Reconstruction of the edentulous mandible with fresh frozen bone grafts and implants: a 4-year report of a prospective clinical study

Allogen bones from tissue bank are often used in dentistry although the data analyzing the long-term success in mandible are scarce. This study evaluated by computed tomography scans (CTS) the bone resorption around the implants installed on fresh frozen bone (FFB) previously grafted, after 4 years of occlusal rehabilitation. Six subjects were grafted with blocks in posterior mandible using FFB. After 6 months, 27 implants were placed and after further 4 months the prostheses were delivered. Following 4 years of the final rehabilitation procedures, another CTS was done in order to measure the resorption in periimplant bone crest at the proximal implant surfaces. It was observed a 100 % survival rate of the implants after 4 years of the fixture installation. The marginal bone resorption after 48 months was 2.82 ± 1.63 mm and no statistical significant difference was observed along the region where the implants were fixed when compared with the interimplantar space. In addition there was no significant correlation regarding the length of the implant used and the amount of marginal bone resorption. The conclusion is that grafted areas with FFB are suitable to implant installation in the posterior mandible.     

Accelerated rehabilitation of an edentulous patient with an implant retained dental prosthesis: a case report

This case report details the successful rehabilitation of an edentulous patient using a complete upper prosthesis and a lower implant retained overdenture. The provision of care was split between a specialist centre and a primary care setting. This approach reduced inconvenience to the patient. Modern surgical and prosthodontic techniques also reduced the total delivery time. After initial consultation a new set of complete dentures was prescribed with changes in design to the originals. The patient was also planned for placement of two mandibular implants to stabilise and retain the mandibular denture. The first line of treatment involved provision of a new set of dentures constructed by the patient's general dental practitioner. Dental implants were then placed in a specialist centre and the patient returned to the dental practice for attachment of the lower denture to the dental implants. The benefits and success of mandibular implant retained dentures are well documented. With delivery of the overdenture, the patient reported increased satisfaction with his prostheses which allowed him to eat a greater range of foods and enabled him to feel confident when speaking and socialising.     

Effect of electromagnetic field on bone regeneration around dental implants after immediate placement in the dog mandible: a pilot study

doi: 10.1111/j.1741‐2358.2011.00525.x Effect of electromagnetic field on bone regeneration around dental implants after immediate placement in the dog mandible: a pilot study Background: Accelerating bone healing around dental implants can reduce the long‐term period between the insertion of implants and functional rehabilitation. Objective: This in vivo study evaluated the effect of a constant electromagnetic field (CEF) on bone healing around dental implants in dogs. Materials and methods: Eight dental implants were placed immediately after extraction of the first pre‐molar and molar teeth on the mandible of two male dogs and divided into experimental (CEF) and control groups. A CEF at magnetic intensity of 0.8 mT with a pulse width of 25 μs and frequency of 1.5 MHz was applied on the implants for 20 min per day for 2 weeks. Result and conclusion: After qualitative histological analysis, a small quantity of newly formed bone was observed in the gap between the implant surface and alveolar bone in both groups.     

Resonance frequency analysis of overdenture retainer implants with immediate loading

doi: 10.1111/j.1741‐2358.2011.00488.x
Resonance frequency analysis of overdenture retainer implants with immediate loading Objective: To evaluate 16 patients of both sexes with lower overdenture and upper complete dentures, by analysing the resonance frequency of the initial and late stability of implants used to retain the overdenture under immediate loading. Background: Oral rehabilitation treatment with complete dentures using implants has been increasingly more common among the specialists in the oral rehabilitation area. This is an alternative for obtaining retention and stability in treatments involving conventional complete dentures, where two implants are enough to retain the overdenture satisfactorily. Materials and methods: The Osstell? Mentor device was used for the analysis in the initial period (primary stability), 3 and 15 months after the installation of the lower overdenture (secondary stability). The statistical analysis was performed with the repeated measures model (p < 0.01). Results: The implant stability quotients were observed to increase after 15 months of the rehabilitating treatment. Conclusion: The use of overdentures over two lower implants should become the treatment of choice for individuals who have a fully edentulous mandible.     

Segmental mandibulectomy and immediate free fibula osteoseptocutaneous flap reconstruction with endosteal implants: an ideal treatment method for mandibular ameloblastoma

Thirteen patients with large ameloblastomas of the mandible underwent segmental mandibulectomy and immediate reconstruction, with simultaneous placement of osseointegrated implants. All patients received palatal mucosal grafts around the dental implants 6 to 10 months after surgical treatment and received implant-supported prostheses another 1 to 2 months later. There were five female and eight male patients, with a mean age of 32 years (range, 17 to 50 years). The mean length of the mandibular defect was 8.8 cm (range, 5 to 13 cm). All free fibula flap procedures were successful, with no reexplorations or partial flap losses. There was no clinical or radiographic evidence of failure during the osseointegration process for any implant. With functional occlusal loading, the marginal bone loss around the implants was less than 1.5 mm in a mean follow-up period of 40 months (range, 18 to 70 months). There were no recurrences during that time. The technique described allows improved access to the bone at the time of reconstruction, immediate assessment of alveolar ridge relationships, and accurate fixation of the implant-fibula construct. The advantages of this procedure include a reduced risk of recurrence with segmental resection, reliable mandibular reconstruction, and reduction of the number of surgical procedures, allowing full oral rehabilitation in a shorter time. It is concluded that segmental mandibulectomy and immediate vascularized fibula osteoseptocutaneous flap reconstruction, with simultaneous placement of osseointegrated implants, represent an ideal treatment method for large ameloblastomas of the mandible.     

Long-term restoration of masticatory function with fixed mandibular implants in cases of oral cancer

The results of the present study show that the fixed mandibular implant system enables patients who have operations to treat oral cancer to use a stabilized denture continuously over an extended period of time.     

Partial trisomy 4q syndrome: Case report and review

Summary In the course of chromosome studies of atomic bomb survivors in Hiroshima using the trypsin-G-banding and Q-banding methods, a 40-year-old male was found to have an abnormal banding pattern in the long arm of a chromosome 7, although no such abnormality was detected by ordinary staining method. Since all other chromosomes apparently had normal banding patterns, the abnormality was determined to be a paracentric inversion of a chromosome 7, which is described as 46,XY,inv(7)(q22q31). This is the first demonstration of a possible paracentric inversion in man.     

Tinea capitis in an adult. Case report

A tinea capitis and tinea faciei case in an elderly female patient with diabetes mellitus type 2 is presented. Her dermatological illness began on her face and later disseminated to her scalp. She received multiple medications which aggravated her condition. The diagnosis was established by means of direct examination and the isolation of Trichophyton tonsurans in culture. Treatment with 200 mg daily dose of itraconazol for two months resulted in clinical and mycological cure.     

Effect of hypoxia on immediate ventilatory load response in dogs.

The effective elastance of the respiratory system (which has been previously shown to provide an index of the ability of the respiratory musculature to compensate rapidly for transient mechanical ventilatory loads) was measured in six hypoxic dogs to determine whether hypoxia hindered immediate load-compensatory mechanisms. The effective elastance value was computed from measurements of control tidal volume and the pressure developed at the airway opening during the first inspiratory effort following airway occlusion at FRC. The mean effective elastance was 197 cmH2O/l while the animals were breathing room air and did not change significantly when the animals were rendered hypoxic by reducing the inspired oxygen concentration, in five dogs, or by controlled hemorrhage, in two dogs. It was concluded that inasmuch as effective elastance measurements remain constant during hypoxia, the stability of ventilation is not significantly impaired in this situation.     

Case report: Miliary blastomycosis with cerebral involvement

A patient was diagnosed as having labyrinthitis and an intracranial brain tumor. At the time a very fine nodularity to the bronchopulmonary markings was noted on the chest roentgenogram. Subsequent follow up examination revealed diffuse nodular densities throughout both lung fields having the appearance of a miliary distribution. Antituberculous therapy was begun empirically, but the patient expired within three weeks. At autopsy multiple granulomas were found in the cerebrum, cerebellum and meninges. By culture and histologic examination, these were determined to contain Blastomyces dermatitidis. The lungs contained numerous small granulomata almost to the exclusion of native pulmonary architecture. Lesions were also seen in spleen, lymph nodes and pancreas.     

The Oberlin procedure for restoration of elbow flexion with the da Vinci robot: four cases

Robotics allows up to 40× visual magnification and 10× magnification of the surgeon's movements, and eliminates physiologic tremors. These properties should allow the development of mini-invasive limb surgery, especially of the brachial plexus. The purpose of this work was to test the feasibility of the restoration of elbow flexion according to the technique of Oberlin using a da Vinci robot. The authors' series included four patients (average age, 31 years) presenting with elbow flexion paralysis. They were operated on 8 months after injury using a da Vinci S robot. In three patients, the open technique (technique 1) was used, and the mini-invasive approach (technique 2) was used for the last one. Strength of elbow flexion was measured. After 1-year follow-up, all of the patients had recovered elbow flexion. No sensory or motor deficit was found in the ulnar nerve territory. There was no difficulty with technique 1; technique 2, however, required a conversion to technique 1 because of difficulty visualizing the operative field. The results of the authors' series show the feasibility of the robot-assisted technique for the Oberlin procedure. The lack of sensory feedback was not an issue. The development of specific retractors and instruments should improve the mini-invasive technique. CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, V.