and more invasive procedures, when we face severe segmental mandibular defects reconstruction. It shows the potential to restore a better anatomical bone regeneration, also providing soft tissues and reducing donor-site morbidity. Patients' education and awareness about the proper use of the transport-disc-distraction device is important to optimize functional outcomes. PMID:26000082

  4. Molarization of Mandibular Second Premolar

    PubMed Central

    Singh Khinda, Vineet Inder; Kallar, Shiminder; Singh Brar, Gurlal

    2014-01-01

    ABSTRACT Macrodontia (megadontia, megalodontia, mac rodontism) is a rare shape anomaly that has been used to describe dental gigantism. Mandibular second premolars show an elevated variability of crown morphology, as are its eruptive potential and final position in the dental arch. To date, only eight cases of isolated macrodontia of second premolars have been reported in the literature. This case report presents clinical and radiographic findings of unusual and rare case of isolated unilateral molarization of left mandibular second premolar. How to cite this article: Mangla N, Khinda VIS, Kallar S, Brar GS. Molarization of Mandibular Second Premolar. Int J Clin Pediatr Dent 2014;7(2):137-139. PMID:25356014

  5. A new coping for overdentures. Part 2: Preliminary results of a clinical study.

    PubMed

    Monfrin, Sandro Barone; Previgliano, Valter; Ceruti, Paola; Preti, Giulio

    2007-01-01

    The aim of this study was to evaluate a new type of coping used for overdentures. Twenty-nine patients received 60 new chairside copings prepared by 3 operators. The copings, used to anchor removable prostheses, were followed up for between 6 months and 4 years with inspection, probing, and radiographic evaluation. Five teeth (8.3%) were extracted. A few clinical problems occurred, including decementation, periodontal pathology (loss of support and bleeding on probing), subgingival decay, and root fracture. No differences were noted in the incidence of complications among the 3 operators. The study demonstrated the clinical predictability of the new copings. PMID:17455440

  6. Implant-connected versus tooth-connected implant-supported partial dentures: 2-year clinical and radiographic comparative evaluation.

    PubMed

    Mostafa, Tamer Mohamed; El-Sheikh, Mohamed M; Abd El-Fattah, Fadel

    2015-01-01

    The purpose of this study was to clinically and radiographically compare implant-connected and tooth-connected implant-supported fixed-detachable mandibular partial dentures. Twenty partially edentulous patients (age range: 25 to 50 years) with mandibular Kennedy Class II configurations were equally divided into two groups receiving a three-unit, fixed-detachable, screw-retained partial denture. Group 1 comprised patients with unilateral missing mandibular molars and premolars. Two implants were placed at the mandibular first premolar and first molar areas. Group 2 comprised patients with missing mandibular molars and second premolars. An implant was placed at the mandibular first molar area, the first premolar was prepared, and a coping was cemented to the tooth with permanent cement. Each case was evaluated clinically and radiographically at baseline (partial denture insertion) and after 6, 12, and 24 months. Data were collected and statistically analyzed using repeated-measures one-way and two-way analysis of variance tests. There was no statistically significant difference between the two groups (P > .05). The implant-tooth-supported prosthesis provided an equally predictable treatment option compared to the totally implant-supported prosthesis in terms of implant survival and loss of marginal bone. PMID:25909533

  7. Biomechanical load analysis of cantilevered implant systems.

    PubMed

    Osier, J F

    1991-01-01

    Historically, dental implants have been placed in areas where quality bone exists. The maxillary sinus areas and mandibular canal proximities have been avoided. From these placements, various cantilevered prosthetic applications have emerged. This analysis uses static engineering principles to define the loads (i.e., forces) placed upon the implants. These principles make use of Newton's first and third laws of mechanics by summing the forces and moments to zero. These summations then generate mathematical equations and their algebraic solutions. Three implant systems are analyzed. The first is a two-implant system. The second is a three-implant cross-arch stabilized system usually found in mandibular replacements of lower full dentures. The third is a five-implant system which is identical to the three-implant cantilevered system but which uses implants in the first molar area, thereby negating the cantilevered load magnification of the three-implant design. These analyses demonstrate that, in a cantilevered application, the implant closest to the point of load application (usually the most posterior implant) takes the largest compressive load. Implants opposite the load application (generally the anterior implant) are in tension. These loads on the implants are normally magnified over the biting force and can easily reach 2 1/2 to five times the biting load. PMID:1942131

  8. Mandibular torus morphology.

    PubMed

    Sellevold, B J

    1980-11-01

    The morphology of the mandibular torus was examined, and comparisons were made between a Medieval Norse skeletal population from Greenland and a 14th to 17th century Greenland Eskimo skeletal series. Three parameters were analyzed: degree of development (on a 4-point scale), position and length, and surface morphology according to the number of knobs, or lobuli. It was found that the Eskimos have a high frequency of weakly developed tori and no cases of the extreme development, while over 20% of the Norsemen had tori in the "extreme" category. The Norse torus was generally found to be longer than that of the Eskimos, and both groups exhibited a slight asymmetry between the sides, the torus on the left side tending to be longer and more forward in position than the right. A great difference was found in surface morphology. The Norse torus is in general very irregular, while the Eskimo torus is rather smooth. These differences are believed to be genetically determined. PMID:7468791

  9. Bilateral Molariform Mandibular Second Premolars

    PubMed Central

    Acharya, Sonu; Kumar Mandal, Pradip; Ghosh, Chiranjit

    2015-01-01

    Macrodontia is a rare dental anomaly that refers to teeth that appear larger than normal. Generalised macrodontia can be associated with certain medical conditions and syndromes. This case report presents clinical and radiographic findings of isolated bilateral macrodontia in a 14-year-old child. The patient was referred to the clinic with local crowding of maxillary and mandibular teeth. Radiographic findings revealed the presence of impacted macrodont mandibular second premolar on one side and erupted macrodontic premolar on the other side and their distinct morphological appearance, characterized by large, multitubercular, and molariform crowns and tapering, single roots. PMID:25685564

  10. Management of mandibular angle fracture.

    PubMed

    Braasch, Daniel Cameron; Abubaker, A Omar

    2013-11-01

    Fractures through the angle of the mandible are one of the most common facial fractures. The management of such fractures has been controversial, however. This controversy is related to the anatomic relations and complex biomechanical aspects of the mandibular angle. The debate has become even more heated since the evolution of rigid fixation and the ability to provide adequate stability of the fractured segments. This article provides an overview of the special anatomic and biomechanical features of the mandibular angle and their impact on the management of these fractures. PMID:24183373

  11. Pediatric maxillary and mandibular tumors.

    PubMed

    Trosman, Samuel J; Krakovitz, Paul R

    2015-02-01

    Pediatric maxillary and mandibular tumors offer considerable challenges to otolaryngologists, oral surgeons, pathologists, and radiologists alike. Because of the close proximity to vital structures, appropriate steps toward a definitive diagnosis and treatment plan are of paramount importance. This article reviews the most common causes of pediatric jaw masses and discusses diagnostic and therapeutic considerations and recommendations. PMID:25442129

  12. Cell sheet-engineered bones used for the reconstruction of mandibular defects in an animal model

    PubMed Central

    DU, CHUNHUA; YAO, CHAO; LI, NINGYI; WANG, SHUANGYI; FENG, YUANYONG; YANG, XUECAI

    2015-01-01

    The aim of the present study was to investigate the generation of cell sheet-engineered bones used for the reconstruction of mandibular defects. Bone marrow stem cells (BMSCs) were cultured and induced to generate osteoblasts. Poly(lactic-co-glycolic acid) (PLGA) scaffolds were wrapped with or without cell sheets and then implanted into dogs with mandibular defects in the right side (experimental group) or the left side (control group), respectively. Subsequently, X-ray analyses, and hematoxylin and eosin staining were performed at various time points (at 4, 8, 12 or 16 weeks post-implantation; n=4 at each time point). The osteogenesis in the experimental group was significantly improved compared with that in the control group. At 16 weeks after implantation, numerous Haversian systems and a few lamellar bones were observed at the periphery. In the control group, the engineered bone (without BMSC sheets) presented fewer Haversian systems and no lamellar bones. The optical density of the fresh bone in the experimental group was significantly higher compared with that in the control group (P<0.05). In conclusion, tissue-engineered bone with the structure of lamellar bones can be generated using BMSC sheets and implantation of these bones had an improved effects compared with the control group. Cell sheet transplantation was found to enhance bone formation at the reconstruction site of the mandibular defects. PMID:26668619

  13. Pearls of Mandibular Trauma Management

    PubMed Central

    Koshy, John C.; Feldman, Evan M.; Chike-Obi, Chuma J.; Bullocks, Jamal M.

    2010-01-01

    Mandibular trauma is a common problem seen by plastic surgeons. When fractures occur, they have the ability to affect the patient's occlusion significantly, cause infection, and lead to considerable pain. Interventions to prevent these sequelae require either closed or open forms of reduction and fixation. Physicians determining how to manage these injuries should take into consideration the nature of the injury, background information regarding the patient's health, and the patient's comorbidities. Whereas general principles guide the management of the majority of injuries, special consideration must be paid to the edentulous patient, complex and comminuted fractures, and pediatric patients. These topics are discussed in this article, with a special emphasis on pearls of mandibular trauma management. PMID:22550460

  14. Exposed Dental Implant? Local Autograft A Saviour!

    PubMed Central

    Rai, Raj; Punde, Prashant A; Suryavanshi, Harshal; Shree, Swetha

    2015-01-01

    Implant exposure due to faulty placement, posses as the most common reason for implant failure. The implant placed too close to buccal or lingual cortex have lead to such failure on numerous occasions. Also, anatomic variations like the thin buccolingual width of alveolar ridge predispose exposure of the implant. 25-year-old female patient had undergone surgical placement of implants in mandibular anterior region 2 months back in the private dental clinic. The clinician noted Grade I mobility in one of the implants placed. The case was referred to the author. Thin overlying gingiva depicted an entire buccal aspect of the implant, which suggested more than 90 % loss of buccal cortex. According to literature and review of similar case reports, the only way suggested was to surgically remove the implant and wait for 12-24 months for the bone to heal for subsequent placement. Rather than the removal of implants as suggested, the author followed a naval approach of reinforcing buccal cortex using an autogenous cortical block from mandibular symphysis. The reinforcement surgery had certainly saved patients time, money and most importantly limits a crucial period of edentulism, which may be enforced on a patient in case the implant was removed. PMID:26668490

  15. BMP-2 impregnated biomimetic scaffolds successfully induce bone healing in a marginal mandibular defect

    PubMed Central

    DeConde, Adam S.; Sidell, Douglas; Lee, Min; Bezouglaia, Olga; Low, Kyle; Elashoff, David; Grogan, Tristan; Tetradis, Sotirios; Aghaloo, Tara; John, Maie St.

    2014-01-01

    Educational Objective: To investigate the ability of an osteoconductive scaffold to heal a clinically common mandibular defect with BMP-2 in an animal model. Objectives: To test the osteoregenerative potential and dosing of bone morphogenetic protein-2 (BMP-2) impregnated biomimetic scaffolds in a rat model of a mandibular defect. Study Design: Prospective study using an animal model. Methods: Varied doses of BMP-2 (0.5, 1, 0.5 and 0.5 in microspheres, 5, 15 ?g) were absorbed onto a biomimetic scaffold. Scaffolds were then implanted into marginal mandibular defects in rats. Blank scaffolds and unfilled defects were used as negative controls. Two months postoperatively, bone healing was analyzed with micro-computerized tomography (microCT). Results: MicroCT analysis demonstrated all doses of BMP-2 induced successful healing of marginal mandibular defects in a rat mandible. Increasing doses of BMP-2 on the scaffolds produced increased tissue healing with 15 ?g demonstrating significantly more healing than all other dosing (p < 0.01). Conclusions: BMP-2 impregnated biomimetic scaffolds successfully induce bone healing in a marginal mandibular defect in the rat. Percentage healing of defect, percentage of bone within healed tissue and total bone volume are all a function of BMP-2 dosing. There appears to be an optimal dose of 5 ?g beyond which there is no increase in bone volume. PMID:23553490

  16. Regenerating mandibular bone using rhBMP-2: part 1 - immediate reconstruction of segmental mandibulectomies

    PubMed Central

    Arzi, Boaz; Verstraete, Frank J.M.; Huey, Daniel J.; Cissell, Derek D.; Athanasiou, Kyriacos A.

    2015-01-01

    Objective To describe a surgical technique utilizing a regenerative approach and internal fixation for immediate reconstruction of critical size bone defects following segmental mandibulectomy. Study design Prospective case series Animals Dogs (n=4) that had reconstruction following segmental mandibulectomy for treatment of malignant or benign tumors. Methods Using a combination of extraoral and intraoral approaches, a locking titanium plate was contoured to match the native mandible. Following segmental mandibulectomy, the plate was secured and a compression resistant matrix (CRM) infused with rhBMP-2, implanted in the defect. The implant was then covered with a soft tissue envelope followed by routine intraoral and extraoral closure. Results All dogs that had mandibular reconstruction healed with intact gingival covering over the mandibular defect and had immediate return to normal function and occlusion. Mineralized tissue formation was observed clinically within 2 weeks and solid cortical bone formation within 3 months. Computed tomographic findings at 3 months postoperatively demonstrated that the newly regenerated mandibular bone had ?50% of the bone density and porosity compared to the contralateral side. No significant complications were noted. Conclusion Mandibular reconstruction using internal fixation and CRM infused with rhBMP-2 is an excellent solution for immediate reconstruction of segmental mandibulectomy defects in dogs. Clinical Relevance In dogs with a segmental mandibulectomy, reconstruction using rhBMP-2 and a CRM should be considered a viable surgical option. PMID:24410740

  17. Digitally planned and fabricated mandibular fixed complete dentures. Part 2. Prosthodontic phase.

    PubMed

    Kattadiyil, Mathew T; Goodacre, Charles J; Lozada, Jaime L; Garbacea, Antoanela

    2015-01-01

    Part 1 of this patient report described a prosthetically driven protocol that used computer-aided engineering for the fabrication of a mandibular conversion denture and maxillary provisional complete denture using the AvaDent Digital Denture system. The report demonstrated that this system combined with NobelClinician implant-planning software can be used to efficiently convert a digital denture into an immediately loaded provisional implant-supported fixed complete denture (hybrid prosthesis). Part 2 of the patient report describes the technique and steps involved in the fabrication of a digitally planned and fabricated mandibular fixed complete denture with incorporated titanium milled bar opposed by a definitive computer-aided design/computer-assisted manufacture-milled maxillary complete denture. PMID:25822295

  18. Pediatric Mandibular Fractures: A Review

    PubMed Central

    Sharma, Sunil; Vashistha, Abhishek; Chugh, Ankita; Kumar, Dinesh; Bihani, Urvashi; Trehan, Mridula; Nigam, Anant G

    2009-01-01

    The pattern of craniomaxillofacial fractures seen in children and adolescents varies with evolving skeletal anatomy and socioenvironmental factors. The general principles of treating mandibular fractures are the same in children and adults: Anatomic reduction is combined with stabilization adequate to maintain it until bone union has occurred. But recognition of some of the differences between children and their adult counterparts is important in long-term esthetic and functional facial rehabilitation as effect of injury, treatment provided has a great influence on their ensuing growth. PMID:25206104

  19. ELECTROMYOGRAPHIC EVALUATION OF MASTICATION AND SWALLOWING IN ELDERLY INDIVIDUALS WITH MANDIBULAR FIXED IMPLANTSUPPORTED PROSTHESES

    PubMed Central

    Berretin-Felix, Giédre; Nary, Hugo; Padovani, Carlos Roberto; Trindade, Alceu Sergio; Machado, Wellington Monteiro

    2008-01-01

    This study evaluated the effect of implant-supported oral rehabilitation in the mandible on the electromyographic activity during mastication and swallowing in edentulous elderly individuals. Fifteen patients aged more than 60 years were evaluated, being 10 females and 5 males. All patients were edentulous, wore removable complete dentures on both dental arches, and had the mandibular dentures replaced by implant-supported prostheses. All patients were submitted to electromyographic evaluation of the masseter, superior orbicularis oris muscles, and the submental muscles, before surgery and 3, 6 and 18 months postoperatively, using foods of different textures. The results obtained at the different periods were analyzed statistically by Kruskal-Wallis non-parametric test. Statistical analysis showed that only the masseter muscle had a significant loss in electromyographic activity (p<0.001), with a tendency of similar response for the submental muscles. Moreover, there was an increase in the activity of the orbicularis oris muscle during rubber chewing after treatment, yet without statistically significant difference. Mandibular fixed implant-supported prostheses in elderly individuals revealed a decrease in electromyographic amplitude for the masseter muscles during swallowing, which may indicate adaptation to new conditions of stability provided by fixation of the complete denture in the mandibular arch. PMID:19089202

  20. Effects of a new implant abutment design on peri-implant soft tissues.

    PubMed

    Chien, Hua-Hong; Schroering, Robert L; Prasad, Hari S; Tatakis, Dimitris N

    2014-10-01

    The purpose of this study was to assess the effects of a modified implant abutment design on peri-implant soft and hard tissues in dogs. Three months after extraction of mandibular premolar teeth, 3 dental implants were placed in each side of the jaw using a 1-stage approach. Implants on one side of the mandible received standard abutments (control), and implants on the contralateral side received modified, patented, grooved abutments (test). Two months after implant placement, animals were euthanized and specimens were prepared for histologic and histomorphometric assessment. The linear distance (in micrometers) was measured from the implant shoulder (IS) to the following landmarks: gingival margin (GM; distance IS-GM), most apical position of the junctional epithelium (JE; distance IS-JE), and bone crest (BC; distance IS-BC). Percent of bone-to-implant contact was also measured. Histologic assessment revealed that all implants were osseointegrated and that interimplant gingival fibers between test abutments appeared to be more numerous and organized than control abutments. The IS-GM and IS-JE distances in test implants were greater than the corresponding distances in control implants (P = .024 and P = .015, respectively), whereas crestal bone loss (IS-BC) was greater for control implants than test implants (P = .037). There were no differences between control and test implants in bone-to-implant contact (P = .69), which averaged close to 50%. These results suggest that the modified groove design incorporated in standard abutments confers both soft and hard tissue benefits. PMID:23339331

  1. Mandibular bone response to plasma-sprayed coatings of hydroxyapatite.

    PubMed

    Denissen, H W; Kalk, W; de Nieuport, H M; Maltha, J C; van de Hooff, A

    1990-01-01

    Sintered hydroxyapatite ceramic particles can be applied as a coating on a titanium substrate using a plasma-spraying technique. The biological and mechanical properties of implants with such a coating were studied in the mandible of a dog. The results indicated that a very strong and direct bonding between the hydroxyapatite coating and the mandibular bone developed. The shear strength of the bone/ceramic interface was higher than the interfacial strength between ceramic and titanium substrate. From the radiologic, macroscopic, and microscopic observations it was concluded that the biological properties of plasma-sprayed coatings of hydroxyapatite are the same as those of sintered hydroxyapatite ceramic. As a result of mechanical failure of the coherence of the hydroxyapatite particles at the outer layer of the coating, free particles of hydroxyapatite were observed in the surrounding bone tissue. PMID:2372367

  2. Removable Partial Denture Supported by Implants with Prefabricated Telescopic Abutments - A Case Report

    PubMed Central

    Sehgal, Komal

    2014-01-01

    Implants have been designed to rehabilitate edentulous patients with fixed prosthesis or implant supported overdentures. Implant-supported single crowns and fixed partial dentures have become successful treatment alternatives to removable and fixed partial dentures. However, it is common to have clinical situations which make it impossible to use conventional as well as implant supported fixed partial dentures. The implant supported removable partial dentures can be a treatment modality that offers the multitude of benefits of implant-based therapy—biologic, biomechanical, social, and psychological to such patients. The aim of this article is to present a case report describing the fabrication and advantages of removable partial denture supported by teeth and implants for a patient with long edentulous span. The patient was satisfied with his dentures in terms of function and aesthetics. Regular follow-up visits over a period of three years revealed that the periodontal condition of remaining natural dentition and peri-implant conditions were stable. There was no evidence of excessive residual ridge resorption or mobility of the teeth, nor were any visible changes in the bone levels of the natural teeth or implants noted on radiographs. PMID:25121066

  3. Breast Implants

    MedlinePLUS

    ... ALCL) in women with breast implants. Outline the regulatory history of breast implants in the United States. ... Freedom of Information Requests More in Breast Implants Regulatory History of Breast Implants in the U.S. Saline- ...

  4. Regenerating mandibular bone using rhBMP-2: part 2 – treatment of chronic, defect non-union fractures

    PubMed Central

    Verstraete, Frank J.M.; Arzi, Boaz; Huey, Daniel J.; Cissell, Derek D.; Athanasiou, Kyriacos A.

    2015-01-01

    Objective To describe a surgical technique utilizing a regenerative approach and internal fixation for reconstruction of critical size bone defect non-union mandibular fractures. Study design Case series Animals Dogs (n = 6) that had internal fixation of defect non-union mandibular fracture. Methods In 5 of the 6 cases the repair was staged and extraction of teeth performed during the first procedure. After 21-98 days (mean 27 days) a pharyngotomy intubation and temporary maxillomandibular fixation were performed. Using an extraoral approach, a locking titanium miniplate plate was contoured and secured. A compression resistant matrix (CRM) infused with rhBMP-2, was implanted in the defect. The implant was then covered with a soft tissue envelope followed by routine closure. Results All dogs had healed with intact gingival covering over the mandibular fracture site defect and had immediate return to normal function and correct occlusion. Hard-tissue formation was observed clinically within 2 weeks and solid cortical bone formation within 3 months. Computed tomographic findings in one case at 3 months postoperatively demonstrated that the newly regenerated mandibular bone had 92% of the bone density and porosity compared to the contralateral side. Long-term follow-up revealed excellent outcome. Conclusion Mandibular reconstruction using internal fixation and CRM infused with rhBMP-2 is an excellent solution for the treatment of critical size defect non-union fractures in dogs. Clinical Relevance In dogs with a mandibular critical size defect non-union fractures, reconstruction using rhBMP-2 and a CRM should be considered as a viable surgical option. PMID:24410723

  5. Alveolar nerve repositioning with rescue implants for management of previous treatment. A clinical report.

    PubMed

    Amet, Edward M; Uehlein, Chris

    2013-12-01

    The goal of modern implant dentistry is to return patients to oral health in a rapid and predictable fashion, following a diagnostically driven treatment plan. If only a limited number of implants can be placed, or some fail and the prosthetic phase of implant dentistry is chosen to complete the patient's treatment, the final outcome may result in partial patient satisfaction and is commonly referred to as a "compromise." Previous All-on-4 implant treatment for the patient presented here resulted in a compromise, with an inadequate support system for the mandibular prosthesis and a maxillary complete denture with poor esthetics. The patient was unable to function adequately and also was disappointed with the resulting appearance. Correction of the compromised treatment consisted of bilateral inferior alveolar nerve elevation and repositioning without bone removal for lateral transposition, to gain room for rescue implants for a totally implant-supported and stabilized prosthesis. Treatment time to return the patient to satisfactory comfort, function, facial esthetics, and speech was approximately 2 weeks. The definitive mandibular prosthesis was designed for total implant support and stability with patient retrievability. Adequate space between the mandibular bar system and the soft tissue created a high water bridge effect for self-cleansing. Following a short interim mandibular healing period, the maxillary sinuses were bilaterally grafted to compensate for bone inadequacies and deficiencies for future maxillary implant reconstruction. PMID:23924033

  6. A Cone-Beam Computed Tomographic Study on Mandibular First Molars in a Chinese Subpopulation

    PubMed Central

    Ma, Yue; Han, Ting; Chen, Xinyu; Wan, Fang; Lu, Yating; Yan, Songhe; Wang, Yan

    2015-01-01

    The purpose of this study was to conduct a cone-beam computed tomographic (CBCT) investigation on the root and canal configuration of the mandibular first molars, especially the morphology of the disto-lingual (DL) root, in a Chinese subpopulation. A total of 910 CBCT images of the mandibular first molars were collected from 455 patients who underwent CBCT examinations as a preoperative assessment for implants or orthodontic treatment. The following information was analyzed and evaluated: tooth position, gender, root and root canal number per tooth, root canal type of the mesial root(s) and distal root(s), angle of the DL root canal curvature, distance between two distal canal orifices in the teeth with DL root, and angle of disto-buccal canal orifice–disto-lingual canal orifice–mesio-lingual canal orifice (DB-DL-ML). Most of the mandibular first molars (64.9%, n = 591) had two roots with three root canals, and most of the mesial root canals (87.7%, n = 798) were type VI. The prevalence of the DL root was 22.1% (n = 201). The right side had a higher prevalence of DL root than the left side (p<0.05). Additionally, the curvature of the DL root canal were greater in the bucco-lingual (BL) orientation (30.10°±14.02°) than in the mesio-distal (MD) orientation (14.03°± 8.56°) (p<0.05). Overall there was a high prevalence of DL root in the mandibular first molars, and most of the DL roots were curved in different degrees. This study provided detailed information about the root canal morphology of the mandibular first molars in a Chinese subpopulation. PMID:26241480

  7. Strategic camouflage treatment of skeletal Class III malocclusion (mandibular prognathism) using bone-borne rapid maxillary expansion and mandibular anterior subapical osteotomy.

    PubMed

    Seo, Yu-Jin; Lin, Lu; Kim, Seong-Hun; Chung, Kyu-Rhim; Nelson, Gerald

    2016-01-01

    This case report presents the camouflage treatment that successfully improved the facial profile of a patient with a skeletal Class III malocclusion using bone-borne rapid maxillary expansion and mandibular anterior subapical osteotomy. The patient was an 18-year-old woman with chief complaints of crooked teeth and a protruded jaw. Camouflage treatment was chosen because she rejected orthognathic surgery under general anesthesia. A hybrid type of bone-borne rapid maxillary expander with palatal mini-implants was used to correct the transverse discrepancy, and a mandibular anterior subapical osteotomy was conducted to achieve proper overjet with normal incisal inclination and to improve her lip and chin profile. As a result, a Class I occlusion with a favorable inclination of the anterior teeth and a good esthetic profile was achieved with no adverse effects. Therefore, the hybrid type of bone-borne rapid maxillary expander and a mandibular anterior subapical osteotomy can be considered effective camouflage treatment of a skeletal Class III malocclusion, providing improved inclination of the dentition and lip profile. PMID:26718385

  8. Rotational Distraction for the Treatment of Severe Mandibular Retrognathia

    PubMed Central

    Mitsugi, Masaharu; Alcalde, Rafael E.; Yano, Tomoyuki; Uemura, Noriko; Okazaki, Mutsumi

    2015-01-01

    Backgrounds: The main problem with intraoral distraction of the mandible is the inability to achieve the three-dimensional mandibular correction as planned preoperatively. We developed a technique that allows spontaneous changes in the direction of mandibular elongation using an intraoral distractor. Methods: After mandibular osteotomy, the distractor is fixed to the distal segment of the mandible using a single bicortical screw, allowing anterior-posterior, vertical and limited lateromedial changes in the vector of distraction. Mandibular lengthening is performed while keeping the maxilla and mandible in class I occlusion with intermaxillary fixation. Results: As the distraction device is activated allowing mandibular elongation, the proximal segment, guided by the surrounding soft tissues, moves and rotates posterosuperiorly. Mandibular lengthening is continued until the condylar head reaches an adequate position in the mandibular fossa as confirmed clinically and radiographically. Conclusion Thirty-three patients with mandibular retrognathia received this treatment and good results were obtained. PMID:26301156

  9. 21 CFR 872.3960 - Mandibular condyle prosthesis.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ...temporary reconstruction of the mandibular condyle in patients who have undergone resective procedures to remove malignant or benign tumors, requiring the removal of the mandibular condyle. See § 870.3 of this chapter. [59 FR 65478, Dec. 20, 1994,...

  10. Mandibular osteonecrosis due to bisphosphonate use

    PubMed Central

    ?alvarc?, Ahmet; Alt?nay, Serdar

    2015-01-01

    Due to their efficient osteoclastic inhibitor effect in bone metabolism and antiangiogenic activity, bisphosphonates are widely used in many cancer diseases particularly in prostate cancers with bone metastasis, lung cancer, breast cancer and multiple myeloma, as well as in systemic diseases such as osteoporosis, osteopenia, Paget disease and osteogenesis imperfect for the last 13 years. Prostate cancer is a common cancer in males and it is the leading cause of bone metastasis. Mandibular metastasis is rarely encountered during the course of prostate cancer. Mandibular osteonecrosis as well has begun to be observed along with the availability of more efficient and stronger formulations developed following the use of bisphosphonates. Zolendronic acid, which has been used also by our patient, has widely come into practice as a 3rd generation bisphosphonate. Because of prostate cancer and widespread bone metastases, our patient has been receiving zolendronic acid with maximum androgen blockage for 4 years. Tomography of the patient, who has undergone intensive treatment because of submandibular abscess, demonstrated extensive osteonecrosis in the fovea sublingual region of the mandible corpus. In large series, although, mandibular osteonecrosis was widely seen due to bisphosphonate use for the metastases of lung and breast cancers, this rate was between 9.6% and 11% for prostate cancer within the series. Although our patient had no mandibular metastasis before, mandibular necrosis was observed due to long-term bisphosphonate use. We are going to present our patient who had this rare complication with his clinical picture. PMID:26328198

  11. Cochlear Implants.

    ERIC Educational Resources Information Center

    Clark, Catherine; Scott, Larry

    This brochure explains what a cochlear implant is, lists the types of individuals with deafness who may be helped by a cochlear implant, describes the process of evaluating people for cochlear implants, discusses the surgical process for implanting the aid, traces the path of sound through the cochlear implant to the brain, notes the costs of…

  12. Long Term Stability and Relapse Following Mandibular Advancement and Mandibular Setback Surgeries: A Cephalometric Study

    PubMed Central

    Darshan, S Vinay; Ronad, Yusuf Ahammed; Kishore, M S V; Shetty, K Sadashiva; Rajesh, M; Suman, S D

    2014-01-01

    Background: The aim was to evaluate the long-term hard and soft tissue changes following mandibular advancement and setback surgeries. Materials and Methods: A total of 16 subjects each were selected who underwent bilateral sagittal split osteotomy mandibular advancement and mandibular setback groups. Pre-surgical (T1), immediate post-surgical (T2) and long-term post-surgical (T3) cephalograms were compared for hard and soft tissue changes. After cephalometric measurements, the quantity of changes between T1-T2 and T1-T3 were determined for each patient. The mean difference between T1-T2 and T1-T3 was compared with assess the long-term changes and stability. Results: In mandibular advancement the mean difference between immediate post-surgical and long term post-surgical is 7%, which accounts for a relapse of 7%. In mandibular setback, the mean difference between immediate post-surgical and long-term post-surgical is 29%, which accounts for a relapse of 29%. Conclusion: Mandibular advancement remained stable over the long period when compared to mandibular setback. PMID:25395792

  13. Clinical evaluation of implant survival based on size and site of placement: A retrospective study of immediate implants at single rooted teeth sites

    PubMed Central

    Ramalingam, Sundar; Al-Hindi, Maryam; Al-Eid, Raniah Abdullah; Nooh, Nasser

    2015-01-01

    Objectives This retrospective clinical study sought to evaluate the survival of immediate implants placed at maxillary and mandibular single-rooted tooth extraction sites and to determine the relationship among implant size, placement site, and implant survival. Methods Between January 2010 and June 2011, 85 patients (33 males, 52 females; mean age: 45 years) underwent immediate implant placement after extraction of single-rooted teeth. All implants were restored between 12 and 14 weeks after implant placement. The implant survival and its relationship with implant size and implantation site were evaluated by odds ratios (ORs). Results Implants were placed at the following sites: upper central incisor (UCI, n = 35), upper lateral incisor (ULI, n = 27), upper second premolar (U2ndP, n = 36), lower incisor (LI, n = 53), and lower premolar (LP, n = 22). Implants of the following sizes were used: 5 × 10 mm (n = 24), 5 × 8 mm (n = 21), 4.3 × 10 mm (n = 77), 4.3 × 8 mm (n = 36), 3.5 × 10 mm (n = 12), and 3.5 × 8 mm (n = 3). After a mean follow-up time of 47 months, the overall implant survival rate was 96%. Survival rate was highest at the LI site (98.1%) and lowest at the ULI site (92.6%). All of the 5-mm implants survived (100%), as did most of the 4.3 × 10 mm implants (96.1%). Implants of 4.3 × 8 mm and 3.5 × 10 mm were the least successful (91.7%). Mandibular implants had a better survival rate (97.3%) than maxillary implants (94.9%). There was no significant OR of increased survival for any particular implant size or site. Conclusions Immediate implant placement in fresh extraction sockets can give predictable clinical outcomes, regardless of the implant size and site of placement. PMID:26082578

  14. Cochlear Implants

    MedlinePLUS

    ... Arts A cochlear implant is a small, complex electronic device that can help to provide a sense ... that can answer questions and provide printed or electronic information on cochlear implants: Cochlear implants Assistive technology ...

  15. Dens invaginatus (dilated odontome) in mandibular canine

    PubMed Central

    Halawar, Sangamesh S; Satyakiran, GVV; Krishnanand, PS; Prashanth, R

    2014-01-01

    Dens invaginatus is a developmental malformation of teeth related to shape of the teeth. Affected teeth show a deep infolding of enamel and dentin starting from the tip of the cusps and may extend deep into the root. It results from the invagination of the enamel organ into the dental papilla before calcification has occurred. Teeth most affected are maxillary lateral incisors. The presence of dens invaginatus in mandibular canine is extremely rare. The tooth was symptomatic in that it was mobile and was oriented horizontally. This article presents a case of symptomatic dens invaginatus in mandibular canine. PMID:25364169

  16. 3D Assessment of Mandibular Growth Based on Image Registration: A Feasibility Study in a Rabbit Model

    PubMed Central

    Kim, I.; Oliveira, M. E.; Duncan, W. J.; Cioffi, I.; Farella, M.

    2014-01-01

    Background. Our knowledge of mandibular growth mostly derives from cephalometric radiography, which has inherent limitations due to the two-dimensional (2D) nature of measurement. Objective. To assess 3D morphological changes occurring during growth in a rabbit mandible. Methods. Serial cone-beam computerised tomographic (CBCT) images were made of two New Zealand white rabbits, at baseline and eight weeks after surgical implantation of 1?mm diameter metallic spheres as fiducial markers. A third animal acted as an unoperated (no implant) control. CBCT images were segmented and registered in 3D (Implant Superimposition and Procrustes Method), and the remodelling pattern described used color maps. Registration accuracy was quantified by the maximal of the mean minimum distances and by the Hausdorff distance. Results. The mean error for image registration was 0.37?mm and never exceeded 1?mm. The implant-based superimposition showed most remodelling occurred at the mandibular ramus, with bone apposition posteriorly and vertical growth at the condyle. Conclusion. We propose a method to quantitatively describe bone remodelling in three dimensions, based on the use of bone implants as fiducial markers and CBCT as imaging modality. The method is feasible and represents a promising approach for experimental studies by comparing baseline growth patterns and testing the effects of growth-modification treatments. PMID:24527442

  17. [Facial nerve paralysis and mandibular fracture].

    PubMed

    Salonna, I; Fanizzi, P; Quaranta, A

    1992-01-01

    The authors describe three cases of peripheral facial nerve paralysis in patients with a mandibular fracture. In two cases, in which the onset of palsy was uncertain, the facial nerve injury was contralateral to the fractured side. Topodiagnostic tests showed neural damage at the third intrapetrosal portion and at the genicular ganglion. In one of the two patients tomography revealed a fracture line through the anterio-superior wall of the external auditory canal homolateral to the facial palsy. In the third subject palsy set in immediately after the trauma and was ipsilateral to the mandibular fracture; the facial lesion was localized at the genicular ganglion. In the first two cases, functional recovery was spontaneous (40 and 0 days after the trauma respectively). In the third subject, the nerve was decompressed surgically with a complete functional recovery two months later. The functional and clinical findings of these three cases show that a contralateral facial palsy secondary to a mandibular fracture resolves spontaneously while the traumatic displacement of the mandibular condyle may determine a temporal bone fracture sometimes followed by a lesion in the intratemporal portion of the facial nerve. An event such as the latter may delay functional recovery and thus warrant surgery such as in cases of Bell's palsy. PMID:1298156

  18. Maxillofacial-derived stem cells regenerate critical mandibular bone defect.

    PubMed

    Steinhardt, Yair; Aslan, Hadi; Regev, Eran; Zilberman, Yoram; Kallai, Ilan; Gazit, Dan; Gazit, Zulma

    2008-11-01

    Stem cell-based bone tissue regeneration in the maxillofacial complex is a clinical necessity. Genetic engineering of mesenchymal stem cells (MSCs) to follow specific differentiation pathways may enhance the ability of these cells to regenerate and increase their clinical relevance. MSCs isolated from maxillofacial bone marrow (BM) are good candidates for tissue regeneration at sites of damage to the maxillofacial complex. In this study, we hypothesized that MSCs isolated from the maxillofacial complex can be engineered to overexpress the bone morphogenetic protein-2 gene and induce bone tissue regeneration in vivo. To demonstrate that the cells isolated from the maxillofacial complex were indeed MSCs, we performed a flow cytometry analysis, which revealed a high expression of mesenchyme-related markers and an absence of non-mesenchyme-related markers. In vitro, the MSCs were able to differentiate into osteogenic, chondrogenic, and adipogenic lineages. Gene delivery of the osteogenic gene BMP2 via an adenoviral vector revealed high expression levels of BMP2 protein that induced osteogenic differentiation of these cells in vitro and induced bone formation in an ectopic site in vivo. In addition, implantation of genetically engineered maxillofacial BM-derived MSCs into a mandibular defect led to regeneration of tissue at the site of the defect; this was confirmed by performing micro-computed tomography analysis. Histological analysis of the mandibles revealed osteogenic differentiation of implanted cells as well as bone tissue regeneration. We conclude that maxillofacial BM-derived MSCs can be genetically engineered to induce bone tissue regeneration in the maxillofacial complex and that this finding may be clinically relevant. PMID:18636943

  19. Lower border bone onlays to augment the severely atrophic (class VI) mandible in preparation for implants: a preliminary report.

    PubMed

    Soehardi, A; Meijer, G J; Berge, S J; Stoelinga, P J W

    2014-12-01

    We present the preliminary results of a study involving a group of consecutive patients who underwent lower border onlay grafting, limited to the symphyseal area, in preparation for implant insertion. This technique allows for maximum-sized implants, followed by prosthetic rehabilitation. The main advantage of this method is the minimal risk of damage to the mental nerve. Sixteen patients were followed for a period of 6 months to 4 years and all were free of neurosensory disturbances. Eight had a removable overdenture placed and were satisfied with the result. This surgical approach allows the patient to wear their dentures during the healing period. A further advantage of lower border grafting over intraoral upper border grafting is that mucosal dehiscences are not seen. PMID:25017193

  20. Effects of selected factors on the osseointegration of dental implants

    PubMed Central

    Koszuta, Piotr; Grafka, Agnieszka; Koszuta, Agnieszka; ?opucki, Maciej; Szyma?ska, Jolanta

    2015-01-01

    Introduction Osseointegration of dental implants with the maxillary and/or mandibular bone is the basis for implant prosthetic treatment. The aim of the study was to assess the influence of the patients’ gender, age, and in the case of women, their menopausal status (before menopause/after menopause/during hormone replacement therapy) on the osseointegration of dental implants. Material and methods The study evaluated the bone loss after implant loading and the success rate of the procedure in 71 women and 30 men. In the postmenopausal group, 20 (28.1%) women were receiving hormone replacement therapy. The implants used in the treatment of the studied patients were the two-phase dental implants. The extent of bone loss was estimated by comparing the post-implantation radiographs and the post-loading ones. Results The implantation procedure was entirely successful in 81 patients (80.2%). The patients’ age, gender and menopausal status did not significantly affect the implantation procedure success rate or bone loss (p > 0.05). A correlation between bone loss and hormone replacement therapy (p = 0.002) was found. Conclusions The hormone replacement therapy contributes to a greater peri-implant bone loss. The patients receiving hormone replacement therapy who consider replacement of missing teeth with implants should be informed about a greater risk of osseointegration failure, which may affect the success of implant therapy. PMID:26528107

  1. Local administration of calcitriol positively influences bone remodeling and maturation during restoration of mandibular bone defects in rats.

    PubMed

    Liu, Hongrui; Cui, Jian; Feng, Wei; Lv, Shengyu; Du, Juan; Sun, Jing; Han, Xiuchun; Wang, Zhenming; Lu, Xiong; Yimin; Oda, Kimimitsu; Amizuka, Norio; Li, Minqi

    2015-04-01

    The aim of this study was to investigate the influence of calcitriol on osteoinduction following local administration into mandibular bone defects. Calcitriol-loaded absorbable collagen membrane scaffolds were prepared using the polydopamine coating method and characterized by scanning electron microscopy. Composite scaffolds were implanted into rat mandibular bone defects in the following groups: no graft material (control), bare collagen membrane (CM group), collagen membrane bearing polydopamine coating (DOP/CM group), and collagen membrane bearing polydopamine coating absorbed with calcitriol (CAL/DOP/CM group). At 1, 2, 4 and 8weeks post-surgery, the osteogenic potential of calcitriol was examined by histological and immunohistochemical methods. Following in vivo implantation, calcitriol-loaded composite scaffolds underwent rapid degradation with pronounced replacement by new bone and induced reunion of the bone marrow cavity. Calcitriol showed strong potential in inhibiting osteoclastogenesis and promotion of osteogenic differentiation at weeks 1, and 2. Furthermore, statistical analysis revealed that the newly formed bone volume in the CAL/DOP/CM group was significantly higher than other groups at weeks 1, and 2. At weeks 4, and 8, the CAL/DOP/CM group showed more mineralized bone and uniform collagen structure. These data suggest that local administration of calcitriol is promising in promoting osteogenesis and mineralization for restoration of mandibular bone defects. PMID:25686922

  2. Complicated canal morphology of mandibular first premolar.

    PubMed

    Pallavi, Vyapaka; Kumar, Janga Ravi; Mandava, Ramesh Babu; Rao, Subramanian Hari

    2015-08-01

    The aim of this article was to report an unusual anatomic variation of mandibular first premolar, with one root and three distinct canals, which leave pulp chamber and merge short of apex to exit as two separate apical foramina. The incidence of three canals existing as two apical foramina has only been documented in the literature by a few case reports. To achieve successful endodontic treatment, the clinician has to identify the different canal configurations and treat them properly. PMID:26538977

  3. Mandibular metastasis of cholangiocarcinoma: A case report

    PubMed Central

    You, Tae Min; Kim, Kee-Deog; Jeong, Ho-Gul

    2015-01-01

    Tumors metastasizing from distant regions to the oral and maxillofacial region are uncommon, comprising only 1%-2% of all malignancies. Cholangiocarcinoma is a malignancy that arises from cholangiocytes, which are epithelial cells that line the bile ducts. These cancers are difficult to diagnose and have a poor prognosis. In this paper, we report a rare case of mandibular metastasis of cholangiocarcinoma diagnosed at the primary site and discuss the radiographic findings observed in this case.

  4. Complicated canal morphology of mandibular first premolar

    PubMed Central

    Pallavi, Vyapaka; Kumar, Janga Ravi; Mandava, Ramesh Babu; Rao, Subramanian Hari

    2015-01-01

    The aim of this article was to report an unusual anatomic variation of mandibular first premolar, with one root and three distinct canals, which leave pulp chamber and merge short of apex to exit as two separate apical foramina. The incidence of three canals existing as two apical foramina has only been documented in the literature by a few case reports. To achieve successful endodontic treatment, the clinician has to identify the different canal configurations and treat them properly. PMID:26538977

  5. Reconstruction of Beagle Hemi-Mandibular Defects with Allogenic Mandibular Scaffolds and Autologous Mesenchymal Stem Cells

    PubMed Central

    Luo, JinChao; Liu, HuaWei; Hu, Min; Yue, Wen

    2014-01-01

    Objective Massive bone allografts are frequently used in orthopedic reconstructive surgery, but carry a high failure rate of approximately 25%. We tested whether treatment of graft with mesenchymal stem cells (MSCs) can increase the integration of massive allografts (hemi-mandible) in a large animal model. Methods Thirty beagle dogs received surgical left-sided hemi-mandibular defects, and then divided into two equal groups. Bony defects of the control group were reconstructed using allografts only. Those of the experimental group were reconstructed using allogenic mandibular scaffold-loaded autologous MSCs. Beagles from each group were killed at4 (n?=?4), 12 (n?=?4), 24 (n?=?4) or 48 weeks (n?=?3) postoperatively. CT and micro-CT scans, histological analyses and the bone mineral density (BMD) of transplants were used to evaluate defect reconstruction outcomes. Results Gross and CT examinations showed that the autologous bone grafts had healed in both groups. At 48 weeks, the allogenic mandibular scaffolds of the experimental group had been completely replaced by new bone, which has a smaller surface area to that of the original allogenic scaffold, whereas the scaffold in control dogs remained the same size as the original allogenic scaffold throughout. At 12 weeks, the BMD of the experimental group was significantly higher than the control group (p<0.05), and all micro-architectural parameters were significantly different between groups (p<0.05). Histological analyses showed almost all transplanted allogeneic bone was replaced by new bone, principally fibrous ossification, in the experimental group, which differed from the control group where little new bone formed. Conclusions Our study demonstrated the feasibility of MSC-loaded allogenic mandibular scaffolds for the reconstruction of hemi-mandibular defects. Further studies are needed to test whether these results can be surpassed by the use of allogenic mandibular scaffolds loaded with a combination of MSCs and osteoinductive growth factors. PMID:25153673

  6. Cochlear Implants

    MedlinePLUS

    A cochlear implant is a small, complex electronic device that can help to provide a sense of sound. People who are ... of-hearing can get help from them. The implant consists of two parts. One part sits on ...

  7. Cochlear implant

    MedlinePLUS

    ... antenna. This part of the implant receives the sound, converts the sound into an electrical signal, and sends it to ... implants allow deaf people to receive and process sounds and speech. However, it is important to understand ...

  8. Survival of Implants in Immediate Extraction Sockets of Anterior Teeth: Early Clinical Results

    PubMed Central

    Sabir, Mohammad

    2015-01-01

    Background The aims and objectives of this study were placement of implants in freshly extracted sockets of anterior teeth and to evaluate the implant stability, peri-implant radiolucency and gingival inflammation around implant over a short period of 30 months. Materials and Methods A total of 12 patients (8 male and 4 female), ranging in the age from 20 to 50 years, from March 2007 to June 2007, were evaluated for immediate implant placement into 22 fresh extraction sockets. Only maxillary and mandibular anterior teeth/roots (central incisors, lateral incisors and canines) were considered for replacement with implants. One piece implant with integrated abutment and integrated surface, non-submerged, threaded and tapered at apical 5 mm, sand-blasted and acid etched surfaced implants (HI-TEC TRX-OP Implants of Life Care Company) were used. Results The mobility was not present in any of the implants at all the follow up visits. There were 2 implants at 6 month, 1 implant at 12 month, 1 implant at 18 month visits, showing peri-implant radiolucency at some sites at bone to implant contact site. Severe gingival inflammation was not observed in any of the implant site. At every follow-up visit, every implant met the criteria of success and none was found to be failed over a 30 months duration i.e. 100% success rate was achieved by implants in immediate extraction socket. Conclusion The success rate of implant survival in this study was found 100%. These implants have fulfilled all the criteria of implant success and based on the defined criteria, the success rate of implants placed in immediate extraction sockets of anterior teeth compared favorably with the conventional implants. The early results of the present study showed that high survival rates with the implants in immediate extraction sockets can be achieved. PMID:26266220

  9. Implant success rates in full-arch rehabilitations supported by upright and tilted implants: a retrospective investigation with up to five years of follow-up

    PubMed Central

    2015-01-01

    Purpose The aim of this retrospective study was to investigate the cumulative success rate, the implant survival rate, and the occurrence of biological complications in implants supporting full-arch immediately loaded rehabilitations supported by upright and tilted implants. Methods The clinical records and periapical radiographs of patients who attended follow-up visits were collected, and information was recorded regarding marginal bone loss resorption, the occurrence of peri-implant infectious diseases, and the implant survival rate. Implants were classified as successful or not successful according to two distinct classifications for implant success. Results A total of 53 maxillary and mandibular restorations including 212 implants were analysed, of which 56 implants were studied over the full five-year follow-up period. After five years, the cumulative success rate was 76.04% according to the Misch classification and 56.34% according to the Albrektsson classification. The cumulative implant survival rate was 100%, although one implant was found to be affected by peri-implantitis at the second follow-up visit. Conclusions The cumulative success rate of the implants dropped over time, corresponding to the progression of marginal bone resorption. The prevalence of peri-implantitis was very low, and the implant survival rate was not found to be related to the cumulative success rate.

  10. Mandibular osteonecrosis following herpes zoster infection in the mandibular branch of the trigeminal nerve: a case report and literature review

    PubMed Central

    2015-01-01

    Herpes zoster virus (HZV) infections are caused by reactivation of the varicella zoster virus. Reactivation symptoms commonly affect the thoracolumbar trunk, and rarely affect the mandibular branches of the trigeminal nerve. When the mandibular branches are involved, lesions appear proximal to the innervation area. This condition may be associated with exfoliation of the teeth and osteonecrosis of the jawbone. We report a case of mandibular osteomyelitis after herpes zoster infection and we present a review of the literature on mandibular-branch involvement of HZV-related osteonecrosis.

  11. Mandibular osteonecrosis following herpes zoster infection in the mandibular branch of the trigeminal nerve: a case report and literature review.

    PubMed

    Song, Jae-Min; Seo, Jeong-Seok; Lee, Jae-Yeol

    2015-12-01

    Herpes zoster virus (HZV) infections are caused by reactivation of the varicella zoster virus. Reactivation symptoms commonly affect the thoracolumbar trunk, and rarely affect the mandibular branches of the trigeminal nerve. When the mandibular branches are involved, lesions appear proximal to the innervation area. This condition may be associated with exfoliation of the teeth and osteonecrosis of the jawbone. We report a case of mandibular osteomyelitis after herpes zoster infection and we present a review of the literature on mandibular-branch involvement of HZV-related osteonecrosis. PMID:26733193

  12. Anodisation Increases Integration of Unloaded Titanium Implants in Sheep Mandible.

    PubMed

    Duncan, Warwick J; Lee, Min-Ho; Bae, Tae-Sung; Lee, Sook-Jeong; Gay, Jennifer; Loch, Carolina

    2015-01-01

    Spark discharge anodic oxidation forms porous TiO2 films on titanium implant surfaces. This increases surface roughness and concentration of calcium and phosphate ions and may enhance early osseointegration. To test this, forty 3.75?mm × 13?mm titanium implants (Megagen, Korea) were placed into healed mandibular postextraction ridges of 10 sheep. There were 10 implants per group: RBM surface (control), RBM + anodised, RBM + anodised + fluoride, and titanium alloy + anodised surface. Resonant frequency analysis (RFA) was measured in implant stability quotient (ISQ) at surgery and at sacrifice after 1-month unloaded healing. Mean bone-implant contact (% BIC) was measured in undemineralised ground sections for the best three consecutive threads. One of 40 implants showed evidence of failure. RFA differed between groups at surgery but not after 1 month. RFA values increased nonsignificantly for all implants after 1 month, except for controls. There was a marked difference in BIC after 1-month healing, with higher values for alloy implants, followed by anodised + fluoride and anodised implants. Anodisation increased early osseointegration of rough-surfaced implants by 50-80%. RFA testing lacked sufficient resolution to detect this improvement. Whether this gain in early bone-implant contact is clinically significant is the subject of future experiments. PMID:26436099

  13. Anodisation Increases Integration of Unloaded Titanium Implants in Sheep Mandible

    PubMed Central

    Duncan, Warwick J.; Lee, Min-Ho; Bae, Tae-Sung; Lee, Sook-Jeong; Gay, Jennifer; Loch, Carolina

    2015-01-01

    Spark discharge anodic oxidation forms porous TiO2 films on titanium implant surfaces. This increases surface roughness and concentration of calcium and phosphate ions and may enhance early osseointegration. To test this, forty 3.75?mm × 13?mm titanium implants (Megagen, Korea) were placed into healed mandibular postextraction ridges of 10 sheep. There were 10 implants per group: RBM surface (control), RBM + anodised, RBM + anodised + fluoride, and titanium alloy + anodised surface. Resonant frequency analysis (RFA) was measured in implant stability quotient (ISQ) at surgery and at sacrifice after 1-month unloaded healing. Mean bone-implant contact (% BIC) was measured in undemineralised ground sections for the best three consecutive threads. One of 40 implants showed evidence of failure. RFA differed between groups at surgery but not after 1 month. RFA values increased nonsignificantly for all implants after 1 month, except for controls. There was a marked difference in BIC after 1-month healing, with higher values for alloy implants, followed by anodised + fluoride and anodised implants. Anodisation increased early osseointegration of rough-surfaced implants by 50–80%. RFA testing lacked sufficient resolution to detect this improvement. Whether this gain in early bone-implant contact is clinically significant is the subject of future experiments. PMID:26436099

  14. Mandibular trauma treatment: A comparison of two protocols

    PubMed Central

    Kommers, Sofie C.; Roccia, Fabio; Forouzanfar, Tymour

    2015-01-01

    Objectives: The aim of this study was to evaluate the treatment of mandibular fractures treated in two European centre in 10 years. Study Design: This study is based on 2 systematic computer-assisted databases that have continuously recorded patients hospitalized with maxillofacial fractures in two centers in Turin, Italy and in Amsterdam, the Netherlands for ten years. Only patients who were admitted for mandibular fractures were considered for this study. Results: Between 2001 and 2010, a total of 752 patients were admitted at Turin hospital with a total of 1167 mandibular fractures not associated with further maxillofacial fractures, whereas 245 patients were admitted at Amsterdam hospital with a total of 434 mandibular fractures. At Amsterdam center, a total of 457 plates (1.5 - 2.7 mm) were used for the 434 mandibular fracture lines, whereas at Turin center 1232 plates (1.5 – 2.5 mm) were used for the management of the 1167 mandibular fracture lines. At Turin center, 190 patients were treated primarily with IMF, whereas 35 patients were treated with such treatment option at Amsterdam center. Conclusions: Current protocols for the management of mandibular fractures are quite efficient. It is difficult to obtain a uniform protocol, because of the difference of course of each occurring fracture and because of surgeons’ experiences and preferences. Several techniques can still be used for each peculiar fracture of the mandible. Key words:Mandibular fracture, facial trauma, maxillofacial, treatment, multicentre, database. PMID:25475782

  15. Stress and strain analysis of the bone-implant interface: a comparison of fiber-reinforced composite and titanium implants utilizing 3-dimensional finite element study.

    PubMed

    Shinya, Akikazu; Ballo, Ahmed M; Lassila, Lippo V J; Shinya, Akiyoshi; Närhi, Timo O; Vallittu, Pekka K

    2011-03-01

    This study analyzed stress and strain mediated by 2 different implant materials, titanium (Ti) and experimental fiber-reinforced composite (FRC), on the implant and on the bone tissue surrounding the implant. Three-dimensional finite element models constructed from a mandibular bone and an implant were subjected to a load of 50 N in vertical and horizontal directions. Postprocessing files allowed the calculation of stress and strain within the implant materials and stresses at the bone-to-implant interface (stress path). Maximum stress concentrations were located around the implant on the rim of the cortical bone in both implant materials; Ti and overall stresses decreased toward the Ti implant apex. In the FRC implant, a stress value of 0.6 to 2.0 MPa was detected not only on the screw threads but also on the implant surface between the threads. Clear differences were observed in the strain distribution between the materials. Based on the results, the vertical load stress range of the FRC implant was close to the stress level for optimal bone growth. Furthermore, the stress at the bone around the FRC implant was more evenly distributed than that with Ti implant. PMID:20545537

  16. Mandibular kinematics after orthognathic surgical treatment a pilot study.

    PubMed

    Sforza, Chiarella; Ugolini, Alessandro; Rocchetta, Davide; Galante, Domenico; Mapelli, Andrea; Giannì, Aldo Bruno

    2010-03-01

    We recorded three-dimensional mandibular movements, while the mouth was being opened and closed, using an optoelectronic motion analyser in 14 patients (5 skeletal Class II, 9 skeletal Class III) who were being assessed 7-49 months after orthognathic operations, and in 44 healthy subjects. All 14 patients had satisfactory healing on clinical examination, and function had been restored. Mandibular movement was divided into its rotational and translational components. On maximum mouth opening, the patients had significantly less total displacement of the mandibular interincisor point (p=0.05), and more mandibular movement that was explained by pure condylar rotation (p=0.006), than control subjects. There was no significant relation between maximum mouth opening and percentage rotation. While mandibular motion was well restored clinically by orthognathic surgery, the kinematics of the joint were modified. Larger studies and longitudinal investigations are necessary to appreciate the clinical relevance of the variations in condylar rotational and translational components. PMID:18938000

  17. Implantable Microimagers

    PubMed Central

    Ng, David C.; Tokuda, Takashi; Shiosaka, Sadao; Tano, Yasuo; Ohta, Jun

    2008-01-01

    Implantable devices such as cardiac pacemakers, drug-delivery systems, and defibrillators have had a tremendous impact on the quality of live for many disabled people. To date, many devices have been developed for implantation into various parts of the human body. In this paper, we focus on devices implanted in the head. In particular, we describe the technologies necessary to create implantable microimagers. Design, fabrication, and implementation issues are discussed vis-à-vis two examples of implantable microimagers; the retinal prosthesis and in vivo neuro-microimager. Testing of these devices in animals verify the use of the microimagers in the implanted state. We believe that further advancement of these devices will lead to the development of a new method for medical and scientific applications.

  18. Preventive implantations.

    PubMed

    Denissen, H W; Kalk, W

    1991-02-01

    Preventive implantology is concerned with the preservation of the alveolar ridge of the (edentulous) jaw. Maintaining the volume of the alveolar ridge is a major problem in the prevention of oral disease. Loss of teeth and tooth roots leads to resorption of residual ridges. This being so, it is a logical approach to substitute artificial analogues for lost tooth roots. Hydroxyapatite implants have been studied as submerged tooth root substitutes and shown to maintain the bulk of the alveolar ridge. A drawback of the implants is that the ridge maintenance depends solely on the physical presence of the hydroxyapatite implants. No physiological influence on bone preservation can be attributed to the implants. However, long term research indicates that 75 per cent of the implants survive under full lower dentures and 100 per cent of the implants under fixed partial dentures. PMID:1848531

  19. Using the "final-on-four" concept to deliver an immediate metal-resin implant-fixed complete dental prosthesis.

    PubMed

    Yilmaz, Burak; Ozcelik, Tuncer Burak; McGlumphy, Edwin

    2015-08-01

    In traditional dental implant therapy, the time between implant placement and delivery of the definitive prosthesis can be long and uncomfortable for a patient wearing a conventional removable denture on an atrophied ridge. New clinical protocols, often with tilted implants, are being used to immediately restore mandibular implants with interim restorations, thus shortening the patient's return to function. However, these conversion type interim restorations do not decrease the time to definitive prosthetic rehabilitation. The Ohio State University (OSU) developed an immediate load surgical and prosthetic protocol to compensate for the disadvantages of previous techniques. With this protocol, a custom, definitive, screw-retained metal-resin fixed prosthesis can be delivered 2 to 4 days postoperatively and has been described using 5 implants. This clinical report presents the OSU immediate loading protocol, combined with a tilted implant technique, for the fabrication of a mandibular metal-resin implant fixed complete dental prosthesis (MRIFCDP) in 3 days postoperatively and with only 4 implants. Replacing the mandibular dentition with an immediate load-fixed metal-resin prosthesis by means of the "final-on-four" technique resulted in a custom, definitive, and functional restorative solution immediately after surgery. PMID:25935086

  20. High Productivity Implantation ''PARTIAL IMPLANT''

    SciTech Connect

    Hino, Masayoshi; Miyamoto, Naoki; Sakai, Shigeki; Matsumoto, Takao

    2008-11-03

    The patterned ion implantation 'PARTIAL IMPLANT' has been developed as a productivity improvement tool. The Partial Implant can form several different ion dose areas on the wafer surface by controlling the speed of wafer moving and the stepwise rotation of twist axis. The Partial Implant system contains two implant methods. One method is 'DIVIDE PARTIAL IMPLANT', that is aimed at reducing the consumption of the wafer. The Divide Partial Implant evenly divides dose area on one wafer surface into two or three different dose part. Any dose can be selected in each area. So the consumption of the wafer for experimental implantation can be reduced. The second method is 'RING PARTIAL IMPLANT' that is aimed at improving yield by correcting electrical characteristic of devices. The Ring Partial Implant can form concentric ion dose areas. The dose of wafer external area can be selected to be within plus or minus 30% of dose of wafer central area. So the electrical characteristic of devices can be corrected by controlling dose at edge side on the wafer.

  1. Arsenic Trioxide-Induced Mandibular Osteomyelitis.

    PubMed

    Lu, Pei-Chen; Wu, Ju-Hui; Chen, Chun-Ming; Du, Je-Kang

    2015-09-01

    Previously, arsenic was a popular devitalizing agent used to necrotize inflamed dental pulp to lower the pulp sensitivity owing to the unavailability of appropriate anesthesia. However, leakage from the apical foramen, lateral or accessory canals, or cracks in the tooth is common. This can be dangerous because of the reportedly high toxic effects of arsenic in both hard and soft tissues, leading to gingival and osseous necrosis and, consequently, osteomyelitis. Therefore, arsenic can prove fatal for both bones and teeth and is no longer used. We encountered a case involving a 50-year-old man who had developed mandibular osteomyelitis with lower lip paresthesia caused by arsenic trioxide used during endodontic treatment. The patient was treated with appropriate antibiotics, adjunctive hyperbaric oxygen therapy, and adequate surgical debridement. Hyperbaric oxygen therapy can induce neovascularization in necrosed tissues and improve bone and soft tissue healing. At a 4-year follow-up visit, bone healing was observed, with restoration of periodontal health, although the paresthesia had persisted. We describe this case, present a review of the relevant published data, and discuss the possible causes, diagnosis, treatment, and follow-up protocol of mandibular osteomyelitis caused by arsenic trioxide. PMID:25896568

  2. Management of a transmigrated mandibular canine

    PubMed Central

    Verma, Sneh Lata; Sharma, V. P.; Singh, Gyan P.

    2012-01-01

    The purpose of this article is to report the management of a transmigrated mandibular canine with emphasis on saving the tooth as natural part rather than surgical removal of the transmigrated tooth. There are several treatment options proposed for impacted mandibular canines including surgical removal, exposure and orthodontic alignment, intra-alveolar tooth transplantation (surgical repositioning of a tooth in its alveolar socket) and observation. The technique, surgical repositioning of a tooth involves the surgical extraction of impacted tooth and fixation in the correct position in the dental arch after surgical preparation (correction) of the alveolar socket. It is especially valuable in cases of difficult-to-treat impaction. A repositioned tooth is better substitute than fixed or removable prostheses, and the technique is more cost effective than other methods. Patients with excellent oral hygiene should be considered as preferred candidates for surgical repositioning of tooth. Disadvantages include the invasiveness of surgery, the difficulty of projecting long term stability due to chances of root resorption and loss of gingival attachment. PMID:24987621

  3. Mandibular fractures in iraq: an epidemiological study.

    PubMed

    Bede, Salwan

    2015-03-01

    The purpose of this study was to evaluate the epidemiological characteristics of the mandibular fractures relating to gender, age, the etiology of injury, and the rendered treatment modalities and complications. The data of the patients who sustained mandibular fractures were retrieved and were analyzed retrospectively, and based on these data a descriptive analysis was conducted. A total of 112 patients were included in this study; the most common cause was road traffic accidents (RTAs) followed by assaults and missile injuries. The most frequently involved age group was 11 to 20 years, treatment modalities included conservative, closed reduction and indirect fixation, and open reduction and internal fixation (ORIF) in 11.6, 79.5, and 8.9% of the cases, respectively. Most of the major complications were injury related. This study showed RTAs to be the most frequent cause followed by assaults, it also showed that a high percentage of assault victims were females mainly of low socioeconomic status. Another distinguishing feature in this study was the high incidence of missile injuries in the form of bullets and blasts. Closed reduction still has an important role in the treatment of fractures of mandible especially when the necessary equipments for ORIF are not readily available. A higher complication rate was observed in patients diagnosed with multiple and comminuted fractures as well as those caused by violence in the form of missile and assault injuries. PMID:25709754

  4. The use of autogeneous mandibular bone block grafts for reconstruction of alveolar defects

    PubMed Central

    Dolanmaz, Do?an; Esen, Alparslan; Y?ld?r?m, Gülsün; ?nan, Özgür

    2015-01-01

    Objective: Purpose of this retrospective study was to evaluate outcomes autogenous bone block grafts obtained from mandible for different indications. The healing of the donor and recipient sites in the postoperative period, morbidity and the resorption of the graft were investigated. Patients and Methods: Twenty-nine patients grafted with mandibular bone block graft were participated in the present study. Grafting was applied in these patients for three indications; reconstruction of alveolar cleft, lateral crest augmentation before dental implantation and sinus floor augmentation. All operations were performed under local anesthesia and in some cases sedation was used as well. Results: Minimal exposure of the block graft occurred in three alveolar cleft patients. Secondary epithelization was achieved in all cleft patients with no symptoms of infection. In one patient infection was seen in donor site 1-week after the operation. The region was curetted and antibiotics administrated again. Two patients showed an infection of recipient site, after 4 weeks the grafts were removed. In all the patients, as the screw head became apparent until 1 thread, amount of the resorption were considered <1.5 mm. Conclusion: The usage of mandibular block grafts is a simple and effective treatment modality for reconstruction of different types of alveolar defects and it also reduces cost of treatment. PMID:26389038

  5. Conventional 2.0 mm miniplates versus 3-D plates in mandibular fractures

    PubMed Central

    Sadhwani, Bipin S.; Anchlia, Sonal

    2013-01-01

    Aim: To compare and evaluate the treatment outcome and postoperative complications in mandibular fractures using 2- and 3-dimensional miniplates. Materials and Methods: This study consisted of a sample of 28 patients (40 fracture sites) divided randomly but equally (single-blind control trial study) into two groups. Each group contains 14 patients (20 similar fracture sites in each group). Group 1 was treated with open reduction and internal fixation using 3-dimensional (3-D) miniplates. Group II was treated using 2-dimensional (2-D) 2-mm miniplates. Results: Out of 14 patients treated by conventional 2-mm miniplates, 2 patients developed occlusal discrepancy, another 2 had postoperative mobility at fracture site, and 1 developed plate failure and subsequent infection, which was treated by removal of the plate under antibiotic coverage. One patient treated by 3-dimensional plates had tooth damage. Statistical Analysis: Chi-square test. Conclusion: The results of this study suggested that the treatment of mandibular fractures (symphysis, parasymphysis, and angle) with 3-dimensional plates provided 3-dimensional stability and carried low morbidity and infection rates. The only probable limitations of 3-dimensional plates were excessive implant material due to the extra vertical bars incorporated for countering the torque forces. PMID:24205475

  6. Surgical extraction of mandibular third molar in pterygomandibular space: a case report

    PubMed Central

    Lee, Young-Kyu; Park, Sung-Soo

    2013-01-01

    Impacted mandibular third molars are located between the second mandibular molar and mandibular ramus. However, ectopic mandibular third molars with heterotopic positions are reported in the subcondylar or pterygomandibular space. The usual cause of malposition is a cyst or tumor, and malposition without a pathology is rare. This case report described an impacted mandibular third molar in the pterygomandibular space without any associated pathology. PMID:24471052

  7. Development and evaluation of porous dental implants in miniature swine.

    PubMed

    Karagianes, M T; Westerman, R E; Rasmussen, J J; Lodmell, A M

    1976-01-01

    Organized bone ingrowth in endosteal porous implants fabricated from VMC titanium alloy and surgically implanted with a tight interference fit, securely anchored the implants in fresh and healed mandibular premolar sites of miniature swine. This bone-implant union retained its integrity under high as well as slight masticatory stresses up to one-year after implantation. Bone invasion of the alumina porcelain implants was impeded by the lack of adequate interconnecting porosity; when the porosity was increased, insufficient ceramic strength prohibited a tight initial bone-implant fit. As a consequence, inadequate initial implant stability resulted in a soft tissue encapsulation of the majority of the ceramic implants. Histological examination and mechanical testing results were similar for bone-ingrown implants exposed to different experimental stresses for 4, 5, 8, and 12 months. Bone ingrowth and interface shear strengths were also similar in the different VMC pore sizes and shapes investigated. The design of intraoral attachments appeared critical, at least in swine where no postoperative treatment was administered. Gingival inflammation and alveolar bone resorption caused by calculus were severe around truncated cone-shaped devices. Slender transgingival posts, occlusal caps, and crown restorations were less susceptible to calculus accumulation, resulting in a more satisfactory gingival and subgingival response. Excessive epithelial invagination was a problem only in implants with transgingival truncated cones. Good adherence of soft tissue to metal under the gingival mucosa prevented epithelial migration around implants with other transgingival devices. Alveolar bone resportion around the tops of bone-ingrown implants was minimal at the time intervals examined (up to one year); however, a definite conclusion should be delayed until longer-term implants under full occlusion are evaluated. PMID:173745

  8. Mandibular first molar with single root and single root canal

    PubMed Central

    Munavalli, Anil; Kambale, Sharnappa; Ramesh, Sachhi; Ajgaonkar, Nishant

    2015-01-01

    Mandibular molars demonstrate considerable anatomic complexities and abnormalities with respect to number of roots and root canals. Clinicians should be aware that there is a possibility of the existence of a fewer number of roots and root canals than the normal root canal anatomy. Mandibular first molar with a single root and single canal was diagnosed with the aid of dental operating microscope and multiple angled radiographs. This case report presents a rare case of successful endodontic management of mandibular first molar with a single root and root canal. PMID:26180424

  9. Deferoxamine Expedites Consolidation during Mandibular Distraction Osteogenesis

    PubMed Central

    Donneys, Alexis; Deshpande, Sagar S.; Tchanque-Fossuo, Catherine N.; Johnson, Kelsey L.; Blough, Jordan T.; Perosky, Joseph E.; Kozloff, Kenneth M.; Felice, Peter A.; Nelson, Noah S.; Farberg, Aaron S.; Levi, Benjamin; Buchman, Steven R.

    2014-01-01

    Background A limitation of mandibular Distraction Osteogenesis (DO) is the length of time required for consolidation. This drawback subjects patients to possible pin-site infections, as well as a prolonged return to activities of normal daily living. Developing innovative techniques to abridge consolidation periods could be immensely effective in preventing these problematic morbidities. Deferoxamine (DFO) is an angiogenic activator that triggers the HIF-1? pathway through localized iron depletion. We previously established the effectiveness of DFO in enhancing regenerate vascularity at a full consolidation period (28 days) in a murine mandibular DO model. To investigate whether this augmentation in vascularity would function to accelerate consolidation, we progressively shortened consolidation periods prior to ?CT imaging and biomechanical testing (BMT). Materials and Methods Three time points (14d, 21d and 28d) were selected and six groups of Sprague-Dawley rats (n=60) were equally divided into control (C) and experimental (E) groups for each time period. Each group underwent external fixator placement, mandibular osteotomy, and a 5.1mm distraction. During distraction, the experimental groups were treated with DFO injections into the regenerate gap. After consolidation, mandibles were imaged and tension tested to failure. ANOVA was conducted between groups, and p < 0.05 was considered statistically significant. Results At 14 days of consolidation the experimental group demonstrated significant increases in Bone Volume Fraction (BVF), Bone Mineral Density (BMD) and Ultimate Load (UL) in comparison to non-treated controls. The benefit of treatment was further substantiated by a striking 100% increase in the number of bony unions at this early time-period (C:4/10 vs. E:8/10). Furthermore, metrics of BVF, BMD, Yield and UL at 14 days with treatment demonstrated comparable metrics to those of the fully consolidated 28d control group. Conclusion Based on these findings, we contend that augmentation of vascular density through localized DFO injection delivers an efficient means for accelerating bone regeneration without significantly impacting bone quality or strength. PMID:23598047

  10. GMP-level adipose stem cells combined with computer-aided manufacturing to reconstruct mandibular ameloblastoma resection defects: Experience with three cases

    PubMed Central

    Wolff, Jan; Sándor, George K.; Miettinen, Aimo; Tuovinen, Veikko J.; Mannerström, Bettina; Patrikoski, Mimmi; Miettinen, Susanna

    2013-01-01

    Background: The current management of large mandibular resection defects involves harvesting of autogenous bone grafts and repeated bending of generic reconstruction plates. However, the major disadvantage of harvesting large autogenous bone grafts is donor site morbidity and the major drawback of repeated reconstruction plate bending is plate fracture and difficulty in reproducing complex facial contours. The aim of this study was to describe reconstruction of three mandibular ameloblastoma resection defects using tissue engineered constructs of beta-tricalcium phosphate (?-TCP) granules, recombinant human bone morphogenetic protein-2 (rhBMP-2), and Good Manufacturing Practice (GMP) level autologous adipose stem cells (ASCs) with progressively increasing usage of computer-aided manufacturing (CAM) technology. Materials and Methods: Patients’ three-dimensional (3D) images were used in three consecutive patients to plan and reverse-engineer patient-specific saw guides and reconstruction plates using computer-aided additive manufacturing. Adipose tissue was harvested from the anterior abdominal walls of three patients before resection. ASCs were expanded ex vivo over 3 weeks and seeded onto a ?-TCP scaffold with rhBMP-2. Constructs were implanted into patient resection defects together with rapid prototyped reconstruction plates. Results: All three cases used one step in situ bone formation without the need for an ectopic bone formation step or vascularized flaps. In two of the three patients, dental implants were placed 10 and 14 months following reconstruction, allowing harvesting of bone cores from the regenerated mandibular defects. Histological examination and in vitro analysis of cell viability and cell surface markers were performed and prosthodontic rehabilitation was completed. Discussion: Constructs with ASCs, ?-TCP scaffolds, and rhBMP-2 can be used to reconstruct a variety of large mandibular defects, together with rapid prototyped reconstruction hardware which supports placement of dental implants. PMID:24205470

  11. Stress Analysis on Single Cobalt/Chrome Prosthesis With a 15-mm Cantilever Placed Over 10/13/15-mm-length Implants: A Simulated Photoelastic Model Study.

    PubMed

    Gastaldo, José Fábio Guastelli; Pimentel, Angélica Castro; Gomes, Maria Helena; Sendyk, Wilson Roberto; Laganá, Dalva Cruz

    2015-12-01

    The aim of study was to assess the stress around 10/13/15-mm implants in the mandibular area with a 15-mm cantilevered acrylic-resin-coated prostheses following the application force, using the photoelasticity method. Three photoelastic mandibular models were created containing 10-, 13-, and 15-mm implants in length and 3.75 mm in diameter. The implants had bore internal hex connections and were placed parallel to the intermental region. Abutments with 1-mm high cuffs were placed over the implants, and a single cobalt/chrome metallic prosthesis with a 15-mm cantilever, coated with thermoplastic acrylic resin, was placed on top. Loads of 1.0 and 3.0 bars were applied, and the images were photographed and assessed by photoelasticity method. The greatest stress levels were observed for the 10-mm implants. The stress pattern was the same regardless of implant length; only the magnitude of the stress along the implant body revealed changes. Increased implant length played a role in reducing stress on the investigated area of the model, and the 15-mm implants exhibited the best performance in regard to stress distribution. The highest stress levels were found in the implants closest to the cantilever and the central implant. The longest implants were more favorable in regard to the stress distribution on the peri-implant support structures in the 15-mm cantilevered prosthesis under loads. PMID:24914673

  12. Reconstruction of mandibular defects in irradiated patients

    SciTech Connect

    Klotch, D.W.; Gump, J.; Kuhn, L. )

    1990-10-01

    In this prospective study, mandibular reconstruction using titanium plates was evaluated in 31 patients treated between July 1988 and January 1990. Sixteen patients had prior surgery; 13 had prior radiotherapy. In 11 patients, prior radiation and surgery had failed. Sixteen patients received postoperative radiotherapy either in standard or accelerated fractions. Twelve patients had complications of either intraoral (8), extraoral (5), or combined (1) plate exposure or fistula formation (2). Factors significantly related to complications were poor nutrition, accelerated radiation, and recurrence. Sixty-one percent of all patients healed uneventfully. When patients with complications secondary to recurrence who subsequently died were excluded, the success rate was 73%. Only one patient had an unacceptable result that produced a cosmetic and functional deformity despite secondary repair.

  13. Spring-mediated mandibular distraction osteogenesis.

    PubMed

    Mofid, Mehrdad M; Inoue, Nozomu; Tufaro, Anthony P; Vander Kolk, Craig A; Manson, Paul N

    2003-09-01

    Successful performance of distraction osteogenesis requires rigorous patient compliance with a daily activation regimen of a percutaneous screw. Previous clinical studies have found that failure of patient compliance with this regimen is the most common complication leading to technical failure of the distraction process. The authors have developed an internalized spring-mediated device for mandibular distraction osteogenesis that can potentially abrogate the risks associated with patient compliance by allowing for automated distraction across an osteotomy. Twenty adult New Zealand White rabbits underwent unilateral mandibular osteotomy. A segment of nickel-titanium shape memory alloy reinforced at both ends with a pinball was fashioned into an inferiorly based arc and secured to the mandible with stainless steel wire. On postoperative day 12, spring activation commenced by cutting a wire binding the two pinballs to one another. Animals were observed for 6 weeks before they were killed. Radiographic studies and decalcified histologic analysis were performed on extracted mandibles. Temperature- and displacement-dependent properties of the shape memory alloy were also examined. Five animals were excluded from the study due to infection, nonunion, or device failure. A mean distraction of 1.2 mm in the distracted hemimandible relative to the nonoperated hemimandible was found (P <.001, two-tailed paired t test). The maximum distraction achieved in an experimental specimen using the spring distractor was 3.7 mm. There were no other histologic or radiographic differences found between study specimens and specimens subjected to traditional distraction methods. Biomechanical testing of the shape memory alloy revealed a temperature-dependent increase in force at body temperature compared with room temperature and a reduction in force with increased displacement of the spring. This study demonstrates the feasibility of spring-mediated distraction osteogenesis across an osteotomy. As the field of distraction osteogenesis matures, the next level of sophistication in the clinical development of devices will incorporate technology that permits fully internalized and automated distraction to occur. PMID:14501343

  14. Mandibular advancement device for obstructive sleep apnea: An overview.

    PubMed

    Jayesh, S Raghavendra; Bhat, Wasim Manzoor

    2015-04-01

    This paper presents an overview of mandibular advancement device (MAD). The primary purpose of MAD is to move the mandible forwards relative to maxilla in ordered to widen the airway to prevent to closure. PMID:26015718

  15. Mandibular advancement device for obstructive sleep apnea: An overview

    PubMed Central

    Jayesh, S. Raghavendra; Bhat, Wasim Manzoor

    2015-01-01

    This paper presents an overview of mandibular advancement device (MAD). The primary purpose of MAD is to move the mandible forwards relative to maxilla in ordered to widen the airway to prevent to closure. PMID:26015718

  16. Geriatric slim implants for complete denture wearers: clinical aspects and perspectives

    PubMed Central

    Huard, Cedric; Bessadet, Marion; Nicolas, Emmanuel; Veyrune, Jean-Luc

    2013-01-01

    Background Advances made in prevention have helped postpone complete edentulism in older patients. However, in the elderly, the physiological state reduces patients’ ability to adapt to oral rehabilitation and degrades the patient’s oral condition. Consequently, elderly edentulous subjects avoid many types of foods, which can lead to substantial nutritional consequences. Complete dentures retained by implants are, currently, the treatment of reference in prosthodontic mandibular rehabilitation. Indeed, the mandibular symphysis generally tolerates implantation, even when the mandible is strongly resorbed. However, in the elderly, implant rehabilitation is compromised by the complexity of the surgical protocol and possible postoperative complications. In this context, the use of geriatric “slim implants” (GSI) offers an interesting alternative. Methods In the present study, the surgical and prosthetic procedures for the use of GSI in a French dental hospital are presented. The objective was the stabilization of a complete mandibular denture in an elderly person, with the immediate implantation of four GSI. Results The operating procedure was found to be less invasive, less expensive, simpler, and more efficient than the conventional procedure. Conclusion The result strongly suggests that this protocol could be used systematically to treat complete edentulism in very elderly patients. Long-term monitoring and the evaluation of the reliability of this type of rehabilitation should be undertaken. PMID:24009432

  17. Mandibular Ramus Fracture: An Overview of Rare Anatomical Subsite

    PubMed Central

    Jadhav, Anendd; Mundada, Bhushan; Deshmukh, Rahul; Bhutekar, Umesh; Kala, Atul; Waghwani, Kapil; Mishra, Apoorva

    2015-01-01

    Aim. The present study aims at exemplifying the incidence, and aetiology and analyses the outcomes of open reduction internal fixation (ORIF) over closed treatment of mandibular ramus fractures. Patients and Method. In the present retrospective analysis of mandibular fracture patients, variables analysed were age, sex, cause of injury, pretreatment occlusion, treatment given, period of maxillo-mandibular fixation (MMF), and posttreatment occlusion. Results. Out of 388 mandibular fractures treated, ramus fractures were 12 (3.09%). In the present study, predominant cause of mandibular ramus fracture was road traffic accident (RTA) n = 07 (58.33%) followed by fall n = 04 (33.33%) and assault n = 1 (8.33%). The average age was 35.9 years with a male predilection. Of these, 9 patients were treated with ORIF while remaining 3 with closed treatment. The average MMF after closed treatment was 21 days and 3 to 5 days after ORIF. There was improvement in occlusion in all 12 patients posttreatment with no major complication except for reduced mouth opening in cases treated with ORIF which recovered with physiotherapy and muscle relaxants. Conclusion. Mandibular ramus fractures accounted for 3.09% with RTA as a common aetiology. ORIF of ramus fractures facilitated adequate functional and anatomic reduction with early return of function. PMID:26613050

  18. A Precise Method of Measuring Simultaneous Intrusion and Uprighting of Mandibular Molar Using Denta Scan – A Case Report

    PubMed Central

    Padmaprabha, Biswas Palukunnu; Ponnambathayil, Shaji Aboobacker; Aynipully, Hariprasad; Reghunathan, Deepak Parambath

    2015-01-01

    A commonly encountered problem in prosthetic dentistry is the supra eruption of teeth due to absence of opposing teeth. Consequently, replacement of the missing teeth with prosthesis becomes difficult due to lack of vertical dimension of the edentulous area. This article describes the space regaining procedure in a 14-year-old female patient who wanted a fixed prosthesis for her missing maxillary 1st molar. On examination, it was observed that mandibular 1st molar had supraerupted and tipped lingually. After considering the various treatment modalities it was decided to simultaneously intrude and upright the mandibular molar using a mini-implant. The precise measurements of intrusion and uprighting were done using Dentascan software. Intrusion of 1.8mm and buccolingual uprighting of 2.3mm was achieved in 45 days. The mini-implant is an efficient non-compliance device to intrude and upright the tooth simultaneously. Dentascan is an accurate and very precise method of measuring the intrusion and uprighting of teeth. PMID:26393217

  19. Volumetric stability of autogenous bone graft with mandibular body bone: cone-beam computed tomography and three-dimensional reconstruction analysis

    PubMed Central

    Lee, Hyeong-Geun

    2015-01-01

    Objectives The purpose of this study was to estimate the volumetric change of augmented autobone harvested from mandibular body cortical bone, using cone-beam computed tomography (CBCT) and three-dimensional reconstruction. In addition, the clinical success of dental implants placed 4 to 6 months after bone grafting was also evaluated. Materials and Methods Ninety-five patients (48 men and 47 women) aged 19 to 72 years were included in this study. A total of 128 graft sites were evaluated. The graft sites were divided into three parts: anterior and both posterior regions of one jaw. All patients included in the study were scheduled for an onlay graft and implantation using a two-stage procedure. The dental implants were inserted 4 to 6 months after the bone graft. Volumetric stability was evaluated by serial CBCT images. Results No major complications were observed for the donor sites. A total of 128 block bones were used to augment severely resorbed alveolar bone. Only 1 of the 128 bone grafts was resorbed by more than half, and that was due to infection. In total, the average amount of residual grafted bone after resorption at the recipient sites was 74.6%±8.4%. Conclusion Volumetric stability of mandibular body autogenous block grafts is predictable. The procedure is satisfactory for patients who want dental implants regardless of atrophic alveolar bone. PMID:26568924

  20. Computer-aided design and manufacturing and rapid prototyped nanoscale hydroxyapatite/polyamide (n-HA/PA) construction for condylar defect caused by mandibular angle ostectomy.

    PubMed

    Li, Jihua; Hsu, Yuchun; Luo, En; Khadka, Ashish; Hu, Jing

    2011-08-01

    The fracture or defect of the mandibular condyle is one of the serious complications during angle-reduction ostectomy. Reconstruction of such defects also is a daunting task. The case report describes a method based on computer-aided design/computer-aided manufacturing (CAD/CAM) and rapid prototyping nanoscale hydroxyapatite/polyamide (n-HA/PA) for individual design, fabrication, and implantation of a mandibular condyle. A 27-year-old woman with a square-shaped face who had previously undergone mandibular angle reduction reported with malocclusion, deviated mouth, collapse of the right side of the face, and masticatory problems. The reason for the problems was the unintended removal of the condyle during the ostectomy procedure. Using computed tomography (CT) data, a biomimetic n-HA/PA scaffold, and CAD/CAM for rapid prototyping by three-dimensional (3D) printing, a perfect-fitting condylar implant was fabricated. A surgical guide system also was developed to reproduce the procedures accurately so a perfect fit could be obtained during surgery. The patient ultimately regained reasonable jaw contour and appearance, as well as appreciable temporomandibular joint (TMJ) function. PMID:20972567

  1. Cochlear Implants

    MedlinePLUS

    ... or after the patient developed language skills The motivation of the patient and his or her family ... from a cochlear implant and will have the motivation to participate in the process. It is important ...

  2. Dental Implants

    MedlinePLUS Videos and Cool Tools

    Dental Implants A fuller, more complete smile is within reach. The following information is designed to provide helpful facts so you ... found in nature. What Happens When You Lose a Tooth? When you lose a tooth, especially a ...

  3. Cochlear Implants

    MedlinePLUS

    ... under the skin behind the ear, connected to electrodes that are inserted inside the cochlea. An external ... stimulator then sends the signals to the implanted electrodes in the cochlea. The electrodes? signals stimulate the ...

  4. [Cochlear implants].

    PubMed

    Gersdorff, M

    1997-01-01

    Cochlear implants aim at the rehabilitation of profound bilateral deafness. The cochlear implant is a prosthesis made out of surgically implanted cochlear electrodes connected to an external vocal processor. The external acoustic signals are converted into electrical signals coded by the vocal processor. They are then sent out, by a transcutaneous mode, to an internal receptor. This receptor transmits the information to the intracochlear electrodes. Initially, the cochlear implantation was recommended to patients totally deaf following a trauma, a degenerative disease of the inner ear, a meningitis or the use of ototoxic drugs. These patients could not gain from conventional hearing aids and were condemned to silence. More recently, the authors have been impressed by spectacular results with patients having lost their hearing during adulthood (postlingual). The challenge here is quite different, as its aim is to open up--and not to reopen--a child to a sensation that he has never perceived before. This allows the child to develop a coding, a recognition of the acoustic message. The first results are very encouraging. Scientifically, the implantation is also a research tool in various fields: surgical, neurophysiological, neuropsychological, speech therapy, social and cultural. The cochlear implant is an "avant-garde" project. It has changed our approach to profound deafness. It represents the only hope for the profoundly deaf person to reach a satisfactory rehabilitation and social integration. PMID:9532864

  5. Prevalence and pattern of mandibular fracture in Central India

    PubMed Central

    Barde, Dhananjay; Mudhol, Anupama; Madan, Ramnik

    2014-01-01

    Introduction: The etiology and pattern of mandibular fracture vary considerably among different study populations. Despite many reports about the incidence, diagnosis and treatment of mandibular fracture there is limited knowledge about the specific type or pattern of mandibular fractures in South Asian countries. This study attempts to delineate predictable patterns of fracture based on patient demographics and mechanism of injury in central part of India. Materials and Methods: The medical records of patients with mandibular fractures treated over a 3 years period were identified and analyzed based on age, sex, mechanism of trauma, seasonal variation, drug/alcohol abuse, number and anatomic location. Results: We reviewed 464 patients having mandibular fractures with age ranging from 7 to 89 years. Male (343, 79%) to female (91, 21%) ratio was 3.7:1, significantly higher for males. The highest incidence (37.5%) of mandibular fractures was in the age group of 21–30 years. The main cause was road traffic accidents (RTAs, 68.8%) followed by falls (16.8%), assaults (11%) and other reasons (3.8%). Parasymphyseal fractures were the most frequent 331 (41.1%), followed by condyle (135) and angle (124) fractures in occurrence. Mandibular angle fractures were found mostly to be associated with assault victims. Conclusion: The mechanism of injury correlates significantly with the anatomic location of fracture and knowledge of these associations should guide the surgeons for appropriate and timely management. Because RTAs are most frequent, good traffic sense needs to be imbibed and developed by the government as well as the public. PMID:25937725

  6. Effects of tissue-engineered articular disc implants on the biomechanical loading of the human temporomandibular joint in a three-dimensional finite element model.

    PubMed

    Al-Sukhun, Jehad; Ashammakhi, Nureddin; Penttila, Heikki

    2007-07-01

    The purpose of this study was to evaluate biomechanical loading of the temporomandibular joint when using a biodegradable laminate implant to replace the articular disc and to test the hypothesis that the use of the implant reduces stress distribution in the condyle, implant, and glenoid fossa. A finite element model of a female human mandible, including the temporomandibular joint, which had two standard endosseous implants inserted bilaterally in the premolar region, was constructed from computed tomography scan images using a commercially available finite element software. The disc, condyle, and glenoid fossa were arbitrarily divided into five regions: the anterior, posterior, medial, lateral, and central. The disc was then replaced with a poly-L/DL-lactide biodegradable laminate. The finite element model was then used to predict principal and Von Mises stresses. The use of poly-L/DL-lactide implant resulted in remarkable reduction in Von Mises stresses (approximately threefold) in the anterior, central, and medial regions of the mandibular condyle in comparison with slight to moderate stress reductions in the corresponding regions of the implant and glenoid fossa. The mandibular condyle also demonstrated the largest total displacement in all directions followed by the implant and glenoid fossa. The use of an alloplastic implant such as the bioresorbable, poly-L/DL-lactide laminate to replace the articular disc reduces loading of the mandibular condyle rather than the implant and glenoid fossa. These findings lead to support the hypothesis that the mandibular condyle more likely functions as a shock absorber than the disc. The use of bioresorbable laminate implants might prove an efficient technique to replace the articular disc and promote normal function of the temporomandibular joint. PMID:17667665

  7. Early radiographic diagnosis of peri-implantitis enhances the outcome of peri-implantitis treatment: a 5-year retrospective study after non-surgical treatment

    PubMed Central

    Chang, Hee-Yung; Park, Shin-Young; Kim, Jin-Ah; Kim, Young-Kyun

    2015-01-01

    Purpose This retrospective study evaluated the relationship between the timing of peri-implantitis diagnosis and marginal bone level after a 5-year follow-up of non-surgical peri-implantitis treatment. Methods Thirty-three patients (69 implants) were given peri-implantitis diagnosis in 2008-2009 in Seoul National University Bundang Hospital. Among them, 31 implants from 16 patients were included in this study. They were treated non-surgically in this hospital, and came for regular maintenance visits for at least 5 years after peri-implantitis treatment. Radiographic marginal bone levels at each interval were measured and statistical analysis was performed. Results Timing of peri-implantitis was one of the significant factors affecting initial bone loss and total bone loss not additional bone after peri-implantitis diagnosis. Patients with cardiovascular disease and diabetic mellitus were positively influenced on both initial bone loss and total bone loss. Patients who needed periodontal treatment after implant placement showed a negative effect on bone loss compared to those who needed periodontal treatment before implant placement during entire periods. Implant location also significantly influenced on amounts of bone loss. Mandibular implants showed less bone loss than maxillary implants. Among surgical factors, combined use of autogenous and xenogenic bone graft materials showed a negative effect on bone loss compared to autogenous bone graft materials. Use of membrane negatively affected on initial bone loss but positively on additional bone loss and total bone loss. Thread exposure showed positive effects on initial bone loss and total bone loss. Conclusions Early peri-implantitis diagnosis led to early non-surgical intervention for peri-implantitis treatment, which resulted in the maintenance of the bone level as well as preservation of the implant. Graphical Abstract PMID:26131368

  8. Mandibular fractures in children: long term results.

    PubMed

    Rémi, Marianowski; Christine, Martins Carvalho; Gael, Potard; Soizick, Pondaven; Joseph-André, Jézéquel

    2003-01-01

    Mandibular fractures in children treated in our department between March 1994 and January 2001 were retrospectively studied. Age, sex, type of fracture, etiology and evolution after treatment, functional mobility and maximal mouth opening were recorded. The population consisted of 19 patients who sustained 30 fractures. The patients ages ranged from 1.5 to 18 years. The mean time of follow up was 28 months. The male to female ratio was 1.7:1. Traffic and bicycle accidents were the main causes of the fractures. The condyle was involved in 16% of the cases, the subcondylar region in 28%. Fractures were multiple in half of the cases. Isolated fractures of the condyloid joint were treated conservatively. For isolated subcondylar fractures, maxillomandibular fixation was the treatment in 40% of the cases. Otherwise, conservative functional treatment was used. Children with a combination of body and condyle fractures were treated by open reduction and maxillomandibular fixation. Neither infection nor retarded facial growth was observed. Only one case of ankylosis of the temporomandibular joint (TMJ) and one case of temporomandibular pain syndrome were recorded. Associated lesions might concern the extremities, the brain and the cervical spine. PMID:12560146

  9. Numerical study of effect of elastomeric stress absorbers on stress reduction in bone-dental implant interface

    PubMed Central

    MEHDI, Ghalem; BELARBI, Abderrahmane; MANSOURI, Bensmaine; AZARI, Zitouni

    2015-01-01

    Objective This paper focused on optimal stress distribution in the mandibular bone surrounding a dental implant and is devoted to the development of a modified Osteoplant® implant type in order to minimize stress concentration in the bone-implant interface. Material and Methods This study investigated 0.4 mm thick layers of two elastomeric stress barriers incorporated into the dental implant using 3-D finite element analysis. Results Overall, this proposed implant provoked lower load transfer in bone-implant interface due to the effect of the elastomers as stress absorbers. The stress level in the bone was reduced between 28% and 42% for three load cases: 75 N, 60 N and 27 N in corono-apical, linguo-buccal and disto-mesial direction, respectively. Conclusion The proposed model provided an acceptable solution for load transfer reduction to the mandible. This investigation also permitted to choose how to incorporate two elastomers into the Osteoplant® implant system. PMID:25760271

  10. Bony healing of large cranial and mandibular defects protected from soft-tissue interposition: A comparative study of spontaneous bone regeneration, osteoconduction, and cancellous autografting in dogs.

    PubMed

    Lemperle, S M; Calhoun, C J; Curran, R W; Holmes, R E

    1998-03-01

    The purpose of this study was to compare spontaneous bone regeneration, osteoconduction, and bone autografting in critical size calvarial and mandibular defects (defects which do not heal spontaneously during the lifetime of the animal) that were protected from soft-tissue interposition. Eighteen adult mongrel dogs underwent osteotomies to create a unilateral 30-mm segmental defect in the midbody of the edentulated right mandible and bilateral 15-mm x 20-mm full-thickness window defects in the parietal bones. The defects were either left empty, implanted with coralline hydroxyapatite (HA) blocks, or autografted with iliac cancellous bone. All defects were protected with a macroporous titanium mesh and the segmental mandibular defects were additionally stabilized by internal plate fixation. Specimens were retrieved after 2 and 4 months and three undecalcified longitudinal central sections including the osteotomy interfaces were prepared from each specimen for histometry and histology. Sections were analyzed for volume fractions of bone, soft tissue, and implant using scanning electron microscopy, backscatter electron imaging and histometric computer software. In the mandibular model, the empty defects exhibited the greatest amount of bone formation after 4 months (47.3 percent), which was greater than the amount of bone in the autografted group (34.8 percent) and significantly greater than the amount of bone within the hydroxyapatite implants (19.0 percent, p < 0.05). In the cranial defects, the autografted specimens demonstrated the greatest volume fraction of bone after 4 months (27.3 percent), which was significantly greater than within both the empty defects (18.2 percent, p < 0.05) and the hydroxyapatite implants (18.2 percent, p < 0.05). New bone formation in the mandibular defects united the cut ends at 4 months regardless of treatment and originated predominantly from the periosteum which remained present only along the alveolar border after surgical closure. In the calvarial defects, periosteum was not preserved and bone regenerated centripetally, originating from the diploë without any evidence of dural osteogenesis. Bone bridging was incomplete in the empty cranial defects at 4 months. In both the mandibular and cranial specimens, new bone at 2 months was a mixture of woven and parallel fibered bone. At 4 months, the new bone had remodeled almost entirely into mature Haversian bone. This study demonstrated a remarkable ability of defect protection with a macroporous protective sheet to facilitate bone regeneration in critical size mandibular and cranial bone defects. When active osteogenic periosteum was present, as in our mandibular model, we concluded that defect protection alone was sufficient to allow for healing even of critical size defects. When periosteum was absent as in our cranial defects, the limited spontaneous bone formation benefited from the added contributions of cancellous grafting and osteoconductive implants, both of which promoted bone bridging across the defects. We suggest that in the future a resorbable macroporous protective sheet would be advantageous in comparison to a titanium mesh to facilitate bone regeneration by preventing soft-tissue prolapse and allowing the migration of mesenchymal cells and the proliferation of blood vessels from the adjacent soft tissues into the bone defect. Finally, this study identified the need to differentiate critical size defects into those with and without defect protection and periosteum. PMID:9500382

  11. Volatiles in the mandibular gland of Tetraponera penzigi: A plant ant of the whistling thorn acacia

    E-print Network

    Palmer, Todd M.

    Volatiles in the mandibular gland of Tetraponera penzigi: A plant ant of the whistling thorn acacia; accepted 11 January 2006 Keywords: Tetraponera penzigi; Hymenoptera; Formicidae; Pseudomyrmecinae; Acacia drepanolobium; Whistling thorn acacia; Mandibular gland; Alarm pheromone 1. Subject and source Workers

  12. Mandibular Incisor Extraction Treatment of a Class I Malocclusion with Bolton Discrepancy: A Case Report

    PubMed Central

    Bayram, Mehmet; Özer, Mete

    2007-01-01

    Many approaches for crowded mandibular anterior teeth are currently employed: distal movement of posterior teeth, lateral movement of canines, labial movement of incisors, interproximal enamel reduction, removal of premolars, removal of one or two incisors, and various combinations of the above. Selecting the best treatment is often difficult, and all guidelines do not apply to every case. Treatment by extraction of one single mandibular incisor is not popular in the orthodontic profession despite the apparent advantages of the extraction in the region of crowding. A case report is presented one mandibular incisor extraction treatment of a 16 year-old female with a Class I malocclusion that shows a significant mandibular arch length deficiency and mandibular tooth-size excess. In this case, the degree of mandibular anterior dental crowding, existing mandibular tooth-size excess, and the dental midline discrepancy were indicated the extraction of one mandibular incisor. PMID:19212499

  13. Continuity resection of the mandible after ameloblastoma - feasibility of oral rehabilitation with rhBMP-2 associated to bovine xenograft followed by implant installation.

    PubMed

    Lustosa, Romulo Maciel; Macedo, Diogo de Vasconcelos; Iwaki, Lilian Cristina Vessoni; Tolentino, Elen de Souza; Hasse, Paulo Norberto; Marson, Giordano Bruno de Oliveira; Iwaki Filho, Liogi

    2015-10-01

    Recombinant human morphogenetic protein (rhBMP) is a graft alternative for extensive mandibular reconstruction after tumor resections. However, the feasibility of rhBMP-2 to receive osseointegrated implants and prosthetic rehabilitation has been rarely reported. This study reports on a case of an extensive solid ameloblastoma along the mandibular body. The treatment consisted of resection followed by off-label use of rhBMP type 2 associated with bovine bone xenograft. Eleven months postoperatively, the patient was prosthetically rehabilitated with dental implants, without evidence of resorption or complications. The literature on mandibular reconstructions using rhBMP and their feasibility for future osseointegrated implant placement was also reviewed. Based on the presented case, the association between rhBMP-2 and a bovine bone xenograft could be considered a feasible option for the reconstruction and rehabilitation of large mandibular defects after tumor resection. According to the literature, the use of rhBMP as a graft material is encouraging, with good clinical outcome. However, there are no long-term studies demonstrating success and survival rates of implants placed in these grafts. Future investigations will be required to ascertain the long-term survival of implants in areas grafted with rhBMP. Also, there is a lack of information regarding the prosthetic rehabilitation of these patients. PMID:26190695

  14. Influence of occlusal plane inclination and mandibular deviation on esthetics

    PubMed Central

    Corte, Cristiane Cherobini Dalla; da Silveira, Bruno Lopes; Marquezan, Mariana

    2015-01-01

    Objective: The aim of this study was to assess the degree of perception of occlusal plane inclination and mandibular deviation in facial esthetics, assessed by laypeople, dentists and orthodontists. Methods: A woman with 5.88° of inclination and 5.54 mm of mandibular deviation was selected and, based on her original photograph, four new images were created correcting the deviations and creating more symmetric faces and smiles. Examiners assessed the images by means of a questionnaire. Their opinions were compared by qualitative and quantitative analyses. Results: A total of 45 laypeople, 27 dentists and 31 orthodontists filled out the questionnaires. All groups were able to perceive the asymmetry; however, orthodontists were more sensitive, identifying asymmetries as from 4.32° of occlusal plane inclination and 4.155 mm of mandibular deviation (p< 0.05). The other categories of evaluators identified asymmetries and assigned significantly lower grades, starting from 5.88° of occlusal plane inclination and 5.54 mm of mandibular deviation (p< 0.05). Conclusion: Occlusal plane inclination and mandibular deviation were perceived by all groups, but orthodontists presented higher perception of deviations. PMID:26560821

  15. Mandibular asymmetry in patients with the crouzon or apert syndrome.

    PubMed

    Elmi, P; Reitsma, J H; Buschang, P H; Wolvius, E B; Ongkosuwito, E M

    2015-05-01

    The aim of this study was to describe directional and fluctuating mandibular asymmetry over time in children with Crouzon or Apert syndrome. Mandibular asymmetry of children between 7.5 and 14 years of age with Crouzon syndrome (n = 35) and Apert syndrome (n = 24) were compared with controls (n = 327). From panoramic radiographs, mandibular directional and fluctuating asymmetry was determined for the three groups. Multilevel statistical techniques were used to describe mandibular asymmetry changes over time. Patients with Crouzon and Apert syndromes showed statistically significant more fluctuating asymmetry for mandibular measures than did controls. Between the Crouzon and Apert syndromes groups, no statistical differences were found in directional and fluctuating asymmetry. The control group showed statistically significantly more directional asymmetry than did patients with Crouzon or Apert syndrome. The controls showed no change over time for the directional asymmetry of condylar-ramal height; however, the directional asymmetry of the gonial angle increased. Patients with Crouzon syndrome showed side dominance for only condylar-ramal height; whereas, patients with Apert syndrome did not show dominance for any of the measurements. Apert and Crouzon syndromes showed developmental instability, in contrast to the controls. No statistically significant longitudinal differences were found for either the directional or the fluctuating asymmetry between Crouzon and Apert syndromes. Findings for fluctuating and directional asymmetry for both syndromes may indicate an inability to cope with genetic and environmental stress during development and treatment, compared with untreated nonsyndromic individuals. PMID:24878346

  16. Enhancement of rehabilitation by use of implantable adjuncts with vascularized bone grafts for mandible reconstruction.

    PubMed

    Sanger, J R; Head, M D; Matloub, H S; Yousif, N J; Larson, D L

    1988-10-01

    Restoration of mandibular continuity after trauma or cancer by means of vascularized bone grafts, as described by Taylor and coworkers in 1979, has become an established method of oral rehabilitation. Still considered by some an endpoint in reconstruction, we have found that the judicious application of newly described dental prosthetic materials can provide the patient with improved appearance and function associated with a fully restored mandible. Twelve patients who underwent vascularized bone grafting for mandibular reconstruction had adjunctive implantation to improve either dentition or to reconstruct the temporomandibular joint. Nine patients had dental implants to restore permanent stable dentition either by placement of the mandibular bone staple plate or osseointegrated implants. Three additional patients underwent placement of metallic condylar head prostheses placed on the vascularized bone graft at the time of transfer. These patients demonstrated good mastication and an excellent incisal opening which was maintained in the late postoperative period. Vascularized bone transfer for restoration of continuity of the mandible should not be considered an endpoint in and of itself. By using implantable dental devices to restore dentition and condylar head prostheses to improve both the aesthetic result and function of the mandible to complement the vascularized osteocutaneous flap, we can bring our patients closer to the goal of total rehabilitation. The majority of these patients would otherwise never have been offered a chance at restoration of dentition. All had beneficial effects with regard to mastication and the majority also had improved speech. PMID:3052122

  17. Mandibular condylectomy in a cow with a chronic luxation of the temporomandibular joint

    PubMed Central

    Sparks, Holly D.; Roquet, Imma; MacKay, Angela; Barber, Spencer

    2014-01-01

    A cow, presented after being struck by a motor vehicle, continued to have difficulty eating after mandibular fracture repair. Imaging showed a temporomandibular luxation and a mandibular condylectomy was performed. Mastication improved greatly but the cow was euthanized due to infection. This is the first report of mandibular condylectomy in cattle. PMID:24891643

  18. Isolated bilateral macrodontia of mandibular second premolars: A case report

    PubMed Central

    Canoglu, Ebru; Canoglu, Harun; Aktas, Alper; Cehreli, Zafer C.

    2012-01-01

    Isolated bilateral macrodontia of mandibular second premolars is an extremely rare dental anomaly with only 5 cases reported to date. This case report presents clinical and radiographic findings of isolated bilateral macrodontia in a 12-year-old child. The patient was referred to the clinic with local crowding of mandibular posterior teeth. Radiographic findings revealed the presence of impacted macrodont mandibular second premolars and their distinct morphological appearance, characterized by large, multitubercular, molariform crowns, and tapering, single roots. Following surgical removal of the impacted premolars, orthodontic therapy was initiated to correct the malocclusion. Along with the features and treatment of this rare anomaly, this case report also illustrates the benefits, in terms of treatment planning and surgical technique, of supplementing conventional radiography with cone-beam computed tomography to localize the macrodont premolars and accurately establish their relationship with the neighboring roots and anatomic structures. PMID:22904663

  19. Dentigerous Cyst associated with Horizontally Impacted Mandibular Second Premolar

    PubMed Central

    Tripathi, Abhay Mani; Rathore, Monika

    2014-01-01

    ABSTRACT Dentigerous Cyst/developmental cyst of benign odontogenic origin are ones that surround the crown of impacted, embedded, unerupted or developing teeth. Dentigerous cyst is second most common cyst of the oral cavity after radicular cyst. They are usually solitary in occurrence and mostly associated with the mandibular third molars. Dentigerous cysts involving impacted second premolars are rarely reported in the literatures. We present a rare case of dentigerous cyst in a 12-year-old female patient associated with an impacted mandibular second premolar. How to cite this article: Mishra R, Tripathi AM, Rathore M. Dentigerous Cyst associated with Horizontally Impacted Mandibular Second Premolar. Int J Clin Pediatr Dent 2014;7(1): 54-57. PMID:25206240

  20. Open reduction-fixation of mandibular subcondylar fractures. A review.

    PubMed

    MacArthur, C J; Donald, P J; Knowles, J; Moore, H C

    1993-04-01

    From 1973 to 1990, 392 mandibular subcondylar fractures were treated at the University of California, Davis, by the Otolaryngology Department. Of these, 17% were handled by open reduction and internal fixation. Twenty-one patients from this group were located for follow-up at an average interval of 64 months. Retrospective review shows the operation to be safe, with few complications and no permanent sequelae. Patient examination often revealed abnormalities of occlusion and mandibular function; however, these objective findings did not correlate well with patients' relative lack of subjective complaints. An 86% incidence of roentgenographic evidence of condylar disease after open reduction and internal fixation was found. We question the long-term efficacy of open reduction and internal fixation in restoring fracture alignment and maintaining mandibular height given the high rate (86%) of condylar disease in our patient population. PMID:8457303

  1. Early Experience with Biodegradable Fixation of Pediatric Mandibular Fractures.

    PubMed

    Mazeed, Ahmed Salah; Shoeib, Mohammed Abdel-Raheem; Saied, Samia Mohammed Ahmed; Elsherbiny, Ahmed

    2015-09-01

    This clinical study aims to evaluate the stability and efficiency of biodegradable self-reinforced poly-l/dl-lactide (SR-PLDLA) plates and screws for fixation of pediatric mandibular fractures. The study included 12 patients (3-12 years old) with 14 mandibular fractures. They were treated by open reduction and internal fixation by SR-PLDLA plates and screws. Maxillomandibular fixation was maintained for 1?week postoperatively. Clinical follow-up was performed at 1?week, 6 weeks, 3 months, and 12 months postoperatively. Radiographs were done at 1?week, 3 months, and 12 months postoperatively to observe any displacement and fracture healing. All fractures healed both clinically and radiologically. No serious complications were reported in the patients. Normal occlusion was achieved in all cases. Biodegradable osteofixation of mandibular fractures offers a valuable clinical solution for pediatric patients getting the benefit of avoiding secondary surgery to remove plates, decreasing the hospital stay, further painful procedures, and psychological impact. PMID:26269728

  2. Orthodontic Treatment of a Mandibular Incisor Extraction Case with Invisalign

    PubMed Central

    Zawawi, Khalid H.

    2014-01-01

    Mandibular incisor extraction for orthodontic treatment is considered an unusual treatment option because of the limited number of patients that meet the criteria for such treatment. Accurate diagnosis and treatment planning is essential to achieve the desired results. Adult orthodontic patients are increasingly motivated by esthetic considerations and reject the idea of conventional fixed appliances. In recent years, Invisalign appliances have gained tremendous attention for orthodontic treatment of adult patients to meet their esthetic demands. In this case report, a case of Class I malocclusion was treated with mandibular incisor extraction using the Invisalign appliance system. Successful tooth alignment of both arches was achieved. The use of Invisalign appliance is an effective treatment option in adult patients with Class I malocclusion that requires incisor extraction due to moderate to severe mandibular anterior crowding. PMID:25024852

  3. Retentive characteristics of Ankylos SynCone conical crown system over long-term use in vitro.

    PubMed

    Zhang, Ren-Guo; Hannak, Wolfgang B; Roggensack, Markus; Freesmeyer, Wolfgang B

    2008-06-01

    18 Ankylos SynCone conical crowns with 4-degree angle and 18 SynCone conical crowns with 6-degree angle were tested in vitro for a total of 5,000 insertion-separation cycles to investigate their retentive characteristics. Under 20 N insertion force, the retentive force of Ankylos SynCone conical crown system was between 5 and 10 N. The rententive force kept almost constant during the entire testing cycles. It was thus shown that the SynCone conical crown system could potentially provide adequate and constant retentive force to retain implant-supported overdentures. It may be considered to retain implant-supported mandibular overdentures as an alternative to bar attachments. PMID:18637380

  4. Mandibular asymmetry: a three-dimensional quantification of bilateral condyles

    PubMed Central

    2013-01-01

    Introduction The shape and volume of the condyle is considered to play an important role in the pathogenesis of the mandibular deviation. Curvature analysis is informative for objectively assess whether the shape of the condyles matches that of the glenoid fossa. In this study, a three-dimensional (3-D) quantification of bilateral asymmetrical condyles was firstly conducted to identify the specific role of 3-D condylar configuration for mandibular asymmetry. Methods 55 adult patients, 26 males (26?±?5 yrs) and 29 females (26?±?5 yrs), diagnosed with mandibular asymmetry were included. The examination of deviation of chin point, deviation of dental midlines, inclination of occlusal plane, and depth of the mandibular occlusal plane were conducted. After the clinical investigation, computed tomography images from the patients were used to reconstruct the 3-D mandibular models. Then the condylar volume, surface size, surface curvature and bone mineral density were evaluated independently for each patient on non-deviated and deviated sides of temporomandibular joint. Results Both the condylar surface size and volume were significantly larger on deviated side (surface size: 1666.14?±?318.3 mm2, volume: 1981.5?±?418.3 mm3). The anterior slope of the condyle was flatter (0.12?±?0.06) and the posterior slope (0.39?±?0.08) was prominently convex on the deviated side. The corresponding bone mineral density values were 523.01 ±118.1 HU and 549.07 ±120. 6 HU on anterior and posterior slopes. Conclusions The incongruence presented on the deviated side resulted in a reduction in contact areas and, thus, an increase in contact stresses and changes of bone density. All aforementioned results suggest that the difference existing between deviated and non-deviated condyles correlates with facial asymmetrical development. In mandibular asymmetry patients, the 3-D morphology of condyle on deviated side differ from the non-deviated side, which indicates the association between asymmetrical jaw function and joint remodeling. PMID:24354862

  5. Nonodontogenic mandibular lesions: differentiation based on CT attenuation

    PubMed Central

    Özgür, An?l; Kara, Engin; Arpac?, Rabia; Arpac?, Taner; Esen, Kaan; Kara, Taylan; Duce, Meltem Nass; Apayd?n, Feramuz Demir

    2014-01-01

    Mandibular lesions are classified as odontogenic and nonodontogenic based on the cell of origin. Odontogenic lesions are frequently encountered at head and neck imaging. However, several nonodontogenic pathologies may also involve mandible and present further diagnostic dilemma. Awareness of the imaging features of nonodontogenic lesions is crucial in order to guide clinicians in proper patient management. Computed tomography (CT) may provide key information to narrow diagnostic considerations. Nonodontogenic mandibular lesions may have lytic, sclerotic, ground-glass, or mixed lytic and sclerotic appearances on CT. In this article, our aim is to present various nonodontogenic lesions of the mandible by categorizing them according to their attenuations on CT. PMID:25297390

  6. Nonodontogenic mandibular lesions: differentiation based on CT attenuation.

    PubMed

    Özgür, An?l; Kara, Engin; Arpac?, Rabia; Arpac?, Taner; Esen, Kaan; Kara, Taylan; Duce, Meltem Nass; Apayd?n, Feramuz Demir

    2014-11-01

    Mandibular lesions are classified as odontogenic and nonodontogenic based on the cell of origin. Odontogenic lesions are frequently encountered at head and neck imaging. However, several nonodontogenic pathologies may also involve mandible and present further diagnostic dilemma. Awareness of the imaging features of nonodontogenic lesions is crucial in order to guide clinicians in proper patient management. Computed tomography (CT) may provide key information to narrow diagnostic considerations. Nonodontogenic mandibular lesions may have lytic, sclerotic, ground-glass, or mixed lytic and sclerotic appearances on CT. In this article, our aim is to present various nonodontogenic lesions of the mandible by categorizing them according to their attenuations on CT. PMID:25297390

  7. Bilateral mandibular subcondylar fractures contributing to airway obstruction.

    PubMed

    Bavitz, J B; Collicott, P E

    1995-08-01

    Bilateral mandibular fracture contributing to airway obstruction is a well-understood phenomenon. This is typically described as a rather immediate or acute process. After trauma, the production of a "flail mandible" with concomitant loss of support of tongue muscles is thought to result in obstruction of the upper airway. An unusual case in which the bilateral mandibular fractures contributed to an airway obstruction 10 days after the initial trauma is described. The cause is explained and methods of prevention and treatment are presented. PMID:7490488

  8. Occlusion for maxillary dentures opposing osseointegrated mandibular prostheses.

    PubMed

    Denissen, H W; Kalk, W; van Waas, M A; van Os, J H

    1993-01-01

    This paper presents a combination of several occlusal concepts designed to contribute to the successful use of maxillary dentures in opposition to osseointegrated mandibular prostheses. To ensure a positive outcome when designing such an occlusion, three factors must be considered: patient satisfaction, maxillary anterior bone preservation, and mandibular arch shortening. It is recommended that for centric occlusion the molars have a lingual contact occlusion, the premolars have a buccal contact occlusion, and the anterior teeth have an open occlusal relationship. For an eccentric occlusion, a balanced articulation is favored instead of mutually protected occlusion. PMID:8297454

  9. [The retromandibular approach in fractures of the mandibular condyle].

    PubMed

    Cheynet, F; Aldegheri, A; Chossegros, C; Bourezak, Z; Blanc, J L

    1997-12-01

    Various approaches have been proposed for surgical treatment of displaced condylar fractures included submandibular approach, preauricular approach, rhytidectomy approach or intraoral approach. Since 1992, we used a short retromandibular approach to treat displaced subcondylar fractures with a miniplate. When open reduction and osteosynthesis are required, the retro-mandibular approach is an easy and safe technique for displaced condylar fractures. The aim of this article was to describe the short retro-mandibular approach. Indications for surgical treatment, surgical approach and techniques of osteosynthesis for condylar fractures are discussed. PMID:9471672

  10. The ankylos endosseous dental implant: assessment of stability up to 18 months with the Periotest.

    PubMed

    Morris, H F; Winkler, S; Ochi, S

    2000-01-01

    Osseointegration is an ongoing histometric process that may vary during clinical function. The implant must be stable at uncovering, which reflects the status of bone-implant interface. The physiology of bone healing associated with endosseous implants suggests that this process occurs between 8 and 12 months, and Periotest values (PTVs) tend to reflect changes in the stability of the bone-implant interface. Stability generally increases gradually from the time of uncovering to an optimal PTV that occurs at a point close to 12 months. This stable interface must remain intact for long-term clinical survival. Rapid development of this optimal PTV is highly desirable in order to prevent premature overloading of the bone-implant interface. The Ankylos implant is a new screw-type implant design in which the thread pitch and length vary to maximize trabecular bone contact. The purpose of this report is to evaluate to 18 months the stability (PTVs) of this implant design. More than 457 implants were placed and followed for a period of 18 months by the multicentered, multidisciplinary Ankylos Implant Clinical Research Group (AICRG). Implant stability (PTVs) was assessed using the Periotest at abutment connection and at 3, 6, 9, 12, and 18 months after uncovering. The Periotest values for all implants rapidly reached an optimal status between uncovering (-3.1 PTVs) and 3 months (-3.4 PTVs). This rapid increase in stability has not previously been reported for other implant designs. The mandibular arch was more negative (-3.8 PTVs) at uncovering as compared with the PTVs for the maxillary arch (-1.7 PTVs). Negative PTVs were recorded (1) as length and diameter increased, (2) as bone density increased, (3) in certain jaw regions, (4) as the number of implants/case increased, and (5) for implants stabile at placement. The Ankylos screw implant design produced rapid stabilization 3 months after uncovering. PMID:11831235

  11. Unique and reliable rat model for the assessment of cell therapy: bone union in the rat mandibular symphysis using bone marrow stromal cells.

    PubMed

    Yagyuu, Takahiro; Kirita, Tadaaki; Hattori, Koji; Tadokoro, Mika; Ohgushi, Hajime

    2015-03-01

    Many kinds of bone graft materials have been developed and reported to repair various bone defects. The defects are usually created by surgical resection of pre-existing bone tissue. However, spontaneous healing of bone defects without implantation of materials could be seen, because bone tissue possesses inherent repairing property. The central portion of the lower jaw bone in many animals consists of fibrous tissue and is called the mandibular symphysis. It persists even in old animals and thus can be interpreted as a physiological bone gap or a non-healing bone defect. We implanted calcium phosphate porous ceramics alone or composites of the ceramics and bone marrow stromal cells (BMSCs) into the bone defect (mandibular symphysis) to examine whether it could be filled with new bone tissue, resulting in bone union. Eight weeks after implantation, micro-computed tomography (micro-CT) and histological and biomechanical analyses demonstrated that bone union of the mandibles occurred in all rats with composites but in none of those with ceramics alone. These results showed that the rat mandibular symphysis is a unique bone defect site for the evaluation of bone graft materials. These analyses demonstrated that ceramics alone could not contribute to bone healing in the defect; however, supplementation with BMSCs drastically changed the properties of the ceramics (turning them into osteogenic ceramics), which completely healed the defect. As BMSCs can be culture-expanded using small amounts of bone marrow, the use of the composites might have clinical significance for the reconstruction of various bone tissues, including facial bone. PMID:23255518

  12. Preventive goals in oral implantology.

    PubMed

    Kalk, W; Denissen, H W; Käyser, A F

    1993-10-01

    Preventive dentistry is mainly concerned with caries and periodontal disease and little or no attention is paid to the prevention of alveolar bone loss. An overdenture contributes to the preservation of alveolar bone and offers a number of advantages in comparison to a conventional complete denture. After tooth extraction the atrophy of edentulous lower jaws can be prevented or delayed by using implants supporting an overdenture or a fixed mandibular prosthesis. Hydroxyapatite implants have been studied as submerged tooth root substitutes and have proven to be able to preserve the bulk of the alveolar ridge. A drawback of this submucosal implant is that the ridge maintenance depends solely on the physical presence of the hydroxyapatite implants. If implants support an overdenture or a fixed prosthesis they also play a role in maintaining the function of the bone in the different stages of reduction of the mandible. In this paper a classification for the different resorption stages of the mandible is presented and is used to determine the correct moment for preventive implantology. In addition the use of a lingualised occlusion is discussed as a contribution to the preventive goals in oral implantology. PMID:8138311

  13. The prevalence of mandibular incisive nerve canal and to evaluate its average location and dimension in Indian population

    PubMed Central

    Ramesh, A. S.; Rijesh, K.; Sharma, Aruna; Prakash, R.; Kumar, Arun; Karthik

    2015-01-01

    Aim: The aim of this study was to find the prevalence of the mandibular incisive canal, evaluate its location and dimensions using cone beam computer tomography (CBCT) in Indian population. Materials and Methods: CBCT scan images of 120 subjects were analyzed for the presence of the mandibular incisive canal, its location, size, and its length. The distance between the incisive canal and the buccal and lingual plate of the alveolar bone, and the distance from the canal to the inferior border of the mandible were also measured to position the canal in the mandible. Results: About 71.66% of the CBCT scans of Indian subjects examined showed the presence of the Incisive canal, of which 48.33% exhibited canals bilaterally and 23.33% showed unilateral canals. 28.33% of the subjects CBCT scans did not exhibit the presence of incisive nerve canal. The average length of the incisive canal was 10.173 mm. The average diameter of the Incisive canal in the CBCT scans was 2.578 mm. The distance from the Inferior border of the mandible to (a) the origin of the Incisive canal was 9.425 mm and (b) to the apex of the Incisive canal was 9.095 mm. The distance from the buccal cortex of the mandible to (a) the origin of the incisive canal was 1.48 mm and (b) to the apex of the incisive canal was 4.476 mm. The distance from the lingual cortex of the mandible to (a) the origin of the incisive canal was 4.464 mm and (b) to the apex of the incisive canal was 5.561 mm. Conclusion: The presence, location, and dimensions of the mandibular incisive canal are an additional required data that needs to be elicited before planning an inter-foraminal placement of implants. PMID:26538925

  14. Trigeminocardiac Reflex by Mandibular Extension on Rat Pial Microcirculation: Role of Nitric Oxide

    PubMed Central

    Lapi, Dominga; Federighi, Giuseppe; Fantozzi, M. Paola; del Seppia, Cristina; Ghione, Sergio; Colantuoni, Antonio; Scuri, Rossana

    2014-01-01

    In the present study we have extended our previous findings about the effects of 10 minutes of passive mandibular extension in anesthetized Wistar rats. By prolonging the observation time to 3 hours, we showed that 10 minutes mandibular extension caused a significant reduction of the mean arterial blood pressure and heart rate respect to baseline values, which persisted up to 160 minutes after mandibular extension. These effects were accompanied by a characteristic biphasic response of pial arterioles: during mandibular extension, pial arterioles constricted and after mandibular extension dilated for the whole observation period. Interestingly, the administration of the opioid receptor antagonist naloxone abolished the vasoconstriction observed during mandibular extension, while the administration of N?-Nitro-L-arginine methyl ester, a nitric oxide synthase inhibitor, abolished the vasodilation observed after mandibular extension. Either drug did not affect the reduction of mean arterial blood pressure and heart rate induced by mandibular extension. By qRT-PCR, we also showed that neuronal nitric oxide synthase gene expression was significantly increased compared with baseline conditions during and after mandibular extension and endothelial nitric oxide synthase gene expression markedly increased at 2 hours after mandibular extension. Finally, western blotting detected a significant increase in neuronal and endothelial nitric oxide synthase protein expression. In conclusion mandibular extension caused complex effects on pial microcirculation involving opioid receptor activation and nitric oxide release by both neurons and endothelial vascular cells at different times. PMID:25551566

  15. Management of Six Root Canals in Mandibular First Molar

    PubMed Central

    Gomes, Fabio de Almeida; Sousa, Bruno Carvalho

    2015-01-01

    Success in root canal treatment is achieved after thorough cleaning, shaping, and obturation of the root canal system. This clinical case describes conventional root canal treatment of an unusual mandibular first molar with six root canals. The prognosis for endodontic treatment in teeth with abnormal morphology is unfavorable if the clinician fails to recognize extra root canals. PMID:25685156

  16. The application of the Risdon approach for mandibular condyle fractures

    PubMed Central

    2013-01-01

    Background Many novel approaches to mandibular condyle fracture have been reported, but there is a relative lack of reports on the Risdon approach. In this study, the feasibility of the Risdon approach for condylar neck and subcondylar fractures of the mandible is demonstrated. Methods A review of patients with mandibular condylar neck and subcondylar fractures was performed from March 2008 to June 2012. A total of 25 patients, 19 males and 6 females, had 14 condylar neck fractures and 11 subcondylar fractures. Results All of the cases were reduced using the Risdon approach. For subcondylar fractures, reduction and fixation with plates was done under direct vision. For condylar neck fractures, reduction and fixation was done with the aid of a trochar in adults and a percutaneous threaded Kirschner wire in children. There were no malunions or nonunions revealed in follow-up care. Mild transient neuropraxia of the marginal mandibular nerve was seen in 4 patients, which was resolved within 1–2 months. Conclusions The Risdon approach is a technique for reducing the condylar neck and subcondylar fractures that is easy to perform and easy to learn. Its value in the reduction of mandibular condyle fractures should be emphasized. PMID:23829537

  17. Minimally invasive mandibular bone augmentation using injectable hydrogels.

    PubMed

    Martínez-Sanz, Elena; Varghese, Oommen P; Kisiel, Marta; Engstrand, Thomas; Reich, Karoline M; Bohner, Marc; Jonsson, Kenneth B; Kohler, Thomas; Müller, Ralph; Ossipov, Dmitri A; Hilborn, Jöns

    2012-12-01

    Hyaluronic acid-based hydrogels are proven biocompatible materials and excellent carriers of bone morphogenetic protein-2 (BMP-2) that have been successfully tested for bone generation in vivo. Different formulations, with or without nanohydroxyapatite, have shown promise for craniofacial applications. In this study, 28 rats were used to investigate whether it is possible to achieve mandibular bone augmentation upon injection of novel hyaluronic acid-based hydrogels containing nanohydroxyapatite and different concentrations of BMP-2 (0, 5 and 150 µg/ml). The biomaterials were injected subperiosteally through fine needles into the innate mandibular diastema, imitating a clinical procedure for resorbed mandibles. No incisions, flaps or sutures were necessary. After 8 weeks the mandibles were evaluated by peripheral quantitative computed tomography (pQCT), micro-computed tomography (?CT), histology, immunohistochemistry and fluorochrome labelling. As a result, engineered bone was observed in all treated mandibles, with a statistically significant increase in mandibular bone volume correlated with the amount of BMP-2 loaded in the hydrogel formula. We therefore demonstrated that minimally invasive mandibular bone augmentation is possible upon injection in rats, when using the appropriate injectable scaffolds. This represents an attractive clinical alternative for oral implantology patients. PMID:22941759

  18. Reinforcement of a mandibular complete denture with internal metal framework.

    PubMed

    Balch, J Heath; Smith, Pamela D; Marin, Mark A; Cagna, David R

    2013-03-01

    Metal framework reinforcement is used in complete dentures to improve the fracture resistance, dimensional stability, accuracy, weight, and retention of a definitive prosthesis. A novel technique for suspending a metal framework within the denture base of mandibular complete dentures is described. PMID:23522371

  19. Ultrastructure of the platypus and echidna mandibular glands.

    PubMed

    Krause, W J

    2011-10-01

    The secretory units of the platypus and echidna mandibular glands consist of a single serous cell type. Secretory granules within the cells of the platypus mandibular gland stained intensely with the periodic acid-Schiff staining procedure but failed to stain with Alcian Blue, suggesting the granules contained neutral glycoproteins. Secretory granules within the mandibular glands of the echidna failed to stain with the methods used indicating little if any glycoprotein was associated with the secretory granules. Ultrastructurally, secretory granules of the platypus mandibular gland were electron dense with a central core of less electron-dense material and were membrane bound. In contrast, those of the echidna presented a lamellated appearance and also were limited by a membrane. These secretory granules appeared to form as a result of concentric layering of lamellae within cisternae of the Golgi membranes. The intralobular ductal system of the platypus was more extensively developed than that of the echidna. The striated ducts of both species were characterized by elaborate infoldings of the basolateral plasmalemma and an abundance of associated mitochondria. PMID:21671995

  20. The effectiveness of articaine in mandibular facial infiltrations

    PubMed Central

    Flanagan, Dennis F

    2016-01-01

    Four percent articaine local anesthetic has been successfully used to attain local anesthesia for dental procedures. Mandibular block anesthesia may consume longer time to attain and have a higher failure of local anesthesia compared to infiltration. Mandibular facial infiltration has been reported to successfully attain effective local anesthesia for dental procedures. This study involved only several tooth sites and found that 1.8 cc of 4% articaine facial infiltration in the mandible may be effective when the facial mandibular cortex is <2.0–3.0 mm. A waiting time of 5–10 minutes may be required for effective anesthesia. An additional 1.8 cc of dose may be required to attain anesthesia if an initial 1.8 cc of dose fails. The need for additional anesthetic may be predicted by a measurement of the facial cortex using cone beam computerized tomography. A study of mandibular sites is needed to delineate the anatomical dimensions, density of cortical bone, and apical neural location for ensuring successful local anesthetic infiltration.

  1. Developing a New Dental Implant Design and Comparing its Biomechanical Features with Four Designs

    PubMed Central

    Rismanchian, Mansour; Birang, Reza; Shahmoradi, Mahdi; Talebi, Hassan; Zare, Reza Jabar

    2010-01-01

    Background: As various implant geometries present different biomechanical behaviors, the purpose of this work was to study stress distribution around tapered and cylindrical threaded implant geometries using three-dimensional finite element stress analysis. Methods: Seven implant models were constructed using Computer Assisted Designing system. After digitized models of mandibular section, the crowns were created. They were combined with implant models, which were previously imported into CATIA software. The combined solid model was transferred to ABAQOUS to create a finite element meshed model which was later analyzed regarding the highest maximum and minimum principal stresses of bone. Results: For all models, the highest stresses of cortical bone were located at the crestal cortical bone around the implant. Threaded implants, triangular thread form and taper body form showed a higher peak of tensile and compressive stress than non-threaded implants, square thread form and straight body form, respectively. A taper implant with triangular threads, which is doubled in the cervical portion of the body, had a significantly lower peak of tensile and compressive stress in the cortical bone than straight/taper triangular or square threaded implant forms. Conclusion: For the investigation of bone implant interfacial stress, the non-bonded state should be studied too. Confirmative clinical and biological studies are required in order to benefit from the results of this study. PMID:22013460

  2. Porous polyethylene implants in facial reconstruction: Outcome and complications.

    PubMed

    Ridwan-Pramana, Angela; Wolff, Jan; Raziei, Ashkan; Ashton-James, Claire E; Forouzanfar, Tymour

    2015-10-01

    The aim of the present study was to assess the indications, results and complications of patients treated with porous polyethylene (Medpor(®)) implants in the Department of Oral and Maxillofacial Surgery of VU Medical Centre, Amsterdam over 17 years. A total of 69 high-density porous polyethylene implants (Medpor(®) Biomaterial; Porex Surgical, Newman, GA) were used in forty patients (22 males, 18 females). All patients were analysed for gender, age, diagnosis, indications for surgery, follow-up period and postoperative complications. A mean age of 34.1 years was observed. The main reason for implant surgery was post-traumatic functional impairment (27.5%). Most implants were placed at the mandibular angel and the orbital floor. Unsatisfactory appearance scored the highest in postoperative complications (10.1%) followed by infection rate (7.2%). Comparing the number of implants placed over the years and the incidence of complications, makes the overall complications rate of porous polyethylene very low. A consensus about antibiotic prophylaxis is needed. The objective measurements in patient satisfaction and proper implant design would be of great use. PMID:26276064

  3. Orthodontic spring guidance of bilateral mandibular distraction in rabbits.

    PubMed

    Yen, S L; Shang, W; Shuler, C; Yamashita, D D

    2001-10-01

    Although distraction osteogenesis can lengthen congenitally small mandibles, the distraction procedure can be difficult to control. To study the efficacy and safety of orthodontic spring guidance on bilateral mandibular distraction, an 8-mm anterior open bite was experimentally produced and corrected during bilateral mandibular distraction in rabbits. Orthodontic springs were attached to the anterior maxilla and mandible to redirect an ongoing distraction procedure. Sixteen rabbits underwent mandibular distraction: 6 rabbits received heavy springs (8 oz), 6 rabbits received light force springs (2 oz), and 4 rabbits served as control animals with anterior open bites without spring guidance. Nickel-titanium springs were applied during the last week of osseous distraction and the first week of consolidation. Distractors were left in place throughout a 2-month consolidation period. None of the animals developed fibrous union as a result of spring guidance. The 8-mm open bite did not close in the control group or in the light spring group after 2 weeks of spring wear or during the consolidation period. Heavy springs completely closed the experimental open bites within 2 weeks (P <.01, analysis of variance). Bite corrections did not change during the consolidation period. This study indicated that the addition of an orthodontic spring to a mandibular distraction procedure did not impair bone healing. With the distraction device in place, heavy spring forces redirected an ongoing mandibular distraction procedure and corrected an open bite, distraction side effect. Direct measurements, radiographic measurements, and tissue histologic factors described changes in segment position and shape of the distraction site. PMID:11606970

  4. Biomechanical Evaluation of a Mandibular Spanning Plate Technique Compared to Standard Plating Techniques to Treat Mandibular Symphyseal Fractures

    PubMed Central

    Richardson, Matthew; Hayes, Jonathan; Jordan, J. Randall; Puckett, Aaron; Fort, Matthew

    2015-01-01

    Purpose. The purpose of this study is to compare the biomechanical behavior of the spanning reconstruction plate compared to standard plating techniques for mandibular symphyseal fractures. Materials and Methods. Twenty-five human mandible replicas were used. Five unaltered synthetic mandibles were used as controls. Four experimental groups of different reconstruction techniques with five in each group were tested. Each synthetic mandible was subjected to a splaying force applied to the mandibular angle by a mechanical testing unit until the construct failed. Peak load and stiffness were recorded. The peak load and stiffness were analyzed using ANOVA and the Tukey test at a confidence level of 95% (P < 0.05). Results. The two parallel plates' group showed statistically significant lower values for peak load and stiffness compared to all other groups. No statistically significant difference was found for peak load and stiffness between the control (C) group, lag screw (LS) group, and the spanning plate (SP1) group. Conclusions. The spanning reconstruction plate technique for fixation of mandibular symphyseal fractures showed similar mechanical behavior to the lag screw technique when subjected to splaying forces between the mandibular gonial angles and may be considered as an alternative technique when increased reconstructive strength is needed. PMID:26649332

  5. Comparative analysis between direct Conventional Mandibular nerve block and Vazirani-Akinosi closed mouth Mandibular nerve block technique

    NASA Astrophysics Data System (ADS)

    Mishra, Sobhan; Tripathy, Ramanupam; Sabhlok, Samrat; Panda, Pankaj Kumar; Patnaik, Satyabrata

    2012-11-01

    Introduction: Over the years different techniques have been developed for achieving mandibular nerve anaesthesia. The main aim of our study was to carry out comparison and clinical efficacy of mandibular nerve anaesthesia by Direct Conventional technique with that of Vazirani-Akinosi mandibular nerve block technique.Materials and Methods: 50 adult patients requiring surgical extraction of premolars, mandibular first, second and third molars were selected randomly to receive Direct Conventional technique and Vazirani- Akinosi technique for nerve block alternatively.Results: No statistically significant differences were observed regarding complete lip anaesthesia at 5 minutes and 10 minutes, nerves anaesthetized with single injection, effectiveness of anaesthesia, supplementary injections and complications in both the techniques. However, onset of lip anaesthesia was found to be faster in Vazirani-Akinosi technique, patients experienced less pain during the Vazirani-Akinosi technique as compared to the Direct Conventional technique. Post injection complication complications were less in the VaziraniAkinosi Technique.Conclusions: Except for faster onset of lip anaesthesia, less pain during injection and fewer post injection complications in Vazirani-Akinosi technique all other parameters were of same efficacy as Direct Conventional technique. This has strong clinical applications as in cases with limited mouth opening, apprehensive patients Vazirani-Akinosi technique is the indicated technique of choice.

  6. Hip Implant Systems

    MedlinePLUS

    ... Devices Products and Medical Procedures Implants and Prosthetics Metal-on-Metal Hip Implants Hip Implants Share Tweet Linkedin Pin ... devices available with different bearing surfaces. These are: Metal-on-Polyethylene: The ball is made of metal ...

  7. The impact of a modified cutting flute implant design on osseointegration.

    PubMed

    Jimbo, R; Tovar, N; Marin, C; Teixeira, H S; Anchieta, R B; Silveira, L M; Janal, M N; Shibli, J A; Coelho, P G

    2014-07-01

    Information concerning the effects of the implant cutting flute design on initial stability and its influence on osseointegration in vivo is limited. This study evaluated the early effects of implants with a specific cutting flute design placed in the sheep mandible. Forty-eight dental implants with two different macro-geometries (24 with a specific cutting flute design - Blossom group; 24 with a self-tapping design - DT group) were inserted into the mandibular bodies of six sheep; the maximum insertion torque was recorded. Samples were retrieved and processed for histomorphometric analysis after 3 and 6 weeks. The mean insertion torque was lower for Blossom implants (P<0.001). No differences in histomorphometric results were observed between the groups. At 3 weeks, P=0.58 for bone-to-implant contact (BIC) and P=0.52 for bone area fraction occupied (BAFO); at 6 weeks, P=0.55 for BIC and P=0.45 for BAFO. While no histomorphometric differences were observed, ground sections showed different healing patterns between the implants, with better peri-implant bone organization around those with the specific cutting flute design (Blossom group). Implants with the modified cutting flute design had a significantly reduced insertion torque compared to the DT implants with a traditional cutting thread, and resulted in a different healing pattern. PMID:24583140

  8. Delivery of growth factors using a smart porous nanocomposite scaffold to repair a mandibular bone defect.

    PubMed

    Liu, Xian; Zhao, Kun; Gong, Tao; Song, Jian; Bao, Chongyun; Luo, En; Weng, Jie; Zhou, Shaobing

    2014-03-10

    Implantation of a porous scaffold with a large volume into the body in a convenient and safe manner is still a challenging task in the repair of bone defects. In this study, we present a porous smart nanocomposite scaffold with a combination of shape memory function and controlled delivery of growth factors. The shape memory function enables the scaffold with a large volume to be deformed into its temporal architecture with a small volume using hot-compression and can subsequently recover its original shape upon exposure to body temperature after it is implanted in the body. The scaffold consists of chemically cross-linked poly(?-caprolactone) (c-PCL) and hydroxyapatite nanoparticles. The highly interconnected pores of the scaffold were obtained using the sugar leaching method. The shape memory porous scaffold loaded with bone morphogenetic protein-2 (BMP-2) was also fabricated by coating the calcium alginate layer and BMP-2 on the surface of the pore wall. Under both in vitro and in vivo environmental conditions, the porous scaffold displays good shape memory recovery from the compressed shape with deformed pores of 33 ?m in diameter to recover its porous shape with original pores of 160 ?m in diameter. In vitro cytotoxicity based on the MTT test revealed that the scaffold exhibited good cytocompatibility. The in vivo micro-CT and histomorphometry results demonstrated that the porous scaffold could promote new bone generation in the rabbit mandibular bone defect. Thus, our results indicated that this shape memory porous scaffold demonstrated great potential for application in bone regenerative medicine. PMID:24467335

  9. Locking compression plate osteosynthesis of complicated mandibular fractures in six horses.

    PubMed

    Kuemmerle, J M; Kummer, M; Auer, J A; Nitzl, D; Fürst, A E

    2009-01-01

    Complicated mandibular fractures were recognised in one foal, one pony and four horses. The foal was two months old while the adult animals ranged in age from 12 to 24 years. Three horses had a unilateral horizontal ramus fracture. Two fractures were open and one was closed. Comminution was present in one of these patients while the other two horses had marked displacement of the fragments. Two suffered from comminuted fractures of the horizontal and vertical ramus of the mandible. One of these patients had open and infected fractures. One foal had a bilateral horizontal ramus fracture with marked periosteal 'new bone' formation and malalignement which required corrective osteotomy. Each horse underwent locking compression plate (LCP) osteosynthesis consisting of open fracture reduction and application of one to three 4.5/5.0 mm LCP at the ventral, lateral or caudal aspect of the mandible under fluoroscopic control. Two 3.5 mm LCP were used in the foal. Plate fixation was supported by application of a cerclage wire construct between the incisor and premolar teeth in most patients. Complete fracture healing, with an excellent functional and cosmetic outcome, was achieved in all of the patients. Complications encountered included seroma formation, screw and wire breakage, as well as implant and apical tooth root infections. The LCP was removed after fracture healing had occurred in four patients. PMID:19151871

  10. Prelamination of the Anterolateral Thigh Flap With a Fibula Graft to Successfully Reconstruct a Mandibular Defect

    PubMed Central

    Sadigh, Parviz Lionel

    2015-01-01

    Summary: Flap prelamination is the process whereby a complex 3- dimensional construct is fashioned in a staged manner. We present a case whereby the tissues of the anterolateral thigh, nourished by perforators of the descending branch of the lateral circumflex femoral artery, were prelaminated with a fibula in the setting of salvage head and neck reconstruction. With a paucity of recipient vessels in the neck and a previous failed free fibula transfer secondary to osteoradionecrosis, a fibula was implanted into a suprafascial pocket created in the anterolateral thigh. This was allowed to pick up a blood supply from this rich vascular bed and mature over a period of 3 weeks before being transferred with the anterolateral thigh tissues as a prelaminated osteocutaneous composite free flap. A bone scan performed both before and after transfer confirmed uptake of radionucleotide by the fibula suggesting neovascularization. The composite mandibular defect was successfully reconstructed using this technique, and we believe this could represent a new strategy in the setting of salvage head and neck surgery. PMID:26495210

  11. Histological evidence of osseointegration in human retrieved fractured hydroxyapatite-coated screw-type implants: a case report.

    PubMed

    Uehara, Toshio; Takaoka, Katsunori; Ito, Koichi

    2004-10-01

    Histological evidence of clinically successful dental implants is very rare. This case report presents histological evidence of osseointegration in human implants retrieved because of fractures at the connected portion between the abutments and fixtures due to a car accident. The duration of functional loading of the implants was 18 months. Two hydroxyapatite (HA)-coated screw-type implants were removed with part of the healthy bone from the mandibular left molar region. A block was prepared using cutting and grinding equipment to obtain a central section approximately 50 microm thick, which was stained with basic fuchsin and methylene blue. Histological examination revealed that the bone was dense and in close relation with the HA coating of the implants. The interspaces of each thread of the implant were filled with mineralized bone. Peri-implant soft tissue was not observed in the section. A high degree of osseointegration was noted, with a bone-to-implant contact of 87.5% (implant corresponding to tooth 36) and 97.4% (implant corresponding to tooth 37). The connection between the 30 and 50 microm HA coating and the metal was uniformly tight and constant. In conclusion, the histological evidence showed a high degree of osseointegration in two HA-coated screw-type dental implants retrieved after functional loading for 18 months. PMID:15355395

  12. A Biomechanical Comparison of Three 1.5-mm Plate and Screw Configurations and a Single 2.0-mm Plate for Internal Fixation of a Mandibular Condylar Fracture

    PubMed Central

    Aquilina, Peter; Parr, William C.H.; Chamoli, Uphar; Wroe, Stephen; Clausen, Philip

    2014-01-01

    The most stable pattern of internal fixation for mandibular condyle fractures is an area of ongoing discussion. This study investigates the stability of three patterns of plate fixation using readily available, commercially pure titanium implants. Finite element models of a simulated mandibular condyle fracture were constructed. The completed models were heterogeneous in bone material properties, contained approximately 1.2 million elements and incorporated simulated jaw adducting musculature. Models were run assuming linear elasticity and isotropic material properties for bone. No human subjects were involved in this investigation. The stability of the simulated condylar fracture reduced with the different implant configurations, and the von Mises stresses of a 1.5-mm X-shaped plate, a 1.5-mm rectangular plate, and a 1.5-mm square plate (all Synthes (Synthes GmbH, Zuchwil, Switzerland) were compared. The 1.5-mm X plate was the most stable of the three 1.5-mm profile plate configurations examined and had comparable mechanical performance to a single 2.0-mm straight four-hole plate. This study does not support the use of rectangular or square plate patterns in the open reduction and internal fixation of mandibular condyle fractures. It does provide some support for the use of a 1.5-mm X plate to reduce condylar fractures in selected clinical cases. PMID:25136411

  13. Patients' Priorities and Attitudes Towards Their Temporo-Mandibular Disorders.

    PubMed

    Kelleher, Martin; Ray-Chaudhuri, Arijit; Khawaja, Noman

    2015-08-01

    The diagnosis and appropriate management of temporo-mandibular disorders (TMDs) remains controversial. Current scientific evidence highlights the importance of psychosocial factors in sufferers and the reducing emphasis on occlusal or dental/prosthetic factors. This paper describes the findings of a survey of 211 patients reporting pain from their temporo-mandibular joint area and associated structures. This article offers busy primary dental care practitioners a cost effective questionnaire for obtaining relevant information from patients about the history of their condition and highlights what patients hope to achieve through the management of their disorder. It also emphasises the importance of communicating effectively with patients and offers practical tips for the management of TMDs in primary care. PMID:26556513

  14. Free greater omental flap for treatment of mandibular osteoradionecrosis

    SciTech Connect

    Moran, W.J.; Panje, W.R.

    1987-04-01

    Osteoradionecrosis can involve the mandible following radical irradiation for treatment of oral cavity cancer. The radionecrosis of the mandible is often associated with severe intractable pain, local or extensive deformity, including pathologic fracture, orocutaneous fistula formation, and frequent loss of function. Treatment has ranged from analgesia and antibiotics to hyperbaric oxygen treatments to local or extensive sequestrectomies with partial or total mandibulectomy and restoration of tissue losses with unirradiated tissue. To our knowledge, this is the first report of the successful use of a free greater omental flap for immediate treatment of mandibular osteoradionecrosis and concomitant reconstruction. We found the omentum to be an excellent vascular bed that rapidly resolved the osteoradionecrosis and pain, promoted healing, and restored mandibular function with minimal discomfort to the patient.

  15. Management of bulbous exophytic malformations of permanent mandibular incisors.

    PubMed

    Kotsanos, Nikolaos; Velonis, Dimitrios

    2012-01-01

    This paper presents the diagnosis and management of a rare case of bulbous exophytic malformation of three permanent mandibular incisors. An 8-year-old Caucasian girl presented with concerns on the appearance of these teeth. Medical history was noncontributory, and there was no recall of relevant past trauma. Upon clinical examination, 3 permanent mandibular incisors exhibited hard bulbous protuberances in the crown's middle and cervical areas. Radiographic examination assisted by dental computed tomography revealed that these were continuous with the tooth structure, contained no pulpal tissue, and the teeth displayed normal root development. They were excised and the teeth were restored with a thin composite facing. They remained asymptomatic with acceptable esthetics for 4 years. Scanning electron microscopy and histology of the biopsied hard tissue revealed a nonhomogeneous structure resembling anomalously intertwined enamel with predentin and dentin. The etiology of this disturbance of dental development remains unknown. PMID:23265170

  16. A rare case of dens invaginatus in a mandibular canine.

    PubMed

    George, Roy; Moule, Alexander J; Walsh, Laurence J

    2010-08-01

    Dens invaginatus (dens in dente) is a common dental anomaly with a reported prevalence of between 0.04% and 10%. It typically affects permanent maxillary lateral incisors, central incisors and premolars. These developmental lesions are less common in mandibular teeth and are extremely rare in canines and molars. This report describes a rare case of dens invaginatus (Oehlers type II) in a permanent mandibular canine. The tooth was mature with a closed apex and showed apical pathosis. The tooth was treated endodontically using a non-surgical technique with hand endodontic files, and then followed up after a period of 8 months. A follow-up radiograph showed some healing of the lesion. PMID:20666755

  17. Transalveolar repositioning of an impacted immature permanent mandibular canine.

    PubMed

    Ozdemir-Ozenen, Didem; Guler, Nurhan; Sungurtekin-Ekci, Elif; Sandalli, Nuket

    2014-01-01

    The purpose of this case report is to discuss the four-year follow-up of a transalveolar transplantation of an impacted immature permanent mandibular left canine. A nine year-old-boy was referred to the dental school because of a mandibular swelling associated with the impacted canine. Under local anesthesia, the tooth was extracted and transplanted in its own space, followed by a two-week orthodontic fixation. The radiographic examination two months later revealed the presence of external inflammatory root resorption, which was treated with an apexification. The overall status of the transplanted tooth and the surrounding hard and soft tissues four years post-treatment indicates a successful outcome. PMID:25514261

  18. Orthopedic Correction of Growing Hyperdivergent, Retrognathic, Patients with Miniscrew Implants

    PubMed Central

    Buschang, Peter H.; Carrillo, Roberto; Rossouw, P. Emile

    2010-01-01

    Traditional orthodontic treatments do not adequately address the skeletal problems of retrognathic, hyperdivergent, Class II adolescents; the few approaches that do require long-term patient compliance. This paper introduces a novel approach using miniscrew implants (MSIa) and growth to treat retrognathic hyperdivergent adolescents. Nine consecutive patients were evaluated at the start of treatment (13.2 ±1.1 years of age) and again at the end of the orthopedic phase (after 1.9 ±0.3 years). Each patient had two MSIs placed in either side of the palate. Coil springs (150 g) extended from the MSIs to a RPE, which served as a rigid segment for intruding the maxillary premolar and molars. Two additional MSIs were placed between the first mandibular molars and second premolars; coil spring (150 g) extended from the MSIs to hold or intrude the mandibular molars. Prior to treatment, the patients exhibited substantial and significant mandibular retrusion (Z-score=?1.0), facial convexity (Z-score=0.7), and hyperdivergence (Z-score=1.6). Treatment produced consistent and substantial orthopedic effects. The chin was advanced an average of 2.4 mm, the SNB angle increased by 2.1°, the mandibular plane angle decreased 3.9°, and facial convexity decreased by approximately 3.2°. Questionnaires showed that this treatment approach was not painful or uncomfortable; the majority of the patients indicated that they were very likely to recommend the treatment to others. Treatment was accomplished by titrating the amount of orthodontic intrusion performed based on the individuals’ growth potential. PMID:21236539

  19. Gingival enlargement associated with a partially erupted mandibular molar.

    PubMed

    Flaitz, C M

    2001-01-01

    Odontogenic lesions may present as enlarged opercula and result in the delayed eruption of teeth. This case report describes the clinical and microscopic features of a peripheral odontogenic fibroma in a 13-year-old boy that involved the overlying gingiva of a partially erupted, mandibular second molar. A differential diagnosis and treatment for lesions presenting as gingival enlargements in the molar region are discussed. PMID:11699171

  20. Masticatory efficiency after rehabilitation of acquired maxillary and mandibular defects

    PubMed Central

    Vijayaraghavan, N. Vasantha; Ramesh, Ganesh; Thareja, Amit; Patil, Seema

    2015-01-01

    The effect of oral cancer with its therapeutic intervention involves significant facial and functional disabilities. It is customary to rehabilitate these patients by surgical or prosthetic means. Studies have been done to assess mastication and other functions after rehabilitation. A review of these studies for assessing masticatory function has been done under separate sections for maxillary and mandibular defects. Different masticatory tests are mentioned. Further scope for research has been highlighted. PMID:26392731

  1. Effects of alveolar ridge preservation on delayed implant osseointegration

    PubMed Central

    Shao, Shan; Li, Bin; Xue, Hui-Min; Huang, Hai-Yun; Liu, Gang-Li

    2015-01-01

    To evaluate the effects of alveolar ridge preservation with Bio-Oss bone substitute (Geistlich Pharma) on delayed implant osseointegration. The 3rd and 4th left and right mandibular premolars were extracted from four adult healthy male and female dogs. For the experimental group, we randomly selected two extraction sockets in each dog to be filled with Bio-Oss bone substitute (Geistlich Pharma). The two remaining extraction sockets remained untreated and served as the control group. Three months after Bio-Oss placement, dental implants were inserted into the alveolar bone of the experimental group and the control group. The osteogenic activity of the bone around the implants was assessed by evaluating the histological morphology and by estimating histomorphometric parameters at 3 and 6 months after delayed implantation. At 3 months, Goldner’s trichrome staining analysis showed that the bone-implant contact rate and mineralised bone area around the implant were significantly higher in the experimental group (75.98% ± 8.97% and 69.52% ± 9.63%, respectively) than in the control group (56.13% ± 8.18% and 52.82% ± 7.25%, respectively; P < 0.05). However, at 6 months, the two groups showed no significant difference. Fluorescence microscopy analysis revealed that the average mineralisation apposition rate of the bone tissue around the dental implant in the experimental group at 3 and 6 months was 6.80 ± 0.43 ?m and 8.38 ± 0.84 ?m, respectively, which was significantly higher than the rate in the control group (P < 0.05). These data indicated that alveolar ridge preservation by using Bio-Oss placement can promote osseointegration of delayed implantation. This may be a promising option for clinical use. PMID:26379871

  2. The ADAMTS1 Gene Is Associated with Familial Mandibular Prognathism.

    PubMed

    Guan, X; Song, Y; Ott, J; Zhang, Y; Li, C; Xin, T; Li, Z; Gan, Y; Li, J; Zhou, S; Zhou, Y

    2015-09-01

    Mandibular prognathism is a facial skeletal malocclusion. Until now, the genetic mechanism has been unclear. The goal of this study was to identify candidate genes or genomic regions directly associated with mandibular prognathism development, by employing whole genome sequencing. A large Chinese family was recruited, composed of 9 affected and 12 unaffected individuals, and the inheritance pattern of this family tends to be autosomal dominant. A single-nucleotide missense mutation in the ADAMTS1 gene (c. 742I>T) was found to segregate in the family, given that the affected individuals must be heterozygous for the mutation. For mutation validation, we screened this candidate mutation and 15 tag single-nucleotide polymorphisms in the coding sequence of ADAMTS1 among 230 unrelated cases and 196 unrelated controls using Sequenom Massarray and found that 3 in 230 cases carried this mutation and none of the controls did. Final results suggested that 2 single-nucleotide polymorphisms (rs2738, rs229038) of ADAMTS1 were significantly associated with mandibular prognathism. PMID:26124221

  3. Individualized treatment for the mandibular segmental defect: a case report.

    PubMed

    Zhang, Zhen; Pan, Juli; Huang, Xin; Chen, Su

    2015-04-01

    Ameloblastomas are slowly growing, locally invasive tumors with high recurrence rate and more common in the mandible, if not treated they can grow to enormous size. Radical resection is the only predictable form of treatment for ameloblastomas. However, mandibular resection can lead to dysfunctions in appearance, speech, mastication, and deglutition, which severely impair the patients' quality of life. The reconstruction of extensive bone defects in the maxillofacial area is still challenging. To meet the demands of functional reconstruction, minimizing the negative influence of mandibular malformation, and disability on patients, the individualized systematic treatment plans highlight denture prosthodontics and require much consideration of multidisciplinary cooperation, with such related fields as maxillofacial surgery, oral implantology, prosthodontics, and radiology taken into account. In this report, we will present a case of reconstructing the mandibular segmental defect after the resection of a rarely giant ameloblastoma. In the case, we took the restoration of the missing teeth and the rehabilitation of the masticatory function as well as restoring bony continuities and facial appearance into consideration, communicated well with prosthodontists and implantologists before surgery, making the individualized systematic treatment plan more effective and efficient. PMID:25972644

  4. Predicting Agenesis of the Mandibular Second Premolar from Adjacent Teeth

    PubMed Central

    2015-01-01

    Early diagnosis of agenesis of the mandibular second premolar (P2) enhances management of the dental arch in the growing child. The aim of this study was to explore the relationship in the development of the mandibular first molar (M1) and first premolar (P1) at early stages of P2 (second premolar). Specifically, we ask if the likelihood of P2 agenesis can be predicted from adjacent developing teeth. We selected archived dental panoramic radiographs with P2 at crown formation stages (N = 212) and calculated the likelihood of P2 at initial mineralisation stage ‘Ci’ given the tooth stage of adjacent teeth. Our results show that the probability of observing mandibular P2 at initial mineralisation stage ‘Ci’ decreased as both the adjacent P1 and M1 matured. The modal stage at P2 ‘Ci’ was P1 ‘Coc’ (cusp outline complete) and M1 ‘Crc’ (crown complete). Initial mineralisation of P2 was observed up to P1 ‘Crc’ and M1 stage ‘R½’ (root half). The chance of observing P2 at least ‘Coc’ (coalescence of cusps) was considerably greater prior to these threshold stages compared to later stages of P1 and M1. These findings suggest that P2 is highly unlikely to develop if P1 is beyond ‘Crc’ and M1 is beyond ‘R½’. PMID:26673218

  5. Retrograde peri-implantitis

    PubMed Central

    Mohamed, Jumshad B.; Shivakumar, B.; Sudarsan, Sabitha; Arun, K. V.; Kumar, T. S. S.

    2010-01-01

    Retrograde peri-implantitis constitutes an important cause for implant failure. Retrograde peri-implantitis may sometimes prove difficult to identify and hence institution of early treatment may not be possible. This paper presents a report of four cases of (the implant placed developing to) retrograde peri-implantitis. Three of these implants were successfully restored to their fully functional state while one was lost due to extensive damage. The paper highlights the importance of recognizing the etiopathogenic mechanisms, preoperative assessment, and a strong postoperative maintenance protocol to avoid retrograde peri-implant inflammation. PMID:20922082

  6. Surgical management of mandibular malposition after malunited condylar fractures in adults.

    PubMed

    Spitzer, W J; Vanderborght, G; Dumbach, J

    1997-04-01

    Fourteen patients who had occlusal disturbance and mandibular malposition following malunited condylar fractures are presented, to demonstrate the variety of surgical corrective procedures used. In order to achieve an anatomically correct mandibular position, a subcondylar osteotomy was performed in 2 patients, and in 11 patients a uni- or bilateral sagittal split osteotomy was carried out. In 1 patient, a Le Fort I osteotomy was the method of choice. In all patients, it was possible to correct the occlusal and mandibular imbalance, as well as to facilitate normal mandibular movement. PMID:9174891

  7. Do flexible acrylic resin lingual flanges improve retention of mandibular complete dentures?

    PubMed Central

    Ahmed Elmorsy, Ayman Elmorsy; Ahmed Ibraheem, Eman Mostafa; Ela, Alaa Aboul; Fahmy, Ahmed; Nassani, Mohammad Zakaria

    2015-01-01

    Objectives: The aim of this study was to compare the retention of conventional mandibular complete dentures with that of mandibular complete dentures having lingual flanges constructed with flexible acrylic resin “Versacryl.” Materials and Methods: The study sample comprised 10 completely edentulous patients. Each patient received one maxillary complete denture and two mandibular complete dentures. One mandibular denture was made of conventional heat-cured acrylic resin and the other had its lingual flanges made of flexible acrylic resin Versacryl. Digital force-meter was used to measure retention of mandibular dentures at delivery and at 2 weeks and 45 days following denture insertion. Results: The statistical analysis showed that at baseline and follow-up appointments, retention of mandibular complete dentures with flexible lingual flanges was significantly greater than retention of conventional mandibular dentures (P < 0.05). In both types of mandibular dentures, retention of dentures increased significantly over the follow-up period (P < 0.05). Conclusions: The use of flexible acrylic resin lingual flanges in the construction of mandibular complete dentures improved denture retention. PMID:26539387

  8. Regenerative Approach to Bilateral Rostral Mandibular Reconstruction in a Case Series of Dogs

    PubMed Central

    Arzi, Boaz; Cissell, Derek D.; Pollard, Rachel E.; Verstraete, Frank J. M.

    2015-01-01

    Extensive rostral mandibulectomy in dogs typically results in instability of the mandibles that may lead to malocclusion, difficulty in prehension, mastication, and pain of the temporomandibular joint. Large rostral mandibular defects are challenging to reconstruct due to the complex geometry of this region. In order to restore mandibular continuity and stability following extensive rostral mandibulectomy, we developed a surgical technique using a combination of intraoral and extraoral approaches, a locking titanium plate, and a compression resistant matrix (CRM) infused with rhBMP-2. Furthermore, surgical planning that consisted of computed tomographic (CT) scanning and 3D model printing was utilized. We describe a regenerative surgical technique for immediate or delayed reconstruction of critical-size rostral mandibular defects in five dogs. Three dogs had healed with intact gingival covering over the mandibular defect and had immediate return to normal function and occlusion. Two dogs had the complication of focal plate exposure and dehiscence, which was corrected with mucosal flaps and suturing; these dogs have since healed with intact gingival covering over the mandibular defect. Mineralized tissue formation was palpated clinically within 2?weeks and solid bone formation within 3?months. CT findings at 6?months postoperatively demonstrated that the newly regenerated mandibular bone had increased in mineral volume with evidence of integration between the native bone, new bone, and CRM compared to the immediate postoperative CT. We conclude that rostral mandibular reconstruction using a regenerative approach provides an excellent solution for restoring mandibular continuity and preventing mandibular instability in dogs. PMID:26664933

  9. Extensive Autogenous Bone Augmentation and Implantation in Patients Under Bisphosphonate Treatment: A 15-Case Series.

    PubMed

    Khoury, Fouad; Hidajat, Herman

    2016-01-01

    Patients under bisphosphonate (BP) treatment could be at high risk for implant treatment and bone augmentation due to the association between BPs and osteonecrosis of the jaws (BRONJ). Fifteen patients with BP intake in their anamnesis because of osteoporosis were treated with extensive bone grafting procedures and dental implants after selection according to their individual risk profile. In 47 sites, mandibular bone blocks were grafted according to the split bone block technique and 14 sinus floor elevations were performed. A total of 71 implants were placed and restored after 4 months. Most of the grafted bone healed as expected, and all implants could be placed as planned. Two patients showed incomplete healing of the grafted bone and were regrafted during implant placement. Two other patients showed limited soft tissue necrosis that was handled successfully with local treatments. One immediately loaded implant was lost. All in all, healing was uneventful and comparable to patients with no history of BP intake. At up to 6 years of follow-up, no major bone loss, BRONJ, infections, or peri-implantitis had occurred and all implants were still well osseointegrated clinically and radiologically. Depending on individual risk profile, bone augmentation could be successfully performed in patients taking low doses of BP treatment. More research and studies are needed. PMID:26697549

  10. Reconstruction of critical-size mandibular defects in immunoincompetent rats with human adipose-derived stromal cells.

    PubMed

    Streckbein, Philipp; Jäckel, Sven; Malik, Christoph-Yves; Obert, Martin; Kähling, Christopher; Wilbrand, Jan-Falco; Zahner, Daniel; Heidinger, Katrin; Kampschulte, Marian; Pons-Kühnemann, Jörn; Köhler, Kernt; Sauer, Heinrich; Kramer, Martin; Howaldt, Hans-Peter

    2013-09-01

    In patients with bony defects, autologous bone grafts are the "gold standard" for reconstruction. In children, autologous bone harvesting is limited but tissue engineering offers an alternative. Next to bone marrow, adipose tissue is a source of mesenchymal stromal cells, and adipose-derived stromal cells (ADSC) can differentiate into osteocytes. The aim of this study was to evaluate the efficacy of bioactive implants (ADSC in fibrin glue) for repair of critical-size mandibular defects in athymic rats. Human adult ADSC embedded in fibrin glue were implanted into a critical-size defect in the rat mandible and their efficacy was compared to those of protected bone healing (pbh), autologous bone graft, and an empty defect. The newly formed bone was quantified using high-resolution flat-panel volumetric CT (fpvCT) during different observation times. After eight weeks, the specimens were assessed histologically and by micro-computed tomography (?-CT). The radiographic examination demonstrated a significantly higher level of ossified defect area in the ADSC side compared with the pbh side. The autologous bone graft side showed significantly enhanced bone formation compared to the empty defect. The histological findings in the specimens with ADSC showed bony bridging of the defect. ADSC were capable of defect reconstruction under our experimental conditions. PMID:23684529

  11. Lip closing force of Class III patients with mandibular prognathism: a case control study

    PubMed Central

    2014-01-01

    Introduction To compare the lip closing force of patients with mandibular prognathism to that of patients without dentofacial anomalies. Methods The subject group included 62 female patients of Class III relationship with mandibular prognathism. The control group been comprised of 71 patients of Class I relationships without skeletal deformities. Maximum lip closing force and average lip closing force were measured using a Y-meter. Student’s t-test was carried out to analyse the differences between the groups. Correlation and stepwise multiple linear regression analyses were performed to analyse the relationship between lip closing force and craniofacial morphology. Results The lower lip closing force of subjects with mandibular prognathism was significantly greater than that of patients in the control group (P??0.05). The lower lip closing force of patients with mandibular prognathism was strongly correlated with IMPA (Lower Incisor - Mandibular Plane angle, P?Mandibular Plane angle, P?mandibular prognathism and was strongly correlated with lower incisor position and mandibular plane angle. PMID:25159036

  12. Reconstruction of the Lateral Mandibular Defect: A Review and Treatment Algorithm.

    PubMed

    Shnayder, Yelizaveta; Lin, Derrick; Desai, Shaun C; Nussenbaum, Brian; Sand, Jordan P; Wax, Mark K

    2015-09-01

    Reconstruction of the lateral mandibular defect presents a complex challenge to the reconstructive surgeon, often involving interconnected soft-tissue and bone requirements. This review examines the current literature on functional outcomes of lateral mandibular reconstruction and presents an algorithm on selecting an optimal reconstructive choice for patients with lateral mandibular defects resulting from oncologic ablative surgery or trauma. PubMed and Medline searches on reconstructing lateral mandibular defect were performed of the English literature. Search terms included lateral mandibular defect, outcomes of mandibular reconstruction, and free flap reconstruction of mandible. Although most of the articles presented are retrospective reviews, priority was given to the articles with high-quality level of evidence. Restoration of function, including speech and swallow, and acceptable cosmetic result are the primary objectives of lateral mandibular reconstruction. When reconstructing the mandible in a patient following tumor extirpation, the patient's overall prognosis, medical comorbidities, and need for adjuvant therapy should be considered. In the patient with aggressive malignant disease and a poor prognosis, a less complex reconstruction, such as soft-tissue flap with or without a reconstruction plate, may be adequate. In a dentate patient with favorable prognosis, a durable reconstruction, such as osseocutaneous microvascular free flap, is often preferred. Various reconstructive options are available for patients with lateral mandibular defects. Depending on the predominance of the soft-tissue or bony components of the defect, with consideration of the patient's characteristics and functional and aesthetic goals, the surgeon can wisely select from these reconstructive possibilities. PMID:26204563

  13. Endodontic Treatment of a Mandibular Second Premolar with Three Roots and Three Canals

    PubMed Central

    Paul, Bonny; Dube, Kavita

    2014-01-01

    Complex root canal system with atypical variations is a common finding among mandibular premolars. Endodontic treatment in these teeth may not be successful due to the failure to recognise and treat multiple canals. This paper presents endodontic treatment of a mandibular second premolar with three roots and three canals. PMID:25431692

  14. Root canal treatment of maxillary and mandibular three-rooted premolars: case reports.

    PubMed

    Shalavi, Sousan; Mohammadi, Zahed; Abdolrazzaghi, Maryam

    2012-01-01

    Familiarity with the normal and abnormal anatomy of the root canal system is essential for successful root canal treatment. The possibility of concomitant three-rooted and three- canalled maxillary and mandibular premolars are extremely rare. The purpose of this paper was to report a case with a three-rooted maxillary first premolar and two three-rooted mandibular premolars. PMID:23056137

  15. [Mandibular metastasis of a cutaneous melanoma or metachronous amelanotic melanoma of the oral cavity? A case report and literature review].

    PubMed

    Vierne, C; Hardy, H; Guichard, B; Barat, M; Péron, J-M; Trost, O

    2014-08-01

    Primary and metastatic mandibular melanoma are extremely rare. We report the original case of a 55-year-old woman treated 16 years before for a cutaneous melanoma, and now presenting with a huge mandibular amelanotic melanoma. Was it an histologically different mandibular metastasis of the previous cutaneous melanoma, or a metachronous oral amelanotic melanoma? PMID:24503521

  16. Treatment of extensive comminuted mandibular fracture between both mandibular angles with bilateral condylar fractures using a reconstruction plate: a case report

    PubMed Central

    Lee, Kwonwoo; Yoon, Kyuho; Cheong, Jeongkwon; Shin, Jaemyung; Bae, Jungho; Ko, Inchan; Park, Hyungkoo

    2014-01-01

    This following case report describes the open reduction, internal fixation and the reconstruction of an extensive comminuted mandibular fracture with bilateral condylar fractures in a 19-year-old male patient with an intellectual disability and autistic disorder. He suffered fall trauma, resulting in shattered bony fragments of the alveolus and mandibular body between both mandibular rami, the fracture of both condyles and the avulsion or dislocation of every posterior tooth of the mandible. The patient underwent open reduction and internal fixation between both mandibular rami using a reconstruction plate, open reduction and internal fixation of the shattered fragments using miniplates and screws, and the closed reduction of the bilateral condylar fractures. PMID:25045641

  17. Treatment of extensive comminuted mandibular fracture between both mandibular angles with bilateral condylar fractures using a reconstruction plate: a case report.

    PubMed

    Lee, Kwonwoo; Yoon, Kyuho; Park, Kwan-Soo; Cheong, Jeongkwon; Shin, Jaemyung; Bae, Jungho; Ko, Inchan; Park, Hyungkoo

    2014-06-01

    This following case report describes the open reduction, internal fixation and the reconstruction of an extensive comminuted mandibular fracture with bilateral condylar fractures in a 19-year-old male patient with an intellectual disability and autistic disorder. He suffered fall trauma, resulting in shattered bony fragments of the alveolus and mandibular body between both mandibular rami, the fracture of both condyles and the avulsion or dislocation of every posterior tooth of the mandible. The patient underwent open reduction and internal fixation between both mandibular rami using a reconstruction plate, open reduction and internal fixation of the shattered fragments using miniplates and screws, and the closed reduction of the bilateral condylar fractures. PMID:25045641

  18. Asymmetric muscle function in patients with developmental mandibular asymmetry.

    PubMed

    Dong, Y; Wang, X M; Wang, M Q; Widmalm, S E

    2008-01-01

    The aim was to test the hypothesis that developmental mandibular asymmetry is associated with increased asymmetry in muscle activity. Patients with mandibular condylar and/or ramus hyperplasia having unilateral cross-bite were compared with healthy subjects with normal occlusion. Muscle activity was recorded with surface electrodes in the masseter, suprahyoid, sternocleidomastoid muscle (SCM) and upper trapezius areas during jaw opening-closing-clenching, head-neck flexion-extension, and elevation-lowering of shoulders. Root mean square (RMS) and mean power frequency (MPF) values were calculated and analysed using anova and t-tests with P < 0.05 chosen as significance level. The SCM and masseter muscles showed co-activation during jaw and head movements, significantly more asymmetric in the patients than in the healthy subjects. The RMS and MPF values were higher in the patients than in the controls in the SCM and suprahyoid areas on both sides during jaw opening-closing movement. The results indicate that the ability to perform symmetric jaw and neck muscle activities is disturbed in patients with developmental mandibular asymmetry. This is of clinical interest because asymmetric activity may be an etiologic factor in temporomandibular joint and cervical pain. The results support that co-activation occurs between jaw and neck muscles during voluntary jaw opening and indicate that postural antigravity reflex activity occurs in the masseter area during head extension. Further studies, where EMG recordings are made from the DMA patients at early stages are motivated to verify activity sources and test if the asymmetric activity is associated with muscle and joint pain in the jaw and cervical areas. PMID:18190358

  19. A mandibular second premolar with three canals and atypical orifices.

    PubMed

    Lotfi, Mehrdad; Vosoughhosseini, Sepideh; Zand, Vahid; Fatemi, Ali; Shyezadeh, Vahab; Ranjkesh, Bahram

    2008-09-01

    Mandibular second premolars with three canals (Type V, Vertucci) and separate foramina are very rare. The anatomy of the pulp chamber floor in these premolars usually reveals one lingual and two buccal orifices at the same level. This case report describes a second premolar with three canals and an unusual pulpal floor anatomy with one distobuccal and one distolingual orifice at the same level and an orifice on the mesiolingual wall. Very careful examination of the pulpal space, preferably with an optical device, is recommended to locate any unusual orifices. PMID:18818477

  20. Mandibular Movements Identify Respiratory Effort in Pediatric Obstructive Sleep Apnea

    PubMed Central

    Martinot, Jean-Benoît; Senny, Fréderic; Denison, Stéphane; Cuthbert, Valérie; Gueulette, Emmanuelle; Guénard, Hervé; Pépin, Jean-Louis

    2015-01-01

    Study Objectives: Obstructive sleep apnea-hypopnea (OAH) diagnosis in children is based on the quantification of flow and respiratory effort (RE). Pulse transit time (PTT) is one validated tool to recognize RE. Pattern analysis of mandibular movements (MM) might be an alternative method to detect RE. We compared several patterns of MM to concomittant changes in PTT during OAH in children with adenotonsillar hypertrophy. Methods: Participants: 33 consecutive children with snoring and symptoms/signs of OAH. Measurements: MMs were measured during polysomnography with a magnetometer device (Brizzy Nomics, Liege, Belgium) placed on the chin and forehead. Patterns of MM were evaluated representing peak to peak fluctuations > 0.3 mm in mandibular excursion (MML), mandibular opening (MMO), and sharp MM (MMS), which closed the mouth on cortical arousal (CAr). Results: The median (95% CI) hourly rate of at least 1 MM (MML, or MMO, or MMS) was 18.1 (13.2–36.3) and strongly correlated with OAHI (p = 0.003) but not with central apnea-hypopnea index (CAHI; p = 0.292). The durations when the MM amplitude was > 0.4 mm and PTT > 15 ms were strongly correlated (p < 0.001). The mean (SD) of MM peak to peak amplitude was larger during OAH than CAH (0.9 ± 0.7 mm and 0.2 ± 0.3 mm; p < 0.001, respectively). MMS at the termination of OAH had larger amplitude compared to MMS with CAH (1.5 ± 0.9 mm and 0.5 ± 0.7 mm, respectively, p < 0.001). Conclusions: MM > 0.4 mm occurred frequently during periods of OAH and were frequently terminated by MMS corresponding to mouth closure on CAr. The MM findings strongly correlated with changes in PTT. MM analysis could be a simple and accurate promising tool for RE characterization and optimization of OAH diagnosis in children. Citation: Martinot JB, Senny F, Denison S, Cuthbert V, Gueulette E, Guénard H, Pépin JL. Mandibular movements identify respiratory effort in pediatric obstructive sleep apnea. J Clin Sleep Med 2015;11(5):567–574. PMID:25766710

  1. Anaplastic mandibular carcinoma in a meerkat (Suricata suricatta).

    PubMed

    Dadone, Liza I; Garner, Michael M; Klaphake, Eric; Johnston, Matthew S; Han, Sushan

    2014-06-01

    An 8-yr-old female slender-tailed meerkat (Suricata suricatta) presented with a necrotic sublingual mass and osteolysis of the mandible. After 1 mo of palliative care, the meerkat was euthanized. The mass was diagnosed histologically as an anaplastic carcinoma with extensive rostral mandibular destruction. Immunohistochemistry for vimentin and cytokeratin was validated in this nontypical species and showed that neoplastic cells expressed both mesenchymal and epithelial characteristics, suggestive of a primitive and poorly differentiated tumor. A review of 150 adult slender-tailed meerkat histopathology reports showed a 2% prevalence of orofacial neoplasia, suggesting that oral neoplasms are uncommon in meerkats. PMID:25000710

  2. Bilateral dens invaginatus in the mandibular premolars – Diagnosis and treatment

    PubMed Central

    Kharangate, Nupur; Figueiredo, Nigel R.; Fernandes, Marina; Lambor, Rajan

    2015-01-01

    Dens invaginatus (DI) is a developmental anomaly that results from an infolding of the dental papilla during tooth development and simulates the appearance of a tooth within another tooth. It shows a wide spectrum of variations in morphology and usually affects the maxillary lateral incisors. This study presents an unusual case of an Oehlers’ Type I DI involving the bilateral mandibular first and second premolars, which presented as an incidental radiographic finding in the first premolars and was associated with a periapical lesion in the second premolars which was successfully treated using nonsurgical endodontics. PMID:26321850

  3. An in vivo evaluation of PLLA/PLLA-gHA nano-composite for internal fixation of mandibular bone fractures.

    PubMed

    Peng, Weihai; Zheng, Wei; Shi, Kai; Wang, Wangshu; Shao, Ying; Zhang, Duo

    2015-01-01

    Internal fixation of bone fractures using biodegradable poly(L-lactic-acid) (PLLA)-based materials has attracted the attention of many researchers. In the present study, 36 male beagle dogs were randomly assigned to two groups: PLLA/PLLA-gHA (PLLA-grafted hydroxyapatite) group and PLLA group. PLLA/PLLA-gHA and PLLA plates were embedded in the muscular bags of the erector spinae and also implanted to fix mandibular bone fractures in respective groups. At 1, 2, 3, 6, 9, and 12 months postoperatively, the PLLA/PLLA-gHA and PLLA plates were evaluated by adsorption and degradation tests, and the mandibles were examined through radiographic analysis, biomechanical testing, and histological analysis. The PLLA/PLLA-gHA plates were non-transparent and showed a creamy white color, and the PLLA plates were transparent and faint yellow in color. At all time points following surgery, adsorption and degradation of the PLLA/PLLA-gHA plates were significantly less than those of the PLLA plates, and the lateral and longitudinal bending strengths of the surgically treated mandibles of the beagle dogs in the PLLA/PLLA-gHA group were significantly greater than those of the PLLA group and reached almost the value of intact mandibles at 12 months postoperatively. Additionally, relatively rapid bone healing was observed in the PLLA/PLLA-gHA group with the formation of new lamellar bone tissues at 12 months after the surgery. The PLLA/PLLA-gHA nano-composite can be employed as a biodegradable material for internal fixation of mandibular bone fractures. PMID:26551378

  4. A Modified Method of Proximal Segment Alignment After Sagittal Split Ramus Osteotomy for Patients With Mandibular Asymmetry

    PubMed Central

    Xia, James J.; Wang, Xudong

    2015-01-01

    Purpose The purpose of this study was to evaluate a modified method of aligning the proximal segment after bilateral sagittal split ramus osteotomy (BSSO) in the treatment of patients with facial asymmetry. Patients and Methods Eleven patients with mandibular excess and facial asymmetries were enrolled in this prospective study. The surgery was planned according to a computer-aided surgical simulation protocol. In addition, the proximal segment on the hypoplastic side was intentionally flared out after the distal segment was rotationally set back. If the gap between the proximal and distal segments was too wide, then bone grafts were used. The surgery was completed according to the computerized plan. The proximal segment on the hypoplastic side was fixed with bicortical lag screws, and the proximal segment on the hyperplastic side was fixed with a 4-hole titanium miniplate. Postoperative evaluation was performed 6 months after surgery. Statistical analyses were performed. Results All surgeries were completed uneventfully. Of the 11 patients, 4 also underwent genioplasty and 3 underwent bone grafting to fill in the gap and smooth the anterior step. The physicians and patients were satisfied with the surgical outcomes. Only 1 patient underwent a secondary revision using an onlay hydroxyapatite implant. Results of statistical analyses showed that the computerized surgical plan could be accurately transferred to the patients at the time of surgery and the surgical outcomes achieved with this modified method were better than with the routine method of aligning the proximal and distal segments in maximal contact. Conclusion The present modified method of aligning the proximal segment for BSSO can effectively correct mandibular asymmetry and obviate a secondary revision surgery. PMID:26026710

  5. Pacemakers and Implantable Defibrillators

    MedlinePLUS

    ... a cardiac pacemaker or an implantable cardioverter defibrillator (ICD). They are devices that are implanted in your ... and coordinate the chambers of the heart. An ICD monitors heart rhythms. If it senses dangerous rhythms, ...

  6. Implantable Medical Devices

    MedlinePLUS

    ... High Blood Pressure Tools & Resources Stroke More Implantable Medical Devices Updated:Sep 15,2015 For Rhythm Control ... Lifestyle Changes Recovery FAQs Medications Surgical Procedures Implantable Medical Devices Healthy Heart Quizzes • Heart Attack Tools & Resources ...

  7. Implantable Heart Aid

    NASA Technical Reports Server (NTRS)

    1984-01-01

    CPI's human-implantable automatic implantable defibrillator (AID) is a heart assist system, derived from NASA's space circuitry technology, that can prevent erratic heart action known as arrhythmias. Implanted AID, consisting of microcomputer power source and two electrodes for sensing heart activity, recognizes onset of ventricular fibrillation (VF) and delivers corrective electrical countershock to restore rhythmic heartbeat.

  8. Cochlear Implants for Children.

    ERIC Educational Resources Information Center

    Hasenstab, M. Suzanne; Laughton, Joan

    1991-01-01

    The use of cochlear implants in children with profound bilateral hearing loss is discussed, focusing on how a cochlear implant works; steps in a cochlear implant program (evaluation, surgery, programing, and training); and rehabilitation procedures involved in auditory development and speech development. (JDD)

  9. Mini Implants Supporting Fixed Partial Dentures in the Posterior Mandible: A Retrospective.

    PubMed

    Flanagan, Dennis

    2015-08-01

    Small-diameter, or mini, dental implants have been successfully used to support removable and fixed oral prostheses. These implants impart about twice the per-square-millimeter force on the supporting bone and this should be addressed during treatment planning. In the posterior jaws, bite forces are of a higher magnitude than in the anterior jaws and may induce an overload of the supporting bone and failure of the osseointegration. Thus there should not be occlusal contact in functional excursions that induce off axial loads. The cases presented herein demonstrate that mini dental implants may be used successfully to support fixed partial dentures in mandibular sites in highly selected patients. Attention should be given to the bone density of the site, very slow seating rotation of the implant with intermissions or cooling during insertion, observation of a 4-month healing time, flapless placement, treatment of any existing periodontitis, an insoluble cement, and exclusion of occlusal contact in functional excursions. Importantly, a narrow, rounded occlusal table should be used to minimize off axial loads and an insoluble luting cement should be used to prevent loosening of the crowns due to dissolution of the cement and an overload of the retained implant with any residual cement-retained in the retainer. The implant that supports the cement retained retainer will be subjected to leveraged rotation that may destroy the osseointegration and result in exfoliation of the implant. PMID:24779887

  10. Superior biofunctionality of dental implant fixtures uniformly coated with durable bioglass films by magnetron sputtering.

    PubMed

    Popa, A C; Stan, G E; Enculescu, M; Tanase, C; Tulyaganov, D U; Ferreira, J M F

    2015-11-01

    Bioactive glasses are currently considered the suitable candidates to stir the quest for a new generation of osseous implants with superior biological/functional performance. In congruence with this vision, this contribution aims to introduce a reliable technological recipe for coating fairly complex 3D-shaped implants (e.g. dental screws) with uniform and mechanical resistant bioactive glass films by the radio-frequency magnetron sputtering method. The mechanical reliability of the bioactive glass films applied to real Ti dental implant fixtures has been evaluated by a procedure comprised of "cold" implantation in pig mandibular bone from a dead animal, followed by immediate tension-free extraction tests. The effects of the complex mechanical strains occurring during implantation were analysed by scanning electron microscopy coupled with electron dispersive spectroscopy. Extensive biocompatibility assays (MTS, immunofluorescence, Western blot) revealed that the bioactive glass films stimulated strong cellular adhesion and proliferation of human dental pulp stem cells, without promoting their differentiation. The ability of the implant coatings to conserve a healthy stem cell pool is promising to further endorse the fabrication of new osseointegration implant designs with extended lifetime. PMID:26282074

  11. Functional outcomes following surgical treatment of bilateral mandibular condylar fractures.

    PubMed

    Chen, C-T; Feng, C-H; Tsay, P-K; Lai, J-P; Chen, Y-R

    2011-01-01

    Debate continues regarding unilateral or bilateral treatment for mandibular condylar fractures. This retrospective study evaluates the functional outcomes of bilateral condylar process fractures after surgical intervention. From May 1994 to December 2004, 51 adult patients with bilateral mandibular condylar process fractures were studied. There were 33 cases of bilateral condylar fractures (type I); 12 cases of condylar-subcondylar fractures (type II); and six cases of bilateral subcondylar fractures (type III). All patients underwent open reduction and internal fixation. Four patients had chin deviation, six had malocclusion, three had poor chewing function and eight had limited mouth opening. Type I patients had a significantly higher incidence of limited mouth opening (P=0.039) and associated maxillary fractures (n=12) and psychiatric disease (n=6) which yielded significantly poor functional outcomes. Complications included transient facial paresis (n=4), fracture and loosening of postoperative plates (n=3) and surgical wound infections (n=2). Open reduction with rigid fixation for bilateral condylar fractures provided satisfactory functional outcomes in this study. Concomitant maxillary fractures and underlying psychiatric problems are poor outcome factors. Aggressive rehabilitation in the first 9 months is important for early functional recovery. PMID:20961735

  12. Overexpressed TGF-? in subchondral bone leads to mandibular condyle degradation.

    PubMed

    Jiao, K; Zhang, M; Niu, L; Yu, S; Zhen, G; Xian, L; Yu, B; Yang, K; Liu, P; Cao, X; Wang, M

    2014-02-01

    Emerging evidence has implied that subchondral bone plays an important role during osteoarthritis (OA) pathology. This study was undertaken to investigate whether abnormalities of the condylar subchondral bone lead to temporomandibular joint (TMJ) OA. We used an osteoblast-specific mutant TGF-?1 transgenic mouse, the CED mouse, in which high levels of active TGF-?1 occur in bone marrow, leading to abnormal bone remodeling. Subchondral bone changes in the mandibular condyles were investigated by micro-CT, and alterations in TMJ condyles were confirmed by histopathological and immunohistochemical analysis. Abnormalities in the condylar subchondral bone, characterized as fluctuant bone mineral density and microstructure and increased but uncoupled activity of osteoclasts and osteoblasts, were apparent in the 1- and 4-month CED mouse groups, while obvious cartilage degradation, in the form of cell-free regions and proteoglycan loss, was observed in the 4-month CED group. In addition, increased numbers of apoptotic chondrocytes and MMP9- and VEGF-positive chondrocytes were observed in the condylar cartilage in the 4-month CED group, but not in the 1-month CED group, compared with their respective age-matched controls. This study demonstrated that progressive degradation of mandibular condylar cartilage could be induced by the abnormal remodeling of the underlying subchondral bone during TMJOA progression. PMID:24309371

  13. Effects of experimentally deviated mandibular position on stress response.

    PubMed

    Amemiya, Ai; Takeda, Tomotaka; Nakajima, Kazunori; Ishigami, Keiichi; Tsujii, Takeo; Sakatani, Kaoru

    2013-01-01

    The purpose of this study was to investigate the effects of stress on -prefrontal cortex (PFC), emotion (using visual analogue scale, VAS, and State-Trait Anxiety Inventory, STAI), and the autonomic nervous system (ANS). Two types of stress were applied: (1) malocclusion-induced physical stress and (2) mental stress induced by an arithmetic task. Malocclusion was induced using an experimentally deviated mandibular device (EDMD) to obtain an experimentally deviated mandibular position (EDMP). A total of 11 healthy volunteers participated in the study. On day 1 they performed a pretrial arithmetic task followed by a 10-min rest, after which they performed a posttrial EDMD + arithmetic task or rest device + arithmetic task. These two tasks were selected at random and assigned at the rate of one per day. Activity in the PFC tended to show an increase in the pretrial arithmetic tasks and rest device + arithmetic task, but a decrease in the EDMD + arithmetic task compared with the rest device + arithmetic task. Heart rate significantly increased during the rest device + arithmetic task, whereas no significant difference was observed during the EDMD + arithmetic task. The EDMD + arithmetic task significantly increased STAI scores (p = 0.0047), and the significant decrease in VAS indicated "unpleasant" (p = 0.035). These findings suggest that EDMP-induced reduction in the level of PFC activity was a response to discomfort, indicating that EDMP affects systemic function such as that of the ANS as an unpleasant stressor. PMID:22879007

  14. Crown Preservation of the Mandibular First Molar Tooth Impacts the Strength and Stiffness of Three Non-Invasive Jaw Fracture Repair Constructs in Dogs

    PubMed Central

    Lothamer, Charles; Snyder, Christopher John; Duenwald-Kuehl, Sarah; Kloke, John; McCabe, Ronald P.; Vanderby, Ray

    2015-01-01

    Repairing mandibular body fractures presents unique challenges not encountered when repairing long bones. Large tooth roots and the presence of the inferior alveolar neurovascular bundle limit safe placement for many types of orthopedic implants. Use of non-invasive fracture repair methods have increasingly become popular and have proven safe and effective at achieving bone healing. Non-invasive fixation constructs have not been tested in dogs using cantilevered bending. Furthermore, non-invasive fracture repair constructs have not been tested at the location of a common fracture location – the mandibular first molar tooth (M1). The objectives of this study were to test the strength and stiffness of three non-invasive mandibular fracture repair constructs and to characterize the impact that tooth crown preservation has on fixation strength for fractures occurring at the M1 location. Specimens were assigned to three treatment groups: (1) composite only, (2) interdental wiring and composite (IWC), and (3) transmucosal fixation screw and composite. For each pair of mandibles, one mandible received crown amputation at the alveolar margin to simulate the effect of crown loss on fixation strength and stiffness. Regardless of the status of crown presence, IWC demonstrated the greatest bending stiffness and load to failure. With the crown removed, IWC was significantly stronger compared to other treatments. All fixation constructs were stiffer when the tooth crown was preserved. In fractures at this location, retaining the tooth crown of M1 significantly increases stiffness of interdental wiring with composite and transmucosal screw with composite constructs. If the crown of M1 was removed, IWC was significantly stronger than the other two forms of fixation. PMID:26664947

  15. Transition from failing dentition to complete-arch implant rehabilitation with a staged approach: a 3-year clinical report.

    PubMed

    Papaspyridakos, Panos; Chronopoulos, Vasilios

    2014-09-01

    The transition of patients from failing dentition to complete-arch implant rehabilitation often means that the patient is rendered edentulous and has to wear a removable complete denture for a time. Many patients find this objectionable. A staged treatment approach provides a fixed interim prosthesis for use throughout the rehabilitation process, allowing patient comfort and prosthodontic control. This clinical report describes a staged approach protocol with a new type of interim prosthesis. The prosthesis is supported by hopeless teeth and the soft tissues of the maxillary tuberosities and mandibular retromolar pads for the complete-arch implant rehabilitation of a patient with failing dentition. This protocol allows for a fixed interim prosthesis with combined tooth and mucosa or implant support during the entire rehabilitation process, thus avoiding the use of complete dentures. The implants and prostheses were functioning successfully after 3 years of clinical service. PMID:24631159

  16. Insight: implantable medical devices.

    PubMed

    Meng, E; Sheybani, R

    2014-09-01

    Implantable electronic medical devices have achieved remarkable medical advances in the treatment of the most challenging conditions, starting with the introduction of the first implantable pacemaker in 1958. Increasing demand for innovation in existing and novel implantable devices is fuelled by the growing aging population and the increased prevalence of chronic diseases. This perspective article provides an overview of the implantable medical device ecosystem, highlights recent developments, and discusses challenges and opportunities for translation of new innovative implants enabled by microtechnologies and microfabrication. PMID:24903337

  17. Trends in Cochlear Implants

    PubMed Central

    Zeng, Fan-Gang

    2004-01-01

    More than 60,000 people worldwide use cochlear implants as a means to restore functional hearing. Although individual performance variability is still high, an average implant user can talk on the phone in a quiet environment. Cochlear-implant research has also matured as a field, as evidenced by the exponential growth in both the patient population and scientific publication. The present report examines current issues related to audiologic, clinical, engineering, anatomic, and physiologic aspects of cochlear implants, focusing on their psychophysical, speech, music, and cognitive performance. This report also forecasts clinical and research trends related to presurgical evaluation, fitting protocols, signal processing, and postsurgical rehabilitation in cochlear implants. Finally, a future landscape in amplification is presented that requires a unique, yet complementary, contribution from hearing aids, middle ear implants, and cochlear implants to achieve a total solution to the entire spectrum of hearing loss treatment and management. PMID:15247993

  18. Prevalence and features of distolingual roots in mandibular molars analyzed by cone-beam computed tomography

    PubMed Central

    Choi, Mi-Ree; Moon, Young-Mi

    2015-01-01

    Purpose This study evaluated the prevalence of distolingual roots in mandibular molars among Koreans, the root canal system associated with distolingual roots, and the concurrent appearance of a distolingual root in the mandibular first molar and a C-shaped canal in the mandibular second molar. Materials and Methods Cone-beam computed tomographic images of 264 patients were screened and examined. Axial sections of 1056 mandibular molars were evaluated to determine the number of roots. The interorifice distances from the distolingual canal to the distobuccal canal were also estimated. Using an image analysis program, the root canal curvature was calculated. Pearson's chi-square test, the paired t-test, one-way analysis of variance, and post-hoc analysis were performed. Results Distolingual roots were observed in 26.1% of the subjects. In cases where a distolingual root was observed in the mandibular molar, a significant difference was observed in the root canal curvature between the buccolingual and mesiodistal orientations. The maximum root canal curvature was most commonly observed in the mesiodistal orientation in the coronal portion, but in the apical portion, maximum root canal curvature was most often observed in the buccolingual orientation. Conclusion The canal curvature of distolingual roots was found to be very complex, with a different direction in each portion. No correlation was found between the presence of a distolingual root in the mandibular first molar and the presence of a C-shaped canal in the mandibular second molar.

  19. Mandibular ramus: An indicator for sex determination - A digital radiographic study

    PubMed Central

    Indira, Annamalai Ponnuswamy; Markande, Archana; David, Maria P

    2012-01-01

    Background: The identification of skeletal remains is of paramount importance in medico-legal investigations. The skeletal components most often investigated for gender determination are the pelvis and skull, with the mandible being a practical element to analyze sexual dimorphism in the fragmented bones. Presence of a dense layer of compact bone makes it very durable and well preserved than many other bones. Mandibular ramus can be used to differentiate between sexes and it also expresses strong univariate sexual dimorphism. When skeleton sex determination is considered, metric analyses on the radiographs are often found to be of superior value owing to their objectivity, accuracy, and reproducibility. Aims and Objectives: (1) To measure, compare, and evaluate the various measurements of mandibular ramus as observed on orthopantomographs. (2) To assess the usefulness of mandibular ramus as an aid in sex determination. Materials and Methods: A retrospective study was conducted using orthopantomographs of 50 males and 50 females, which were taken using Kodak 8000C Digital Panoramic and Cephalometric System (73 kVp, 12 mA, 13.9 s). Mandibular ramus measurements were carried out using Master View 3.0 software. The measurements of the mandibular ramus were subjected to discriminant function analysis. Results: We observed each variable of the mandibular ramus to be a significant predictor in classifying a given sample (P < 0.001). Conclusion: This study on mandibular ramus measurements using orthopantomograph shows strong evidence suggesting that the ramus can be used for gender determination for forensic analysis. PMID:23741142

  20. Treating dental crowding with mandibular incisor extraction in an Angle Class I patient

    PubMed Central

    Machado, Gislana Braga

    2015-01-01

    Mandibular dental crowding often encourages patients to seek orthodontic treatment. The orthodontist should decide between protrusion of incisors or decrease in dental volume so as to achieve proper alignment and leveling. The present study reports the treatment of an Angle Class I malocclusion adolescent female brachyfacial patient with severe mandibular dental crowding, increased curve of Spee and deep overbite. The patient was treated with extraction of a mandibular incisor. This case was presented to the Brazilian Board of Orthodontics and Dentofacial Orthopedics (BBO) as a requirement for the title of certified by the BBO. PMID:26154463

  1. [A study of mandibular movement velocity and acceleration in young adults with normal people].

    PubMed

    Lu, P J

    1993-09-01

    The velocity and acceleration of mandibular movements including the border movement, habitual movement and functional movement were studied in 25 young adults by using D-SGG measuring instrument. The results showed that the conception of functional velocity and the maximum velocity of mandibular movement were developed. The physiological and clinical significance of the value of mandibular movement acceleration can be explained by Newton's Second law, F = ma. The author pointed out that in order to keep the necessary masticatory efficiency, the masticatory velocity enjoy the priority in matching with the masticatory force in mastication. PMID:8194415

  2. Nanotechnology and Dental Implants

    PubMed Central

    Lavenus, Sandrine; Louarn, Guy; Layrolle, Pierre

    2010-01-01

    The long-term clinical success of dental implants is related to their early osseointegration. This paper reviews the different steps of the interactions between biological fluids, cells, tissues, and surfaces of implants. Immediately following implantation, implants are in contact with proteins and platelets from blood. The differentiation of mesenchymal stem cells will then condition the peri-implant tissue healing. Direct bone-to-implant contact is desired for a biomechanical anchoring of implants to bone rather than fibrous tissue encapsulation. Surfaces properties such as chemistry and roughness play a determinant role in these biological interactions. Physicochemical features in the nanometer range may ultimately control the adsorption of proteins as well as the adhesion and differentiation of cells. Nanotechnologies are increasingly used for surface modifications of dental implants. Another approach to enhance osseointegration is the application of thin calcium phosphate (CaP) coatings. Bioactive CaP nanocrystals deposited on titanium implants are resorbable and stimulate bone apposition and healing. Future nanometer-controlled surfaces may ultimately direct the nature of peri-implant tissues and improve their clinical success rate. PMID:21253543

  3. Removal of an extensive mandibular odontoma using an intraoral approach.

    PubMed

    Lehman, Hadas; Lustmann, Joshua; Regev, Eran

    2013-01-01

    Odontomas, the most common odontogenic tumors, occur more frequently in the maxilla and are rarely larger than a tooth. They are usually found incidentally on routine dental radiographs during the second decade of life. The treatment of choice is surgical removal, and large tumors are challenging as damage may occur to surrounding anatomic structures. In this article we describe a "giant" compound odontoma occupying the entire body of the mandible and ramus in a 7-year-old girl. A conservative intraoral enucleation was used to avoid facial scarring and preserve mandibular continuity and function. The huge bony defect healed completely without a bone graft or further intervention. This case report emphasizes the importance of the early diagnosis of these lesions and a conservative surgical approach as well as the extraordinary healing potential of young patients. PMID:23479585

  4. MANDIBULAR ASYMMETRY CHARACTERIZATION USING GENERALIZED TENSOR-BASED MORPHOMETRY

    PubMed Central

    Paniagua, Beatriz; Alhadidi, Abeer; Cevidanes, Lucia; Styner, Martin; Oguz, Ipek

    2012-01-01

    Quantitative assessment of facial asymmetry is crucial for successful planning of corrective surgery. We propose a tensor-based morphometry (TBM) framework to locate and quantify asymmetry using 3D CBCT images. To this end, we compute a rigid transformation between the mandible segmentation and its mirror image, which yields global rotation and translation with respect to the cranial base to guide the surgery’s first stage. Next, we nonrigidly register the rigidly aligned images and use TBM methods to locally analyze the deformation field. This yields data on the location, amount and direction of “growth” (or “shrinkage”) between the left and right sides. We visualize this data in a volumetric manner and via scalar and vector maps on the mandibular surface to provide the surgeon with optimal understanding of the patient’s anatomy. We illustrate the feasibility and strength of our technique on 3 representative patients with a wide range of facial asymmetries. PMID:24443671

  5. Implant Supported Distal Extension over Denture Retained by Two Types of Attachments. A Comparative Radiographic Study by Cone Beam Computed Tomography

    PubMed Central

    Mahrous, Ahmed I; Aldawash, Hussien A; Soliman, Tarek A; Banasr, Fahad H; Abdelwahed, Ahmed

    2015-01-01

    Background: This study was conducted to compare and evaluate the effect of two different attachments (locator attachment and ball and socket [B&S] attachment) on implants and natural abutments supporting structures, in cases of limited inter-arch spaces in mandibular Kennedy Class I implant supported removable partial over dentures by measuring the bone height changes through the cone beam radiographic technology. Materials and Methods: Two implants were positioned in the first or second molar area following the two-stage surgical protocol. Two equal groups were divided ten for each: Group I: Sides were the placed implants restored by the locator attachment. Group II: The other sides, implants were restored by B&S attachment. Evaluation of the implants and main abutments supporting structures of each group was done at the time of removable partial over denture insertion, 6, 12 and 18 months by measuring the bone height changes using cone beam computed tomography. Results: Implants with locator attachment showed marginal bone height better effects on implants and main abutments supporting structures. Conclusion: Implants restored by locator attachment shows better effects on bone of both main natural abutments and implant than those restored with ball and socket. PMID:26028894

  6. MultiModality Surgical and Hyperbaric Management of Mandibular Osteoradionecrosis

    SciTech Connect

    Freiberger, John J.; Yoo, David S.; Lisle Dear, Guy de; McGraw, Thomas A.; Blakey, George H.; Padilla Burgos, Rebecca; Kraft, Kevin; Nelson, John W.; Moon, Richard E.; Piantadosi, Claude A.

    2009-11-01

    Purpose: To elucidate long-term outcomes in 65 consecutive patients meeting a uniform definition of mandibular osteoradionecrosis (ORN) treated with multimodality therapy including hyperbaric oxygen (HBO). Methods and Materials: Pretreatment, post-treatment and long-term follow-up of mandibular lesions with exposed bone were ranked by a systematic review of medical records and patient telephone calls. The ranking system was based on lesion diameter and number plus disease progression. Changes from pretreatment to post-treatment and follow-up were analyzed by Wilcoxon signed-rank tests. Improved wound survival, measured by time to relapse, defined as any less favorable rank after HBO treatment, was assessed by Kaplan-Meier analysis. Results: In all, 57 cases (88%) resolved or improved by lesion grade or progression and evolution criteria after HBO (p < 0.001). Four patients healed before surgery after HBO alone. Of 57 patients who experienced improvement, 41 had failed previous nonmultimodality therapy for 3 months and 26 for 6 months or more. A total of 43 patients were eligible for time-to-relapse survival analysis. Healing or improvement lasted a mean duration of 86.1 months (95% confidence interval [95% CI], 64.0-108.2) in nonsmokers (n = 20) vs. 15.8 months (95% CI, 8.4-23.2) in smokers (n = 14) versus 24.2 months (95% CI, 15.2-33.2) in patients with recurrent cancer (n = 9) (p = 0.002 by the log-rank method). Conclusions: Multimodality therapy using HBO is effective for ORN when less intensive therapies have failed. Although the healing rate in similarly affected patients not treated with HBO is unknown, the improvements seen with peri-operative HBO were durable provided that the patients remained cancer free and abstained from smoking.

  7. Analysis and design of an adjustable bone plate for mandibular fracture fixation

    E-print Network

    Cervantes, Thomas Michael

    2011-01-01

    This thesis presents the design, analysis and testing of a bone plate for mandibular fracture fixation. Conventional bone plates are commonly used to set fractures of the mandible in a surgical setting. If proper alignment ...

  8. Root Canal Morphology of Human Mandibular First Permanent Molars in an Iranian Population

    PubMed Central

    Shahi, Shahriar; Yavari, Hamid Reza; Rahimi, Saeed; Torkamani, Reza

    2008-01-01

    Background and aims The knowledge of variations in root canal morphology is critical for a successful endodontic treatment. The purpose of this study was to investigate variations in the root canal system of human mandibular first permanent molars in an Iranian population. Materials and methods In this study, 209 mandibular first molar teeth were decalcified, dye-injected, and cleared in order to determine the number and configuration of the root canals. Results The results demonstrated that 65.56% of the mandibular first molars under study had three, 31.57% had four and 2.87% had two canals. Conclusion According to the results of this study and considering variations in the root canal systems of the mandibular first molars, it seems that great care should be taken in the root canal treatment of these teeth. PMID:23285325

  9. [The artificial lens implant].

    PubMed

    Cârstocea, B; Selaru, D; Filip, M; Sandu, E; Stefan, C; Isp??oiu, C; Banaeu, I

    1993-01-01

    The paper presents a short history of the cataract intervention, starting from the lens luxation in vitreum and going to the implant of artificial lens. From the three classes of artificial lenses, up-to-date options are the posterior chamber artificial lenses. Today, in 80% of the cases, artificial lens implant is done, 80% of the implanted lenses being posterior chamber lenses. The paper also exposes various operatorial techniques, post-operatorial evolution and the results obtained. PMID:8507623

  10. [Silastic implant and synovitis].

    PubMed

    Sennwald, G

    1989-07-22

    The silastic implant based on siloxane polymere induces granulomatous synovitis in certain predisposed individuals, a reaction which may continue even after removal of the implant. This is also true of a prosthesis of the trapezium in two of our patients, though to a lesser degree. This is probably the reason why the problem has not yet been widely recognized. The hypothesis is put forward that an enzymatic predisposition may allow chemical degradation of the fragmented silastic implant into a toxic component responsible for the pathologic condition. The slow progression of the lesions is a challenge for the future and puts in question the further use of silastic implants. PMID:2678435

  11. A Complex Implant-Supported Reconstruction with Monolithic-Minimally Veneered Zirconia: A Clinical Report.

    PubMed

    Moscovitch, Michael

    2015-01-01

    The purpose of this case report is to highlight the issues of treating a complex maxillary and mandibular fixed, implant-supported reconstruction. It discusses the use of established evidence-based information along with recently developed supporting digital technologies for diagnostics and laboratory procedures, combined with high-strength zirconia ceramic and acrylic materials (polymethyl methacrylate) for provisionals and prototypes. These developments have created an accurate and precise workflow to provide reliable long-term performance and esthetic outcomes without the associated prevalence of damage and wear with previously used restorative materials. PMID:26247443

  12. Fast and early mandibular osteodistraction (FEMOD) in severe Pierre Robin Sequence.

    PubMed

    Cascone, Piero; Papoff, Paola; Arangio, Paolo; Vellone, Valentino; Calafati, Vincenzo; Silvestri, Alessandro

    2014-10-01

    Pierre Robin Sequence (PRS) is a congenital abnormality characterized by mandibular hypoplasia, glossoptosis and often secondary palate cleft. It may be an isolated or part of a most complicated syndrome. The genetic syndrome that most frequently co-occurs is Stickler syndrome characterized by skeletal abnormalities, joint pain, congenital myopia and retinal detachment. The authors describe their fast and early mandibular osteodistraction (FEMOD) protocol in severe cases of PRS airway obstruction. PMID:24787079

  13. Surgical repair of mandibular symphyseal fractures in three silver arowana (Osteoglossum bicirrhosum) using interfragmentary wire.

    PubMed

    Lloyd, Richard; Sham, Nor

    2014-12-01

    Three silver arowana (Osteoglossum bicirrhosum) were presented with unstable fractures of the mandibular symphyses. Surgical repair was performed to reduce and stabilize the fractures using interfragmentary wire. The fish returned to light feeding at 2 days and normal feeding at 5 days postsurgery. The wires were removed at 6 wk postsurgery with good alignment of the mandibular symphyses and stable fracture sites. There had been no further complications at the time of writing 18 wk postsurgery. PMID:25632685

  14. Endodontic management of bilateral mandibular canine with type two canals configuration.

    PubMed

    Yadav, Seema

    2015-01-01

    Successful endodontic treatment depends upon the clinician's knowledge and ability to manage aberrant anatomy. The mandibular canine normally comprises one canal and one root but 15% may have two canals with one or two foramina and even less frequent may have two roots. This paper presents a case report of bilateral mandibular canine having two root canals which merge into one canal and one foramina. PMID:26681863

  15. Inferior Alveolar Nerve Lateralization and Transposition for Dental Implant Placement. Part I: a Systematic Review of Surgical Techniques

    PubMed Central

    Juodzbalys, Gintaras

    2015-01-01

    ABSTRACT Objectives The purpose of this first part of a two-part series was to review the literature concerning the indications, contraindications, advantages, disadvantages and surgical techniques of the lateralization and transposition of the inferior alveolar nerve, followed by the placement of an implant in an edentulous atrophic posterior mandible. Material and Methods A comprehensive review of the current literature was conducted according to the PRISMA guidelines by accessing the NCBI PubMed and PMC database, academic sites and books. The articles were searched from January 1997 to July 2014 and comprised English-language articles that included adult patients between 18 and 80 years old with minimal residual bone above the mandibular canal who had undergone inferior alveolar nerve (IAN) repositioning with a minimum 6 months of follow-up. Results A total of 16 studies were included in this review. Nine were related to IAN transposition, 4 to IAN lateralization and 3 to both transposition and lateralization. Implant treatment results and complications were presented. Conclusions Inferior alveolar nerve lateralization and transposition in combination with the installation of dental implants is sometimes the only possible procedure to help patients to obtain a fixed prosthesis, in edentulous atrophic posterior mandibles. With careful pre-operative surgical and prosthetic planning, imaging, and extremely precise surgical technique, this procedure can be successfully used for implant placement in edentulous posterior mandibular segments. PMID:25937873

  16. Bifid mandibular canal: confirmation of limited cone beam CT findings by gross anatomical and histological investigations

    PubMed Central

    Fukami, K; Shiozaki, K; Mishima, A; Kuribayashi, A; Hamada, Y; Kobayashi, K

    2012-01-01

    Objectives The aims of this study were (1) to assess the validity of limited cone beam CT (CBCT) in detecting the distribution of bifid mandibular canals in the retromolar region by comparing its findings with those of panoramic radiography and spiral CT imaging, and (2) to confirm the contents of such canals depicted on limited CBCT images by using gross anatomical and histological methods. Methods Bilateral bifid mandibular canals of a Japanese cadaver were investigated. The canals depicted on panoramic radiography, spiral CT and limited CBCT images were compared. Cross-sectional limited CBCT images of these canals were compared with gross anatomical sections of the mandible and their contents were confirmed histologically. Results The spiral CT and limited CBCT images showed the bilateral bifid mandibular canals in the retromolar region whereas the panoramic radiographs indicated the presence of only the left bifid mandibular canal. The canal distribution was more distinct in the limited CBCT images than in the spiral CT images and the cross-sectional limited CBCT images were consistent with the gross anatomical sections. Histologically, the canals contained several nerve bundles and arteries among which the largest nerve and artery were of a similar size. Conclusion Limited CBCT is valuable for assessing the distribution of bifid mandibular canals. It is clinically significant to accurately localize a bifid mandibular canal of the retromolar region because it contains a nerve bundle and artery. PMID:22116121

  17. The Influence of a Mandibular Advancement Plate on Polysomnography in Different Grades of Obstructive Sleep Apnea

    PubMed Central

    Mattila, Pauli; Huuskonen, Usko; Oikarinen, Kyösti; Sándor, George K.

    2015-01-01

    ABSTRACT Objectives The purpose of this study was to investigate the effect of a mandibular advancement device on different grades of obstructive sleep apnea using a relatively simple test for the apnea-hypopnea index to determine if a mandibular device will be effective. Material and Methods A total of 68 patients with obstructive sleep apnea syndrome (OSAS) including, 31 with mild, 23 with moderate and 14 with severe OSAS were treated with a mandibular advancement device (MAD) and monitored with polysomnography. Results 25 of the 31 mild, 15 of the 23 moderate and 2 of the 14 severe OSAS patients were cured of their OSAS if a post treatment apnea-hypopnea index of less than 5 is regarded as cured. The odds ratios for success with MAD therapy are 3 for women over men, 14.9 for mild obstructive sleep apnea, 5.42 for moderate obstructive sleep apnea if severe obstructive sleep apnea is assigned an odds ratio of 1. Conclusions The use of the apnea-hypopnea index alone is useful in mild and moderate disease to predict the effectiveness of mandibular advancement device. Treatment with a mandibular advancement device is very effective in treating mild and moderate obstructive sleep apnea. Conservative treatment with a mandibular advancement device can be successful in less severe grades of sleep apnea and may be an alternative for non-surgical patients with severe obstructive sleep apnea intolerant of Continuous Positive Airway Pressure management. PMID:25937875

  18. Root Canal Configuration of Mandibular First and Second Premolars in an Iranian Population

    PubMed Central

    Rahimi, Saeed; Shahi, Shahriar; Yavari, Hamid Reza; Manafi, Hakimeh; Eskandarzadeh, Nemat

    2007-01-01

    Background and aims It is critical to have a proper knowledge of the normal anatomy of the pulp and its variations for the success of endodontic treatment. The aim of this study was to determine the canal configuration and the prevalence of C-shaped canals in mandibular first and second premolars in a North-Western Iranian population. Materials and methods A total of 163 extracted mandibular first and 103 mandibular second premolars were injected with India ink and demineralized . They were made clear and transparent with methyl salicylate and the anatomy of their canal(s) was studied. Results The results showed that 98% of mandibular first premolars had one root, 2% had two roots, 70.6% had one canal, 27.8% had two canals, 1.2% had three canals and the prevalence of C-shaped canals was 2.4%. All mandibular second premolars had one root, 80.5% had one canal, 17.5% had two canals and the prevalence of C-shaped canals was 2%. Conclusion It is important that clinicians, before treatment of mandibular first and second premolars, pay complete attention to radiographs, have a true concept of the number of root(s) and canal(s), and prepare a correct access cavitiy. PMID:23277835

  19. [Development of a computerized three-dimension system for displaying and analyzing mandibular helical axis pathways].

    PubMed

    Chen, Li; Zhang, Hao; Feng, Hailan; Zhang, Fengjun

    2014-12-01

    This paper is aimed to develop a computerized three dimensional system for displaying and analyzing mandibular helical axis pathways. Mandibular movements were recorded using a six-degrees-of-freedom ultrasonic jaw movement recording device. The three-dimensional digital models of the midface and the mandible were reconstructed and segmented from CT skull images. The digital models were then transformed to the coordinate system of mandibular motion data by using an optical measuring system. The system was programmed on the base of the Visualization ToolKit and Open Scene Graphics Library. According to the motion data, transformation matrices were calculated to simulate mandibular movements. Meanwhile, mandibular helical axis pathways were calculated and displayed three dimensionally by means of an eigenvalues method. The following parameters of mandibular helical axis were calculated: the rotation around instantaneous helical axis, the translation along it, its spatial orientation, its position and distance relative to any special reference point. These parameters could be exported to describe comprehensively the whole mandiblular movements. It could be concluded that our system would contribute to the study of mandiblular helical axis pathways. PMID:25868236

  20. Orthodontic treatment for a mandibular prognathic girl of short stature under growth hormone therapy.

    PubMed

    Pan, Chin-Yun; Lan, Ting-Hung; Chou, Szu-Ting; Tseng, Yu-Chuan; Chang, Jenny Zwei-Chieng; Chang, Hong-Po

    2013-12-01

    This report presents a case of a 12-year-old girl with maxillary deficiency, mandibular prognathism, and facial asymmetry, undergoing growth hormone (GH) therapy due to idiopathic short stature. Children of short stature with or without GH deficiency have a deviating craniofacial morphology with overall smaller dimensions; facial retrognathism, especially mandibular retrognathism; and increased facial convexity. However, a complete opposite craniofacial pattern was presented in our case of a skeletal Class III girl with idiopathic short stature. The orthodontic treatment goal was to inhibit or change the direction of mandibular growth and stimulate the maxillary growth of the girl during a course of GH therapy. Maxillary protraction and mandibular retraction were achieved using occipitomental anchorage (OMA) orthopedic appliance in the first stage of treatment. In the second stage, the patient was treated with a fixed orthodontic appliance using a modified multiple-loop edgewise archwire technique of asymmetric mechanics and an active retainer of vertical chin-cup. The treatment led to an acceptable facial profile and obvious facial asymmetry improvement. Class I dental occlusion and coincident dental midline were also achieved. A 3½-year follow-up of the girl at age 18 showed a stable result of the orthodontic and dentofacial orthopedic treatment. Our case shows that the OMA orthopedic appliance of maxillary protraction combined with mandibular retraction is effective for correcting skeletal Class III malocclusion with midface deficiency and mandibular prognathism in growing children with idiopathic short stature undergoing GH therapy. PMID:24331110

  1. Mandibular incisor extractions in orthodontics: pitfalls and triumphs: a report of three cases.

    PubMed

    Hegde, Chatura; Hegde, Manjunath

    2014-01-01

    Mandibular incisor extraction therapy has been used as a treatment option since the early 1900s to relieve tooth size-arch length discrepancies in the anterior segment of the mandible. The advantages of this therapy include potential reduction in treatment time, possibility of achieving better long-term stability in the mandibular anterior segment since inter canine width is not increased and maintenance of the soft-tissue profile because retraction of the mandibular incisors is less compared with mandibular premolar extractions These advantages are counterbalanced, however, by some potential disadvantages. The most significant of these is the possibility of the space reopening in the long term, an occlusal result less than ideal because of a significant tooth-mass reduction in the anterior mandibular region, development of an open gingival embrasure and the need for permanent or long term retention. We present three cases with three different indications for mandibular incisor extraction where the patient was benefited despite this atypical extraction pattern. PMID:25109054

  2. Percutaneous and skeletal biocarbon implants

    NASA Technical Reports Server (NTRS)

    Mooney, V.

    1977-01-01

    Review of carbon implants developed by NASA discussed four different types of implants and subsequent improvements. Improvements could be of specific interest to rehabilitation centers and similar organizations.

  3. Implantable, Ingestible Electronic Thermometer

    NASA Technical Reports Server (NTRS)

    Kleinberg, Leonard

    1987-01-01

    Small quartz-crystal-controlled oscillator swallowed or surgically implanted provides continuous monitoring of patient's internal temperature. Receiver placed near patient measures oscillator frequency, and temperature inferred from previously determined variation of frequency with temperature. Frequency of crystal-controlled oscillator varies with temperature. Circuit made very small and implanted or ingested to measure internal body temperature.

  4. Computer-aided resection and reconstruction in a case of aneurysmal bone cyst of the mandibular condylar head.

    PubMed

    Smolka, Wenko; Müller-Lisse, Ullrich; Sotlar, Karl; Cornelius, Carl-Peter

    2015-12-01

    A case is presented of a 16-year-old girl with an aneurysmal bone cyst (ABC) of the mandibular condyle of the temporomandibular joint (TMJ). This lesion rarely involves the mandibular condyle, and involvement of condylar head is even rarer. To our knowledge, only 12 cases have been reported in the literature so far. This is the first case of ABC of the mandibular condyle with 3D planning of costochondral graft reconstruction described in the literature. PMID:26129824

  5. Voxel-based registration of simulated and real patient CBCT data for accurate dental implant pose estimation

    NASA Astrophysics Data System (ADS)

    Moreira, António H. J.; Queirós, Sandro; Morais, Pedro; Rodrigues, Nuno F.; Correia, André Ricardo; Fernandes, Valter; Pinho, A. C. M.; Fonseca, Jaime C.; Vilaça, João. L.

    2015-03-01

    The success of dental implant-supported prosthesis is directly linked to the accuracy obtained during implant's pose estimation (position and orientation). Although traditional impression techniques and recent digital acquisition methods are acceptably accurate, a simultaneously fast, accurate and operator-independent methodology is still lacking. Hereto, an image-based framework is proposed to estimate the patient-specific implant's pose using cone-beam computed tomography (CBCT) and prior knowledge of implanted model. The pose estimation is accomplished in a threestep approach: (1) a region-of-interest is extracted from the CBCT data using 2 operator-defined points at the implant's main axis; (2) a simulated CBCT volume of the known implanted model is generated through Feldkamp-Davis-Kress reconstruction and coarsely aligned to the defined axis; and (3) a voxel-based rigid registration is performed to optimally align both patient and simulated CBCT data, extracting the implant's pose from the optimal transformation. Three experiments were performed to evaluate the framework: (1) an in silico study using 48 implants distributed through 12 tridimensional synthetic mandibular models; (2) an in vitro study using an artificial mandible with 2 dental implants acquired with an i-CAT system; and (3) two clinical case studies. The results shown positional errors of 67+/-34?m and 108?m, and angular misfits of 0.15+/-0.08° and 1.4°, for experiment 1 and 2, respectively. Moreover, in experiment 3, visual assessment of clinical data results shown a coherent alignment of the reference implant. Overall, a novel image-based framework for implants' pose estimation from CBCT data was proposed, showing accurate results in agreement with dental prosthesis modelling requirements.

  6. Graphene for Biomedical Implants

    NASA Astrophysics Data System (ADS)

    Moore, Thomas; Podila, Ramakrishna; Alexis, Frank; Rao, Apparao; Clemson Bioengineering Team; Clemson Physics Team

    2013-03-01

    In this study, we used graphene, a one-atom thick sheet of carbon atoms, to modify the surfaces of existing implant materials to enhance both bio- and hemo-compatibility. This novel effort meets all functional criteria for a biomedical implant coating as it is chemically inert, atomically smooth and highly durable, with the potential for greatly enhancing the effectiveness of such implants. Specifically, graphene coatings on nitinol, a widely used implant and stent material, showed that graphene coated nitinol (Gr-NiTi) supports excellent smooth muscle and endothelial cell growth leading to better cell proliferation. We further determined that the serum albumin adsorption on Gr-NiTi is greater than that of fibrinogen, an important and well understood criterion for promoting a lower thrombosis rate. These hemo-and biocompatible properties and associated charge transfer mechanisms, along with high strength, chemical inertness and durability give graphene an edge over most antithrombogenic coatings for biomedical implants and devices.

  7. Bone Morphometric Evaluation around Immediately Placed Implants Covered with Porcine-Derived Pericardium Membrane: An Experimental Study in Dogs.

    PubMed

    Jimbo, Ryo; Marin, Charles; Witek, Lukasz; Suzuki, Marcelo; Tovar, Nick; Chesnoiu-Matei, Ioana; Dragan, Irina Florentina; Coelho, Paulo G

    2012-01-01

    Objective. To investigate whether porcine-derived bioresorbable pericardium membrane coverage enhances the osseointegration around implants placed in fresh extraction sockets. Study Design. Twenty-four commercially available endosseous implants were placed in the fresh extraction sockets of the mandibular first molar of mature beagles (n = 6). On one side, implants and osteotomy sites were covered with porcine-derived bioresorbable pericardium membranes, whereas on the other side, no membranes were used. After 6 weeks, samples were retrieved and were histologically processed for histomorphometric analysis. Results. The histological observation showed that bone loss and soft tissue migration in the coronal region of the implant were evident for the control group, whereas bone fill was evident up to the neck of the implant for the membrane-covered group. Bone-to-implant contact was significantly higher for the membrane-covered group compared to the control group, 75% and 45% (P < 0.02), respectively. Conclusion. The experimental membranes proved to regenerate bone around implants placed in fresh extraction sockets without soft tissue intrusion. PMID:23227052

  8. Reduced mandibular range of motion in Duchenne Muscular Dystrophy: predictive factors.

    PubMed

    van Bruggen, H W; Van Den Engel-Hoek, L; Steenks, M H; Bronkhorst, E M; Creugers, N H J; de Groot, I J M; Kalaykova, S I

    2015-06-01

    Patients with Duchenne muscular dystrophy (DMD) experience negative effects upon feeding and oral health. We aimed to determine whether the mandibular range of motion in DMD is impaired and to explore predictive factors for the active maximum mouth opening (aMMO). 23 patients with DMD (mean age 16.7 ± 7.7 years) and 23 controls were assessed using a questionnaire about mandibular function and impairments. All participants underwent a clinical examination of the masticatory system, including measurement of mandibular range of motion and variables related to mandibular movements. In all patients, quantitative ultrasound of the digastric muscle and the geniohyoid muscle and the motor function measure (MFM) scale were performed. The patients were divided into early and late ambulatory stage (AS), early non-ambulatory stage (ENAS) and late non-ambulatory stage (LNAS). All mandibular movements were reduced in the patient group (P < 0.001) compared to the controls. Reduction in the aMMO (<40 mm) was found in 26% of the total patient group. LNAS patients had significantly smaller mandibular movements compared to AS and ENAS (P < 0.05). Multiple linear regression analysis for aMMO revealed a positive correlation with the body height and disease progression, with MFM total score as the strongest independent risk factor (R(2) = 0.71). Mandibular movements in DMD are significantly reduced and become more hampered with loss of motor function, including the sitting position, arm function, and neck and head control. We suggest that measurement of the aMMO becomes a part of routine care of patients with DMD. PMID:25600935

  9. A comparative study of incisor procumbency and mandibular morphology in vampire bats.

    PubMed

    Davis, Jillian S; Nicolay, Christopher W; Williams, Susan H

    2010-07-01

    The three species of vampire bats (Phyllostomidae: Desmodontinae), Desmodus rotundus, Diaemus youngi, and Diphylla ecaudata, are the only mammals that obtain all nutrition from vertebrate blood (sanguinivory). Because of the unique challenges of this dietary niche, vampire bats possess a suite of behavioral, physiological, and morphological specializations. Morphological specializations include a dentition characterized by small, bladelike, non-occlusive cheek teeth, large canines, and extremely large, procumbent, sickle-shaped upper central incisors. The tips of these incisors rest in cuplike pits in the mandible behind the lower incisors (mandibular pits). Here, we use microCT scanning and high-resolution radiography to describe the morphology of the mandible and anterior dentition in vampire bats, focusing on the relationship between symphyseal fusion, mandibular pit size, incisor size, and procumbency. In Desmodus and Diaemus, highly procumbent upper incisors are associated with relatively small mandibular pits, an unfused mandibular symphysis with substantial bony interdigitations linking the dentaries, and a diastema between the lower central incisors that helps to facilitate the lapping of blood from a wound. In Diphylla, less procumbent upper incisors are associated with relatively large mandibular pits, a completely fused mandibular symphysis, and a continuous lower toothrow lacking a central diastema. We hypothesize that symphyseal morphology and the presence or absence of the diastema are associated with the angle of upper incisor procumbency and mandibular pit development, and that spatial constraints influence the morphology of the symphysis. Finally, this morphological variation suggests that Diphylla utilizes a different feeding strategy as compared to Desmodus and Diaemus, possibly resulting from the functional demands of specialization on avian, rather than mammalian, blood. PMID:20544874

  10. Occlusal morphology of permanent mandibular first and second molars in Gujarati population

    PubMed Central

    Dholia, Bhavik; Manjunatha, Bhari Sharanesha

    2015-01-01

    Background: Dental identification has been used since long time for disaster victim identification protocol. There is a difference of opinion regarding whether ethnicity influences dental morphology or not. Few studies have shown the associations between these dental features and crown traits in humans using quantitative methods. The present study is an attempt to find correlation of occlusal morphology of Gujarati population with forensic Odontology. Aim: To study different occlusal morphology of permanent mandibular first and second molars in Gujarati Population. Materials and Methods: This study comprised of a total of 100 participants of Gujarati origin, selected by random sampling method. Total number of cusps and groove patterns of mandibular first and second molar were examined clinically and photographs of the same were taken. A descriptive statistics, Chi-square test and Student t-test were used for analysis of data. Results: Mandibular first molar with 5 cusps in 71%, 4 cusps in 18% and 6 cusps in 11% were noted in the study. Mandibular first molars with “+” groove pattern in 39.5% and “Y” groove pattern in 60.5% were recorded. Mandibular second molar with 5 cusps in 6.5% and 4 cusps in 93.5% were recorded in the study. Mandibular second molars with “+” groove pattern in 93.5% and “Y” groove pattern in 6.5% were recorded. Conclusion: The most common occlusal morphology in permanent mandibular first molar is “5 cusp” and “Y” groove pattern in about 47% and for second molar is “4 cusp” and “+” groove pattern in 88.5% of Gujarati population. It may be concluded that variation in degree of expression and frequency of teeth in dentitions of different populations is different, which may help in forensic identification. PMID:26005303

  11. Deferoxamine enhances bone regeneration in mandibular distraction osteogenesis

    PubMed Central

    Farberg, Aaron S.; Sarhaddi, Deniz; Donneys, Alexis; Deshpande, Sagar S.; Buchman, Steven R.

    2015-01-01

    Background Distraction osteogenesis (DO) is a powerful reconstructive technique for bone growth and repair. An angiogenic means to enhance the efficacy of this metabolically demanding procedure would be beneficial in expanding its therapeutic potential. We posit that the angiogenic effect of Deferoxamine (DFO), an iron chelator that has been shown to increase angiogenesis, will improve bone regeneration via augmentations in quality and quantity of bone and bone producing cells. Methods Two groups of rats (n=12) underwent surgical external fixation and subsequent distraction. During the distraction stage, the experimental DFO group (n=5) was treated with injections into the distraction gap. After 28 days of consolidation, mandibles were harvested and prepared for histological analysis. Results We found a proliferation of osteocytes in the DFO treated group when compared to the regenerate (RG) of the control group. DFO effected a significant increase in osteocytes, as well as increase in bone volume fraction with subsequent decreased osteoid volume fraction. The data also demonstrated no significant difference in empty lacunae. Conclusions Our study demonstrates the effectiveness of DFO treatment to enhance the number of osteocytes within the RG in a murine mandibular DO model. Maintenance of full lacunae supports our findings of a robust cellular response to DFO therapy. These results suggest that the angiogenic capabilities of DFO translate into an increase in number of bone forming cells in the RG. DFO may have utility in optimizing bone formation in DO and lead to superior reconstructive capabilities for craniofacial surgeons in the future. PMID:24572857

  12. Trigeminocardiac reflexes: maxillary and mandibular variants of the oculocardiac reflex.

    PubMed

    Lang, S; Lanigan, D T; van der Wal, M

    1991-09-01

    Three case reports are presented to illustrate the existence and importance of reflex bradycardic responses that can occur during maxillofacial surgical procedures. All three patients were healthy young adults undergoing operations which did not include any manipulation of orbital structures. After the patients had been anaesthetized for some time and were haemodynamically stable, profound bradycardia or ventricular asystole occurred suddenly in response to manipulations of the bony structures of the maxilla or mandible, or dissection of, or traction on, the attached soft tissue structures. The parasympathetic supply to the face is carried in the trigeminal nerve. Alternative afferent pathways must exist via the maxillary and/or mandibular divisions, in addition to the commonly reported pathway via the ophthalmic division of the trigeminal nerve in the classic oculocardiac reflex. The efferent arc involves the vagus, regardless of which branch of the trigeminal nerve transmits the afferent impulses. All patients undergoing maxillofacial procedures should be monitored carefully for reflex bradycardia and ventricular asystole. PMID:1914059

  13. Mandibular involvement of solitary plasmocytoma: a case report.

    PubMed

    Canger, Emin Murat; Celenk, Peruze; Alkan, Alper; Günhan, Omer

    2007-01-01

    Plasma cell neoplasms (multiple myeloma, solitary plasmocytoma of bone and extra medullar plasmocytoma) are characterized by a monoclonal neoplastic proliferation of plasma cells. Solitary plasmocytoma of bone (SPB) is a localized form of them. SPB is most frequently seen in vertebrae and secondarily in long bones. Its presence in jaws is extremely rare and when it is seen, angulus and ramus mandible are most common sites of occurrence. Prognosis of SPB is worse than extra medullar plasmacytoma (EMP) and approximately 50% of SPB will transform to multiple myelom. A 76-year old woman consulted to our clinic with a chief complaint of slowly developed swelling in her mandible. She had an operation from caput femur because of plasmocytoma two months before. Panoramic radiography revealed a radiolucent lesion in the mandibular anterior region, 60x35 mm in dimension. Aspiration biopsy was performed and histopathological examination was reported as plasmocytoma. She was referred to the oncology department for treatment but died before the treatment finished. PMID:17195833

  14. Dental Implant Systems

    PubMed Central

    Oshida, Yoshiki; Tuna, Elif B.; Aktören, Oya; Gençay, Koray

    2010-01-01

    Among various dental materials and their successful applications, a dental implant is a good example of the integrated system of science and technology involved in multiple disciplines including surface chemistry and physics, biomechanics, from macro-scale to nano-scale manufacturing technologies and surface engineering. As many other dental materials and devices, there are crucial requirements taken upon on dental implants systems, since surface of dental implants is directly in contact with vital hard/soft tissue and is subjected to chemical as well as mechanical bio-environments. Such requirements should, at least, include biological compatibility, mechanical compatibility, and morphological compatibility to surrounding vital tissues. In this review, based on carefully selected about 500 published articles, these requirements plus MRI compatibility are firstly reviewed, followed by surface texturing methods in details. Normally dental implants are placed to lost tooth/teeth location(s) in adult patients whose skeleton and bony growth have already completed. However, there are some controversial issues for placing dental implants in growing patients. This point has been, in most of dental articles, overlooked. This review, therefore, throws a deliberate sight on this point. Concluding this review, we are proposing a novel implant system that integrates materials science and up-dated surface technology to improve dental implant systems exhibiting bio- and mechano-functionalities. PMID:20480036

  15. Implant-Supported Prosthetic Rehabilitation of a Patient with Localized Severe Attrition: A Clinical Report.

    PubMed

    Cekic-Nagas, Isil; Ergun, Gulfem

    2015-06-01

    Patients usually adapt to their existing occlusal vertical dimension (OVD). It is essential to resolve each of the problems associated with decreased vertical dimension as a result of attrition. This report describes the multidisciplinary dental treatment of a 40-year-old male patient who had severe tooth wear, resulting in reduced vertical dimension. After clinical evaluations, extraoral examination showed a reduction of the lower facial height, drooping, and overclosed commissures. Ten dental implants were placed into the maxillary and mandibular alveolar processes. During the osseointegration period, an interim removable partial denture was made at increased OVD to use in the first stage of rehabilitation. It was used for 3 months as a guide for preparing the definitive restorations. The patient's adaptation to the increased OVD was evaluated. During this period, he was asymptomatic. Following the evaluation period, the provisional fixed restoration was used for 3 months. Then, full-mouth definitive prostheses supported by a combination of implants and teeth were fabricated to upper and lower jaws. Osseointegration of the implants, peri-implant mucosa health, prosthesis function, and esthetics were assessed after 1 week and 1, 3, and 6 months. After 3 years of follow-up, no functional or esthetic difficulties with the implants and restorations were noted. PMID:25219770

  16. Oxygen implanter for simox

    NASA Astrophysics Data System (ADS)

    Guerra, M.; Benveniste, V.; Ryding, G.; Douglas-Hamilton, D. H.; Reed, M.; Gagne, G.; Armstrong, A.; Mack, M.

    1985-01-01

    Interest in silicon or) insulator (SOI) technology has led to the development of several alternatives to silicon on sapphire. One of the most promising techniques makes use of an ion implanter to form a buried oxide layer directly in the silicon substrate. To have useful single crystalline silicon on top of the oxide layer, it is necessary to do the implant at high wafer temperatures and rely on solid phase epitaxy to maintain surface structure. A high current, 160 keV, Nova ion implanter has been adapted to provide the ability to perform oxygen implants at elevated temperatures. The operator is free to choose any temperature in the range between 400°C and 600°C. The system then preheats the wafers to the selected temperature before the implant begins. A novel technique for providing both heating and cooling capability to the end station is employed. An infrared signal from the wafers is monitored by a room temperature lead salt detector. This signal is then used by a servo-loop to control the heating of the end station and to maintain the wafer temperature to within ± 20°C during the implant. High doses of the type necessary to form a silicon dioxide buried layer require long lived, high current oxygen sources. An oxygen source has been specially developed, which provides as much as 10 mA of ion current. At a 6 mA output, source lifetimes in excess of 40 hours have been achieved. The implanter uses a specifically designed high temperature disk, which holds ten wafers, each of four inch diameter. A variety of implant angles lying between 0° and 15° is available. The beam is scanned mechanically and an electron flood gun can be used to prevent wafer charging. Special thermal barriers have been employed to protect the apparatus from extreme temperatures and to make the heating sequence more efficient and more rapid. Every effort has been made to avoid contamination of the implant. The implant disk, for example, is overcoated with silicon monoxide. Silicon apertures have also been designed for the machine. The implanter has been used to do a high current oxygen implant with a dose of 1.25 × 10 18/cm 2, at a temperature of 570°C. Preliminary analysis of the results is very promising.

  17. Deformation of implant abutments after framework connection using strain gauges.

    PubMed

    Hollweg, Henrique; Jacques, Letícia Borges; da Silva Moura, Márcio; Bianco, Vinícius Cappo; Souza, Edson Antonio Capello; Rubo, José Henrique

    2012-04-01

    When a cylinder is connected to an abutment it is expected that abutment and cylinder will be subjected to compression forces throughout their periphery because of the clamping force exerted by the screw. The deformation resultant of this compression should be measurable and uniform along the periphery of the abutment. Considering that multiple retainers connected to each other can affect the fit of a framework, as well as the use of different alloys, it is expected that the abutments will present different levels of deformation as a result of framework connection. The aim of this study was to evaluate the deformation of implant abutments after frameworks, cast either in cobalt-chromium (CoCr) or silver-palladium (AgPd) alloys, were connected. Samples (n ?=? 5) simulating a typical mandibular cantilevered implant-supported prosthesis framework were fabricated in cobalt-chromium and silver-palladium alloys and screwed onto standard abutments positioned on a master-cast containing 5 implant replicas. Two linear strain gauges were fixed on the mesial and distal aspects of each abutment to capture deformation as the retention screws were tightened. A combination of compressive and tensile forces was observed on the abutments for both CoCr and AgPd frameworks. There was no evidence of significant differences in median abutment deformation levels for 9 of the 10 abutment aspects. Visually well-fit frameworks do not necessarily transmit load uniformly to abutments. The use of CoCr alloy for implant-supported prostheses frameworks may be as clinically acceptable as AgPd alloy. PMID:22568468

  18. Comparison of articaine and prilocaine anesthesia by infiltration in maxillary and mandibular arches.

    PubMed Central

    Haas, D. A.; Harper, D. G.; Saso, M. A.; Young, E. R.

    1990-01-01

    Claims that labial infiltration of the local anesthetic articaine HCl (Ultracaine DS) results in anesthesia of mandibular pulpal as well as maxillary and mandibular lingual soft tissue have never been scientifically substantiated. The aim of this investigation was to evaluate these claims, by comparing articaine to a standard anesthetic, prilocaine HCl (Citanest Forte). To investigate this, a double blind, randomized study was conducted in healthy adult volunteers. In each volunteer, the ability to induce maxillary and mandibular anesthesia following labial infiltration with articaine was compared to prilocaine given contralaterally. Anesthesia was determined by measuring sensation to electrical stimulation at the tooth, labial and lingual soft tissue for each of the 4 non-carious, non-restored, canines. Results showed that mandibular canine pulpal anesthesia had a success rate of 65% for articaine and 50% for prilocaine. Success rates for palatal and lingual anesthesia averaged 5% for each agent. As determined by chi-square analysis, no statistically significant differences were found between articaine and prilocaine for any tissue at any of the 6 sites (P greater than 0.05). A time-course assessment also failed to demonstrate a difference between the two drugs. Therefore these data are not consistent with superior anesthesia efficacy being produced by articaine at any site, including the mandibular pulpal, lingual or maxillary palatal tissues, in the canine teeth studied. PMID:2096746

  19. Intraoperative Hemorrhage and Postoperative Sequelae after Intraoral Vertical Ramus Osteotomy to Treat Mandibular Prognathism

    PubMed Central

    Chen, Chun-Ming; Lai, Steven; Chen, Ker-Kong; Lee, Huey-Er

    2015-01-01

    Objective. To investigate the factors affecting intraoperative hemorrhage and postoperative sequelae after orthognathic surgery. Materials and Methods. Eighty patients with mandibular prognathism underwent surgical mandibular setback with intraoral vertical ramus osteotomy (IVRO). The correlation between the blood loss volume and postoperative VAS with the gender, age, and operating time was assessed using the t-test and Spearman rank correlation coefficient. The correlation between the magnitude of mandibular setback with the presence of TMJ clicking symptoms and lip sensation was also assessed. Results. The mean operating time and blood loss volume for men and women were 249.52?min and 229.39?min, and 104.03?mL and 86.12?mL, respectively. The mean VAS in men and women was 3.21 and 2.93, and 1.79 and 1.32 on the first and second postoperative days. There is no gender difference in the operating time, blood loss, VAS, TMJ symptoms, and lip numbness. The magnitude of mandibular setback was not correlated with immediate and long-term postoperative lip numbness. Conclusion. There are no gender differences in the intraoperative hemorrhage and postoperative sequelae (pain, lip numbness, and TMJ symptoms). In addition, neither symptom was significantly correlated with the amount of mandibular setback. PMID:26543855

  20. Effect of umbilical cord mesenchymal stem cell in peri-implant bone defect after immediate implant: an experiment study in beagle dogs

    PubMed Central

    Hao, Peng-Jie; Wang, Zhi-Guo; Xu, Quan-Chen; Xu, Sheng; Li, Zhuo-Ri; Yang, Pi-Shan; Liu, Zhong-Hao

    2014-01-01

    Background: For the sake of reducing post extraction resorption, getting optimal positioning of the implant and shortening treatment time, immediate implant placement following tooth extraction has been proposed as a treatment option. However, the large bone defect peri-implant has a negative influence on the process of bone healing. In this study, umbilical cord mesenchymal stem cells (UCMSCs) were transplanted into the bone defect peri-implant inbeagle dogs and the effect of UCMSCs on bone regeneration in peri-implant were assessed. Methods: The mandibular second, third and fourth premolars of 8 beagle dogs were extracted bilaterally. The defects in one side were filled with platelet-rich fibrin (PRF) and then UCMSCs were injected into the defect area, while the defects in the other side were filled with PRF only as control group. The titanium implant was placed into the distal root socket of each extracted tooth. The animals were sacrificed at week 2, 4 and 8 post operative. The bone defects adjacent to the implant which are 4 mm in height, 4 mm in the mesio-distal direction and 3.5 mm in the bucco-lingual direction were made after immediate implant. Histomorphometric analysis was performed using methylene blue-fuchsin acid staining and hematoxylin and eosin (HE) staining to evaluate bone regeneration. Results: The direct bone-to-implant contact (BIC) in the experiment after 4 and 8 weeks was 56.47±1.18% and 76.23±2.08%; and in the control group was40.79±0.65% and 61.17±2.79%, respectively. The percentage of newly formed bone after 2, 4 and 8 weeks was 17.60±1.5%, 49.82±4.02% and 67.16±2.1% in experiment group; and in control group 14.30±1.25%, 37.04±2.29% and 58.83±3.36%, respectively. These results represented significant differences statistically. Conclusion: Intra-bone marrow injection of UCMSCs can promote new bone formation. UCMSCs can be used to as excellent seed cells to repair the large defect peri-implant after immediate implant. PMID:25550885

  1. Evaluation in a Dog Model of Three Antimicrobial Glassy Coatings: Prevention of Bone Loss around Implants and Microbial Assessments

    PubMed Central

    López-Píriz, Roberto; Solá-Linares, Eva; Rodriguez-Portugal, Mercedes; Malpica, Beatriz; Díaz-Güemes, Idoia; Enciso, Silvia; Esteban-Tejeda, Leticia; Cabal, Belén; Granizo, Juan José; Moya, José Serafín; Torrecillas, Ramón

    2015-01-01

    Objectives The aim of the present study is to evaluate, in a ligature-induced peri-implantitis model, the efficacy of three antimicrobial glassy coatings in the prevention of biofilm formation, intrasulcular bacterial growth and the resulting peri-implant bone loss. Methods Mandibular premolars were bilaterally extracted from five beagle dogs. Four dental implants were inserted on each hemiarch. Eight weeks after, one control zirconia abutment and three with different bactericidal coatings (G1n-Ag, ZnO35, G3) were connected. After a plaque control period, bacterial accumulation was allowed and biofilm formation on abutments was observed by Scanning Electron Microscopy (SEM). Peri-implantitis was induced by cotton ligatures. Microbial samples and peri-implant crestal bone levels of all implant sites were obtained before, during and after the breakdown period. Results During experimental induce peri-implantitis: colony forming units counts from intrasulcular microbial samples at implants with G1n-Ag coated abutment remained close to the basal inoculum; G3 and ZnO35 coatings showed similar low counts; and anaerobic bacterias counts at control abutments exhibited a logarithmic increase by more than 2. Bone loss during passive breakdown period was no statistically significant. Additional bone loss occurred during ligature-induce breakdown: 0.71 (SD 0.48) at G3 coating, 0.57 (SD 0.36) at ZnO35 coating, 0.74 (SD 0.47) at G1n-Ag coating, and 1.29 (SD 0.45) at control abutments; and statistically significant differences (p<0.001) were found. The lowest bone loss at the end of the experiment was exhibited by implants dressing G3 coated abutments (mean 2.1; SD 0.42). Significance Antimicrobial glassy coatings could be a useful tool to ward off, diminish or delay peri-implantitis progression. PMID:26489088

  2. Ion implantation at elevated temperatures

    SciTech Connect

    Lam, N.Q.; Leaf, G.K.

    1985-11-01

    A kinetic model has been developed to investigate the synergistic effects of radiation-enhanced diffusion, radiation-induced segregation and preferential sputtering on the spatial redistribution of implanted solutes during implantation at elevated temperatures. Sample calculations were performed for Al and Si ions implanted into Ni. With the present model, the influence of various implantation parameters on the evolution of implant concentration profiles could be examined in detail.

  3. Biocompatibility of surgical implants

    NASA Technical Reports Server (NTRS)

    Kaelble, D. H.

    1979-01-01

    Method of selecting biocompatible materials for surgical implants uses fracture mechanic relationships and surface energies of candidate materials in presence of blood plasma. Technique has been used to characterize 190 materials by parameters that reflect their biocompatibility.

  4. Risks of Breast Implants

    MedlinePLUS

    ... larger and longer than these conducted so far. Breastfeeding Some women who undergo breast augmentation can successfully ... breast implant silicone shell into breast milk during breastfeeding. Although there are currently no established methods for ...

  5. Superelastic Orthopedic Implant Coatings

    NASA Astrophysics Data System (ADS)

    Fournier, Eric; Devaney, Robert; Palmer, Matthew; Kramer, Joshua; El Khaja, Ragheb; Fonte, Matthew

    2014-07-01

    The demand for hip and knee replacement surgery is substantial and growing. Unfortunately, most joint replacement surgeries will fail within 10-25 years, thereby requiring an arduous, painful, and expensive revision surgery. To address this issue, a novel orthopedic implant coating material ("eXalt") has been developed. eXalt is comprised of super elastic nitinol wire that is knit into a three-dimensional spacer fabric structure. eXalt expands in vivo to conform to the implantation site and is porous to allow for bone ingrowth. The safety and efficacy of eXalt were evaluated through structural analysis, mechanical testing, and a rabbit implantation model. The results demonstrate that eXalt meets or exceeds the performance of current coating technologies with reduced micromotion, improved osseointegration, and stronger implant fixation in vivo.

  6. A stereomicroscopy study of root apices of human maxillary central incisors and mandibular second premolars in an Iranian population.

    PubMed

    Rahimi, Saeed; Shahi, Shahriar; Yavari, Hamid R; Reyhani, Mohammad F; Ebrahimi, Mohammad E; Rajabi, Eeinollah

    2009-09-01

    Mandibular second premolars and maxillary central incisors usually have one root, one canal, and one apical foramen. However, some studies have revealed anatomic variations in these teeth. The aim of the present study was to investigate such variations in canal configuration, foramina, lateral and accessory canals and apical deltas in the root apex of human maxillary central incisors and mandibular second premolars, using a clearing technique and stereomicroscopy. One hundred maxillary central incisors and 137 mandibular second premolars were collected, and India ink was injected into their canals. The teeth were then demineralized with 0.5 N nitric acid, cleared with methyl salicylate, and studied at x 5 and x 16 magnification. The incidence of one canal and one apical foramen was 100% for maxillary central incisors and 94.16% for mandibular second premolars. The main apical foramen was located in the center of the root apex in 21.89% and 17% of mandibular second premolars and maxillary central incisors, respectively. Lateral and accessory canals were found in 84.50% and 77.15% of maxillary central incisors and mandibular second premolars, respectively. Several foramina were found in 11% of maxillary central incisors and 24.08% of mandibular second premolars. Apical deltas were seen in 4.38% and 2% of mandibular second premolars and maxillary central incisors, respectively. The rate of anatomic variations in the apical part of the tooth, especially in posterior teeth, is thus considered to be high. PMID:19776508

  7. Pedicled lingual flap to provide keratinized tissue regeneration over dental implants: a description of the technique and a case report.

    PubMed

    Herford, Alan S; Tandon, Rahul; Pivetti, Luca; Cicciù, Marco

    2015-04-01

    The aim of this study is to report the efficacy of a lingual pedicle flap for soft tissue pre-prosthetic surgery in implant rehabilitation. While it has been demonstrated that keratinized gingiva is an important factor for implant success, there remains a dearth of case reports concerning the use of a lingual pedicle flap to achieve this desired outcome in such a large reconstructive effort. For this case report, the patient underwent an anterior mandibular resection of an ameloblastoma and subsequent reconstruction, resulting in soft tissue loss. To satisfy the patient's desires, both functionally and esthetically, a bilateral rotated pedicled lingual flap was performed to augment keratinized tissue on the anterior mandibular ridge. An additional vestibuloplasty with two collagen matrices was also performed, and an acrylic splint was then applied to achieve better stabilization. The primary outcome was to evaluate the efficacy of this technique, which, until now, was used only for exposed root coverage. The site demonstrated excellent healing over time, even resulting in an excess of healthy and pink soft tissue, which later had to be corrected with a small gingivectomy. Although the patient reported slight discomfort for a few days after surgery, she was nonetheless pleased both with her ability to function and her appearance. The results of this study show that the bilateral rotated pedicled lingual flap is a viable technique for the correction of soft tissue defects in implant dentistry, providing a good amount of keratinized gingiva. PMID:23425252

  8. Simple Implant Augmentation Rhinoplasty.

    PubMed

    Nguyen, Anh H; Bartlett, Erica L; Kania, Katarzyna; Bae, Sang Mo

    2015-11-01

    Augmentation rhinoplasty among Asian patients is often performed to improve the height of the nasal dorsum. As the use of autogenous tissues poses certain limitations, alloplastic materials are a viable alternative with a long history of use in Asia. The superiority of one implant prosthesis over another for augmentation rhinoplasty is a matter of debate, with each material representing varying strengths and weaknesses, indications for use, and precautions to consider in nasal implant placement. An implant prosthesis should be used on a case-by-case basis. Augmentation rhinoplasty requires the consideration of specific anatomical preoperative factors, including the external nose, nasal length, nasofrontal angle, humps, and facial proportions. It is equally important to consider several operative guidelines to appropriately shape implants to minimize the occurrence of adverse effects and postoperative complications. The most common postoperative complications include infection, nasal height change, movement of implant prosthesis, and silicone implant protrusion. In addition, the surgeon should consider the current standards of Asian beauty aesthetics to better understand the patient's desired outcome. PMID:26648804

  9. Biomaterials in cochlear implants

    PubMed Central

    Stöver, Timo; Lenarz, Thomas

    2011-01-01

    The cochlear implant (CI) represents, for almost 25 years now, the gold standard in the treatment of children born deaf and for postlingually deafened adults. These devices thus constitute the greatest success story in the field of ‘neurobionic’ prostheses. Their (now routine) fitting in adults, and especially in young children and even babies, places exacting demands on these implants, particularly with regard to the biocompatibility of a CI’s surface components. Furthermore, certain parts of the implant face considerable mechanical challenges, such as the need for the electrode array to be flexible and resistant to breakage, and for the implant casing to be able to withstand external forces. As these implants are in the immediate vicinity of the middle-ear mucosa and of the junction to the perilymph of the cochlea, the risk exists – at least in principle – that bacteria may spread along the electrode array into the cochlea. The wide-ranging requirements made of the CI in terms of biocompatibility and the electrode mechanism mean that there is still further scope – despite the fact that CIs are already technically highly sophisticated – for ongoing improvements to the properties of these implants and their constituent materials, thus enhancing the effectiveness of these devices. This paper will therefore discuss fundamental material aspects of CIs as well as the potential for their future development. PMID:22073103

  10. Fusion of a supernumerary tooth to right mandibular second molar: a case report and literature review

    PubMed Central

    Zhu, Min; Liu, Chao; Ren, Shuangshuang; Lin, Zintong; Miao, Leiying; Sun, Weibin

    2015-01-01

    Gemination or fusion is a rare occurrence in the mandibular posterior teeth. The aim of this article is to describe the problems encountered and the strategy employed in treating such cases. A 34 years old patient came with the complaint of spontaneous and radiating pain in the right mandibular posterior region. The tooth in concern was an anomalous ‘double’ second mandibular molar diagnosed as having necrotic pulp with chronic apical abscess of endodontic origin. The present case emphasizes the importance of identifying anatomical anomalies during treatment of fused teeth with supernumerary tooth, and the need for the use of advanced imaging modalities like CBCT which is a critical aid in the diagnosis of such cases. Fused teeth can be managed quite efficiently by an overall combined treatment including both endodontic and periodontal therapy. PMID:26550101

  11. Manual reduction of articular disc after traumatic extraction of mandibular third molar: a case report

    PubMed Central

    Camino, Rubens; Manzi, Marcello Roberto; de Carvalho, Matheus Furtado; Luz, João Gualberto de Cerqueira; Pimentel, Angélica Castro; Deboni, Maria Cristina Zindel

    2015-01-01

    Introduction: Disc displacement without reduction with limited opening is an intracapsular biomechanical disorder involving the condyle-disc complex. With the mouth closed, the disc is in an anterior position in relation to the condylar head and does not reduce with mouth opening. This disorder is associated with persistent limited mandibular opening. Case report: The patient presented severe limitation to fully open the mouth, interfering in her ability to eat. Clinical examination also revealed maximum assisted jaw opening (passive stretch) with less than 40 mm of maximum interincisal opening. Magnetic resonance imaging was the method of choice to identify the temporomandibular disorders. Conclusion: By means of reporting this rare case of anterior disc displacement without reduction with limited opening, after traumatic extraction of a mandibular third molar, in which manual reduction of temporomandibular joint articular disc was performed, it was possible to prove that this technique is effective in the prompt restoration of mandibular movements. PMID:26560828

  12. Prosthodontic rehabilitation of patient with marginal mandibular resection using attachment supported prostheses: A clinical report

    PubMed Central

    Mundhe, Kailas; Pruthi, Gunjan; Jain, Veena

    2014-01-01

    Marginal mandibular resection to treat neoplasms leads to loss of alveolar bone and teeth at the affected side. Consequently patient suffers with poor masticatory performance and esthetic disfigurement, which we need to restore with the help of prosthodontic rehabilitation. The success of rehabilitation of these patients depends on strategic treatment planning and choice of most suitable treatment modality. In this article, case of a patient has been presented who underwent marginal mandibular resection and reported with many limiting factors like obliterated buccal and lingual sulci, attachment of lingual frenum and lower lip at the level of alveolar ridge and Macroglossia. Impression making and fabrication of a retentive prosthesis were the main challenges. Therefore, a modified impression technique was used to fabricate mandibular cast partial denture with extracoronal semi precision attachments to enhance the retention of the prosthesis. PMID:24808712

  13. A Complex Facial Trauma Case with Multiple Mandibular Fractures and Dentoalveolar Injuries

    PubMed Central

    Guven, Yeliz; Zorlu, Sevgi; Cankaya, Abdulkadir Burak; Aktoren, Oya; Gencay, Koray

    2015-01-01

    The principles of management of mandibular fractures differ in children when compared to adults and depend on the specific age-related status of the growing mandible and the developing dentition. This paper presents a case report with a complex facial trauma affecting the mandibular body and condyle region and dentoalveolar complex. Clinical examination revealed soft tissue injuries, limited mouth opening, lateral deviation of the mandible, an avulsed incisor, a subluxated incisor, and a fractured crown. CBCT examination revealed a nondisplaced fracture and an oblique greenstick fracture of the mandibular body and unilateral fracture of the condyle. Closed reduction technique was chosen to manage fractures of the mandible. Favorable healing outcomes on multiple fractures of the mandible throughout the 6-year follow-up period proved the success of the conservative treatment. This case report is important since it presents a variety of pathological sequelae to trauma within one case. PMID:26339511

  14. Unusual intrabony transmigration of mandibular canine: case series (report of 4 cases).

    PubMed

    Tarsariya, Vivek Muljibhai; Jayam, Cheranjeevi; Parmar, Yuvaraj Suryakant; Bandlapalli, Anila

    2015-01-01

    Intrabony cross arch migration (transmigration) of impacted teeth is a very rare dental anomaly. Transmigration is commonly seen in permanent dentition of the lower jaw. The tooth most commonly involved is the mandibular canine. The prevalence of transmigrated canine has been found to be only 0.14-0.31%. Transmigration of the canine most frequently occurs in a mesial direction resulting in migration across the mandibular symphysis to the opposite side of the dental arch. We report a case series (4 cases) of rare transmigration of mandibular canines and emphasise the need to use panoramic radiography in cases presenting with either over retained deciduous canines and/or missing permanent canines. We also propose a newer modification to the present classification of transmigration for one of these cases as the present classification does not include all the entities. PMID:26361803

  15. Inferior Alveolar Nerve Injuries Associated with Mandibular Fractures at Risk: A Two-Center Retrospective Study

    PubMed Central

    Boffano, Paolo; Roccia, Fabio; Gallesio, Cesare; Karagozoglu, K.; Forouzanfar, Tymour

    2014-01-01

    The aim of the study was to investigate the incidence of the inferior alveolar nerve (IAN) injury in mandibular fractures. This study is based on two databases that have continuously recorded patients hospitalized with maxillofacial fractures in two departments—Department of Maxillofacial Surgery, Vrije Universiteit University Medical Center, Amsterdam, the Netherlands, and Division of Maxillofacial Surgery, San Giovanni Battista Hospital, Turin, Italy. Demographic, anatomic, and etiology variables were considered for each patient and statistically assessed in relation to the neurosensory IAN impairment. Statistically significant associations were found between IAN injury and fracture displacement (p?=?0.03), isolated mandibular fractures (p?=?0.01), and angle fractures (p?=?0.004). A statistically significant association was also found between IAN injury and assaults (p?=?0.03). Displaced isolated mandibular angle fractures could be considered at risk for increased incidence of IAN injury. Assaults seem to be the most important etiological factor that is responsible for IAN lesions. PMID:25383147

  16. Orthodontic treatment of a mandibular incisor fenestration resulting from a broken retainer.

    PubMed

    Farret, Marcel M; Farret, Milton M B; da Luz Vieira, Gustavo; Assaf, Jamal Hassan; de Lima, Eduardo Martinelli S

    2015-08-01

    This article describes the orthodontic relapse with mandibular incisor fenestration in a 36-year-old man who had undergone orthodontic treatment 21 years previously. The patient reported that his mandibular 3 × 3 bonded retainer had been partially debonded and broken 4 years earlier. The mandibular left lateral incisor remained bonded to the retainer and received the entire load of the incisors; consequently, there was extreme labial movement of the root, resulting in dental avulsion. As part of the treatment, the root was repositioned lingually using a titanium-molybdenum segmented archwire for 8 months, followed by endodontic treatment, an apicoectomy, and 4 months of alignment and leveling of both arches. The treatment outcomes were excellent, and the tooth remained stable, with good integrity of the mesial, distal, and lingual alveolar bones and periodontal ligament. The 1-year follow-up showed good stability of the results. PMID:26232842

  17. An Evaluation of Pathologic Changes in the Follicle of Impacted Mandibular Third Molars

    PubMed Central

    Tambuwala, Aruna Azhar; Oswal, Rakesh Gulabchand; Desale, Rushikesh Suresh; Oswal, Nitin Prakash; Mall, Prashant Edwin; Sayed, Aatif Riyaz; Pujari, Aniket Tarachand

    2015-01-01

    Background: The purpose of this study was to evaluate the early pathologic changes in the follicular tissue of completely impacted mandibular third molar. Materials and Methods: 52 patients, between 18 and 52 years of age of which 25 were males and 27 were females, were selected. They had impacted mandibular third molars, which were indicated for extraction. After extraction, the follicle was sent for a histopathological evaluation to two different oral pathologists. Results: The results showed that 80.8% of the specimen had normal follicles. 11.5% specimen suggested cystic changes while 7.7% suggested infected follicle. Conclusion: It is desirable to consider prophylactic removal of impacted mandibular third molar presenting at a younger age, whereas their removal remains an enigma for the older age group and should only be considered appropriate in those cases where frank causes for its removal are established. PMID:25954073

  18. Radix Entomolaris in Mandibular First Molars in Indian Population: A Review and Case Reports

    PubMed Central

    Attam, Kanika; Nawal, Ruchika Roongta; Utneja, Shivani; Talwar, Sangeeta

    2012-01-01

    Purpose. The aim of this paper is to present cases of mandibular first molars with an additional distolingual root and their management using appropriate instruments and techniques. Basic Procedures and Main Findings. Mandibular molars can sometimes present a variation called radix entomolaris, wherein the tooth has an extra root attached to its lingual aspect. This additional root may complicate the endodontic management of the tooth if it is misdiagnosed or maltreated. This paper reviews the prevalence of such cases in Indian population and reports the management of 6 such teeth. Principal Conclusions. (1) It is crucial to be familiar with variations in tooth/canal anatomy and characteristic features since such knowledge can aid location and negotiation of canals, as well as their subsequent management. (2) Accurate diagnosis and careful application of clinical endodontic skill can favorably alter the prognosis of mandibular molars with this root morphology. PMID:23125938

  19. Chondrocytes Directly Transform into Bone Cells in Mandibular Condyle Growth.

    PubMed

    Jing, Y; Zhou, X; Han, X; Jing, J; von der Mark, K; Wang, J; de Crombrugghe, B; Hinton, R J; Feng, J Q

    2015-12-01

    For decades, it has been widely accepted that hypertrophic chondrocytes undergo apoptosis prior to endochondral bone formation. However, very recent studies in long bone suggest that chondrocytes can directly transform into bone cells. Our initial in vivo characterization of condylar hypertrophic chondrocytes revealed modest numbers of apoptotic cells but high levels of antiapoptotic Bcl-2 expression, some dividing cells, and clear alkaline phosphatase activity (early bone marker). Ex vivo culture of newborn condylar cartilage on a chick chorioallantoic membrane showed that after 5 d the cells on the periphery of the explants had begun to express Col1 (bone marker). The cartilage-specific cell lineage-tracing approach in triple mice containing Rosa 26(tdTomato) (tracing marker), 2.3 Col1(GFP) (bone cell marker), and aggrecan Cre(ERT2) (onetime tamoxifen induced) or Col10-Cre (activated from E14.5 throughout adult stage) demonstrated the direct transformation of chondrocytes into bone cells in vivo. This transformation was initiated at the inferior portion of the condylar cartilage, in contrast to the initial ossification site in long bone, which is in the center. Quantitative data from the Col10-Cre compound mice showed that hypertrophic chondrocytes contributed to ~80% of bone cells in subchondral bone, ~70% in a somewhat more inferior region, and ~40% in the most inferior part of the condylar neck (n = 4, P < 0.01 for differences among regions). This multipronged approach clearly demonstrates that a majority of chondrocytes in the fibrocartilaginous condylar cartilage, similar to hyaline cartilage in long bones, directly transform into bone cells during endochondral bone formation. Moreover, ossification is initiated from the inferior portion of mandibular condylar cartilage with expansion in one direction. PMID:26341973

  20. Nitrogen solubility in odontocete blubber and mandibular fats in relation to lipid composition.

    PubMed

    Lonati, Gina L; Westgate, Andrew J; Pabst, D Ann; Koopman, Heather N

    2015-08-01

    Understanding toothed whale (odontocete) diving gas dynamics is important given the recent atypical mass strandings of odontocetes (particularly beaked whales) associated with mid-frequency naval sonar. Some stranded whales have exhibited gas emboli (pathologies resembling decompression sickness) in their specialized intramandibular and extramandibular fat bodies used for echolocation and hearing. These tissues have phylogenetically unique, endogenous lipid profiles with poorly understood biochemical properties. Current diving gas dynamics models assume an Ostwald nitrogen (N2) solubility of 0.07?ml N2 ml(-1) oil in odontocete fats, although solubility in blubber from many odontocetes exceeds this value. The present study examined N2 solubility in the blubber and mandibular fats of seven species across five families, relating it to lipid composition. Across all species, N2 solubility increased with wax ester content and was generally higher in mandibular fats (0.083 ± 0.002?ml N2 ml(-1) oil) than in blubber (0.069 ± 0.007?ml N2 ml(-1) oil). This effect was more pronounced in mandibular fats with higher concentrations of shorter, branched fatty acids/alcohols. Mandibular fats of short-finned pilot whales, Atlantic spotted dolphins and Mesoplodon beaked whales had the highest N2 solubility values (0.097 ± 0.005, 0.081 ± 0.007 and 0.080 ± 0.003?ml N2?ml(-1)?oil, respectively). Pilot and beaked whales may experience high N2 loads during their relatively deeper dives, although more information is needed about in vivo blood circulation to mandibular fats. Future diving models should incorporate empirically measured N2 solubility of odontocete mandibular fats to better understand N2 dynamics and potential pathologies from gas/fat embolism. PMID:26290593

  1. Assessment of upper airways measurements in patients with mandibular skeletal Class II malocclusion

    PubMed Central

    Silva, Nayanna Nadja e; Lacerda, Rosa Helena Wanderley; Silva, Alexandre Wellos Cunha; Ramos, Tania Braga

    2015-01-01

    Objective: Mandibular Class II malocclusions seem to interfere in upper airways measurements. The aim of this study was to assess the upper airways measurements of patients with skeletal Class II malocclusion in order to investigate the association between these measurements and the position and length of the mandible as well as mandibular growth trend, comparing the Class II group with a Class I one. Methods: A total of 80 lateral cephalograms from 80 individuals aged between 10 and 17 years old were assessed. Forty radiographs of Class I malocclusion individuals were matched by age with forty radiographs of individuals with mandibular Class II malocclusion. McNamara Jr., Ricketts, Downs and Jarabak's measurements were used for cephalometric evaluation. Data were submitted to descriptive and inferential statistical analysis by means of SPSS 20.0 statistical package. Student's t-test, Pearson correlation and intraclass correlation coefficient were used. A 95% confidence interval and 5% significance level were adopted to interpret the results. Results: There were differences between groups. Oropharynx and nasopharynx sizes as well as mandibular position and length were found to be reduced in Class II individuals. There was a statistically significant positive correlation between the size of the oropharynx and Xi-Pm, Co-Gn and SNB measurements. In addition, the size of the nasopharynx was found to be correlated with Xi-Pm, Co-Gn, facial depth, SNB, facial axis and FMA. Conclusion: Individuals with mandibular Class II malocclusion were shown to have upper airways measurements diminished. There was a correlation between mandibular length and position and the size of oropharynx and nasopharynx. PMID:26560826

  2. Risk Factors and Dose-Effect Relationship for Mandibular Osteoradionecrosis in Oral and Oropharyngeal Cancer Patients

    SciTech Connect

    Lee, Ik Jae; Koom, Woong Sub; Lee, Chang Geol; Kim, Yong Bae; Yoo, Sei Whan; Keum, Ki Chang; Kim, Gwi Eon; Choi, Eun Chang; Cha, In Ho

    2009-11-15

    Purpose: To analyze risk factors and the dose-effect relationship for osteoradionecrosis (ORN) of the mandible after radiotherapy of oral and oropharyngeal cancers. Materials and Methods: One-hundred ninety-eight patients with oral (45%) and oropharyngeal cancer (55%) who had received external radiotherapy between 1990 and 2000 were retrospectively reviewed. All patients had a dental evaluation before radiotherapy. The median radiation dose was 60 Gy (range, 16-75 Gy), and the median biologically effective dose for late effects (BED{sub late}) in bone was 114 Gy{sub 2} (range, 30-167 Gy{sub 2}). Results: The frequency of ORN was 13 patients (6.6%). Among patients with mandibular surgery, eight had ORN at the surgical site. Among patients without mandibular surgery, five patients had ORN on the molar area of the mandible. The median time to ORN was 22 months (range, 1-69 months). Univariate analysis revealed that mandibular surgery and Co-60 were significant risk factors for ORN (p = 0.01 and 0.04, respectively). In multivariate analysis, mandibular surgery was the most important factor (p = 0.001). High radiation doses over BED 102.6 Gy{sub 2} (conventional dose of 54 Gy at 1.8 Gy/fraction) were also a significant factor for ORN (p = 0.008) and showed a positive dose-effect relationship in logistic regression (p = 0.04) for patients who had undergone mandibular surgery. Conclusions: Mandibular surgery was the most significant risk factor for ORN of mandible in oral and oropharyngeal cancers patients. A BED of 102.6 Gy{sub 2} or higher to the mandible also significantly increases the risk of ORN.

  3. Retrospective study on change in pharyngeal airway space and hyoid bone position after mandibular setback surgery

    PubMed Central

    On, Sung Woon; Han, Min Woo; Hwang, Doo Yeon

    2015-01-01

    Objectives The purpose of this study was to evaluate changes in the pharyngeal airway space and hyoid bone position after mandibular setback surgery with bilateral sagittal split ramus osteotomy (BSSRO) and to analyze the correlation between the amount of mandibular setback and the amount of change in pharyngeal airway space or hyoid bone position. Materials and Methods From January 2010 to February 2013, a total of 30 patients who were diagnosed with skeletal class III malocclusion and underwent the same surgery (BSSRO) and fixation method in the Division of Oral and Maxillofacial Surgery, Department of Dentistry at the Ajou University School of Medicine (Suwon, Korea) were included in this study. Lateral cephalograms of the 30 patients were assessed preoperatively (T1), immediately postoperatively (T2), and 6 months postoperatively (T3) to investigate the significance of changes by time and the correlation between the amount of mandibular setback and the amount of change in the airway space and hyoid bone position. Results Three regions of the nasopharynx, oropharynx, and hypopharynx were measured and only the oropharynx showed a statistically significant decrease (P<0.01). A significant posterior and inferior displacement of the hyoid bone was found 6 months after surgery (P<0.01). Analysis of the correlation between the amount of mandibular setback and the amount of final change in the airway space and hyoid bone position with Pearson's correlation showed no significant correlation. Conclusion In this study, the oropharynx significantly decreased after mandibular setback surgery, and changes in the surrounding structures were identified through posteroinferior movement of the hyoid bone during long-term follow-up. Therefore, postoperative obstructive sleep apnea should be considered in patients who plan to undergo mandibular setback surgery, and necessary modifications to the treatment plan should also be considered. PMID:26568923

  4. Simulating certain aspects of hypogravity: Effects on the mandibular incisors of suspended rats (PULEH model)

    NASA Technical Reports Server (NTRS)

    Simmons, D. J.; Winter, F.; Morey-Holton, E. R.

    1984-01-01

    The effect of a hypogravity simulating model on the rate of mandibular incisor formation, dentinogenesis and, amelogenesis in laboratory rats was studied. The model is the partial unloading by elevating the hindquarters. In this system, rat hindquarters are elevated 30 to 40 deg from the cage floors to completely unload the hindlimbs, but the animals are free to move about using their forelimbs. This model replicates the fluid sift changes which occur during the weightlessness of spaceflight and produces an osteopenia in the weight bearing skeletons. The histogenesis and/or mineralization rates of the mandibular incisor during the first 19d of PULEH in young growing rats are recorded.

  5. Immediate reconstruction of mandibular defects with a composite sternocleidomastoid musculoclavicular graft

    SciTech Connect

    Barnes, D.R.; Ossoff, R.H.; Pecaro, B.; Sisson, G.A.

    1981-01-01

    The problem of mandibular reconstruction has been approached using many surgical techniques. This article studies one such approach--reconstruction using full-thickness clavicle pedicled on the sternocleidomastoid muscle. Five patients with stage II and stage III carcinoma of the anterior part of the floor of the mouth were treated with mandibular resection and neck dissection. The resulting defects were immediately reconstructed with the clavicle-sternocleidomastoid muscle technique. The patients were observed from one to three years and were examined postoperatively with technetium Tc 99m medronate scans, which demonstrated the grafts to be viable. The technique proved reliable in a limited clinical trial.

  6. Hybrid approach to fabrication of hollow internally weighted mandibular denture: A case report

    PubMed Central

    Hazari, Puja; Mishra, Sunil Kumar

    2015-01-01

    Preservation of ridge dimensions is critical for denture success. For long the concept of an internally weighted denture, which suggested that gravity and the additional weight to the mandibular complete denture aids in prosthetic retention is widely accepted. However, excessive weight and pressure can accelerate bone resorption. Here, we describe a unique modification of internally weighted metal denture base for the resorbed mandibular ridge with an incorporated additional hollow section over the anterior knife-edge ridge. The weight provided retention and stability while the hollow portion prevented further resorption of the bone. PMID:26604604

  7. Root Canal Treatment of a Mandibular Second Premolar with Three Roots and Canals – An Anatomic Variation

    PubMed Central

    Gandhi, Bhavana; Patil, Anand C

    2013-01-01

    Dental anatomical variations play a significant role in the diagnosis and a successful treatment outcome in endodontics. It is essential for the clinician to have a clear picture and understanding of the pulpal anatomy and its variations. In a mandibular second premolar, it is rare to find extra roots and canals. The aim of the present article is to report a case about the successful diagnosis, and clinical management of a three-rooted mandibular second premolar with three independent roots and canals. PMID:24910669

  8. Osteochondroma of the mandibular condyle: an unusual case of dentofacial asymmetry.

    PubMed

    Power, Andrew; Carter, Lachlan

    2015-05-01

    An osteochondroma of the mandibular condyle is a rare tumour of the maxillofacial region that could first present to the general dental practitioner. This case report describes an osteochondroma of the posterio-medial mandibular condyle presenting with marked facial asymmetry and trismus over a six- month period. Appropriate referral and investigation enabled successful removal of the tumour, recontouring of the condyle and an uncomplicated, positive outcome for our patient. Clinical Relevance: Temporomandibular joint disorders can be a cause of dento-facial asymmetry. Pathology of the temporomandibular joint should be considered in the differential diagnosis when such a patient presents. PMID:26062262

  9. Inflammatory Paradental Cyst in the Mandibular Region: A Report of Two Cases.

    PubMed

    Sokhn, Saydé; Noujeim, Marcel; Bacho, Riad; Nasseh, Hitaf Nasrallah

    2015-05-01

    A distinctive form of paradental cyst can occur on the buccal and apical aspects of erupted mandibular molars. This cyst has peculiar clinical and radiographic features, although the microscopic findings are the same as those of odontogenic inflammatory cysts. Diagnostic and therapeutic problems can occur when this lesion is misinterpreted as a radicular cyst. The purpose of this paper is to present two additional cases of a paradental cyst in the buccal and mesial aspects of a mandibular first molar involving the apical area. The difficulty of diagnosis, treatment, and controversies regarding terminology are also discussed. PMID:26234012

  10. Surgical treatment and a unique management of rostral mandibular fracture with cerclage wire in a horse

    PubMed Central

    Naddaf, Hadi; Sabiza, Soroush; Kavosi, Narges

    2015-01-01

    A 3-year-old Arabian colt was presented for a major gingiva wound at the right rostral part of mandible. After clinical assessments, rostral mandibular fracture was determined. Stabilization of fractured region was achieved via cerclage wire application under general anesthesia. Fixation wires were left in place for 6 weeks. A 3 -month follow up revealed complete fracture healing. The purpose of this case report was to give clinical information about rostral mandibular fractures and treatment of these fractures and nutrition protocol in a horse, as this fracture is of the most common type of jaw fracture sustained by young horses. PMID:26261717

  11. Surgical treatment and a unique management of rostral mandibular fracture with cerclage wire in a horse.

    PubMed

    Naddaf, Hadi; Sabiza, Soroush; Kavosi, Narges

    2015-01-01

    A 3-year-old Arabian colt was presented for a major gingiva wound at the right rostral part of mandible. After clinical assessments, rostral mandibular fracture was determined. Stabilization of fractured region was achieved via cerclage wire application under general anesthesia. Fixation wires were left in place for 6 weeks. A 3 -month follow up revealed complete fracture healing. The purpose of this case report was to give clinical information about rostral mandibular fractures and treatment of these fractures and nutrition protocol in a horse, as this fracture is of the most common type of jaw fracture sustained by young horses. PMID:26261717

  12. Teeth movement in denture and implant-supported prosthesis influenced by microwave flask systems

    PubMed Central

    Consani, Rafael L.X.; Sonehara, Leonardo G.; Mesquita, Marcelo F.; Barão, Valentim A.R.; Caetano, Conrado R.

    2015-01-01

    Background/Aims This study evaluated the teeth movement in maxillary dentures and mandibular implantsupported prostheses processed by microwave flasks. Methods A model mounted on articulator was used to manufacture Co-Cr frameworks. Pins were placed for measurements on the incisal edge of upper and lower central incisors (I), buccal cusp of first upper and lower premolars (PM), and mesiobuccal cusps of upper and lower second molars (M). Distances I-I (incisor to incisor), PM-PM (premolar to premolar), M-M (molar to molar), RI-RM (right incisor to right molar), and LI-LM (left incisor to left molar) were measured before and after processing using a microscope (0.0005 mm). Vertical misfit between abutment and implant platform was evaluated for regions A (left distal implant), B (left median implant), C (medial implant), D (right median implant), and E (right distal implant) in predetermined labial and lingual sites. Prostheses were divided into groups G1 – conventional flask, and G2 – experimental HH flask. Acrylic resin was microwaved at 1400 W (30% for 3 min, 0% for 3 min, and 60% for 3 min). Horizontal teeth displacement and vertical misfit between abutment and implant platform were considered before and after procedures. Data were submitted to three-way ANOVA and Tukey's test (? = 0.05). Results Except for M-M distance, the teeth showed displacements without statistical difference for prosthesis and flask factors. There was no significant difference for vertical misfit values for both flasks. Conclusion Diferente flasks did not cause significant changes in the teeth displacement, except for M-M. Vertical misfit values were not influenced by the flasks. PMID:26605143

  13. Conservative condylectomy alone for the correction of mandibular asymmetry caused by osteochondroma of the mandibular condyle: a report of five cases

    PubMed Central

    Kim, Dong Sung; Kim, Jae-Young; Jeong, Chan-Woo; Park, Kwang-Ho

    2015-01-01

    We describe our experience with conservative condylectomy for the correction of facial asymmetry in five patients with osteochondroma of the mandibular condyle. All five patients presented with malocclusion and facial asymmetry, which are common clinical findings of osteochondroma involving the mandibular condyle. We performed conservative condylectomy without additional orthognathic surgery for all five patients, preserving the vertical height of the condylar process as much as possible. Following surgery, intermaxillary traction using a skeletal anchorage system with rubber elastics was performed on all patients to improve occlusion, and, when necessary, additional minimal orthodontic treatment was performed. The mean follow-up period was 42 months. At the last follow-up visit, all patients exhibited satisfactory facial symmetry and remodeling of the remaining condyle, with stable health and no signs of recurrence. In conclusion, conservative condylectomy alone, without subsequent orthognathic surgery, is adequate for the restoration of facial symmetry and the preservation of vertical condylar height in select patients with condylar osteochondroma. PMID:26568928

  14. Bupivacaine Mandibular Nerve Block Affects Intraoperative Blood Pressure and Heart Rate in a Yucatan Miniature Swine Mandibular Condylectomy Model: A Pilot Study

    PubMed Central

    Bova, Jonathan F.; da Cunha, Anderson F.; Stout, Rhett W.; Bhumiratana, Sarindr; Alfi, David M.; Eisig, Sidney B.; Vunjak-Novakovic, Gordana; Lopez, Mandi J.

    2015-01-01

    Purpose/Aim The primary objective was to evaluate the effect of a bupivacaine mandibular nerve block on intraoperative blood pressure (BP) and heart rate (HR) in response to surgical stimulation and the need for systemic analgesics postoperatively. We hypothesized that a mandibular nerve block would decrease the need for systemic analgesics both intraoperatively and postoperatively. Materials and Methods Fourteen adult male Yucatan pigs were purchased. Pigs were chemically restrained with ketamine, midazolam, and dexmedetomidine and anesthesia was maintained with isoflurane inhalant anesthesia. Pigs were randomized to receive a mandibular block with either bupivacaine (bupivacaine group) or saline (control group). A nerve stimulator was used for administration of the block with observation of masseter muscle twitch to indicate the injection site. Invasive BP and HR were measured with the aid of an arterial catheter in eight pigs. A rescue analgesic protocol consisting of fentanyl and lidocaine was administered if HR or BP values increased 20% from baseline. Postoperative pain was quantified with a customized ethogram. HR and BP were evaluated at base line, pre-rescue, 10 and 20 min post-rescue. Results Pre-rescue mean BP was significantly increased (p = .001) for the bupivacaine group. Mean intraoperative HR was significantly lower (p = .044) in the bupivacaine versus saline group. All other parameters were not significant. Conclusion Addition of a mandibular nerve block to the anesthetic regimen in the miniature pig condylectomy model may improve variations in intraoperative BP and HR. This study establishes the foundation for future studies with larger animal numbers to confirm these preliminary findings. PMID:25394295

  15. Implant isotopy (II).

    PubMed

    Muratori, G

    1995-01-01

    Because nature has given humans from 14 to 16 teeth per arch, the author maintains that an implantologist ought to replace each missing tooth with an implant and calls this philosophical creed "implant isotopy". Three different prosthetic solutions are suggested for the cases of either complete or partially edentulous arches, where from 12 to 14 abutments are emerging from the gingiva. The first type consists of parallel protruding posts. The second type is a modification of the first method through the connection of all the posts (although they are not perfectly parallel) via a titanium wire-drawn bar to be welded via endoral welding. Finally, the third type consists of a laboratory cast titanium denture composed of different sections that can be connected to one another and to the implant abutments via endoral welding. PMID:7473871

  16. Dental Implant Complications.

    PubMed

    Liaw, Kevin; Delfini, Ronald H; Abrahams, James J

    2015-10-01

    Dental implants have increased in the last few decades thus increasing the number of complications. Since many of these complications are easily diagnosed on postsurgical images, it is important for radiologists to be familiar with them and to be able to recognize and diagnose them. Radiologists should also have a basic understanding of their treatment. In a pictorial fashion, this article will present the basic complications of dental implants which we have divided into three general categories: biomechanical overload, infection or inflammation, and other causes. Examples of implant fracture, loosening, infection, inflammation from subgingival cement, failure of bone and soft tissue preservation, injury to surround structures, and other complications will be discussed as well as their common imaging appearances and treatment. Lastly, we will review pertinent dental anatomy and important structures that are vital for radiologists to evaluate in postoperative oral cavity imaging. PMID:26589696

  17. Current trends in dental implants

    PubMed Central

    Gaviria, Laura; Salcido, John Paul; Guda, Teja

    2014-01-01

    Tooth loss is very a very common problem; therefore, the use of dental implants is also a common practice. Although research on dental implant designs, materials and techniques has increased in the past few years and is expected to expand in the future, there is still a lot of work involved in the use of better biomaterials, implant design, surface modification and functionalization of surfaces to improve the long-term outcomes of the treatment. This paper provides a brief history and evolution of dental implants. It also describes the types of implants that have been developed, and the parameters that are presently used in the design of dental implants. Finally, it describes the trends that are employed to improve dental implant surfaces, and current technologies used for the analysis and design of the implants. PMID:24868501

  18. Implantable Heart Aid

    NASA Technical Reports Server (NTRS)

    1980-01-01

    Medrad utilized NASA's Apollo technology to develop a new device called the AID implantable automatic pulse generator which monitors the heart continuously, recognizes the onset of ventricular fibrillation and delivers a corrective electrical shock. AID pulse generator is, in effect, a miniaturized version of the defibrillator used by emergency squads and hospitals to restore rhythmic heartbeat after fibrillation, but has the unique advantage of being permanently available to the patient at risk. Once implanted, it needs no specially trained personnel or additional equipment. AID system consists of a microcomputer, a power source and two electrodes which sense heart activity.

  19. Gender difference and root canal morphology in mandibular premolars: A cone-beam computed tomography study in an Iranian population

    PubMed Central

    Kazemipoor, Maryam; Hajighasemi, Afrooz; Hakimian, Roqayeh

    2015-01-01

    Background: Mandibular premolars are of the most difficult teeth to treat endodontically. Aims: To compare the root canal morphology of mandibular premolars between two genders in an Iranian population. Settings and Design: Totally, 230 cone-beam computed tomography images of the mandibles belonged to 115 males and 115 females were evaluated in the three spatial planes. Materials and Methods: The total number of roots and canals in the mandibular premolars was counted, and the difference between males and females were analyzed. Statistical Analysis: Data were analyzed using Chi-square test. The significance level was set as P < 0.05. Results: The majority of mandibular first and second premolars had one root (85.7% and 94.8%, respectively) and one canal (63.9% and 78.3%, respectively). The number of roots in the mandibular first premolars had statistically significant difference between two genders (P = 0.001). There was no significant difference between two genders in the number of roots (P = 0.208) and canals (P = 0.498) in the mandibular second premolars. Conclusion: According to the results of this study, the root canal morphology in the mandibular first premolars had statistically significant difference between two genders. PMID:26321843

  20. Root Canal Morphology of Permanent Maxillary and Mandibular Canines in Indian Population Using Cone Beam Computed Tomography

    PubMed Central

    Somalinga Amardeep, Nikhita; Raghu, Sandhya; Natanasabapathy, Velmurugan

    2014-01-01

    Aim. To investigate the root canal anatomy of single-rooted permanent maxillary and mandibular canines in an Indian population using cone beam computed tomography (CBCT). Methodology. A total of 250 permanent maxillary canines and 250 permanent mandibular canines were selected and scanned using CBCT. The root anatomy of each tooth was evaluated for the following parameters: the pattern of the root canals, anatomic length of the crown and the root, the presence of accessory canals, the shape of the access cavity, the position of the apical foramina, root diameter, and dentin thickness of the root. Results. Majority of the teeth had a Type I canal configuration in both maxillary canines (81.6%) and mandibular canines (79.6%). In maxillary canine the other canal patterns found were Type III (11.6%), Type II (2.8%), Type V (2%), Type XIX (1.2%), and Type IV (0.8%). In mandibular canines the various other canal patterns found were Type III (13.6%), Type II (3.2%), Type V (2%), and Type XIX (1.6%). Apical foramina were laterally positioned in the majority of the teeth, 70.4% and 65.6% in maxillary and mandibular canines, respectively. 12% of the maxillary canines and 12.8% of the mandibular canines had accessory canals. Conclusion. The root canal anatomy of permanent maxillary and mandibular canines varied widely in an Indian population. PMID:24895538

  1. Five-year retrospective radiographic follow-up study of dental implants with sandblasting with large grit, and acid etching-treated surfaces

    PubMed Central

    2015-01-01

    Objectives The purpose of this study is to evaluate five-year radiographic follow-up results of the Korean sandblasting with large grit, and acid etching (SLA)-treated implant system. Materials and Methods The subjects of the study are 54 patients who have been followed-up to date, of the patients who underwent implant surgery from May 1, 2009 to April 30, 2011. In all, 176 implant placements were performed. Radiographs were taken before the first surgery, immediately after the first and second surgeries, immediately and six months after the final prosthesis installation, and every year after that. Bone loss was evaluated by the method suggested by Romanos and Nentwig. Results A total of 176 implant placements were performed-122 in men and 54 in women. These patients have been followed-up for an average of 4.9 years. In terms of prosthetic appliances, there were 156 bridges and 20 single prostheses. Nine implants installed in the maxillary molar area, three in the mandibular molar area and two in the maxillary premolar area were included in group M, with bone loss less than 2 mm at the crestal aspect of the implant. Of these, eight implants were single prostheses. In all, six implants failed-four in the mandible and two in the maxilla. All of these failures occurred in single-implant cases. The implant survival rate was 98.1% on the maxilla and 94.3% on the mandible, with an overall survival of 96.6%. Conclusion Within the limitations of this study, implants with the SLA surface have a very superior survival rate in relatively poor bone environments such as the maxilla.

  2. Unilateral Molariform Macrodont Mandibular Second Premolar: An Unusual Case Report in A Nonsyndromic Patient

    PubMed Central

    Chaurasia, Vishwajit Rampratap; Masamatti, Vinay Kumar; Tiwari, Samarth; Malik, Sidharath

    2014-01-01

    Macrodontia is a rare dental anomaly that refers to teeth appears larger than normal. It can be generalized or isolated macrodontia. Isolated macrodontia involving premolar is very rare. This case report presents an unusual unilateral molarifrom macrodontia of mandibular second premolar. PMID:25177648

  3. Combination of Mandibular Constriction and Intraoral Vertical Ramus Osteotomies for a Transverse Jaw Discrepancy

    PubMed Central

    Mitsugi, Masaharu; Hirose, Hisamitsu; Tatemoto, Yukihiro

    2015-01-01

    Background: The aim of the present study was to evaluate the treatment of patients developing a transverse jaw width discrepancy who exhibited class III malocclusion and/or facial asymmetry by a combination of mandibular constriction (MC) and intraoral vertical ramus osteotomies (IVROs). Subjects and methods: In a retrospective study, functional results, postoperative complications, and skeletal stability were analyzed for all the patients who had undergone MC and IVRO, with more than 2 years of follow-up. A mandibular midline osteotomy for constriction with lag screw technique and IVROs was used for MC and setback. Results: Sixteen patients were included in the present study. The average degree of MC was 6.34 mm. Both the occlusal relationship and facial appearance in all patients were significantly improved by the surgical orthodontic treatment, with no harmful clinical symptoms. In addition, our original MC using lag screw technique provided the most reliable results in terms of skeletal stability. Conclusions: This study showed that MC using lag screw technique gives a very stable mandibular width constriction, and the combination of MC and IVROs offers a promising treatment alternative for patients with mandibular prognathism developing a transverse jaw width discrepancy. PMID:26495234

  4. Automated classification of mandibular cortical bone on dental panoramic radiographs for early detection of osteoporosis

    NASA Astrophysics Data System (ADS)

    Horiba, Kazuki; Muramatsu, Chisako; Hayashi, Tatsuro; Fukui, Tatsumasa; Hara, Takeshi; Katsumata, Akitoshi; Fujita, Hiroshi

    2015-03-01

    Findings on dental panoramic radiographs (DPRs) have shown that mandibular cortical index (MCI) based on the morphology of mandibular inferior cortex was significantly correlated with osteoporosis. MCI on DPRs can be categorized into one of three groups and has the high potential for identifying patients with osteoporosis. However, most DPRs are used only for diagnosing dental conditions by dentists in their routine clinical work. Moreover, MCI is not generally quantified but assessed subjectively. In this study, we investigated a computer-aided diagnosis (CAD) system that automatically classifies mandibular cortical bone for detection of osteoporotic patients at early stage. First, an inferior border of mandibular bone was detected by use of an active contour method. Second, regions of interest including the cortical bone are extracted and analyzed for its thickness and roughness. Finally, support vector machine (SVM) differentiate cases into three MCI categories by features including the thickness and roughness. Ninety eight DPRs were used to evaluate our proposed scheme. The number of cases classified to Class I, II, and III by a dental radiologist are 56, 25 and 17 cases, respectively. Experimental result based on the leave-one-out cross-validation evaluation showed that the sensitivities for the classes I, II, and III were 94.6%, 57.7% and 94.1%, respectively. Distribution of the groups in the feature space indicates a possibility of MCI quantification by the proposed method. Therefore, our scheme has a potential in identifying osteoporotic patients at an early stage.

  5. Factors associated with the efficacy of mandibular advancing device treatment in adult OSA patients.

    PubMed

    Milano, Francesca; Billi, Maria Celeste; Marra, Francesca; Sorrenti, Giovanni; Gracco, Antonio; Bonetti, Giulio A

    2013-09-01

    The aim of this study was to evaluate the anthropometric, demographic, occlusal and cephalometric characteristics of a group of adult obstructive sleep apnea (OSA) patients treated with mandibular advancement devices (MADs) and to determine the factors associated with treatment efficacy. Twenty-three consecutive patients with mild to severe OSA (polysomnographically diagnosed [T0]) were recruited for this prospective study; they were treated with a Silensor(®) appliance, and a polysomnographic exam with the MAD in situ was performed 2 to 3 months later (T1) to evaluate MAD's efficacy. Based on apnea-hypopnea index (AHI) differences between the T0 and T1 values, patients were classified into two groups: completely recovered and not completely recovered patients. The differences in anthropometric, demographic, occlusal and cephalometric parameters between the two groups were analyzed, and significant parameters verified. The sample showed these prevalent characteristics: deep bite, crossbite, tooth wear, dental and skeletal Class II, mesofacial mandibular vertical growth pattern, low position of the hyoid bone, longer soft palate length. The transverse diameters of upper maxilla had the greatest impact on T0 AHI. The factors associated with MAD efficacy were: age under 55 years, distance between the hyoid bone and the mandibular plane (H-MP) less than 20 mm, divergence of mandibular vertical growth pattern (SN^MP) less than 29°. PMID:23867336

  6. Bone histomorphometry detection of autologous bone powder graft repair of partial mandibular defects in rabbits.

    PubMed

    Wu, J-Q; Liu, J; Wang, L-L; Xie, A-G; Liu, D-L

    2015-01-01

    The aim of this study was to understand the effect of autologous bone powder graft repair of partial mandibular defects of rabbits by the quantitative detection of bone formation. New Zealand rabbits (N = 18) were selected as the test objects, and subjected to bilateral partial mandibular defect induction. One side of the mandibular defect acted as the test group, upon which the autologous bone powder backfilling graft was performed; the other side was put aside and acted as the negative control group. All used an autogenous control. At the twelfth postoperative week, the animals were sacrificed, and semi-automatic image analysis was used to conduct bone histomorphometric detection. Immediately subsequent, quantitative detection of bone formation was performed in the test group. Fluorescent perimeter percent, mineralization apposition rate, and bone formation rate were selected as the dynamic indicators; and trabecular area percent, trabecular thickness, trabecular number, and trabecular separation degree were selected as the static indicators for single factorial variance testing. It was found that the values of P are less than 0.05 between the test group and the control group, indicating that the effect of autologous bone powder graft repair on partial mandibular defects in rabbits was positive. PMID:26535696

  7. Mandibular Motor Control during the Early Development of Speech and Nonspeech Behaviors

    ERIC Educational Resources Information Center

    Steeve, Roger W.; Moore, Christopher A.

    2009-01-01

    Purpose: The mandible is often portrayed as a primary structure of early babble production, but empiricists still need to specify (a) how mandibular motor control and kinematics vary among different types of multisyllabic babble, (b) whether chewing or jaw oscillation relies on a coordinative infrastructure that can be exploited for early types of…

  8. 78 FR 9010 - Dental Devices; Reclassification of Temporary Mandibular Condyle Prosthesis

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-02-07

    ..., 1993 (59 FR 65475; December 20, 1994). In response to a petition dated April 30, 1996 (FDA-1996-P-0253... malignant and benign tumors (63 FR 71743). In 2009, FDA published an order for the submission of information on mandibular condyle prostheses indicated for temporary reconstruction (74 FR 16214; April 9,...

  9. MANDIBULAR REPATTERNING RESULTS FROM IN UTERO ANTAGONISM OF ENDOTHELIN RECEPTORS IN MICE

    EPA Science Inventory

    BRANNEN, K.C.1,2, E.S. HUNTER1,2, M.B. ROSEN2, and J.M. ROGERS1,2. 1Curriculum in Toxicology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina; 2Reproductive Toxicology Division, NHEERL, U.S. EPA, Research Triangle Park, North Carolina. Mandibular repatte...

  10. Afferent and Efferent Aspects of Mandibular Sensorimotor Control in Adults Who Stutter

    ERIC Educational Resources Information Center

    Daliri, Ayoub; Prokopenko, Roman A.; Max, Ludo

    2013-01-01

    Purpose: Individuals who stutter show sensorimotor deficiencies in speech and nonspeech movements. For the mandibular system, the authors dissociated the sense of kinesthesia from the efferent control component to examine whether kinesthetic integrity itself is compromised in stuttering or whether deficiencies occur only when generating motor…

  11. Mandibular Repair in Rats with Premineralized Silk Scaffolds and BMP-2-modified bMSCs

    PubMed Central

    Jiang, Xinquan; Zhao, Jun; Wang, Shaoyi; Sun, Xiaojuan; Zhang, Xiuli; Chen, Jake; Kaplan, David L.; Zhang, Zhiyuan

    2010-01-01

    Premineralized silk fibroin protein scaffolds (mSS) were prepared to combine the osteoconductive properties of biological apatite with aqueous-derived silk scaffold (SS) as a composite scaffold for bone regeneration. The aim of present study was to evaluate the effect of premineralized silk scaffolds combined with bone morphogenetic protein-2 (BMP-2) modified bone marrow stromal cells (bMSCs) to repair mandibular bony defects in a rat model. bMSCs were expanded and transduced with adenovirus AdBMP-2, AdLacZ gene in vitro. These genetically modified bMSCs were then combined with premineralized silk scaffolds to form tissue engineered bone. Mandibular repairs with AdBMP-2 transduced bMSCs/mSS constructs were compared with those treated with AdLacZ transduced bMSCs/mSS constructs, native (nontransduced) bMSCs/mSS constructs and mSS alone. Eight weeks post-operation, the mandibles were explanted and evaluated by radiographic observation, micro-CT, histological analysis and immunohistochemistry. The presence of BMP-2 gene enhanced tissue engineered bone in terms of the most new bone formed and the highest local bone mineral densities (BMD) found. These results demonstrated that premineralized silk scaffold could serve as a potential substrate for bMSCs to construct tissue engineered bone for mandibular bony defects. BMP-2 gene therapy and tissue engineering techniques could be used in mandibular repair and bone regeneration. PMID:19501905

  12. Correction of facial and mandibular asymmetry using a computer aided design/computer aided manufacturing prefabricated titanium implant.

    PubMed

    Watson, Jason; Hatamleh, Muhanad; Alwahadni, Ahed; Srinivasan, Dilip

    2014-05-01

    Patients with significant craniofacial asymmetry may have functional problems associated with their occlusion and aesthetic concerns related to the imbalance in soft and hard tissue profiles. This report details a case of facial asymmetry secondary to left mandible angle deficiency due to undergoing previous radiotherapy. We describe the correction of the bony deformity using computer aided design/computer aided manufacturing custom-made titanium onlay using novel direct metal laser sintering. The direct metal laser sintering onlay proved a very accurate operative fit and showed a good aesthetic correction of the bony defect with no reported complications postoperatively. It is a useful low-morbidity technique, and there is no resorption or associated donor-site complications. PMID:24777002

  13. Hader bar and clip attachment retained mandibular complete denture

    PubMed Central

    Singh, Kunwarjeet; Gupta, Nidhi; Kapoor, Vikram; Gupta, Ridhimaa

    2013-01-01

    Bar and clip attachments significantly improve the level of satisfaction of denture-wearing patients by enhancing the retention and stability of the prosthesis. These attachments have been most commonly used for connecting the prosthesis to implants, but they can be effectively used to retain tooth-supported prosthesis as well. The primary functions of bar attachments are splinting the abutments together, even distribution of forces to the abutments and supporting areas, guiding the prosthesis into place, improving the retention, stability, support and comfort of the patient. The primary requirement for the use of bar attachments is the availability of sufficient vertical and buccolingual space for the proper placement of the bar, sleeves, teeth arrangement and sufficient thickness of acrylic denture base to minimise incidence of denture fracture in the area of bar assembly. PMID:24145505

  14. Regional variation of bone tissue properties at the human mandibular condyle.

    PubMed

    Kim, Do-Gyoon; Jeong, Yong-Hoon; Kosel, Erin; Agnew, Amanda M; McComb, David W; Bodnyk, Kyle; Hart, Richard T; Kim, Min Kyung; Han, Sang Yeun; Johnston, William M

    2015-08-01

    The temporomandibular joint (TMJ) bears different types of static and dynamic loading during occlusion and mastication. As such, characteristics of mandibular condylar bone tissue play an important role in determining the mechanical stability of the TMJ under the macro-level loading. Thus, the objective of this study was to examine regional variation of the elastic, plastic, and viscoelastic mechanical properties of human mandibular condylar bone tissue using nanoindentation. Cortical and trabecular bone were dissected from mandibular condyles of human cadavers (9 males, 54-96 years). These specimens were scanned using microcomputed tomography to obtain bone tissue mineral distribution. Then, nanoindentation was conducted on the surface of the same specimens in hydration. Plastic hardness (H) at a peak load, viscoelastic creep (Creep/Pmax), viscosity (?), and tangent delta (tan ?) during a 30 second hold period, and elastic modulus (E) during unloading were obtained by a cycle of indentation at the same site of bone tissue. The tissue mineral and nanoindentation parameters were analyzed for the periosteal and endosteal cortex, and trabecular bone regions of the mandibular condyle. The more mineralized periosteal cortex had higher mean values of elastic modulus, plastic hardness, and viscosity but lower viscoelastic creep and tan ? than the less mineralized trabecular bone of the mandibular condyle. These characteristics of bone tissue suggest that the periosteal cortex tissue may have more effective properties to resist elastic, plastic, and viscoelastic deformation under static loading, and the trabecular bone tissue to absorb and dissipate time-dependent viscoelastic loading energy at the TMJ during static occlusion and dynamic mastication. PMID:25913634

  15. Postauricular Approach for Mandibular Angle Ostectomy: An Alternative for Shortening the Recovery Time.

    PubMed

    Lim, Hyoseob; Kang, Minbum

    2016-01-01

    Many surgical procedures to improve mandibular contour have been introduced in East Asia. Despite consensus regarding mandible contouring surgery, surgery which includes angle ostectomy and lateral cortex excision, some patients require only mandibular angle ostectomy. The intraoral approach is a widely used method, but has disadvantages with regard to the need for endotracheal intubation and patients are limited in their food intake for a considerable length of time. The authors wanted to shorten the recovery period and so the postauricular approach is introduced in this study and assessed.One hundred seventy-five Asian patients underwent mandibular angle ostectomy via a postauricular approach. All operations were performed under intravenous sedation without endotracheal intubation. Superficial subcutaneous dissection and vertical dissection were performed, with special care taken to avoid injuring the facial nerve. Patients responded to a simple questionnaire during the postoperative period. Questions solicited the patient's reason for their choice of this approach and their satisfaction with it.No visible scar and no palpable bony step were observed without ear pulling. Some patients experienced temporary sensory changes in the postauricular area. None of the patients complained of perioral numbness or facial paralysis. Six patients had significant bleeding in the operative field and 1 patient experienced salivary leakage for 2 weeks which was managed well without event. Of the 175 patients, 133 responded to the questionnaire. Satisfaction was expressed by 94.7% of patients and 88.7% of patients would recommend this surgery to their friends; 69.2% of patients experienced inconvenience for 1 week or less.The postauricular approach for mandibular angle ostectomy is a very convenient method for surgeons to use for patients who want to undergo mandibular angle ostectomy with a short recovery time. PMID:25325390

  16. Reconstruction of Mandibular Defects Using Nonvascularized Autogenous Bone Graft in Nigerians

    PubMed Central

    Ndukwe, Kizito Chioma; Aregbesola, Stephen Babatunde; Ikem, Innocent Chinedu; Ugboko, Vincent I; Adebiyi, Kehinde Emmanuel; Fatusi, Olawunmi Adedoyin; Owotade, Foluso John; Braimah, Ramat Oyebunmi

    2014-01-01

    Objectives: The aim of this study is to evaluate the success rate and complications of mandibular reconstruction with nonvascularized bone graft in Ile-Ife, Nigeria. Patients and Methods: A total of 25 patients who underwent reconstruction of mandibular discontinuity defects between January 2003 and February 2012, at the Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife constituted the study sample. Relevant information was retrieved from the patients’ records. This information include patients’ demographics (age and sex) as well as the type of mandibular defect, cause of the defect, type of mandibular resection done, source of the bone graft used, and the method of graft immobilization. Morbidity associated with the graft procedures were assessed by retrieving information on graft failures, length of hospital stay following surgery, rehabilitation device used and associated graft donor and recipient site complications. Result: There were 12 males and 13 females with a male:female ratio was 1:1.1. The age of the patients ranged from 13 to 73 years with a mean age for males 32.7 ± standard deviation (SD) 12.9 and for females 35.0 ± SD 17.1. Jaw defect was caused by resection for tumours and other jaw pathologies in 92% of cases. Complete symphyseal involvement defect was the most common defect recorded 11 (44%). Reconstruction with nonvascularized rib graft accounted for 68% of cases while iliac crest graft was used in 32% of the patients. Successful take of the grafts was recorded in 22 patients while three cases failed. Wound dehiscence (two patients) and postoperative wound infection (eight patients) were the most common complications recorded. Conclusion: The use of nonvascularized graft is still relevant in the reconstruction of large mandibular defects caused by surgical ablation of benign conditions in Nigerians. Precise surgical planning and execution, extended antibiotic therapy, and meticulous postoperative care contributed to the good outcome. PMID:25191100

  17. Class III malocclusion treated with distalization of the mandibular dentition with miniscrew anchorage: A 2-year follow-up.

    PubMed

    Chen, Kun; Cao, Yang

    2015-12-01

    This case report describes the orthodontic camouflage treatment for a 16-year-old Chinese girl with a Class III malocclusion. The treatment included extractions of the mandibular second molars, fixed appliance therapy, and miniscrew-aided mandibular arch distalization. Pretreatment, posttreatment, and 2-year follow-up records are shown. The anterior negative overjet and the Class III molar and canine relationships were corrected. The patient's facial profile was greatly improved. The mandibular third molars erupted into the second molar spaces, with acceptable intercuspation with the maxillary dentition. PMID:26672711

  18. Cone Beam Computed Tomography Assisted Endodontic Management of a Rare Case of Mandibular First Premolar with Three Roots

    PubMed Central

    Balakasireddy, K; Kumar, K Pavan; John, Gijo; Gagan, C

    2015-01-01

    Understanding the morphological anatomy of the root and root canal systems of the teeth increases the success rate of endodontic therapy. Advanced diagnostic imaging techniques like cone beam computed tomography (CBCT) are an essential aid in understanding the anatomy of teeth especially in mandibular premolars. Most commonly mandibular first and second premolars have a single root and a single canal. However, multiple root and canals have also been reported. The present case report discusses endodontic management of a three rooted mandibular first premolar using CBCT. PMID:26124611

  19. Root Canal Treatment of Mandibular Second Premolar with Three Separate Roots and Canals Using Spiral Computed Tomographic

    PubMed Central

    Hariharavel, V. P.; Kumar, A. Ashok; Ganesh, C.; Aravindhan, R.

    2014-01-01

    Anatomic and internal morphology of a root canal system is more complex and differs for each individual tooth of which mandibular premolars have earned the reputation for having aberrant anatomy. The occurrence of three canals with three separate foramina in mandibular second premolars is very rare. A wider knowledge on both clinical and radiological anatomy especially spiral computed tomographic is absolutely essential for the success of endodontic treatment. These teeth may require skillful and special root canal special shaping and obturating techniques. This paper reports an unusual case of a mandibular second premolar with atypical canal pattern that was successfully treated endodontically. PMID:25101187

  20. Implantable Impedance Plethysmography

    PubMed Central

    Theodor, Michael; Ruh, Dominic; Ocker, Martin; Spether, Dominik; Förster, Katharina; Heilmann, Claudia; Beyersdorf, Friedhelm; Manoli, Yiannos; Zappe, Hans; Seifert, Andreas

    2014-01-01

    We demonstrate by theory, as well as by ex vivo and in vivo measurements that impedance plethysmography, applied extravascularly directly on large arteries, is a viable method for monitoring various cardiovascular parameters, such as blood pressure, with high accuracy. The sensor is designed as an implant to monitor cardiac events and arteriosclerotic progression over the long term. PMID:25123467

  1. Allergy to Surgical Implants.

    PubMed

    Pacheco, Karin A

    2015-01-01

    Surgical implants have a wide array of therapeutic uses, most commonly in joint replacements, but also in repair of pes excavatum and spinal disorders, in cardiac devices (stents, patches, pacers, valves), in gynecological implants, and in dentistry. Many of the metals used are immunologically active, as are the methacrylates and epoxies used in conjunction with several of these devices. Allergic responses to surgical components can present atypically as failure of the device, with nonspecific symptoms of localized pain, swelling, warmth, loosening, instability, itching, or burning; localized rash is infrequent. Identification of the specific metal and cement components used in a particular implant can be difficult, but is crucial to guide testing and interpretation of results. Nickel, cobalt, and chromium remain the most common metals implicated in implant failure due to metal sensitization; methacrylate-based cements are also important contributors. This review will provide a guide on how to assess and interpret the clinical history, identify the components used in surgery, test for sensitization, and provide advice on possible solutions. Data on the pathways of metal-induced immune stimulation are included. In this setting, the allergist, the dermatologist, or both have the potential to significantly improve surgical outcomes and patient care. PMID:26362550

  2. Semiconductor Ion Implanters

    SciTech Connect

    MacKinnon, Barry A.; Ruffell, John P.

    2011-06-01

    In 1953 the Raytheon CK722 transistor was priced at $7.60. Based upon this, an Intel Xeon Quad Core processor containing 820,000,000 transistors should list at $6.2 billion. Particle accelerator technology plays an important part in the remarkable story of why that Intel product can be purchased today for a few hundred dollars. Most people of the mid twentieth century would be astonished at the ubiquity of semiconductors in the products we now buy and use every day. Though relatively expensive in the nineteen fifties they now exist in a wide range of items from high-end multicore microprocessors like the Intel product to disposable items containing 'only' hundreds or thousands like RFID chips and talking greeting cards. This historical development has been fueled by continuous advancement of the several individual technologies involved in the production of semiconductor devices including Ion Implantation and the charged particle beamlines at the heart of implant machines. In the course of its 40 year development, the worldwide implanter industry has reached annual sales levels around $2B, installed thousands of dedicated machines and directly employs thousands of workers. It represents in all these measures, as much and possibly more than any other industrial application of particle accelerator technology. This presentation discusses the history of implanter development. It touches on some of the people involved and on some of the developmental changes and challenges imposed as the requirements of the semiconductor industry evolved.

  3. Implantable electrical device

    NASA Technical Reports Server (NTRS)

    Jhabvala, M. D. (inventor)

    1982-01-01

    A fully implantable and self contained device is disclosed composed of a flexible electrode array for surrounding damaged nerves and a signal generator for driving the electrode array with periodic electrical impulses of nanoampere magnitude to induce regeneration of the damaged nerves.

  4. Implantable Drug Dispenser

    NASA Technical Reports Server (NTRS)

    Collins, E. R. J.

    1983-01-01

    Drugs such as insulin are injected as needed directly into bloodstream by compact implantable dispensing unit. Two vapor cavities produce opposing forces on drug-chamber diaphragm. Heaters in cavities allow control of direction and rate of motion of bellows. Dispensing capsule fitted with coil so batteries can be recharged by induction.

  5. Remote actuated valve implant

    DOEpatents

    McKnight, Timothy E; Johnson, Anthony; Moise, Jr., Kenneth J; Ericson, Milton Nance; Baba, Justin S; Wilgen, John B; Evans, III, Boyd McCutchen

    2014-02-25

    Valve implant systems positionable within a flow passage, the systems having an inlet, an outlet, and a remotely activatable valve between the inlet and outlet, with the valves being operable to provide intermittent occlusion of the flow path. A remote field is applied to provide thermal or magnetic activation of the valves.

  6. Salvaging the Exposed Cochlear Implant.

    PubMed

    Seo, Bommie Florence; Park, Sang Wook; Han, Hyun Ho; Moon, Suk-Ho; Oh, Deuk Young; Rhie, Jong Won

    2015-11-01

    Cochlear implant exposure is an uncommon occurrence that may imperil the fate of the implant. Insertion of this costly device is a delicate procedure, and reimplantation with another implant after removal is expensive and emotionally stressful for patients. Salvage of the original implant can be quite successful with a fully vascularized scalp-nape of the neck rotation flap. The authors review the literature and report their experience in salvaging exposed implants in 2 patients, who had risk factors that compromised healing. PMID:26594996

  7. Potentially implantable miniature batteries.

    PubMed

    Heller, Adam

    2006-06-01

    All presently used batteries contain reactive, corrosive or toxic components and require strong cases, usually made of steel. As a battery is miniaturized, the required case dominates its size. Hence, the smallest manufactured batteries are about 50 mm3 in size, much larger then the integrated circuits or sensors of functional analytical packages, as exemplified by implantable glucose sensors for diabetes management. The status of the miniaturization of the power sources of such implantable packages is reviewed. Three microcells, consisting only of potentially harmless subcutaneously implantable anodes and cathodes, are considered. Because their electrolyte would be the subcutaneous interstitial fluid, the cells do not have a case. One potentially implantable cell has a miniature Nafion-coated Zn anode and a biocompatible hydrogel-shielded Ag/AgCl cathode. The core innovation on which the cell is based is the growth of a hopeite-phase Zn2+ conducting solid electrolyte film on the discharging anode. The film blocks the transport of O2 to the Zn, preventing its corrosion, while allowing the necessary transport of Zn2+. The second cell, with the same anode, would have a bioinert hydrogel-shielded wired bilirubin oxidase-coated carbon cathode, on which O2 dissolved in the subcutaneous fluid would be electroreduced to water. In the third cell, the glucose of the subcutaneous interstitial would be electrooxidized to gluconolactone at an implanted wired glucose anode, similar to that tested now for continuous glucose monitoring in diabetic people, and O2 in the subcutaneous fluid would be electroreduced to water on its wired bilirubin oxidase cathode. PMID:16538459

  8. Mandibular Branch of the Facial Nerve in Wistar Rats: New Experimental Model to Assess Facial Nerve Regeneration

    PubMed Central

    Bento, Ricardo Ferreira; Salomone, Raquel; Nascimento, Silvia Bona do; Ferreira, Ricardo Jose Rodriguez; Silva, Ciro Ferreira da; Costa, Heloisa Juliana Zabeu Rossi

    2014-01-01

    Introduction?The ideal animal model for nerve regeneration studies is the object of controversy, because all models described by the literature have advantages and disadvantages. Objective?To describe the histologic and functional patterns of the mandibular branch of the facial nerve of Wistar rats to create a new experimental model of facial nerve regeneration. Methods?Forty-two male rats were submitted to a nerve conduction test of the mandibular branch to obtain the compound muscle action potential. Twelve of these rats had the mandibular branch surgically removed and submitted to histologic analysis (number, partial density, and axonal diameter) of the proximal and distal segments. Results?There was no statistically significant difference in the functional and histologic variables studied. Conclusion?These new histologic and functional standards of the mandibular branch of the facial nerve of rats establish an objective, easy, and greatly reproducible model for future facial nerve regeneration studies. PMID:25992106

  9. Mandibular branch of the facial nerve in wistar rats: new experimental model to assess facial nerve regeneration.

    PubMed

    Bento, Ricardo Ferreira; Salomone, Raquel; Nascimento, Silvia Bona do; Ferreira, Ricardo Jose Rodriguez; Silva, Ciro Ferreira da; Costa, Heloisa Juliana Zabeu Rossi

    2014-07-01

    Introduction?The ideal animal model for nerve regeneration studies is the object of controversy, because all models described by the literature have advantages and disadvantages. Objective?To describe the histologic and functional patterns of the mandibular branch of the facial nerve of Wistar rats to create a new experimental model of facial nerve regeneration. Methods?Forty-two male rats were submitted to a nerve conduction test of the mandibular branch to obtain the compound muscle action potential. Twelve of these rats had the mandibular branch surgically removed and submitted to histologic analysis (number, partial density, and axonal diameter) of the proximal and distal segments. Results?There was no statistically significant difference in the functional and histologic variables studied. Conclusion?These new histologic and functional standards of the mandibular branch of the facial nerve of rats establish an objective, easy, and greatly reproducible model for future facial nerve regeneration studies. PMID:25992106

  10. Evaluation of canine retraction following periodontal distraction using NiTi coil spring and implants – A clinical study

    PubMed Central

    Khanna, Rohit; Tikku, Tripti; Sachan, Kiran; Maurya, R.P.; Verma, Geeta; Ojha, Vivek

    2014-01-01

    Objective To evaluate the amount of canine retraction with periodontal distraction using miniscrew implants and NiTi coil spring. Material and method Sample comprised of 25 patients who were scheduled for all 1st premolar extraction (13 males and 12 females), in the age range of 16–22 years with mean age 18.8 ± 2.7 years. For each patient left side served as control side (Group I) and right side as experimental side (Group II). At the time of first premolar extraction, periodontal distraction was performed only on the experimental side, followed by retraction of canine from mini-implant by closed NiTi coil spring on both the sides. “Nemotech” software was used to evaluate the amount of canine retraction for a period of 3 months. Results Significantly higher amount of tooth movement was seen from T0–T1 and from T1–T2 in Group II for the maxillary parameters 3C-5C, 6CF-3C, 3C-I/3C-J and for the mandibular parameter 6CF?-3C?. Whereas no significant amount of tooth movement was observed for maxillary and mandibular parameters between T2-T3 except for 6CF?-3C? (p ? 0.01) which was significantly higher for the Group II. Conclusion There was accelerated canine retraction on the periodontal distraction side as compared to the control side, with negligible anchorage loss. PMID:25737943

  11. [Multivariate analysis of mandibular morphology with fetal growth by means of the soft standardized radiographs].

    PubMed

    Uchida, Y; Akiyoshi, T; Goto, M; Katsuki, T

    1993-11-01

    Mandibular growth of the fetus is a great matter of importance to anatomy, anthropology and also oral and Maxillofacial surgery. The postnatal changes of the mandible that have occurred with growth have been reported by numerous investigators. However, a few researchers have investigated the prenatal growth of the mandible. The purposes of this study were discussed how to change in size and shape of the mandible during the fetal period. The materials consisted of 162 human fetuses from the body length (BL) of 95 mm, to 500 mm. They were divided into four groups: 95-199 mm (BL1, N = 40), 200-299 mm (BL2, N = 76), 300-399 mm (BL3, N = 26), 400-500 mm (BL4, N = 20). All specimens were stored in formalin, and only those free from gross deformation were selected for study. The heads were removed by decapitation at the level of the hyoid bone. The soft standardized radiographs were taken of the frontal, lateral, basal aspects. They were used for tracing and angular and linear measurements (total thirty). The data were used to evaluate the mandibular form by multivariate analysis. They were supported the univariate analysis. The findings leads to the following conclusions: 1) Cluster analysis and principal component analysis were applied to the data to make clear the correlation between 30 variables. Four clusters were constructed at the level ninety similarities in cluster analysis. They were corresponded to four factors were obtained in principal component analysis. 2) The data were subjected to a stepwise discriminant function analysis using the seventeen of original 30 variables. Nine variables, mandibular length (Go-Me), mandibular ramus height (Col-Go), Symphyseal height (Id-Me), mandibular body height (Kr'-beta), gonial angle (< Co2, Go, Me), mental angle (< Id, Pog, Go), gonial width (BGo), alveolar width (BKr'), basal angle of mandible (< RGo, Me, LGo), were selected as the best discriminators. The incidence of correctly classified cases 88.68%. 3) As a result of the first discriminant function of the discriminant analysis and one-way analysis of variance (ANOVA) and t-test, mandibular length (Go-Me), gonial width (BGo), alveolar width (BKr'), Symphyseal height (Id-Me) were longer in tall group that short group (BL4 > BL3 > BL2 > BL1). Therefore, the first discriminant function was accounted for the size factor. 4) In consequence of the second discriminant function of the discriminant analysis and regression analysis, gonial width (BGo) was grown broader than alveolar width (BKr') from BL1 to BL2.(ABSTRACT TRUNCATED AT 400 WORDS) PMID:8276342

  12. Pediatric Cochlear Implantation: Why Do Children Receive Implants Late?

    PubMed Central

    Ham, Julia; Whittingham, JoAnne

    2015-01-01

    Objectives: Early cochlear implantation has been widely promoted for children who derive inadequate benefit from conventional acoustic amplification. Universal newborn hearing screening has led to earlier identification and intervention, including cochlear implantation in much of the world. The purpose of this study was to examine age and time to cochlear implantation and to understand the factors that affected late cochlear implantation in children who received cochlear implants. Design: In this population-based study, data were examined for all children who underwent cochlear implant surgery in one region of Canada from 2002 to 2013. Clinical characteristics were collected prospectively as part of a larger project examining outcomes from newborn hearing screening. For this study, audiologic details including age and severity of hearing loss at diagnosis, age at cochlear implant candidacy, and age at cochlear implantation were documented. Additional detailed medical chart information was extracted to identify the factors associated with late implantation for children who received cochlear implants more than 12 months after confirmation of hearing loss. Results: The median age of diagnosis of permanent hearing loss for 187 children was 12.6 (interquartile range: 5.5, 21.7) months, and the age of cochlear implantation over the 12-year period was highly variable with a median age of 36.2 (interquartile range: 21.4, 71.3) months. A total of 118 (63.1%) received their first implant more than 12 months after confirmation of hearing loss. Detailed analysis of clinical profiles for these 118 children revealed that late implantation could be accounted for primarily by progressive hearing loss (52.5%), complex medical conditions (16.9%), family indecision (9.3%), geographical location (5.9%), and other miscellaneous known (6.8%) and unknown factors (8.5%). Conclusions: This study confirms that despite the trend toward earlier implantation, a substantial number of children can be expected to receive their first cochlear implant well beyond their first birthday because they do not meet audiologic criteria of severe to profound hearing loss for cochlear implantation at the time of identification of permanent hearing loss. This study underscores the importance of carefully monitoring all children with permanent hearing loss to ensure that optimal intervention including cochlear implantation occurs in a timely manner. PMID:26035143

  13. Anchorage reinforcement with a fixed functional appliance during protraction of the mandibular second molars into the first molar extraction sites.

    PubMed

    Chhibber, Aditya; Upadhyay, Madhur

    2015-07-01

    Protraction of posterior teeth into edentulous spaces is a challenge. This report describes the treatment of a 19-year-old woman with missing mandibular first molars owing to caries. A fixed functional appliance was used for anchorage reinforcement during mandibular second molar protraction. Eight millimeters of bilateral protraction was done with bodily mesial movement of the molars and no lingual tipping of the incisors. PMID:26124039

  14. Paracrine dialogue in implantation.

    PubMed

    Dominguez, F; Pellicer, A; Simón, C

    2002-01-25

    We know that the implantation process requires a functionally normal embryo at the blastocyst stage and a receptive endometrium, but also a communication link between them is needed. This paracrine dialogue between the embryo, endometrium and the corpus luteum are known to occur in ruminants and primates, more specifically endometrial-embryonic interactions have been reported in rodents and primates but not in humans. This process is a highly regulated mechanism and many molecules take part in this cross-talk. Here, we present updated information in humans on the embryonic regulation of endometrial epithelial molecules such as chemokines, adhesion and anti-adhesion molecules, and leptin during the apposition and adhesion phases of human implantation. PMID:11900893

  15. Piezosurgery in implant dentistry

    PubMed Central

    Stübinger, Stefan; Stricker, Andres; Berg, Britt-Isabelle

    2015-01-01

    Piezosurgery, or the use of piezoelectric devices, is being applied increasingly in oral and maxillofacial surgery. The main advantages of this technique are precise and selective cuttings, the avoidance of thermal damage, and the preservation of soft-tissue structures. Through the application of piezoelectric surgery, implant-site preparation, bone grafting, sinus-floor elevation, edentulous ridge splitting or the lateralization of the inferior alveolar nerve are very technically feasible. This clinical overview gives a short summary of the current literature and outlines the advantages and disadvantages of piezoelectric bone surgery in implant dentistry. Overall, piezoelectric surgery is superior to other methods that utilize mechanical instruments. Handling of delicate or compromised hard- and soft-tissue conditions can be performed with less risk for the patient. With respect to current and future innovative surgical concepts, piezoelectric surgery offers a wide range of new possibilities to perform customized and minimally invasive osteotomies. PMID:26635486

  16. Miniature implantable ultrasonic echosonometer

    NASA Technical Reports Server (NTRS)

    Kojima, G. K. (inventor)

    1978-01-01

    A miniature echosonometer adapted for implantation in the interior of an animal for imaging the internal structure of a organ, tissue or vessel is presented. The echosonometer includes a receiver/transmitter circuit which is coupled to an ultrasonic transducer. Power is coupled to the echosonometer by electromagnetic induction through the animal's skin. Imaging signals from the echosonometer are electromagnetically transmitted through the animal's skin to an external readout apparatus.

  17. Orthodontic treatment combined with tooth transplantation for an adult patient with a missing mandibular first molar: long-term follow-up.

    PubMed

    Watanabe, Yohei; Mohri, Tamaki; Yoshida, Rumi; Yamaki, Masaki; Saito, Isao

    2014-04-01

    A Japanese woman, age 29 years 8 months, had a missing mandibular left first molar, bimaxillary dentoalveolar protrusion, and crowding. She had a skeletal Class II relationship and a long face with a steep mandible. She had previously undergone root canal treatment for the mandibular right second premolar, and the mandibular left third molar was impacted. The maxillary left first premolar was extracted for autotransplantation to the mandibular left first molar region. After confirmation of a favorable prognosis for the transplanted tooth, the maxillary right first premolar, the mandibular right second premolar, and the impacted mandibular left third molar were extracted for orthodontic treatment. The active orthodontic treatment period was 32 months. The patient returned for follow-up records 12 years 7 months after the active treatment, and her facial profile and occlusion were well maintained. At 13 years 9 months after transplantation, no abnormalities were observed with the transplanted tooth in the radiographic and clinical evaluations. PMID:24680019

  18. Management of obstructive sleep apnea in an edentulous lower jaw patient with a mandibular advancement device.

    PubMed

    Keyf, Filiz; Ciftci, Bülent; F?rat Güven, Selma

    2014-01-01

    Obstructive sleep apnea (OSA) is the most common sleep-related breathing disorder with periodic reduction or cessation of airflow during sleep. It is associated with loud snoring, disrupted sleep, and witnessed apneas. Treatment of OSA varies from simple measures such as oral appliances and nasal continuous positive airway pressure (CPAP) to surgical procedures like uvulopalatopharyngoplasty and tracheostomy. Oral appliances are a viable nonsurgical treatment alternative in patients with OSA, of which mandibular advancement devices are most common. Edentulism which contributes to the worsening of OSA reduces the number of available therapeutic strategies and is considered a contraindication to oral appliance therapy. This clinical report describes the treatment of a 63-year-old edentulous OSA patient for whom a mandibular advancement device was designed. PMID:24551463

  19. Maxillary and mandibular first premolars showing three-cusp pattern: an unusual presentation.

    PubMed

    Nayak, Ramakant; Kotrashetti, Vijayalakshmi; Nayak, Aarati; Patil, Viraj; Kulkarni, Mayuri; Somannavar, Pradeep; Hosmani, Jagadish

    2013-01-01

    Dental anatomy is the study of morphology of various teeth in human dentitions. The application of dental anatomy in clinical practice is important, and dentist should have a thorough knowledge regarding the morphology of the teeth. At times as a result of genetic variation, environmental factors, diet of an individual and race, variations in the morphology of the teeth can be observed. These variations have been extensively studied by the researcher in the field of anthropology to define a particular race. The most commonly observed changes include peg-shaped laterals, shovel-shaped incisors, and extra cusp on molar. Common variations documented with regard to maxillary and mandibular first premolars are the variation in the number of roots. But the variations with respect to crown morphology are few. We report a first documented unusual presentation of maxillary and mandibular first premolars with three-cusps pattern in a female patient. PMID:23476817

  20. Comparative study of mandibular linear measurements obtained by cone beam computed tomography and digital calipers

    PubMed Central

    Tarazona-Álvarez, Pablo; Romero-Millán, Javier; Peñarrocha-Oltra, David; Fuster-Torres, María Á.; Tarazona, Beatriz

    2014-01-01

    Objectives: Cone beam computed tomography (CBCT) is an innovative dental of imaging system characterized by rapid volumetric imaging with patient exposure to a single dose of radiation. The present study was carried out to compare the linear measurements obtained with CBCT and digital caliper in 20 mandibles from human cadavers. Study design: A total of 4800 linear measurements were measured between different mandibular anatomical points with CBCT and digital caliper. The real measurements were defined as those obtained with the digital caliper. Posteriorly, the mandibles were scanned to obtain the CBCT images, with software-based measurements of the distances. Results: The measurements obtained with the digital caliper were greater. The CBCT technique underestimated distances greater than 100 mm. Conclusions: CBCT allows to obtain linear mandibular anatomical measurements equivalent to those obtained with digital caliper. The differences existing between both methods were clinically acceptable. Key words:Computed tomography, cone beam CT, accuracy, reliability, digital caliper. PMID:25136429

  1. Sudden rupture of the internal maxillary artery causing pseudoaneurysm (mandibular part) secondary to subcondylar mandible fracture.

    PubMed

    Bozkurt, Mehmet; Kapi, Emin; Karakol, Percin; Yorgancilar, Ediz

    2009-09-01

    The mandible is one of the most frequently fractured bones of the face. Condylar fractures are the most common mandibular fractures in adults. The potential complications of mandibular fractures are infection, paresthesia, malunion, nonunion, asymmetry, and long-term functional and growth disturbances. In this article, we report an uncommon case of life-threatening pseudoaneurysm of the internal maxillary artery secondary to subcondylar fracture. We believe that the subcondylar fracture on the vertical vector and oblique direction can damage vital tissues such as the internal maxillary artery, and this injury was, to our knowledge, the first reported acute pseudoaneurysm, which occurred just after the injury at the initial part of the maxillary artery. PMID:19816273

  2. [Surgical versus non-surgical treatment of unilateral dislocated fractures of the lower mandibular condyle].

    PubMed

    Worsaae, N; Thorn, J J

    1995-06-12

    To compare open versus closed reduction of unilaterally dislocated low subcondylar fractures in adults, 101 consecutive patients were treated either by closed reduction with a median of four weeks of maxillomandibular fixation or by a median of six weeks of maxillomandibular fixation after surgical repositioning and transosseous wiring of the dislocated condylar fragment. No selection of patients was done for either treatment. Fifty-two patients were observed for a median of two years after treatment. Complications such as malocclusion, mandibular asymmetry, impaired masticatory function, and pain located to the affected joint or masticatory muscles were significantly more frequent in patients treated with closed reduction (39%) compared with those treated surgically (4%)(p = 0.005). Neither the degree of dislocation of the proximal fragment, concomitant mandibular fractures, nor the absence of posterior occlusal support seemed to influence the results. PMID:7792975

  3. On the genetics of mandibular prognathism: analysis of large European noble families.

    PubMed Central

    Wolff, G; Wienker, T F; Sander, H

    1993-01-01

    Mandibular prognathism is assumed to be a polygenic trait in the vast majority of cases. In a few families, this phenotype and perhaps a syndrome with a broader spectrum of facial anomalies seems to be determined by a single dominant gene of very low frequency (McKusick No *176700). The phenotype is known to have occurred independently in several European noble families. We constructed a pedigree comprising 13 of these families with 409 members in 23 generations in which mandibular prognathism has been segregating. Obviously, the presumed dominant gene is not fully penetrant in the heterozygous state. Pedigree analysis using the Elston-Stewart algorithm yields a maximum likelihood estimate (MLE) of p = 0.955 (SE 0.038) of the penetrance parameter. Images PMID:8445614

  4. Endodontic Retreatment of a Mandibular Second Molar with four Separate Roots: A Case Report

    PubMed Central

    Idris, Mohamed; Sakkir, Nasil; KJ, Nandakishore; Kini, Annapurna

    2014-01-01

    Aberrations in the root canal anatomy are a commonly occurring phenomenon. Although the mandibular second molar is commonly a bi-rooted tooth with an uncomplicated endodontic anatomy, variations have to be considered every time endodontic therapy is performed. This case report describes the non-surgical endodontic retreatment performed on a mandibular second molar with four seperate roots and canals. ProTaper Universal rotary nickel-titanium instruments (Dentsply Maillefer, Ballaigues, Switzerland) for treatment and retreatment were used to remove the old gutta percha and to clean and shape all root canals, followed by the complete obturation of root canal system. Post-operative CBCT scan was taken to confirm the quality of the performed treatment. PMID:24783160

  5. Assessment of Relapse Following Intraoral Vertical Ramus Osteotomy Mandibular Setback and Short-term Immobilization

    PubMed Central

    Talesh, Koroush Taheri; Motamedi, Mohammad Hosein Kalantar; Sazavar, Mahdi; Yazdani, Javad

    2010-01-01

    Aim: Relapse is an important issue of concern following operations for mandibular setback. Decreasing the immobilization (IMF) period may play a role in this regard. Usual IMF period ranges from 1 to 2 months. We aimed to assess relapse following a 1-week IMF period. Materials and methods: This study aimed to assess 40 purely prognathic patients who had undergone Vertical Ramus osteotomy for mandibular setback. After the release of IMF, guiding elastics were used to direct the mandible to maximal intercuspation for 3 weeks. Relapse was measured from cephalometric radiographs preoperatively and 1 year postoperatively. Results: The mean skeletal horizontal relapse after 1 year in 40 treated patients was 0.6 mm. Conclusion: The mean skeletal horizontal relapse after 1 year was similar to figures reported for this operation with longer fixation. PMID:20694038

  6. Endodontic therapy of a mandibular canine tooth with irreversible pulpitis secondary to dentigerous cyst.

    PubMed

    MacGee, Scott

    2014-01-01

    Dentigerous cysts are uncommon, yet are being reported with increasing frequency in the veterinary literature. Dentigerous cysts are a type of benign odontogenic cyst associated with impacted teeth, most commonly the mandibular first premolar tooth. Significant bone destruction can occur secondary to the expansion of a dentigerous cyst. The expanding cyst can lead to pathology of neighboring teeth, which can include external root resorption or pulpitis. Intraoral dental radiographs are imperative to properly assess the presence and extent of a dentigerous cyst, as well as the status of the neighboring teeth. This case report describes treatment for dentigerous cyst including cyst lining curettage, mandibular bone regeneration, and endodontic therapy for a canine tooth with irreversible pulpitis. PMID:24902411

  7. The Inferior Alveolar Nerve of the Horse: Course and Anatomical Relationship with Mandibular Cheek Teeth.

    PubMed

    Iacopetti, I; Faughnan, M; Bono, S; Cozzi, B; Facchini, C

    2015-10-01

    The precise location of neurovascular structures within the relatively long mandibular canal of the horse is of paramount importance in surgical procedures of the area. The inferior alveolar nerve (IAN) enters the mandibular canal on the medial (lingual) surface of the mandible and innervates all the mandibular teeth. During its course, the nerve moves laterally, crossing the roots of the inferior cheek teeth. However, the exact anatomical relationships occurring between the IAN and the roots of the equine mandibular cheek teeth have not been described in detail. In this study, the mandibles of 40 horses were examined with CT scans and then used for bilateral detailed anatomical dissection, to assess the path of the IAN and its relationship to the roots of the lower cheek teeth. The data obtained show that the equine IAN is located ventral to the apices of the molar teeth (311/411, 310/410, 309/409 according to the Triadan numerical system). At the level of PM(4) (308/408), the IAN is located on the lingual side of the roots and coronally to its apices. At the level of PM(3) (307/407), the IAN is then found on the lingual side of the roots but in proximity to the apices. In 2 of 40 horses (=5%), the IAN moves towards the lingual side between the mesial and the distal root of PM(4). Our observations are valuable for planning a surgical approach to the ventral side of the mandible in the horse and to avoid potential post-operative complications. PMID:25182080

  8. [Use of adaptogens for antioxidant system correction in complex treatment of mandibular fractures].

    PubMed

    Ushnitsky, I D; Terenteva, Z V; Kerschengolts, B M; Vinocurov, M M; Voronov, I V; Egorova, L I

    2015-01-01

    Antioxidatic protection has been studied in 84 patients with mandibular fractures between the ages of 21 and 40; the patients were divided into two groups. Activation of lipid peroxidation in both groups was revealed. The increase of antioxidant's activity system in 37.18% in the main study group that along with traditional treatment received Epsorin was determined. No complications in the main group during the post-surgery period were recorded. PMID:26271700

  9. Effect of alendronate on endochondral ossification in mandibular condyles of growing rats

    PubMed Central

    Bradaschia-Correa, V.; Barrence, F.A.C.; Ferreira, L.B.; Massa, L.F.; Arana-Chavez, V.E.

    2012-01-01

    The replacement of the calcified cartilage by bone tissue during the endochondral ossification of the mandibular condyle is dependent of the resorbing activity of osteoclats. After partial resorption, calcified cartilage septa are covered by a primary bone matrix secreted by osteoblasts. Osteoadherin (OSAD) is a small proteoglycan present in bone matrix but absent in cartilage during the endochondral ossification. The aim of this study was to analyze the effect of alendronate, a drug known to inhibit bone resorption by osteoclasts, on the endochondral ossification of the mandibular condyle of young rats, by evaluating the distribution of osteoclasts and the presence of OSAD in the bone matrix deposited. Wistar newborn rats (n=45) received daily injections of alendronate (n=27) or sterile saline solution as control (n=18) from the day of birth until the ages of 4, 14 and 30 days. At the days mentioned, the mandibular condyles were collected and processed for transmission electron microscopy analysis. Specimens were also submitted to tartrate resistant acid phosphatase (TRAP) histochemistry and ultrastructural immunodetection of OSAD. Alendronate treatment did not impede the recruitment and fusion of osteoclasts at the ossification zone during condyle growth, but they presented inactivated phenotype. The trabeculae at the ossification area consisted of cartilage matrix covered by a layer of primary bone matrix that was immunopositive to OSAD at all time points studied. Apparently, alendronate impeded the removal of calcified cartilage and maturation of bone trabeculae in the mandibular ramus, while in controls they occurred normally. These findings highlight for giving attention to the potential side-effects of bisphosphonates administered to young patients once it may represent a risk of disturbing maxillofacial development. PMID:22688305

  10. Proliferative periostitis of the mandibular ramus and condyle: a case report

    PubMed Central

    Seok, Hyun; Kim, Seong-Gon

    2015-01-01

    Proliferative periostitis is a rare form of osteomyelitis that is characterized by new bone formation with periosteal reaction common causes of proliferative periostitis are dental caries, periodontitis, cysts, and trauma. While proliferative periostitis typically presents as a localized lesion, in this study, we describe an extensive form of proliferative periostitis involving the whole mandibular ramus and condyle. Because the radiographic findings were similar to osteogenic sarcoma, an accurate differential diagnosis was important for proper treatment. PMID:26339579

  11. Computed Tomographic Morphometry of the Internal Anatomy of Mandibular Second Primary Molars

    PubMed Central

    Sharma, Pranjal; Swamy, Dinesh Francis; Shashidara, R; Swamy, Elaine Barretto

    2015-01-01

    ABSTRACT Need for the study: The most important procedure for a successful endodontic treatment is the cleaning and shaping of the canal system. Understanding the internal anatomy of teeth provides valuable information to the clinician that would help him achieve higher clinical success during endodontic therapy. Aims: To evaluate by computed tomography—the internal anatomy of mandibular second primary molars with respect to the number of canals, cross-sectional shape of canals, cross-sectional area of canals and the root dentin thickness. Materials and methods: A total of 31 mandibular second primary molars were subjected to computed-tomographic evaluation in the transverse plane, after mounting them in a prefabricated template. The images, thus, obtained were analyzed using De-winter Bio-wizard® software. Results: All the samples demonstrated two canals in the mesial root, while majority of the samples (65.48%) demonstrated two canals in the distal root. The cross-sectional images of the mesial canals demonstrated a round shape, while the distal canals demonstrated an irregular shape. The root dentin thickness was highly reduced on the distal aspect of mesial and mesial aspect of distal canals. Conclusion: The mandibular second primary molars demonstrated wide variation and complexities in their internal anatomy. A thorough understanding of the complexity of the root canal system is essential for understanding the principles and problems of shaping and cleaning, determining the apical limits and dimensions of canal preparations, and for performing successful endodontic procedures. How to cite this article: Kurthukoti AJ, Sharma P, Swamy DF, Shashidara R, Swamy EB. Computed Tomographic Morphometry of the Internal Anatomy of Mandibular Second Primary Molars. Int J Clin Pediatr Dent 2015;8(3):202-207. PMID:26628855

  12. Endodontic and Clinical Considerations in the Management of Variable Anatomy in Mandibular Premolars: A Literature Review

    PubMed Central

    Hammo, Mohammad

    2014-01-01

    Mandibular premolars are known to have numerous anatomic variations of their roots and root canals, which are a challenge to treat endodontically. The paper reviews literature to detail the various clinically relevant anatomic considerations with detailed techniques and methods to successfully manage these anomalies. An emphasis and detailed description of every step of treatment including preoperative diagnosis, intraoperative identification and management, and surgical endodontic considerations for the successful management of these complex cases have been included. PMID:24895584

  13. Mandibular ramus length as an indicator of chronological age and sex.

    PubMed

    de Oliveira, Fernando Toledo; Soares, Mariana Quirino Silveira; Sarmento, Viviane Almeida; Rubira, Cassia Maria Fischer; Lauris, José Roberto Pereira; Rubira-Bullen, Izabel Regina Fischer

    2015-01-01

    Age and sex estimation is crucial in forensic investigations, whether in legal situations that involve living people or to identify mortal remains. The aim of this study was to establish reference values in a Brazilian population to estimate age and sex by measuring the length of the mandibular ramus on lateral cephalometric radiographs, and to determine the probability that an individual being is 18 years or older, based on the results that were obtained. Two hundred and eighteen scanned lateral cephalograms of individuals between 6 and 20 years of age (101 males and 117 females) were measured with reference to mandibular ramus length (the distance between Condylion superior (Cs) and Gonion (Go)) using ImageJ 1.41 software (NIH, Bethesda, MA, USA). The results showed that sexual dimorphism was not observed until 16 years and, based on the ramus length measurements in this sample, it is possible to predict sex with an accuracy of only 54 %. There was a positive correlation between age and ramus length (r?=?0.90; p?mandibular ramus length was not effective in discriminating sex. Mandibular length is strongly related to chronological age and can be used to predict whether an individual is 18 years or older with high degree of expected accuracy. PMID:25270589

  14. In Vivo Characteristics of Premixed Calcium Phosphate Cements When Implanted in Subcutaneous Tissues and Periodontal Bone Defects

    PubMed Central

    Sugawara, Akiyoshi; Fujikawa, Kenji; Hirayama, Satoshi; Takagi, Shozo; Chow, Laurence C.

    2010-01-01

    Previous studies showed that water-free, premixed calcium phosphate cements (Pre-CPCs) exhibited longer hardening times and lower strengths than conventional CPCs, but were stable in the package. The materials hardened only after being delivered to a wet environment and formed hydroxyapatite as the only product. Pre-CPCs also demonstrated good washout resistance and excellent biocompatibility when implanted in subcutaneous tissues in rats. The present study evaluated characteristics of Pre-CPCs when implanted in subcutaneous tissues (Study I) and used for repairing surgically created two-wall periodontal defects (Study II). Pre-CPC pastes were prepared by combining CPC powders that consisted of CPC-1: Ca4(PO4)2O and CaHPO4, CPC-2: ?-Ca3(PO4)2 and CaCO3 or CPC-3: DCPA and Ca(OH)2 with a glycerol at powder-to-liquid mass ratios of 3.5, 2.5, and 2.5, respectively. In each cement mixture, the Ca to P molar ratio was 1.67. The glycerol contained Na2HPO4 (30 mass %) and hydroxypropyl methylcellulose (0.55 %) to accelerate cement hardening and improve washout resistance, respectively. In Study I, the test materials were implanted subcutaneously in rats. Four weeks after the operation, the animals were sacrificed and histopathological observations were performed. The results showed that all of the implanted materials exhibited very slight or negligible inflammatory reactions in tissues contacted with the implants. In Study II, the mandibular premolar teeth of mature beagle dogs were extracted. One month later, two-wall periodontal bone defects were surgically created adjacent to the teeth of the mandibular bone. The defects were filled with the Pre-CPC pastes and the flaps replaced in the preoperative position. The dogs were sacrificed at 1, 3 and 6 months after surgery and sections of filled defects resected. Results showed that one month after surgery, the implanted Pre-CPC-1 paste was partially replaced by bone and was converted to bone at 6 months. The pockets filled with Pre-CPC-2 were completely covered by newly formed bone in 1 month. The Pre-CPC-2 was partially replaced by trabecular bone in 1 month and was completely replaced by bone in 6 months. Examination of 1 month and 3 month samples indicated that Pre-CPC-2 resorbed and was replaced by bone more rapidly than Pre-CPC 1. Both Pre-CPC pastes were highly osteoconductive. When implanted in periodontal defects, Pre-CPC-2 was replaced by bone more rapidly than Pre-CPC-1. PMID:21037803

  15. JOM March 200846 www.tms.org/jom.html OverviewBiological Materials Science

    E-print Network

    Meyers, Marc A.

    failed hard tissue. Examples include ar- tificial hip joints, artificial knee joints, bone plates, screws for dentistry devices such as implants, crowns, bridges, overdentures, and dental implant prosthesis components

  16. The Evolution of Breast Implants.

    PubMed

    Gabriel, Allen; Maxwell, G Patrick

    2015-10-01

    Breast augmentation remains one of the most common procedures performed in the United States. However, shape, feel, safety, and longevity of the implants remain important areas of research. The data provided by manufacturers show the safety and efficacy of these medical devices. Clinicians should strive to provide ongoing data and sound science to continue to improve clinical outcomes in the future. This article explores the evolution of breast implants with special emphasis on the advancement of silicone implants. PMID:26408431

  17. Development of a biointegrated mandibular reconstruction device consisting of bone compatible titanium fiber mesh scaffold.

    PubMed

    Hirota, Makoto; Shima, Takaki; Sato, Itaru; Ozawa, Tomomichi; Iwai, Toshinori; Ametani, Akihiro; Sato, Mitsunobu; Noishiki, Yasuharu; Ogawa, Takahiro; Hayakawa, Tohru; Tohnai, Iwai

    2016-01-01

    Coating biomaterials with a thin hydroxyapatite (HA) was proven effective in enhancing bone compatibility. Segmental bone defects are considered as the most difficult defect to repair in bone regeneration therapy. We developed submicron-thin HA-coated titanium fiber mesh scaffolds to reconstruct immediately loaded segmental mandibular defects and evaluated their bone compatibility in vitro and in vivo. Human osteoblasts attachment, proliferation, and osteocalcin expression in non- and HA-coated scaffolds were evaluated. A 10-mm long segmental bone defect in a rabbit mandibular bone was reconstructed with non- or HA-coated scaffolds, which were removed at 9 and 21 weeks, to evaluate the mechanical strength of the bone-scaffold connection and the bone formation around the scaffold. Expression of osteocalcin was greater in HA-coated scaffolds. In vivo bone formation in HA-coated scaffolds was greater than that in non-coated scaffolds at 21 weeks. Newly formed bone in HA-coated scaffolds mostly restored bone continuity. Scanning electron microscopy identified strong integration of the bone and HA-coated scaffolds. The mechanical strength of the bone-scaffold connection was 3-fold greater in HA-coated scaffolds than that in non-coated scaffolds. These results suggest that a thin HA-coated titanium fiber mesh scaffold is a bone-compatible mandibular reconstruction device in immediately loaded segmental defects. PMID:26513415

  18. Automated scheme for measuring mandibular cortical thickness on dental panoramic radiographs for osteoporosis screening

    NASA Astrophysics Data System (ADS)

    Matsumoto, T.; Hayashi, T.; Hara, T.; Katsumata, A.; Muramatsu, C.; Zhou, X.; Iida, Y.; Matsuoka, M.; Katagi, Ki.; Fujita, H.

    2012-03-01

    Findings of dental panoramic radiographs (DPRs) have shown that the mandibular cortical thickness (MCT) was significantly correlated with osteoporosis. Identifying asymptomatic patients with osteoporosis through dental examinations may bring a supplemental benefit for the patients. However, most of the DPRs are used for only diagnosing dental conditions by dentists in their routine clinical work. The aim of this study was to develop a computeraided diagnosis scheme that automatically measures MCT to assist dentists in screening osteoporosis. First, the inferior border of mandibular bone was detected by use of an active contour method. Second, the locations of mental foramina were estimated on the basis of the inferior border of mandibular bone. Finally, MCT was measured on the basis of the grayscale profile analysis. One hundred DPRs were used to evaluate our proposed scheme. Experimental results showed that the sensitivity and specificity for identifying osteoporotic patients were 92.6 % and 100 %, respectively. We conducted multiclinic trials, in which 223 cases have been obtained and processed in about a month. Our scheme succeeded in detecting all cases of suspected osteoporosis. Therefore, our scheme may have a potential to identify osteoporotic patients at an early stage.

  19. Magnesium-enriched hydroxyapatite as bone filler in an ameloblastoma mandibular defect

    PubMed Central

    Grigolato, Roberto; Pizzi, Natalia; Brotto, Maria C; Corrocher, Giovanni; Desando, Giovanna; Grigolo, Brunella

    2015-01-01

    The aim of this study was to evaluate the clinical performance of a magnesium-enriched hydroxyapatite biomaterial used as bone substitute in a case of mandibular ameloblastoma treated with conservative surgery. A 63 year old male patient was treated for an ameloblastoma in the anterior mandibular profile. After tissue excision, the bone defect was filled with a synthetic hydroxyapatite biomaterial enriched with magnesium ions, in order to promote bone tissue regeneration and obtain a good aesthetic result. Twenty-five months after surgery, due to ameloblastoma recurrence in an area adjacent to the previously treated one, the patient underwent to a further surgery. In that occasion the surgeon performed a biopsy in the initially treated area, in order to investigate the nature of the newly-formed tissue and to evaluate the bone regenerative potential of this biomaterial by clinical, radiographic and histological analyses. The clinical, radiographic and histological evaluations showed various characteristics of bone remodeling stage with an ongoing osteogenic formation and a good osteo-integration. In conclusion, magnesium-enriched hydroxyapatite used as bone substitute in a mandibular defect due to ameloblastoma excision showed an effective bone regeneration at 25 months follow-up, demonstrating an excellent biocompatibility and a high osteo-integration property. PMID:25784998

  20. Treating temporomandibular disorders with permanent mandibular repositioning: is it medically necessary?

    PubMed

    Greene, Charles S; Obrez, Ales

    2015-05-01

    In this paper, the authors review the rationale and history of mandibular repositioning procedures in relation to temporomandibular disorders (TMDs) as these procedures have evolved over time. A large body of clinical research evidence shows that most TMDs can and should be managed with conservative treatment protocols that do not include any mandibular repositioning procedures. Although this provides a strong clinical argument for avoiding such procedures, very few reports have discussed the biologic reasons for either accepting or rejecting them. This scientific information could provide a basis for determining whether mandibular repositioning procedures can be defended as being medically necessary. This position paper introduces the biologic concept of homeostasis as it applies to this topic. The continuing adaptability of teeth, muscles, and temporomandibular joints throughout life is described in terms of homeostasis, which leads to the conclusion that each person's current temporomandibular joint position is biologically "correct." Therefore, that position does not need to be changed as part of a TMD treatment protocol. This means that irreversible TMD treatment procedures, such as equilibration, orthodontics, full-mouth reconstruction, and orthognathic surgery, cannot be defended as being medically necessary. PMID:25864818

  1. Non-CPAP therapies in obstructive sleep apnoea: mandibular advancement device therapy.

    PubMed

    Marklund, Marie; Verbraecken, Johan; Randerath, Winfried

    2012-05-01

    Mandibular advancement devices (MADs) represent the main non-continuous positive airway pressure (non-CPAP) therapy for patients with obstructive sleep apnoea (OSA). The aim of the European Respiratory Society Task Force was to review the evidence in favour of MAD therapy. Effects of tongue-retaining devices are not included in this report. Custom-made MADs reduce apnoea/hypopnoea index (AHI) and daytime sleepiness compared with placebo devices. CPAP more effectively diminishes AHI, while increasing data suggest fairly similar outcomes in relation to symptoms and cardiovascular health from these treatments. Patients often prefer MADs to CPAP. Milder cases and patients with a proven increase in upper airway size as a result of mandibular advancement are most likely to experience treatment success with MADs. A custom-made device titrated from an initial 50% of maximum mandibular advancement has been recommended. More research is needed to define the patients who will benefit from MAD treatment compared with CPAP, in terms of the effects on sleep-disordered breathing and on other diseases related to OSA. In conclusion, MADs are recommended for patients with mild to moderate OSA (Recommendation Level A) and for those who do not tolerate CPAP. The treatment must be followed up and the device adjusted or exchanged in relation to the outcome. PMID:22075487

  2. Masticatory mandibular movements for different foods textures related to onomatopoetic words.

    PubMed

    Nakajima, J; Hideshima, M; Takahashi, M; Taniguchi, H; Ohyama, T

    2001-12-01

    This study aimed to investigate the effects of different sensory-evaluated food textures on masticatory movements, and to identify meaningful factors that correspond to different food textures. Masticatory movements of three healthy subjects were evaluated with a jaw movement tracking device using five different test foods: almond, hard and light rice crackers, apple, and chewing gum. The movements of the incisor point, working and non-working condyle and the entire mandible at the occlusal phase in the horizontal plane were analyzed. For harder foods, the incisor entered the intercuspal position from a rear and lateral, the working condyle showed anterior and noticeable medial movements as the entire mandible translated posteriorly and medially. For soft foods, the incisor movements were nearly coincidental with the lateral border movements, and the mandible rotated towards the inner side near the working condyle. Although the overall paths of the mandibular movements are individually different, it appeared that jaw movement at the final closure is particular to the food texture. From the standpoint of mandibular movements, it is suggested that masticatory movements during the occlusal phase in the horizontal plane is useful for revealing the relationship between mandibular movements and food textures that were evaluated with onomatopoetic words. PMID:12160249

  3. Localized periodontal defect associated with unusual furcation involvement on a mandibular incisor.

    PubMed

    Kwon, TaeHyun; Intini, Giuseppe; Kim, David M; Levin, Liran

    2013-10-01

    A localized periodontal defect associated with an unusual furcation on a mandibular central incisor and its treatment sequences are presented. A 54-year-old woman presented with a persistent localized periodontal defect, which was not responsive to nonsurgical periodontal therapy. An exploratory surgery revealed complete through and through furcation involvement on the right mandibular central incisor, resulting in a three-walled infrabony defect. Following thorough mechanical debridement and root planing, the infrabony aspect of the defect was grafted with freeze-dried bone allograft combined with the recombinant human platelet-derived growth factor-BB. The flaps were positioned to enable patient's home care and professional dental cleaning. Follow-up examination revealed uneventful healing and resolution of the infrabony periodontal defect. Clinicians should be aware of this unusual condition and consider it as a potential etiology when dealing with a persistent localized periodontal defect in the mandibular anterior sextant, which may not respond to the conventional nonsurgical periodontal therapy. Eliminating the active disease as well as enabling careful maintenance and oral hygiene may prevent further deterioration and result in a stable long-term outcome preserving the compromised tooth. PMID:23878844

  4. Mandibular bone mineral density in patients with Behçet’s disease

    PubMed Central

    Asutay, Fatih; Atalay, Yusuf; Acar, Ahmet Hüseyin; Asutay, Hilal; Ero?lu, Selma; Burdurlu, Muammer Ça?r?

    2015-01-01

    Objectives Behçet’s disease (BD) is a chronic, recurring vasculitis of unknown etiology. Patients with BD may use a lot of medications associated with the clinical symptoms. Drugs that are used in the treatment of BD may cause bone loss. The aims of the current study were to compare the bone mineral density (BMD) values between BD and healthy volunteers and describe the effect of disease duration on mandibular BMD. Materials and methods The study comprised 30 healthy volunteers (15 males and 15 females, mean age 35.50±6.80 years) and 45 patients with BD (24 males and 21 females, mean age 38.93±8.93 years). The BD group was subdivided according to disease duration (0–5, 6–10, and >10 years). The BMD value of the mandibular body was determined by the dual energy X-ray absorptiometry technique. Results The mean mandibular body BMD values were 1.294±0.21 g/cm2 in the control group and 1.216±0.22 g/cm2 in the BD patients, although there was no statistically significant difference. The BMD was observed to decrease with increased disease duration but not to a statistically significant degree. Conclusion The results of this study showed that although the BMD value decreased as the duration of the disease increased, no statistically significant difference was found between the BD patients and the healthy control group. PMID:26508868

  5. A retrospective study of temporomandibular joint ankylosis secondary to surgical treatment of mandibular condylar fractures.

    PubMed

    Xiang, Guo-lin; Long, Xing; Deng, Mo-hong; Han, Qian-chao; Meng, Qing-gong; Li, Bo

    2014-03-01

    We investigated the incidence of ankylosis of the temporomandibular joint (TMJ) after open operations for fractures of the mandibular condyle, and analysed possible risk factors in a total of 385 patients with 492 condylar fractures who had been operated on in our department from 2001 to 2010. Sixteen patients developed postoperative ankylosis of the TMJ with 26 joints (5%) affected during a follow-up of 6 months-10 years. Of the 492 condylar fractures, the most common ones that were associated with postoperative ankylosis were those of the condylar head (20/248), followed by the condylar neck (6/193). Subcondylar fractures did not cause postoperative ankylosis (0/51). Among the 16 patients with postoperative ankylosis, 13 had associated anterior mandibular fractures. Long-screw (bicortical screw) fixation of fractures of the condylar head seemed to be associated with a lower incidence of postoperative ankylosis than fixation by miniplate and wire or removal of the fractured fragment. The articular discs were damaged in all ankylosed joints, and the remaining fractured fragment was found in 10 ankylosed joints after fractures of the condylar head. The results suggest that fractures of the condylar head are more prone to lead to postoperative ankylosis of the TMJ, and that the possible risk factors seem to include the technique used for fixation and damage to the disc, together with an anterior mandibular fracture with the fractured fragment remaining. PMID:24485809

  6. Traumatic dislocation of the mandibular condyle into the middle cranial fossa in an elderly patient.

    PubMed

    Tutela, John P; Verbist, Daniel E; Kelishadi, Shahrooz; Little, Jarrod A

    2013-09-01

    Dislocation of the mandibular condyle into the middle cranial fossa is a rare traumatic injury caused by transmission of upward force through the condyle onto the glenoid fossa resulting in fracture of the fossa and superior displacement of the condylar head. This type of injury occurs when the "safety mechanisms" of the mandible fail or are absent. The authors present the case of a 72-year-old female patient with multiple comorbidities who suffered a subcondylar fracture of the left mandible and dislocation of the right mandibular condyle into the middle cranial fossa after a fall. Bilateral external fixation of the mandible to the zygomatic arch was utilized to minimize operative time and provide definitive treatment. Many factors must be taken into account when determining the treatment modality for this type of injury, and the final decision should be tailored to each individual case based on several factors including the length of time between injury and presentation, concomitant neurologic deficit, age, and stability of the patient. The goals of treatment are reduction of the dislocation, avoidance of neurologic injury, and restoration of mandibular function. A multidisciplinary effort is necessary to optimize patient care. PMID:24036758

  7. Comparison of Mandibular Phenotypic and Genetic Integration between Baboon and Mouse

    PubMed Central

    Roseman, Charles C.; Rogers, Jeffrey; Cheverud, James M.; Richtsmeier, Joan T.

    2011-01-01

    In this study we compare patterns of mandibular integration between mice and baboons using both phenotypic and quantitative genetic data. Specifically, we test how well each species fits with the mosaic model of mandibular integration suggested by Atchley and Hall (Biol Rev Camb Philos Soc 66:101–157, 1991) based on developmental modules. We hypothesize that patterns of integration will be similar for mice and baboons and that both species will show strong integration within developmental modules and weaker integration between modules. Corresponding landmark data were collected from the hemi-mandibles of an advanced intercross mouse sample (N = 1239) and mandibles from a baboon sample of known pedigree from the Southwest Foundation for Biomedical Research (N = 430). We used four methods of analysis to quantify and compare the degree of mandibular integration between species including two methods based on a priori assumptions, and two a posteriori analyses. We found that patterns of integration are broadly similar for baboon and mouse mandibles, with both species displaying a modular pattern of integration. While there is a general trend of similarity in integration patterns between species, there were some marked differences. Mice are strongly correlated among distances within the coronoid process and the incisive alveolar region, whereas baboons are strongly integrated within the condylar process. We discuss the potential evolutionary implications of the similar patterns of integration between these species with an emphasis on the role of modularity. PMID:22212926

  8. Ectopic third molar in the mandibular condyle: A review of the literature

    PubMed Central

    Iglesias-Martin, Fernando; Torres-Carranza, Eusebio; Prats-Golczer, Victoria-Eugenia; Garcia-Perla-Garcia, Alberto

    2012-01-01

    Objectives: To evaluate the etiopathogenesis, clinical features, therapeutic options, and surgical approaches for removal of ectopic third molars in the mandibular condyle. Study design: MEDLINE search of articles published on ectopic third molars in the mandibular condyle from 1980 to 2011. 14 well-documented clinical cases from the literature were evaluated together with a new clinical case provided by the authors, representing a sample of 15 patients. Results: We found a mean age at diagnosis of 48.6 years and a higher prevalence in women. In 14 patients, associated radiolucent lesions were diagnosed on radiographic studies and confirmed histopathologically as odontogenic cysts. Clinical symptoms were pain and swelling in the jaw or preauricular region, trismus, difficulty chewing, cutaneous fistula and temporomandibular joint dysfunction. Treatment included conservative management in one case and in the other cases, surgical removal by intra- or extraoral approaches, the latter being the most common approach carried out. In most reported cases, serious complications were not outlined. Conclusions: The etiopathogenic theory involving odontogenic cysts in the displacement of third molars to the mandibular condyle seems to be the most relevant. They must be removed if they cause symptoms or are associated with cystic pathology. The surgical route must be planned according to the location and position of the ectopic third molar, and the possible morbidity associated with surgery. Key words:Third molar, ectopic tooth, condyle, mandible. PMID:22926463

  9. Wound ballistics of the pig mandibular angle: a preliminary finite element analysis and experimental study.

    PubMed

    Chen, Yubin; Miao, Yingyun; Xu, Chuan; Zhang, Gang; Lei, Tao; Tan, Yinghui

    2010-04-19

    To study wound ballistics of the mandibular angle, a combined hexahedral-tetrahedral finite element (FE) model of the pig mandible was developed to simulate ballistic impact. An experimental study was carried out by measuring impact load parameters from 14 fresh pig mandibles that were shot at the mandibular angle by a standard 7.62 mm M43 bullet. FE analysis was executed through the LS-DYNA code under impact loads similar to those obtained from the experimental study. The resulting residual velocity, the transferred energy from the bullet to the mandible, and the surface area of the entrance wound had no statistical differences between the FE simulation and the experimental study. However, the mean surface area of the exit wounds in the experimental study was significantly larger than that in the simulation. According to the FE analysis, the stress concentrated zones were mainly located at the region of impact, condylar neck, coronoid process and mandibular body. The simulation results also indicated that trabecular bone had less stress concentration and a lower speed of stress propagation compared with cortical bone. The FE model is appropriate and conforms to the basic principles of wound ballistics. This modeling system will be helpful for further investigations of the biomechanical mechanisms of wound ballistics. PMID:20079496

  10. Complications of mandibular distraction osteogenesis for acquired deformities: a systematic review of the literature.

    PubMed

    Verlinden, C R A; van de Vijfeijken, S E C M; Tuinzing, D B; Becking, A G; Swennen, G R J

    2015-08-01

    A systematic review on complications in all forms of mandibular distraction osteogenesis (MDO) for acquired deformities was performed. Search terms expressing distraction osteogenesis were used in 'AND' combination with search terms comprising 'mandible' and terms for complication, failure, and morbidity. A search using PubMed (National Library of Medicine, NCBI), EMBASE, and the Cochrane Controlled Trials Register yielded 644 articles published between 1966 and mid October 2013. Three hundred and twenty-one eligible articles were screened in detail. Complications related to MDO in acquired deformities were reported in 105 clinical articles, involving 1332 patients. Treatments included alveolar distraction osteogenesis (ADO), mandibular lengthening, DO in bone grafts, and bi-/trifocal transport disc DO (TDDO) for segmental mandibular defects. A high incidence of complications was seen in MDO for acquired deformities (ADO 44.4%; residual group 43.9%). An index for classifying complications in MDO, based on the impact and further treatment or final results, was used. In the ADO group, soft tissue complications (8.0%), insufficient vector control (7.6%), temporary inferior alveolar nerve (IAN) neurosensory disturbances (6.5%), device-related problems (3.5%), mandible fractures (2.8%), insufficient bone formation (2.5%), and fracture of the transport disc (1.3%) were seen. In the residual group, temporary IAN neurosensory disturbances (13.4%), minor infection (5.3%), DO failure (4.0%), and device-related problems (3.8%) were reported. PMID:25842053

  11. Complications of Mandibular Fracture: Study of the Treatment Methods in Calabar, Nigeria

    PubMed Central

    Anyanechi, CE; Saheeb, BD

    2014-01-01

    Objective: The plethora of techniques available for the treatment of mandibular fractures suggests that there is controversy regarding their definitive outcome. The purpose of this study was to clinically study the complications associated with the different treatment methods of mandibular fractures at the University of Calabar Teaching Hospital (UCTH), Nigeria. Methods: This was a three-year prospective study carried out at the Dental and Maxillofacial Clinic of the hospital. Patients who met the inclusion criteria had their data recorded in a proforma questionnaire. Results: Out of the 256 patients studied, 17.2% developed complications. Complications were commoner (70.5%) between ages 21 and 50 years. Thirty-five (79.5%) were males while nine (20.5%) were females with a male:female ratio of 4.9:1. Following treatment by closed reduction, conservative and open reduction, 16.6%, 17.2% and 20.7% had complications, respectively. Whereas occlusal derangement was the most common complication, numbness of the cheek and lower lip was recorded following all treatment methods. Conclusion: Although the complications recorded in this patient population were managed during postoperative follow-up period, the methods of treatment available give good results, are cost-effective and patient compliance is good. This suggests that the older methods of treatment of mandibular fractures can still be used with reliability in contemporary dental practice. PMID:25429480

  12. Morphology of the Physiological Apical Foramen in Maxillary and Mandibular First Molars

    PubMed Central

    Abarca, J.; Zaror, C.; Monardes, H.; Hermosilla, V.; Muñoz, C.; Cantin, M.

    2015-01-01

    SUMMARY Information regarding the anatomy of the physiological apical foramen is limited. Knowing its diameter and shapes contributes to clinical work, specifically to the cleaning and shaping of the apical third. The aim of this ex vivo study was to determine the minimum and maximum diameters and shape of the physiological apical foramen in the roots of maxillary and mandibular first molars. A descriptive study was conducted on 89 recently extracted first molars. Roots 3–5 mm from the apex were sectioned and prepared for analysis at 40× magnification. The minimum and maximum diameters of each physiological foramen were measured using the program Motic Images plus 2.0 ML. The shape of the foramina, classified as round, oval or irregular, was determined by the difference between the maximum and minimum diameters. A total of 174 physiological foramina were analyzed. The average of the minimum and maximum diameters was between 0.24–0.33 mm in maxillary first molars and between 0.25–0.33 mm in mandibular first molars. In maxillary molars, the most common shape of the foramen was oval (50%), then irregular (32%), then round (18%). In mandibular molars, the oval shape was also the most frequent (59%), followed by irregular (23%) and round (18%). The findings of this study regarding the morphology of physiological apical foramina in first molars make it easier for the operator to choose the appropriately-sized instruments to perform endodontic therapy successfully. PMID:25937698

  13. Current Concepts in the Mandibular Condyle Fracture Management Part I: Overview of Condylar Fracture

    PubMed Central

    Yang, Jung-Dug; Chung, Ho-Yun; Cho, Byung-Chae

    2012-01-01

    The incidence of condylar fractures is high, but the management of fractures of the mandibular condyle continues to be controversial. Historically, maxillomandibular fixation, external fixation, and surgical splints with internal fixation systems were the techniques commonly used in the treatment of the fractured mandible. Condylar fractures can be extracapsular or intracapsular, undisplaced, deviated, displaced, or dislocated. Treatment depends on the age of the patient, the co-existence of other mandibular or maxillary fractures, whether the condylar fracture is unilateral or bilateral, the level and displacement of the fracture, the state of dentition and dental occlusion, and the surgeonnds on the age of the patient, the co-existence of othefrom which it is difficult to recover aesthetically and functionally;an appropriate treatment is required to reconstruct the shape and achieve the function ofthe uninjured status. To do this, accurate diagnosis, appropriate reduction and rigid fixation, and complication prevention are required. In particular, as mandibular condyle fracture may cause long-term complications such as malocclusion, particularly open bite, reduced posterior facial height, and facial asymmetry in addition to chronic pain and mobility limitation, great caution should be taken. Accordingly, the authors review a general overview of condyle fracture. PMID:22872830

  14. Implant biomaterials: A comprehensive review

    PubMed Central

    Saini, Monika; Singh, Yashpal; Arora, Pooja; Arora, Vipin; Jain, Krati

    2015-01-01

    Appropriate selection of the implant biomaterial is a key factor for long term success of implants. The biologic environment does not accept completely any material so to optimize biologic performance, implants should be selected to reduce the negative biologic response while maintaining adequate function. Every clinician should always gain a thorough knowledge about the different biomaterials used for the dental implants. This article makes an effort to summarize various dental bio-materials which were used in the past and as well as the latest material used now. PMID:25610850

  15. Implant-supported denture in a patient with Huntington's disease: interdisciplinary aspects.

    PubMed

    Jackowski, J; Andrich, J; Käppeler, H; Zöllner, A; Jöhren, P; Müller, T

    2001-01-01

    Patients with extrapyramidal diseases often cannot maintain independent, efficient oral hygiene due to restricted motor ability of the upper extremities and lack of coordination. The hermetic closure of the mouth and lips, and the associated ability to keep liquid and toothpaste in the mouth, can become so weak that effective oral hygiene cannot be maintained. Over a period of many years, this illness leads to loss of teeth and the need for complete prosthodontic care. Dyskinesia and hyperkinesia of the tongue and the peri-oral musculature, combined with xerostomia and pooling of saliva, make it impossible for the patient to wear a conventional complete denture, despite an anatomically-adequate bearing area. In such cases, an implant-supported prosthesis is a better therapeutic measure, although some aspects of oral hygiene must initially be disregarded. Two ITI implants were inserted into the anterior mandibular region of a patient with Huntington's chorea, because a complete denture could not be retained on the alveolar ridge, despite adequate vestibule depth, due to tongue dyskinesia. A bar joint was used to anchor this mucosal-borne denture. This implant-supported complete denture led to a clear improvement in the patient's chewing function when observed over a period of a year. PMID:11795447

  16. Remotely Controlled Mandibular Protrusion during Sleep Predicts Therapeutic Success with Oral Appliances in Patients with Obstructive Sleep Apnea

    PubMed Central

    Remmers, John; Charkhandeh, Shouresh; Grosse, Joshua; Topor, Zbigniew; Brant, Rollin; Santosham, Peter; Bruehlmann, Sabina

    2013-01-01

    Study Objectives: The present study addresses the need for a validated tool that prospectively identifies favorable candidates for oral appliance therapy in treatment of obstructive sleep apnea. The objective of the study was to evaluate the ability of a mandibular titration study, performed with a remotely controlled mandibular positioner (RCMP), to predict treatment outcome with a mandibular repositioning appliance (MRA) and to predict an effective target protrusive position (ETPP). Design: A prospective, blinded, outcome study. Setting: Standard clinical care with tests performed in the polysomnographic laboratory. Participants: Consecutive patients (n = 67) recruited from a sleep center or a dental practice using broad inclusion criteria (age 21-80 years; AHI > 10/h; BMI < 40 kg/m2). Interventions: Therapeutic outcome with a mandibular protruding oral appliance was predicted following a mandibular protrusive titration study in the polysomnographic laboratory using a remotely controlled positioner and prospectively established predictive rules. An ETPP was also prospectively determined for participants predicted to be therapeutically successful with MRA therapy. All participants were blindly treated with a MRA, at either the predicted ETPP or a sham position, and therapeutic outcome was compared against prediction. Measurements and Results: At the final protrusive position, standard predictive parameters (sensitivity, specificity, positive and negative predictive values) showed statistically significant predictive accuracy (P < 0.05) in the range of 83% to 94%. The predicted ETPP provided an efficacious protrusive position in 87% of participants predicted to be therapeutically successful with MRA therapy (P < 0.05). Conclusions: Using prospectively established rules for interpreting the polysomnographic data, the mandibular titration study predicted mandibular repositioning appliance therapeutic outcome with significant accuracy, particularly with regard to accurately predicting therapeutic success. As well, among the participants predicted to be therapeutically successful with mandibular repositioning appliance therapy, the effective target protrusive position provided efficacious mandibular protrusion in the majority. Citation: Remmers J; Charkhandeh S; Grosse J; Topor Z; Brant R; Santosham P; Bruehlmann S. Remotely controlled mandibular protrusion during sleep predicts therapeutic success with oral appliances in patients with obstructive sleep apnea. SLEEP 2013;36(10):1517-1525. PMID:24082311

  17. Using implants for prosthodontic rehabilitation of a 4-year-old with ectodermal dysplasia.

    PubMed

    Toomarian, Lida; Ardakani, Mohammad Reza Talebi; Ramezani, Jamileh; Adli, Amin Rezaei; Tabari, Zahra Alizadeh

    2014-01-01

    Ectodermal dysplasia (ED) is an inherited disorder that affects ectodermally derived organs, such as teeth. Pathogenesis is thought to involve an altered epithelium-mesenchymal interaction. ED patients have oligodontia (or sometimes anodontia) in addition to other abnormalities involving the skin, sweat glands, or hair. Many different subtypes have been introduced in the literature. This article describes the case of a 4-year-old patient who, after being diagnosed with ED, was put on a treatment plan that involved mandibular implants, reshaping of the maxillary primary central incisors, and prosthetic dental rehabilitation. Due to the child's rapid growth, both dentures were changed 9 months post-treatment. Two years post-treatment, the maxillary denture was changed again and the child was placed under close supervision. PMID:25184725

  18. A Lightweight Cryptographic System for Implantable Biosensors

    E-print Network

    De Micheli, Giovanni

    A Lightweight Cryptographic System for Implantable Biosensors Sara S. Ghoreishizadeh, Tolga Yalc presents a lightweight cryptographic system integrated onto a multi-function implantable biosensor--Lightweight encryption, Keccak hash function, Authentication, Privacy, Implantable biosensor. I. INTRODUCTION Recently

  19. Neutrophil Responses to Sterile Implant Materials

    E-print Network

    Jhunjhunwala, Siddharth

    In vivo implantation of sterile materials and devices results in a foreign body immune response leading to fibrosis of implanted material. Neutrophils, one of the first immune cells to be recruited to implantation sites, ...

  20. 21 CFR 522.1350 - Melatonin implant.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 2010-04-01 false Melatonin implant. 522.1350 Section 522.1350...ANIMAL DRUGS § 522.1350 Melatonin implant. (a) Specifications . The drug is a silicone rubber elastomer implant containing 2.7 milligrams of...

  1. 21 CFR 522.1350 - Melatonin implant.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ...2013-04-01 2013-04-01 false Melatonin implant. 522.1350 Section 522...FORM NEW ANIMAL DRUGS § 522.1350 Melatonin implant. (a) Specifications ...implant containing 2.7 milligrams of melatonin. (b) Sponsor . See No....

  2. 21 CFR 522.1350 - Melatonin implant.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ...2012-04-01 2012-04-01 false Melatonin implant. 522.1350 Section 522...FORM NEW ANIMAL DRUGS § 522.1350 Melatonin implant. (a) Specifications ...implant containing 2.7 milligrams of melatonin. (b) Sponsor . See No....

  3. 21 CFR 522.1350 - Melatonin implant.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ...2011-04-01 2011-04-01 false Melatonin implant. 522.1350 Section 522...FORM NEW ANIMAL DRUGS § 522.1350 Melatonin implant. (a) Specifications ...implant containing 2.7 milligrams of melatonin. (b) Sponsor . See No....

  4. 21 CFR 522.1350 - Melatonin implant.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ...2014-04-01 2014-04-01 false Melatonin implant. 522.1350 Section 522...FORM NEW ANIMAL DRUGS § 522.1350 Melatonin implant. (a) Specifications. ...implant containing 2.7 milligrams of melatonin. (b) Sponsor. See No....

  5. Broad beam ion implanter

    DOEpatents

    Leung, Ka-Ngo (Hercules, CA)

    1996-01-01

    An ion implantation device for creating a large diameter, homogeneous, ion beam is described, as well as a method for creating same, wherein the device is characterized by extraction of a diverging ion beam and its conversion by ion beam optics to an essentially parallel ion beam. The device comprises a plasma or ion source, an anode and exit aperture, an extraction electrode, a divergence-limiting electrode and an acceleration electrode, as well as the means for connecting a voltage supply to the electrodes.

  6. Implantable medical sensor system

    DOEpatents

    Darrow, Christopher B. (Pleasanton, CA); Satcher, Jr., Joe H. (Modesto, CA); Lane, Stephen M. (Oakland, CA); Lee, Abraham P. (Walnut Creek, CA); Wang, Amy W. (Berkeley, CA)

    2001-01-01

    An implantable chemical sensor system for medical applications is described which permits selective recognition of an analyte using an expandable biocompatible sensor, such as a polymer, that undergoes a dimensional change in the presence of the analyte. The expandable polymer is incorporated into an electronic circuit component that changes its properties (e.g., frequency) when the polymer changes dimension. As the circuit changes its characteristics, an external interrogator transmits a signal transdermally to the transducer, and the concentration of the analyte is determined from the measured changes in the circuit. This invention may be used for minimally invasive monitoring of blood glucose levels in diabetic patients.

  7. Regenerative Surgical Treatment of Peri-implantitis

    ClinicalTrials.gov

    2015-07-16

    Failure of Dental Implant Due to Infection; Infection; Inflammation; Peri-implantitis; Bacterial Infections; Bleeding of Subgingival Space; Molecular Sequence Variation; Periodontal Diseases; Mouth Diseases

  8. Bimaxillary protrusion with an atrophic alveolar defect: orthodontics, autogenous chin-block graft, soft tissue augmentation, and an implant.

    PubMed

    Chiu, Grace S C; Chang, Chris H N; Roberts, W Eugene

    2015-01-01

    Bimaxillary protrusion in a 28-year-old woman was complicated by multiple missing, restoratively compromised, or hopeless teeth. The maxillary right central incisor had a history of avulsion and replantation that subsequently evolved into generalized external root resorption with Class III mobility and severe loss of the supporting periodontium. This complex malocclusion had a discrepancy index of 21, and 8 additional points were scored for the atrophic dental implant site (maxillary right central incisor). The comprehensive treatment plan included extraction of 4 teeth (both maxillary first premolars, the maxillary right central incisor, and the mandibular right first molar), orthodontic closure of all spaces except for the future implant site (maxillary right central incisor), augmentation of the alveolar defect with an autogenous chin-block graft, enhancement of the gingival biotype with a connective tissue graft, and an implant-supported prosthesis. Orthodontists must understand the limitations of bone grafts. Augmented alveolar defects are slow to completely turn over to living bone, so they are usually good sites for implants but respond poorly to orthodontic space closure. However, postsurgical orthodontic treatment is often indicated to optimally finish the esthetic zone before placing the final prosthesis. The latter was effectively performed for this patient, resulting in a total treatment time of about 36 months for comprehensive interdisciplinary care. An excellent functional and esthetic result was achieved. PMID:25533077

  9. Porous metal for orthopedics implants

    PubMed Central

    Matassi, Fabrizio; Botti, Alessandra; Sirleo, Luigi; Carulli, Christian; Innocenti, Massimo

    2013-01-01

    Summary Porous metal has been introduced to obtain biological fixation and improve longevity of orthopedic implants. The new generation of porous metal has intriguing characteristics that allows bone healing and high osteointegration of the metallic implants. This article gives an overview about biomaterials properties of the contemporary class of highly porous metals and about the clinical use in orthopaedic surgery. PMID:24133527

  10. Anatomic consideration for preventive implantation.

    PubMed

    Denissen, H W; Kalk, W; Veldhuis, H A; van Waas, M A

    1993-01-01

    The aim of preventive implant therapy is to prevent or delay loss of alveolar ridge bone mass. For use in an anatomic study of 60 mandibles, resorption of the alveolar ridge was classified into four preventive stages: (1) after extraction of teeth; (2) after initial resorption; (3) when the ridge has atrophied to a knife-edge shape; and (4) when only basal bone remains. Implantation in stage 3 necessitates removal of the knife-edge ridge to create space for cylindrical implants. Therefore, implantation in stage 2 is advocated to prevent the development of stage 3. The aim of implantation in stage 4 is to prevent total loss of function of the atrophic mandible. PMID:8359876

  11. A new system for assessment of growth using mandibular canine calcification stages and its correlation with modified MP3 stages

    PubMed Central

    Hegde, Gautham; Hegde, Nanditha; Kumar, Anil; Keshavaraj

    2014-01-01

    Objective: Orthodontic diagnosis and treatment planning for growing children must involve growth prediction, especially in the treatment of skeletal problems. Studies have shown that a strong association exists between skeletal maturity and dental calcification stages. The present study was therefore taken up to provide a simple and practical method for assessing skeletal maturity using a dental periapical film and standard dental X-ray machine, to compare the developmental stages of the mandibular canine with that of developmental stages of modified MP3 and to find out if any correlation exists, to determine if the developmental stages of the mandibular canine alone can be used as a reliable indicator for assessment of skeletal maturity. Materials and Methods: A total of 160 periapical radiographs, of the mandibular right canine and the MP3 region was taken and assessed according to the Dermirjian's stages of dental calcification and the modified MP3 stages. Results and Discussion: The correlation coefficient between MP3 stages and developmental stages of mandibular canine was found to be significant in both male and female groups. When the canine calcification stages were compared with the MP3 stages it was found that with the exception of the D stage of canine calcification the remaining stages showed a very high correlation with the modified MP3 stages. Conclusion: The correlation between the mandibular canine calcification stages, and the MP3 stages was found to be significant. The canine calcification could be used as a sole indicator for assessment of skeletal maturity. PMID:25210386

  12. Impacted Mandibular Third Molars: Review of Literature and a Proposal of a Combined Clinical and Radiological Classification

    PubMed Central

    Santosh, P

    2015-01-01

    Tooth impaction is a pathological situation where a tooth fails to attain its normal functional position. Impacted third molars are commonly encountered in routine dental practice. The impaction rate is higher for third molars when compared with other teeth. The mandibular third molar impaction is said to be due to the inadequate space between the distal of the second mandibular molar and the anterior border of the ascending ramus of the mandible. Impacted teeth may remain asymptomatic or may be associated with various pathologies such as caries, pericoronitis, cysts, tumors, and also root resorption of the adjacent tooth. Even though various classifications exist in the literature, none of those address the combined clinical and radiologic assessment of the impacted third molar. Literature search using the advanced features of various databases such as PubMed, Scopus, Embase, Google Scholar, Directory of Open Access Journals and Cochrane electronic databases was carried out. Keywords like impaction, mandibular third molar, impacted mandibular third molar, complications, anatomy, inferior alveolar nerve injury, lingual nerve injury were used to search the databases. A total of 826 articles were screened, and 50 articles were included in the review which was obtained from 1980 to February 2015. In the present paper, the authors have proposed a classification based on clinical and radiological assessment of the impacted mandibular third molar. PMID:26229709

  13. Evaluation of reference gene suitability for quantitative expression analysis by quantitative polymerase chain reaction in the mandibular condyle of sheep

    PubMed Central

    JIANG, XIN; XUE, YANG; ZHOU, HONGZHI; LI, SHOUHONG; ZHANG, ZONGMIN; HOU, RUI; DING, YUXIANG; HU, KAIJIN

    2015-01-01

    Reference genes are commonly used as a reliable approach to normalize the results of quantitative polymerase chain reaction (qPCR), and to reduce errors in the relative quantification of gene expression. Suitable reference genes belonging to numerous functional classes have been identified for various types of species and tissue. However, little is currently known regarding the most suitable reference genes for bone, specifically for the sheep mandibular condyle. Sheep are important for the study of human bone diseases, particularly for temporomandibular diseases. The present study aimed to identify a set of reference genes suitable for the normalization of qPCR data from the mandibular condyle of sheep. A total of 12 reference genes belonging to various functional classes were selected, and the expression stability of the reference genes was determined in both the normal and fractured area of the sheep mandibular condyle. RefFinder, which integrates the following currently available computational algorithms: geNorm, NormFinder, BestKeeper, and the comparative ?Ct method, was used to compare and rank the candidate reference genes. The results obtained from the four methods demonstrated a similar trend: RPL19, ACTB, and PGK1 were the most stably expressed reference genes in the sheep mandibular condyle. As determined by RefFinder comprehensive analysis, the results of the present study suggested that RPL19 is the most suitable reference gene for studies associated with the sheep mandibular condyle. In addition, ACTB and PGK1 may be considered suitable alternatives. PMID:26238421

  14. Impacted Mandibular Third Molars: Review of Literature and a Proposal of a Combined Clinical and Radiological Classification.

    PubMed

    Santosh, P

    2015-01-01

    Tooth impaction is a pathological situation where a tooth fails to attain its normal functional position. Impacted third molars are commonly encountered in routine dental practice. The impaction rate is higher for third molars when compared with other teeth. The mandibular third molar impaction is said to be due to the inadequate space between the distal of the second mandibular molar and the anterior border of the ascending ramus of the mandible. Impacted teeth may remain asymptomatic or may be associated with various pathologies such as caries, pericoronitis, cysts, tumors, and also root resorption of the adjacent tooth. Even though various classifications exist in the literature, none of those address the combined clinical and radiologic assessment of the impacted third molar. Literature search using the advanced features of various databases such as PubMed, Scopus, Embase, Google Scholar, Directory of Open Access Journals and Cochrane electronic databases was carried out. Keywords like impaction, mandibular third molar, impacted mandibular third molar, complications, anatomy, inferior alveolar nerve injury, lingual nerve injury were used to search the databases. A total of 826 articles were screened, and 50 articles were included in the review which was obtained from 1980 to February 2015. In the present paper, the authors have proposed a classification based on clinical and radiological assessment of the impacted mandibular third molar. PMID:26229709

  15. Cochlear Implantation in Extraordinary Cases

    PubMed Central

    Çelenk, Fatih; Cevizci, Ra?it; Alt?nyay, ?enay; Bayaz?t, Y?ld?r?m Ahmet

    2015-01-01

    Background: Although cochlear implantation has been almost a standard otological procedure worldwide, it may still create a dilemma for the surgeon in some unusual instances such as Seckel syndrome, aural atresia and posterior fossa arachnoid cyst. Case Report: Three extraordinary cases of cochlear implantation were reported. The first case was a case of Seckel syndrome with a cardiac pacemaker due to complete atrioventricular block. The second case had posterior fossa arachnoid cyst that had retrosigmoid cyst removal and cochlear implantation simultaneously. The last case had cochlear implantation in the ear with congenital aural atresia. All cases could be implanted successfully with full electrode insertion and good audiological outcome. Delayed facial paralysis that occurred in the patient with arachnoid cyst resolved spontaneously. Conclusion: This study addressed the efficiency of cochlear implantation in cases of Seckel syndrome, complete atrioventricular block managed with cardiac pacemaker, congenital aural atresia and posterior fossa arachnoid cyst. In addition, the retrosigmoid approach and cochlear implantation can be performed simultaneously. PMID:26167347

  16. Microsystems Technology for Retinal Implants

    NASA Astrophysics Data System (ADS)

    Weiland, James

    2005-03-01

    The retinal prosthesis is targeted to treat age-related macular degeneration, retinitis pigmentosa, and other outer retinal degenerations. Simulations of artificial vision have predicted that 600-1000 individual pixels will be needed if a retinal prosthesis is to restore function such as reading large print and face recognition. An implantable device with this many electrode contacts will require microsystems technology as part of its design. An implantable retinal prosthesis will consist of several subsystems including an electrode array and hermetic packaging. Microsystems and microtechnology approaches are being investigated as possible solutions for these design problems. Flexible polydimethylsiloxane (PDMS) substrate electrode arrays and silicon micromachined electrode arrays are under development. Inactive PDMS electrodes have been implanted in 3 dogs to assess mechanical biocompatibility. 3 dogs were followed for 6 months. The implanted was securely fastened to the retina with a single retinal tack. No post-operative complications were evident. The array remained within 100 microns of the retinal surface. Histological evaluation showed a well preserved retina underneath the electrode array. A silicon device with electrodes suspended on micromachined springs has been implanted in 4 dogs (2 acute implants, 2 chronic implants). The device, though large, could be inserted into the eye and positioned on the retina. Histological analysis of the retina from the spring electrode implants showed that spring mounted posts penetrated the retina, thus the device will be redesigned to reduce the strength of the springs. These initial implants will provide information for the designers to make the next generation silicon device. We conclude that microsystems technology has the potential to make possible a retinal prosthesis with 1000 individual contacts in close proximity to the retina.

  17. Correction of Angle Class II division 1 malocclusion with a mandibular protraction appliances and multiloop edgewise archwire technique

    PubMed Central

    Freitas, Heloiza; dos Santos, Pedro César F; Janson, Guilherme

    2014-01-01

    A Brazilian girl aged 14 years and 9 months presented with a chief complaint of protrusive teeth. She had a convex facial profile, extreme overjet, deep bite, lack of passive lip seal, acute nasolabial angle, and retrognathic mandible. Intraorally, she showed maxillary diastemas, slight mandibular incisor crowding, a small maxillary arch, 13-mm overjet, and 4-mm overbite. After the diagnosis of severe Angle Class II division 1 malocclusion, a mandibular protraction appliance was placed to correct the Class II relationships and multiloop edgewise archwires were used for finishing. Follow-up examinations revealed an improved facial profile, normal overjet and overbite, and good intercuspation. The patient was satisfied with her occlusion, smile, and facial appearance. The excellent results suggest that orthodontic camouflage by using a mandibular protraction appliance in combination with the multiloop edgewise archwire technique is an effective option for correcting Class II malocclusions in patients who refuse orthognathic surgery. PMID:25309867

  18. The Use of 2.4-mm Locking Plate System in Treating Comminuted Mandibular Fracture by Firearm

    PubMed Central

    Pereira, Cassiano Costa Silva; Letícia dos Santos, Pâmela; Jardim, Ellen Cristina Gaetti; Júnior, Idelmo Rangel Garcia; Shinohara, Elio Hitoshi; Araujo, Marcelo Marotta

    2012-01-01

    Maxillofacial trauma caused by firearms has considerably increased, in which the mandibular body is the site of highest incidence of firearm projectiles. In these cases, the use of titanium plates and screws allows the early restoration of form and function of the mandible with stable and predictable results. Recently, conventional plates have been extensively used to treat comminuted mandibular fractures. Nevertheless, the conventional system presents several limitations such as screw compression against the bone interface and the necessity of precise fit of plate to the bone. To overcome such drawbacks, the locking plates have emerged. The present clinical case reported the operative treatment of mandibular fracture caused by firearm projectiles with the use of locking plate. The indications, advantages, and disadvantages of this system are presented. PMID:23730424

  19. A Novel Approach for Restoration of Hemisectioned Mandibular Second Molar with Modified Tunnel Restoration: A Case Report

    PubMed Central

    Varma K, Madhu; Satish R, Kalyan; Kumar M, Sita Rama; Sajjan, Girija S

    2014-01-01

    Hemisection refers to sectioning of a mandibular molar into two halves followed by removal of the diseased root and its coronal portion. Hemisection of a mandibular molar may be a suitable treatment option when the decay is restricted to one root and the other root is healthy. The retained root is endodontically treated and the furcation area is made self-cleansable. Retained tooth structure is restored as premolar which helps to reduce the masticatory load. Hemisection of mandibular molar was often referred to as premolarization. Studies showed that the remaining coronal structure influenced the fracture resistance of endodontically treated maxillary first premolars. Clinical experience showed the viability of tunnel restoration as an alternative to class II conventional cavity preparation in initial proximal lesion. This article discusses a case that presents the novel technique involved in restoration of the remaining hemisected tooth using modified tunnel restoration. PMID:25478460

  20. Correction of Angle Class II division 1 malocclusion with a mandibular protraction appliances and multiloop edgewise archwire technique.

    PubMed

    Freitas, Benedito; Freitas, Heloiza; Dos Santos, Pedro César F; Janson, Guilherme

    2014-09-01

    A Brazilian girl aged 14 years and 9 months presented with a chief complaint of protrusive teeth. She had a convex facial profile, extreme overjet, deep bite, lack of passive lip seal, acute nasolabial angle, and retrognathic mandible. Intraorally, she showed maxillary diastemas, slight mandibular incisor crowding, a small maxillary arch, 13-mm overjet, and 4-mm overbite. After the diagnosis of severe Angle Class II division 1 malocclusion, a mandibular protraction appliance was placed to correct the Class II relationships and multiloop edgewise archwires were used for finishing. Follow-up examinations revealed an improved facial profile, normal overjet and overbite, and good intercuspation. The patient was satisfied with her occlusion, smile, and facial appearance. The excellent results suggest that orthodontic camouflage by using a mandibular protraction appliance in combination with the multiloop edgewise archwire technique is an effective option for correcting Class II malocclusions in patients who refuse orthognathic surgery. PMID:25309867

  1. Mandibular fractures in British military personnel secondary to blast trauma sustained in Iraq and Afghanistan.

    PubMed

    Breeze, J; Gibbons, A J; Hunt, N C; Monaghan, A M; Gibb, I; Hepper, A; Midwinter, M

    2011-12-01

    Blast trauma is the primary cause of maxillofacial injury sustained by British service personnel on deployment, and the mandible is the maxillofacial structure most likely to be injured in combat, but there are few reports about the effect of blast trauma on it. The Joint Theatre Trauma Registry identified all mandibular fractures sustained by British servicemen secondary to blast injury between 1 January 2004 and 30 September 2009. These were matched to corresponding hospital notes from the Royal Centre for Defence Medicine (RCDM) for those evacuated servicemen and autopsy records for those who died of wounds. Seventy-four mandibular fractures were identified in 60 servicemen. Twenty-two soldiers were evacuated to the RCDM and the remaining 38 died from wounds. Fractures of the symphysis (39/106, 37%) and body (31/106, 29%) were more common than those of the angle (26/106, 25%) and condyle (10/106, 9%). This pattern of injury differs from that of civilian blunt trauma where the condyle is the site that is injured most often. Those fractures thought to result from the blast wave itself usually caused simple localised fractures, whereas those fractures thought to result from fragments of the blast caused comminution that affected several areas of the mandible. The pattern of fractures in personnel injured while they were inside a vehicle resembled that traditionally seen in blunt trauma, which supports the requirement for mandatory wearing of seat-belts in the rear of vehicles whenever tactically viable. All mandibular fractures in servicemen injured while in the turret of a vehicle had evidence of foreign bodies or radio-opaque fragments as a result of their exposed position. Many of these injuries could therefore be potentially prevented by the adoption of facial protection. PMID:21074305

  2. Mandibular and hyoid muscles of Galeomorph sharks (Chondrichthyes: Elasmobranchii), with remarks on their phylogenetic intrarelationships.

    PubMed

    Soares, Mateus C; de Carvalho, Marcelo R

    2013-10-01

    The superorder Galeomorph comprises the orders Heterodontiformes, Orectolobiformes, Lamniformes, and Carcharhiniformes. Recent morphological and molecular support that it is a monophyletic taxon. The phyletic relationship within the Galeomorphi are also well resolved. However, only few morphological characters of the mandibular and hyoid muscles have been employed, and a detailed description of these muscles and their variations may contribute new interpretations of homology and to the discussion of different hypothesis of intrarelationships. This paper provides a detailed description of mandibular and hyoid arch muscles in galeomorph sharks, within a comparative elasmobranch framework, with the objective to discuss putative homologies that may elucidate our understanding of galeomorph evolution. Twenty-eight galeomorph species were dissected, described, illustrated and compared with other elasmobranchs and with data from the literature. The Galeomorphi are supported as monophyletic by presenting the m. levator labii superioris attached directly to the neurocranium, different from the attachment through a tendon in basal squalomorphs. Heterodontiformes and Orectolobiformes share particular variations in the position and insertion of the m. levator labii superioris and the presence of a well-defined m. levator hyomandibulae. Lamniformes and Carcharhiniformes show similar patterns in the position and attachment of the m. levator labii superioris, subdivision of the m. adductor mandibulae, and the presence of an almost indivisible m. levator hyomandibulae and m. constrictor hyoideus dorsalis, similar to the condition, albeit independently, in basal squalomorphs. No specific mandibular or hyoid arch muscle character was found to support the clade composed of Orectolobiformes, Lamniformes, and Carcharhiniformes, as advocated by recent phylogenetic analyses. PMID:23801591

  3. Deferoxamine Enhances the Vascular Response of Bone Regeneration in Mandibular Distraction Osteogenesis

    PubMed Central

    Donneys, Alexis; Farberg, Aaron S.; Tchanque-Fossuo, Catherine N.; Deshpande, Sagar S.; Buchman, Steven R.

    2015-01-01

    Background Bone regeneration during Distraction Osteogenesis (DO) is intricately associated with an enhanced vascular response. Augmenting this response may offer considerable clinical advantages such as optimizing the quality of regenerate formation, decreasing lengthy consolidation periods or increasing regenerate size and distance. Using Deferoxamine (DFO), an angiogenic transcriptional activator, we posit that substantial increases in vascular volume beyond the normal response to mechanical distraction can be quantified with Micro-Computed Tomography (?CT) after vessel perfusion during mandibular DO. Methods Two groups of Sprague-Dawley rats (n=12) underwent external fixator placement, mandibular osteotomy, and a 5.1 mm distraction. During distraction, the experimental group (n=6) was treated with DFO injections into the distraction gap. After consolidation, the animals were perfused and imaged with ?CT. Vascular radiomorphometrics were calculated and statistical comparison was conducted with the independent samples t-test. p?0.05 was considered statistically significant. Results A 40% statistically significant increase in the number of vessels (0.82 vessels/mm vs. 1.15 vessels/mm, p ? .012), and a complimentary decrease in the space between vessels (1.18 mm vs. 0.86 mm, p ? .012) was calculated in the experimental regenerate when compared to control. This robust increase in vascularity could also be readily observed with ?CT image reconstruction. Gross examination revealed a denser regenerate in the DFO injected group that is clearly illustrated with faxitron radiography. Conclusion Our study quantifies the ability of DFO to augment the vascular response of mandibular DO and establishes correlations between this therapeutic enrichment and enhanced regenerate formation. PMID:22456357

  4. Why the Long Face? The Mechanics of Mandibular Symphysis Proportions in Crocodiles

    PubMed Central

    Walmsley, Christopher W.; Smits, Peter D.; Quayle, Michelle R.; McCurry, Matthew R.; Richards, Heather S.; Oldfield, Christopher C.; Wroe, Stephen; Clausen, Phillip D.; McHenry, Colin R.

    2013-01-01

    Background Crocodilians exhibit a spectrum of rostral shape from long snouted (longirostrine), through to short snouted (brevirostrine) morphologies. The proportional length of the mandibular symphysis correlates consistently with rostral shape, forming as much as 50% of the mandible’s length in longirostrine forms, but 10% in brevirostrine crocodilians. Here we analyse the structural consequences of an elongate mandibular symphysis in relation to feeding behaviours. Methods/Principal Findings Simple beam and high resolution Finite Element (FE) models of seven species of crocodile were analysed under loads simulating biting, shaking and twisting. Using beam theory, we statistically compared multiple hypotheses of which morphological variables should control the biomechanical response. Brevi- and mesorostrine morphologies were found to consistently outperform longirostrine types when subject to equivalent biting, shaking and twisting loads. The best predictors of performance for biting and twisting loads in FE models were overall length and symphyseal length respectively; for shaking loads symphyseal length and a multivariate measurement of shape (PC1– which is strongly but not exclusively correlated with symphyseal length) were equally good predictors. Linear measurements were better predictors than multivariate measurements of shape in biting and twisting loads. For both biting and shaking loads but not for twisting, simple beam models agree with best performance predictors in FE models. Conclusions/Significance Combining beam and FE modelling allows a priori hypotheses about the importance of morphological traits on biomechanics to be statistically tested. Short mandibular symphyses perform well under loads used for feeding upon large prey, but elongate symphyses incur high strains under equivalent loads, underlining the structural constraints to prey size in the longirostrine morphotype. The biomechanics of the crocodilian mandible are largely consistent with beam theory and can be predicted from simple morphological measurements, suggesting that crocodilians are a useful model for investigating the palaeobiomechanics of other aquatic tetrapods. PMID:23342027

  5. Incidence and pattern of mandibular fractures in Rohilkhand region, Uttar Pradesh state, India: A retrospective study

    PubMed Central

    Giri, Kolli Yada; Singh, Aishwarya Pratap; Dandriyal, Ramakant; Indra, Niranjanaprasad; Rastogi, Sanjay; Mall, Sunil Kumar; Chowdhury, Shouvik; Singh, Himanshu Pratap

    2015-01-01

    Aims To understand and evaluate the significance of various aetiological factors in determining the incidence and dictating the patterns of mandibular fractures in Rohilkhand region. Methods The patient records and radiographs for 144 patients treated for mandibular fractures were reviewed between the time periods from January 2012 to December 2013. Data on age, gender, aetiology, use of intoxicants, head injury, associated injuries, days of the week, anatomic site and multiple fractures within the mandible were recorded and assessed. Results Maximum incidence of fractures was observed among the individuals in 3rd decade (35.4%) followed by 2nd and 4th decades, which exhibited 32 and 30 cases (22.2% and 20.8%), respectively. Male to female ratio was biased (4:1) portraying a male predominance. Road traffic accidents (RTAs) were observed to be the predominant aetiological factor responsible accounting for 79.2% of the total injuries followed by assaults (11.8%) and falls (9%). Parasymphysis exhibited the highest incidence (32.63%) amongst the anatomic sites, followed by body (18.75%), angle (16.66%), condyle (15.27%), symphysis (12.50%), ramus (2.77%) and coronoid (1.38%). Conclusion The study reveals that majority of affected patients were in the 2nd and 3rd decades. A definitive relationship existed between RTA and the incidence of mandibular fractures. The frequency further increased with consumption of social intoxicants. The most commonly fractured site was parasymphysis either isolated or associated with other fractures in the mandible. PMID:26587379

  6. Pediatric cochlear implantation: an update.

    PubMed

    Vincenti, Vincenzo; Bacciu, Andrea; Guida, Maurizio; Marra, Francesca; Bertoldi, Barbara; Bacciu, Salvatore; Pasanisi, Enrico

    2014-01-01

    Deafness in pediatric age can adversely impact language acquisition as well as educational and social-emotional development. Once diagnosed, hearing loss should be rehabilitated early; the goal is to provide the child with maximum access to the acoustic features of speech within a listening range that is safe and comfortable. In presence of severe to profound deafness, benefit from auditory amplification cannot be enough to allow a proper language development. Cochlear implants are partially implantable electronic devices designed to provide profoundly deafened patients with hearing sensitivity within the speech range. Since their introduction more than 30 years ago, cochlear implants have improved their performance to the extent that are now considered to be standard of care in the treatment of children with severe to profound deafness. Over the years patient candidacy has been expanded and the criteria for implantation continue to evolve within the paediatric population. The minimum age for implantation has progressively reduced; it has been recognized that implantation at a very early age (12-18 months) provides children with the best outcomes, taking advantage of sensitive periods of auditory development. Bilateral implantation offers a better sound localization, as well as a superior ability to understand speech in noisy environments than unilateral cochlear implant. Deafened children with special clinical situations, including inner ear malformation, cochlear nerve deficiency, cochlear ossification, and additional disabilities can be successfully treated, even thogh they require an individualized candidacy evaluation and a complex post-implantation rehabilitation. Benefits from cochlear implantation include not only better abilities to hear and to develop speech and language skills, but also improved academic attainment, improved quality of life, and better employment status. Cochlear implants permit deaf people to hear, but they have a long way to go before their performance being comparable to that of the intact human ear; researchers are looking for more sophisticated speech processing strategies as well as a more efficient coupling between the electrodes and the cochlear nerve with the goal of dramatically improving the quality of sound of the next generation of implants. PMID:25179127

  7. Analysis of the compatibility of dental implant systems in fibula free flap reconstruction.

    PubMed

    Carbiner, Ramin; Jerjes, Waseem; Shakib, Kaveh; Giannoudis, Peter V; Hopper, Colin

    2012-01-01

    As a result of major ablative surgery, head and neck oncology patients can be left with significant defects in the orofacial region. The resultant defect raises the need for advanced reconstruction techniques. The reconstruction in this region is aimed at restoring function and facial contour. The use of vascularised free flaps has revolutionised the reconstruction in the head and neck. Advances in reconstruction techniques have resulted in continuous improvement of oral rehabilitation. For example, endosteal implants are being used to restore the masticatory function by the way of prosthetic replacement of the dentition. Implant rehabilitation usually leads to improved facial appearance, function, restoration of speech and mastication. Suitable dental implant placement's site requires satisfactory width, height and quality of bone. Reconstruction of hard tissue defects therefore will need to be tailored to meet the needs for implant placement.The aim of this feasibility study was to assess the compatibility of five standard commercially available dental implant systems (Biomet 3i, Nobel Biocare, Astra tech, Straumann and Ankylos) for placement into vascularised fibula graft during the reconstruction of oromandibular region.Radiographs (2D) of the lower extremities from 142 patients in the archives of the Department of Radiology in University College London Hospitals (UCLH) were analysed in this study. These radiographs were from 61 females and 81 males. Additionally, 60 unsexed dry fibular bones, 30 right sided, acquired from the collection of the Department of Anatomy, University College London (UCL) were also measured to account for the 3D factor.In the right fibula (dry bone), 90% of the samples measured had a width of 13.1 mm. While in the left fibula (dry bone), 90% of the samples measured had a width of 13.3 mm. Fibulas measured on radiographs had a width of 14.3 mm in 90% of the samples. The length ranges of the dental implants used in this study were: 7-13 mm (Biomet 3i), 10-13 mm (Nobel biocare), 8-13 mm (Astra Tech), 8-12 mm (Straumann ) and 8-11 mm (Ankylos).This study reached a conclusion that the width of fibula is sufficient for placement of most frequently used dental implants for oral rehabilitation after mandibular reconstructive procedures. PMID:22721258

  8. Analysis of the compatibility of dental implant systems in fibula free flap reconstruction

    PubMed Central

    2012-01-01

    As a result of major ablative surgery, head and neck oncology patients can be left with significant defects in the orofacial region. The resultant defect raises the need for advanced reconstruction techniques. The reconstruction in this region is aimed at restoring function and facial contour. The use of vascularised free flaps has revolutionised the reconstruction in the head and neck. Advances in reconstruction techniques have resulted in continuous improvement of oral rehabilitation. For example, endosteal implants are being used to restore the masticatory function by the way of prosthetic replacement of the dentition. Implant rehabilitation usually leads to improved facial appearance, function, restoration of speech and mastication. Suitable dental implant placement’s site requires satisfactory width, height and quality of bone. Reconstruction of hard tissue defects therefore will need to be tailored to meet the needs for implant placement. The aim of this feasibility study was to assess the compatibility of five standard commercially available dental implant systems (Biomet 3i, Nobel Biocare, Astra tech, Straumann and Ankylos) for placement into vascularised fibula graft during the reconstruction of oromandibular region. Radiographs (2D) of the lower extremities from 142 patients in the archives of the Department of Radiology in University College London Hospitals (UCLH) were analysed in this study. These radiographs were from 61 females and 81 males. Additionally, 60 unsexed dry fibular bones, 30 right sided, acquired from the collection of the Department of Anatomy, University College London (UCL) were also measured to account for the 3D factor. In the right fibula (dry bone), 90% of the samples measured had a width of 13.1?mm. While in the left fibula (dry bone), 90% of the samples measured had a width of 13.3?mm. Fibulas measured on radiographs had a width of 14.3?mm in 90% of the samples. The length ranges of the dental implants used in this study were: 7-13?mm (Biomet 3i), 10-13?mm (Nobel biocare), 8-13?mm (Astra Tech), 8-12?mm (Straumann ) and 8-11?mm (Ankylos). This study reached a conclusion that the width of fibula is sufficient for placement of most frequently used dental implants for oral rehabilitation after mandibular reconstructive procedures. PMID:22721258

  9. Disto-angular transmigrated impacted mandibular molar with enostosis: A rare intraoral lesion

    PubMed Central

    Natarajan, Shanmuganathan; Madhankumar, Seenivasan; Jeyapalan, Karthigeyan; Athiban, I.; Elengkumaran, S.; Periyakaruppiah, K. P. S.

    2015-01-01

    A 29-year-old male patient reported for replacement of missing teeth. The patient gave history of unerupted right lower posterior teeth and the orthopantomogram revealed transmigrated mandibular second molar to the inferior border of mandible just below the root apices of second premolar associated with enostosis distally toward the ramus of mandible with size of about 21 mm ? 20 mm. This rare interosseous defect plays a vital role in deciding prosthetic treatment options for missing teeth and utmost care should be taken to preserve the health of the patient during such procedures. PMID:26538971

  10. Variant Anterior Digastric Muscle Transfer for Marginal Mandibular Branch of Facial Nerve Palsy

    PubMed Central

    2014-01-01

    Summary: Marginal mandibular branch of facial nerve (MMBFN) palsy is a common consequence of head and neck surgeries. MMBFN palsy results in paralysis of muscles which depress the inferior lip. Current management of MMBFN palsy involves ruination of normal neuromuscular anatomy and physiology to restore symmetry to the mouth. The article outlines the possibility to transfer variant anterior digastric musculature to accomplish reanimation of the mouth without adversely affecting normal nonvariant anatomy. The procedure may have the additional cosmetic benefit of correcting asymmetrical muscular bulk in the submental region. PMID:25289304

  11. Treatment of obstructive sleep apnea with mandibular advancement appliance over prostheses: A case report

    PubMed Central

    Guimarães, Thais Moura; Colen, Sâmia; Cunali, Paulo Afonso; Rossi, Rowdley; Dal-Fabbro, Cibele; Ferraz, Otávio; Tufik, Sergio; Bittencourt, Lia

    2015-01-01

    Treatment with a mandibular advancement device (MAD) is recommended for mild obstructive sleep apnea (OSA), primary snoring and as a secondary option for Continuous Positive Airway Pressure, because it has better adherence and acceptance. However, edentulous patients do not have supports to hold the MAD. This study aimed to present a possible to OSA treatment with MAD in over complete upper and partial lower dentures. The patient, a 38-year-old female with mild OSA, was treated with a MAD. The respiratory parameter, such as apnea–hypopnea index, arousal index and oxyhemoglobin saturation was improved after treatment. PMID:26483952

  12. Treatment of obstructive sleep apnea with mandibular advancement appliance over prostheses: A case report.

    PubMed

    Guimarães, Thais Moura; Colen, Sâmia; Cunali, Paulo Afonso; Rossi, Rowdley; Dal-Fabbro, Cibele; Ferraz, Otávio; Tufik, Sergio; Bittencourt, Lia

    2015-01-01

    Treatment with a mandibular advancement device (MAD) is recommended for mild obstructive sleep apnea (OSA), primary snoring and as a secondary option for Continuous Positive Airway Pressure, because it has better adherence and acceptance. However, edentulous patients do not have supports to hold the MAD. This study aimed to present a possible to OSA treatment with MAD in over complete upper and partial lower dentures. The patient, a 38-year-old female with mild OSA, was treated with a MAD. The respiratory parameter, such as apnea-hypopnea index, arousal index and oxyhemoglobin saturation was improved after treatment. PMID:26483952

  13. An unusual presentation of clear cell odontogenic carcinoma in mandibular anterior region

    PubMed Central

    Ganvir, Sindhu M; Gajbhiye, Namrata Yashwant

    2014-01-01

    Clear cell odontogenic carcinoma (CCOC) is a rare, potentially aggressive odontogenic epithelial tumor with tendency for recurrence. It was first described as a clinicopathological entity in 1985 and to date only 73 cases has been reported in English literature. A case of CCOC in 64-year-old male patient in mandibular anterior region is presented which when recurred in soft tissue 5 years after wide surgical resection of mandible, revealed a biphasic pattern as against monophasic pattern of primary neoplasm and was unusually associated with primary squamous cell carcinoma, suggestive of hybrid tumor. PMID:25949004

  14. Severe osteoarthrosis after fracture of the mandibular condyle: a clinical and histologic study of seven patients.

    PubMed

    Wu, X G; Hong, M; Sun, K H

    1994-02-01

    The factors that induce complications subsequent to fractures of the mandibular condyle have long been controversial. A clinical and histologic study of seven patients (nine temporomandibular joints [TMJs]) who suffered from severe TMJ problems subsequent to condylar fractures showed that the complications were related to comminution of the condyle, sagittal fracture of the condyle, and subcondylar fracture dislocation. Alterations in these TMJs all involved secondary osteoarthrosis. Additionally, aseptic necrosis, bifid deformity of the condyle (two of the three sagittally fractured condyles), and TMJ ankylosis occurred in these patients. It is suggested that the involved fracture patterns be given more attention by clinicians. PMID:8295047

  15. Mural Adenomatoid Odontogenic Tumour as Anterior Mandibular Swelling: A Diagnostic Challenge

    PubMed Central

    Sarkar, Reena Bhola; Grewal, Jessica; Grewal, Ripin; Bansal, Arun

    2014-01-01

    Adenomatoid odontogenic tumour is an uncommon, benign, hamartomatous lesion that commonly affects the anterior maxilla and has two radiographic variants, follicular and extrafollicular where the former is more common than the latter. Here, we report a case of 15-year-old female with midline swelling of the mandible. Radiographically, impacted right permanent mandibular canine was associated with the radiolucent lesion. Dentigerous cyst was given as provisional diagnosis. However, histologically the lesion represented the features of cystic variant of Adenomatoid odontogenic tumour. PMID:25121073

  16. Adenomatoid odontogenic tumor associated with an unerupted mandibular lateral incisor: a case report

    PubMed Central

    2015-01-01

    Adenomatoid odontogenic tumor (AOT) is a rare, benign odontogenic tumor that predominantly appears in the second decade of life in female patients. Most AOTs occur in the anterior part of the maxilla and are usually associated with impacted anterior teeth. There are three types of AOT, follicular, extrafollicular, and peripheral, which are classified based on the location of the lesion and its association with the impacted tooth. We report a rare case of AOT associated with an impacted right mandibular lateral incisor in an 11-year-old female patient.

  17. The lingual splint: an often forgotten method for fixating pediatric mandibular fractures.

    PubMed

    Binahmed, Abdulaziz; Sansalone, Claudio; Garbedian, Justin; Sándor, George K B

    2007-01-01

    Maxillofacial fractures are uncommon in the pediatric population, and their treatment is unique due to the psychological, physiological, developmental and anatomical characteristics of children. We present the case of a boy who was treated in an outpatient dental clinic using a lingual splint for the reduction, stabilization and fixation of a mandibular body fracture. This technique is a reliable, noninvasive procedure that dentists may consider in selected cases by referral to an oral and maxillofacial surgeon. It also limits the discomfort and morbidity that can be associated with maxillomandibular fixation or open reduction and internal fixation in pediatric patients. PMID:17672958

  18. Effect of rotopositioning on the growth and maturation of mandibular bone in immobilized Rhesus monkeys

    NASA Technical Reports Server (NTRS)

    Simmons, D. J.; Parvin, C.; Smith, K. C.; France, P.; Kazarian, L.

    1986-01-01

    The rates of bone formation and mineralization in the mandibular cortex of juvenile Rhesus monkeys exposed to immobilization/rotopositioning are evaluated. The monkeys were restrained in a supine position and rotated 90 deg every 30 minutes through a full 360 deg for 14 days. The microscopic distribution of mineral densities in osteonal bone and the porosity of cortical bone are studied using microradiographs, and osteon closure rates are assessed using tetracycline labeling; normal distributions of osteons of different mineral density and cortical bone porosity values are observed. It is concluded that 14 days of immobilization/rotopositioning did not cause abnormal changes in osteon mineralization, cortical porosity, and osteon closure rates.

  19. Modified lingual split technique for extraction of impacted mandibular third molars.

    PubMed

    Lewis, J E

    1980-08-01

    Critical evaluation of existing chisel and bur techniques for removal of impacted mandibular third molars reveals a high incidence of complications. Both approaches require creation of a buccal defect immediately distal to the second molar for the insertion of an elevator, which may cause pocketing to occur postoperatively. The method described here minimizes periosteal reflection, almost completely avoids loss of bone, and effectively reduces the use of rotary instrumentation. The planning of the soft tissue flaps and bony cuts assists in primary wound closure, obliteration of dead space, and reduction of postoperative morbidity. PMID:6930459

  20. Three-dimensional accuracy of different impression techniques for dental implants

    PubMed Central

    Nakhaei, Mohammadreza; Madani, Azam S; Moraditalab, Azizollah; Haghi, Hamidreza Rajati

    2015-01-01

    Background: Accurate impression making is an essential prerequisite for achieving a passive fit between the implant and the superstructure. The aim of this in vitro study was to compare the three-dimensional accuracy of open-tray and three closed-tray impression techniques. Materials and Methods: Three acrylic resin mandibular master models with four parallel implants were used: Biohorizons (BIO), Straumann tissue-level (STL), and Straumann bone-level (SBL). Forty-two putty/wash polyvinyl siloxane impressions of the models were made using open-tray and closed-tray techniques. Closed-tray impressions were made using snap-on (STL model), transfer coping (TC) (BIO model) and TC plus plastic cap (TC-Cap) (SBL model). The impressions were poured with type IV stone, and the positional accuracy of the implant analog heads in each dimension (x, y and z axes), and the linear displacement (?R) were evaluated using a coordinate measuring machine. Data were analyzed using ANOVA and post-hoc Tukey tests (? = 0.05). Results: The ?R values of the snap-on technique were significantly lower than those of TC and TC-Cap techniques (P < 0.001). No significant differences were found between closed and open impression techniques for STL in ?x, ?y, ?z and ?R values (P = 0.444, P = 0.181, P = 0.835 and P = 0.911, respectively). Conclusion: Considering the limitations of this study, the snap-on implant-level impression technique resulted in more three-dimensional accuracy than TC and TC-Cap, but it was similar to the open-tray technique. PMID:26604956

  1. Treatment of Mandibular Condyle Fractures Using a Modified Transparotid Approach via the Parotid Mini-Incision: Experience with 31 Cases

    PubMed Central

    Shi, Jun; Yuan, Hao; Xu, Bing

    2013-01-01

    Surgery for mandibular condyle fractures must allow direct vision of the fracture, reduce surgical trauma and achieve reduction and fixation while avoiding facial nerve injury. This prospective study was conducted to introduce a new surgical approach for open reduction and internal fixation of mandibular condyle fractures using a modified transparotid approach via the parotid mini-incision, and surgical outcomes were evaluated. The modified transparotid approach via the parotid mini-incision was applied and rigid internal fixation using a small titanium plate was carried out for 36 mandibular condyle fractures in 31 cases. Postoperative follow-up of patients ranged from 3 to 26 months; in the first 3 months after surgery, outcomes for all patients were analyzed by evaluating the degree of mouth opening, occlusal relationship, facial nerve function and results of imaging studies. The occlusal relationships were excellent in all patients and none had symptoms of intraoperative ipsilateral facial nerve injury. The mean degree of mouth opening was 4.0 (maximum 4.8 cm, minimum 3.0 cm). No mandibular deviations were noted in any patient during mouth opening. CT showed complete anatomical reduction of the mandibular condyle fracture in all patients. The modified transparotid approach via the smaller, easily concealed parotid mini-incision is minimally invasive and achieves anatomical reduction and rigid internal fixation with a simplified procedure that directly exposes the fracture site. Study results showed that this procedure is safe and feasible for treating mandibular condyle fracture, and offers a short operative path, protection of the facial nerve and satisfactory aesthetic outcomes. PMID:24386221

  2. Accidental Implant Screwdriver Ingestion: A Rare Complication during Implant Placement

    PubMed Central

    Jain, Anshul; Baliga, Shridhar D

    2014-01-01

    One of the complications during a routine dental implant placement is accidental ingestion of the implant instruments, which can happen when proper precautions are not taken. Appropriate radiographs should be taken to locate the correct position of foreign body; usually the foreign body passes asymptomatically from gastrointestinal tract but sometimes it may lead to intestinal obstruction, perforations and impactions. The aim of this article is to report accidental ingestion of 19 mm long screw driver by a senile patient. PMID:25628702

  3. [Using dynamic magnetotherapy and transdermal electroneurostimulation in the combined treatment of patients with mandibular fractures and concomitant periodontal inflammatory diseases].

    PubMed

    Lepilin, A V; Erokina, N L; Rogatina, T V; Khlusov, I Iu

    2009-01-01

    The objective of this study was to compare results of dynamic magnetotherapy (DMT), transdermal electroneurostimulation (TDENS), and traditional ultrahigh frequency (UHF) therapy in 473 patients with mandibular fractures and concomitant inflammatory diseases of paradontium. The parameters measured in the study included hygienic and paradontal indices, microcirculation patterns (using laser Doppler flowmetry), and the degree of mandibular fragment consolidation. It was shown that combined treatment with DMT and TDENS using an AMO-ATOS-E apparatus permits to eliminate clinical symptoms of paradontal inflammatory diseases twice as fast as traditional ultrahigh frequency therapy and ensures a two-fold reduction in the frequency of complications. PMID:19711518

  4. Healing of an Extensive Periradicular Lesion Subsequent to a Proper Endodontic Treatment of a Mandibular First Premolar with Complex Anatomy

    PubMed Central

    Ashraf, Hengameh; Paymanpour, Payam; Bidabadi, Maryam Mojtahed; Hajrezai, Reihaneh

    2013-01-01

    Long-term success of endodontic treatment is strictly dependent on proper shaping and cleaning of the root canal system followed by obturation of entire prepared space. Anatomical variations should be considered during radiographic and clinical evaluation as parts of endodontic treatment. A mandibular premolar with three canals is quite rare and such a tooth requires special canal preparation and obturation techniques. An astute clinician should identify different canal configurations and treat them endodontically well, because presence of an untreated canal could be a reason for failure of endodontic treatment. This paper describes the conventional orthograde endodontic therapy on an unusual mandibular first premolar with three root canals. PMID:24383015

  5. Advances in lens implant technology

    PubMed Central

    Kampik, Anselm; Dexl, Alois K.; Zimmermann, Nicole; Glasser, Adrian; Baumeister, Martin; Kohnen, Thomas

    2013-01-01

    Cataract surgery is one of the oldest and the most frequent outpatient clinic operations in medicine performed worldwide. The clouded human crystalline lens is replaced by an artificial intraocular lens implanted into the capsular bag. During the last six decades, cataract surgery has undergone rapid development from a traumatic, manual surgical procedure with implantation of a simple lens to a minimally invasive intervention increasingly assisted by high technology and a broad variety of implants customized for each patient’s individual requirements. This review discusses the major advances in this field and focuses on the main challenge remaining – the treatment of presbyopia. The demand for correction of presbyopia is increasing, reflecting the global growth of the ageing population. Pearls and pitfalls of currently applied methods to correct presbyopia and different approaches under investigation, both in lens implant technology and in surgical technology, are discussed. PMID:23413369

  6. ANTIARRHYTHMICS VERSUS IMPLANTABLE DEFIBRILLATORS (AVID)

    EPA Science Inventory

    Evaluates whether use of an implantable cardiac defibrillator (ICD) results in reduction in total mortality, when compared with conventional pharmacological therapy, in patients resuscitated from sudden cardiac death who are otherwise at very high risk of mortality from arrhythmi...

  7. Complications in cochlear implant surgery

    PubMed Central

    Gheorghe, DC; Zamfir-Chiru-Anton, A

    2015-01-01

    For the last 6 years, cochlear implantation has become a standard practice in our department. The number of patients rose from 5 to 21/ year. Using multiple types of cochlear implants and indicating the surgery also to malformed inner ears led to the encounter of some complications. Objective: to present the surgical complications from our department. Material: all the patients admitted and operated in our clinic have been reviewed. Results: 9 complications (8,86%) have occurred: the impossibility of establishing a reliable cochleostomy (due to ossification), air in the cochlea through lack of sealing of the cochleostomy (exteriorization of the electrode array), cochlear implant postoperative migration from its bed, weak hearing discrimination due to “double electrodes” in the scala tympani, gusher. Conclusions: cochlear implanting needs to respect the technical steps of the surgery and the best technical/ tactical solution has to be found to whatever complications arise in complex or malformed cases! PMID:26351535

  8. Ciliary Sulcus Ahmed Valve Implantation

    PubMed Central

    Moon, Kun; Kim, Kwang Soo

    2007-01-01

    Purpose Ahmed glaucoma valves were implanted into the ciliary sulcus of two patients diagnosed with neovascular glaucoma with favorable outcomes. Methods The study patients presented to our hospital with ocular pain caused by increased intraocular pressure (IOP). A thorough history was taken, and an ophthalmic examination was performed. Results A 71-year-old male patient and a 57-year-old female patient visited our hospital for ocular pain and persistent, elevated IOP. Each were diagnosed with neovascular glaucoma and underwent an Ahmed glaucoma valve implantation to the sulcus. After surgery, the patients maintained stable IOPs without major complications. Conclusions The method of Ahmed glaucoma valve implantation into the ciliary sulcus could reduce complications caused by implantation to the anterior chamber. It is thought to be an efficient method for the maintenance of appropriate IOP after surgery. PMID:17592246

  9. Fabrication of implantable microshunt using

    E-print Network

    Bifano, Thomas

    Fabrication of implantable microshunt using a novel channel sealing technique Alioune Diouf microelectromechanical systems MEMS fabrication processes. The key features of our mi- croshunt fabrication process fabrication process suitable for mass production. These features were realized using electroplating

  10. Why are mini-implants lost: The value of the implantation technique!

    PubMed Central

    Romano, Fabio Lourenço; Consolaro, Alberto

    2015-01-01

    The use of mini-implants have made a major contribution to orthodontic treatment. Demand has aroused scientific curiosity about implant placement procedures and techniques. However, the reasons for instability have not yet been made totally clear. The aim of this article is to establish a relationship between implant placement technique and mini-implant success rates by means of examining the following hypotheses: 1) Sites of poor alveolar bone and little space between roots lead to inadequate implant placement; 2) Different sites require mini-implants of different sizes! Implant size should respect alveolar bone diameter; 3) Properly determining mini-implant placement site provides ease for implant placement and contributes to stability; 4) The more precise the lancing procedures, the better the implant placement technique; 5) Self-drilling does not mean higher pressures; 6) Knowing where implant placement should end decreases the risk of complications and mini-implant loss. PMID:25741821

  11. Ion implanted dielectric elastomer circuits

    NASA Astrophysics Data System (ADS)

    O'Brien, Benjamin M.; Rosset, Samuel; Anderson, Iain A.; Shea, Herbert R.

    2013-06-01

    Starfish and octopuses control their infinite degree-of-freedom arms with panache—capabilities typical of nature where the distribution of reflex-like intelligence throughout soft muscular networks greatly outperforms anything hard, heavy, and man-made. Dielectric elastomer actuators show great promise for soft artificial muscle networks. One way to make them smart is with piezo-resistive Dielectric Elastomer Switches (DES) that can be combined with artificial muscles to create arbitrary digital logic circuits. Unfortunately there are currently no reliable materials or fabrication process. Thus devices typically fail within a few thousand cycles. As a first step in the search for better materials we present a preliminary exploration of piezo-resistors made with filtered cathodic vacuum arc metal ion implantation. DES were formed on polydimethylsiloxane silicone membranes out of ion implanted gold nano-clusters. We propose that there are four distinct regimes (high dose, above percolation, on percolation, low dose) in which gold ion implanted piezo-resistors can operate and present experimental results on implanted piezo-resistors switching high voltages as well as a simple artificial muscle inverter. While gold ion implanted DES are limited by high hysteresis and low sensitivity, they already show promise for a range of applications including hysteretic oscillators and soft generators. With improvements to implanter process control the promise of artificial muscle circuitry for soft smart actuator networks could become a reality.

  12. Biomechanics of Corneal Ring Implants

    PubMed Central

    2015-01-01

    Purpose: To evaluate the biomechanics of corneal ring implants by providing a related mathematical theory and biomechanical model for the treatment of myopia and keratoconus. Methods: The spherical dome model considers the inhomogeneity of the tunica of the eye, dimensions of the cornea, lamellar structure of the corneal stroma, and asphericity of the cornea. It is used in this study for calculating a strengthening factor sf for the characterization of different ring-shaped corneal implant designs. The strengthening factor is a measure of the amount of strengthening of the cornea induced by the implant. Results: For ring segments and incomplete rings, sf = 1.0, which indicates that these implants are not able to strengthen the cornea. The intracorneal continuous complete ring (MyoRing) has a strengthening factor of up to sf = 3.2. The MyoRing is, therefore, able to strengthen the cornea significantly. Conclusions: The result of the presented biomechanical analysis of different ring-shaped corneal implant designs can explain the different postoperative clinical results of different implant types in myopia and keratoconus. PMID:26312619

  13. Therapy using implanted organic bioelectronics

    PubMed Central

    Jonsson, Amanda; Song, Zhiyang; Nilsson, David; Meyerson, Björn A.; Simon, Daniel T.; Linderoth, Bengt; Berggren, Magnus

    2015-01-01

    Many drugs provide their therapeutic action only at specific sites in the body, but are administered in ways that cause the drug’s spread throughout the organism. This can lead to serious side effects. Local delivery from an implanted device may avoid these issues, especially if the delivery rate can be tuned according to the need of the patient. We turned to electronically and ionically conducting polymers to design a device that could be implanted and used for local electrically controlled delivery of therapeutics. The conducting polymers in our device allow electronic pulses to be transduced into biological signals, in the form of ionic and molecular fluxes, which provide a way of interfacing biology with electronics. Devices based on conducting polymers and polyelectrolytes have been demonstrated in controlled substance delivery to neural tissue, biosensing, and neural recording and stimulation. While providing proof of principle of bioelectronic integration, such demonstrations have been performed in vitro or in anesthetized animals. Here, we demonstrate the efficacy of an implantable organic electronic delivery device for the treatment of neuropathic pain in an animal model. Devices were implanted onto the spinal cord of rats, and 2 days after implantation, local delivery of the inhibitory neurotransmitter ?-aminobutyric acid (GABA) was initiated. Highly localized delivery resulted in a significant decrease in pain response with low dosage and no observable side effects. This demonstration of organic bioelectronics-based therapy in awake animals illustrates a viable alternative to existing pain treatments, paving the way for future implantable bioelectronic therapeutics. PMID:26601181

  14. Auditory Midbrain Implant: A Review

    PubMed Central

    Lim, Hubert H.; Lenarz, Minoo; Lenarz, Thomas

    2009-01-01

    The auditory midbrain implant (AMI) is a new hearing prosthesis designed for stimulation of the inferior colliculus in deaf patients who cannot sufficiently benefit from cochlear implants. The authors have begun clinical trials in which five patients have been implanted with a single shank AMI array (20 electrodes). The goal of this review is to summarize the development and research that has led to the translation of the AMI from a concept into the first patients. This study presents the rationale and design concept for the AMI as well a summary of the animal safety and feasibility studies that were required for clinical approval. The authors also present the initial surgical, psychophysical, and speech results from the first three implanted patients. Overall, the results have been encouraging in terms of the safety and functionality of the implant. All patients obtain improvements in hearing capabilities on a daily basis. However, performance varies dramatically across patients depending on the implant location within the midbrain with the best performer still not able to achieve open set speech perception without lip-reading cues. Stimulation of the auditory midbrain provides a wide range of level, spectral, and temporal cues, all of which are important for speech understanding, but they do not appear to sufficiently fuse together to enable open set speech perception with the currently used stimulation strategies. Finally, several issues and hypotheses for why current patients obtain limited speech perception along with several feasible solutions for improving AMI implementation are presented. PMID:19762428

  15. 21 CFR 872.3980 - Endosseous dental implant accessories.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ...false Endosseous dental implant accessories. 872.3980...DEVICES DENTAL DEVICES Prosthetic Devices § 872.3980 Endosseous dental implant accessories. (a) Identification. Endosseous dental implant accessories are...

  16. 21 CFR 872.3980 - Endosseous dental implant accessories.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ...false Endosseous dental implant accessories. 872.3980...DEVICES DENTAL DEVICES Prosthetic Devices § 872.3980 Endosseous dental implant accessories. (a) Identification. Endosseous dental implant accessories are...

  17. Experience with the Use of Prebent Plates for the Reconstruction of Mandibular Defects

    PubMed Central

    Salgueiro, Martin I.; Stevens, Mark R.

    2010-01-01

    Bending of large titanium plates for mandibular reconstruction is a tedious task. This is usually done by trial and error over an intraoperatively bent template. By means of rapid prototype technology, accurate three-dimensional models can be obtained. Using these models, it is possible to design, obtain, and adapt custom hardware for individual surgical cases. Reductions of operating room time when using this technology have been reported from 17% to 60%, with an average of 20%. This translates to reduction of cost and risks, improving the overall surgical outcome. The purpose of this article is to establish the indications and contraindication for the use three-dimensional models and prebent plates. We present our experience with five cases in which prebent reconstruction plates were used for mandibular reconstruction. No significant complications occurred, and satisfactory results were achieved in all cases. We found that the models required to obtain the hardware are extremely accurate, have multiple reported applications, and represent a valuable surgical tool in the planning and execution of reconstructive surgery. PMID:22132258

  18. [Anesthetic management of a patient with osteogenesis imperfecta combined with mandibular defect].

    PubMed

    Tsukamoto, Masanori; Hirokawa, Jun; Sako, Saori; Fujiwara, Shigeki; Yokoyama, Takeshi

    2014-06-01

    Osteogenesis imperfecta (OI) is a rare hereditary disorder characterized by an excessive tendency to bone fractures and retarded growth. We report an anesthetic management of the patient with OI who has the history of vertebral bone fracture by coughing. A 44-year-old female underwent mandibular resection and reconstruction with a metal instrument due to ossifying fibroma 35 years ago. Since then, she had undergone mandibular resection and shaving the instrument several times because of recurrence of the tumor and/or fracture of the instrument. This time, some parts of the instrument were removed under general anesthesia since it had exposed from the skin. Difficulty in mask ventilation and intubation was predicted due to the defect of mandible and some muscles supporting the tongue and the pharynx. Awake fiber-optic nasotracheal intubation, therefore, was performed in consideration of airway obstruction. Dexmedetomidine was administered to reduce the risk of bone fracture in addition to low doses of midazolam and fentanyl. Considering incomplete respiration after extubation, the tracheal tube was extubated after inserting the tube exchanger into the trachea through the tube. The tube exchanger was pulled out after confirming spontaneous respiration and upper airway patency. The patient was cooperative, and respiratory and hemodynamic conditions were stable throughout. PMID:24979864

  19. Volumetric fibular transfer planning with shape-based indicators in mandibular reconstruction.

    PubMed

    Nakao, Megumi; Hosokawa, Mamoru; Imai, Yuichiro; Ueda, Nobuhiro; Hatanaka, Toshihide; Kirita, Tadaaki; Matsuda, Tetsuya

    2015-03-01

    In preoperative planning for mandibular reconstructive surgery, it is necessary to determine the osteotomy lines for fibular shaping and the proper placement of fibular segments in the mandible. Although virtual surgical planning has been utilized in preoperative decision making, current software designs require manual operation and a trial-and-error process to refine the reconstruction plan. We have developed volumetric fibular transfer simulation software that can quickly design a preoperative plan based on direct volume manipulation and quantitative comparison with the patient's original mandible. We propose three quantitative shape indicators-volume ratio, contour error, and maximum projection-for symmetrical lesions of the mandible, and have implemented a parallel computation algorithm for the semiautomatic placement of fibular segments. Using this virtual planning software, we conducted a retrospective study of the computed tomography data from nine patients. We found that combining direct volume manipulation with real-time local search of placement improved the applicability of the planning system to optimize mandibular reconstruction. PMID:24801875

  20. Afferent and Efferent Aspects of Mandibular Sensorimotor Control in Adults who Stutter

    PubMed Central

    Daliri, Ayoub; Prokopenko, Roman A.; Max, Ludo

    2013-01-01

    Purpose Individuals who stutter show sensorimotor deficiencies in speech and nonspeech movements. For the mandibular system, we dissociated the sense of kinesthesia from the efferent control component to examine whether kinesthetic integrity itself is compromised in stuttering or whether deficiencies occur only when generating motor commands. Method We investigated 11 stuttering and 11 nonstuttering adults’ kinesthetic sensitivity threshold and kinesthetic accuracy for passive jaw movements as well as their minimal displacement threshold and positioning accuracy for active jaw movements. We also investigated the correlation with an anatomical index of jaw size. Results The groups showed no statistically significant differences on sensory measures for passive jaw movements. Although some stuttering individuals performed more poorly than any nonstuttering participants on the active movement tasks, between-group differences for active movements were also not statistically significant. Unlike fluent speakers, however, the stuttering group showed a statistically significant correlation between mandibular size and performance in the active and passive near-threshold tasks. Conclusions Previously reported minimal movement differences were not replicated. Instead, stuttering individuals’ performance varied with anatomical properties. These correlational results are consistent with the hypothesis that stuttering participants generate and perceive movements based on less accurate internal models of the involved neuromechanical systems. PMID:23816664