Midpalatal suture maturation: Classification method for individual assessment before rapid maxillary expansion

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Volumetric upper airway assessment in patients with transverse maxillary deficiency after surgically assisted rapid maxillary expansion

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Eight-Year Follow-Up of a Fixed-Detachable Maxillary Prosthesis Utilizing an Attachment System: Clinical Protocol for Individuals With Skeletal Class III Malocclusions

The aim of this article is to describe a successful clinical protocol for prosthodontic rehabilitation of a patient with a skeletal Class III malocclusion using a fixed-detachable maxillary prosthesis supported by 6 implants and the MK1 attachment system. The patient was followed up for 8 years. A 46-year-old edentulous woman with a skeletal Class III malocclusion expressed dissatisfaction with her old existing maxillary denture from an esthetic point of view and frustration regarding its function. A fixed-detachable maxillary prosthesis using the MK1 attachment system was made. The patient was followed up clinically and radiographically for 8 years. No bone loss, fracture of prosthetic components, or fracture of the prosthesis was detected in that period. A fixed detachable maxillary prosthesis using the MK1 attachment system is a treatment option for patients with Class III malocclusions who opt not to undergo orthognathic surgery.

Isolated Bilateral Blowout Fracture With Extensive Pneumatization of the Maxillary Sinuses

The blowout fracture injuries are often associated with fractures of the zygomatic complex and other facial structures but can also occur in an isolated fashion. Isolated bilateral blowout fractures are uncommon and constitute a challenge with regard to both assessment and reconstruction. This article describes an uncommon case of isolated bilateral blowout fracture in a patient with extensive pneumatization of the maxillary sinuses.

The edentulous ridge expansion (ERE) technique an experimental study in the dog

Objective: To compare the healing and bony crest resorption at implants installed conventionally or applying an edentulous ridge expansion (ERE) technique in the maxilla.Material and methods: In six Labrador dogs, the first and second maxillary incisors were extracted bilaterally. In the left side of the maxilla (Test), the flaps were elevated and the buccal plate of the alveoli and septa was removed. After 3 months of healing, partial-thickness (split) flaps were dissected and the residual alveolar bone was exposed. In the right side of the maxilla, an implant was installed conventionally (Type IV; Control) while, in the left side, the ERE technique was adopted. Hence, an expansion of the buccal bony crest was obtained, and the implant was subsequently installed (Test). After 3 months of healing, biopsies were obtained and ground sections were prepared for histological analyses.Results: A buccal vertical resorption of the bony crest of 2.2 +/- 1.2 mm and 1.6 +/- 0.7 mm was found at the test and control sites, respectively. The difference, however, did not reach statistical significance. The coronal level of osseointegration at the buccal aspect was located at 3.1 +/- 1.0 mm and 2.2 +/- 0.7 mm from the implant shoulder at the test and control sites, respectively, the difference being statistically significant. The mean values of the mineralized bone-to-implant contact (MBIC%) ranged from 43% to 48% at the buccal and lingual sites. No differences reached statistical significance.Conclusions: Implants installed by applying an ERE technique may osseointegrate similarly to conventional implant installation. However, vertical and horizontal resorption of the displaced buccal bony wall occurred as well.

Influence on alveolar resorption of the buccal bony plate width in the edentulous ridge expansion (ERE) - an experimental study in the dog

Objective: To compare the hard tissue changes at implants installed applying edentulous ridge expansion (E.R.E.) at sites with a buccal bony wall thickness of 1 or 2 mm.Material and methods: In six Labrador dogs, the first and second maxillary incisors were extracted, and the buccal alveolar bony plates and septa were removed. After 3 months of healing, partial-thickness flaps were dissected, and the E.R.E. was applied bilaterally. Hence, an expansion of the buccal bony crest was obtained in both sides of the maxilla with a displacement of either a 1- or a 2-mm-wide buccal bony plate at the test and control sites, respectively. After 3 months of healing, biopsies were obtained for histological analyses.Results: A buccal vertical resorption of the alveolar crest of 2.3 +/- 0.8 and 2.1 +/- 1.1 mm, and a coronal level of osseointegration at the buccal aspect of 2.7 +/- 0.5 and 2.9 +/- 0.9 mm were found at the test (1 mm) and control (2 mm) sites, respectively. The differences did not reach statistical significance. The mean values of the mineralized bone-to-implant contact (MBIC%) ranged from 62% to 73% at the buccal and lingual sites. No statistically significant differences were found. Horizontal volume gains of 1.8 and 1.1 mm were observed at the test and control sites, respectively, and the difference being statistically significant.Conclusions: Implants installed using the E.R.E. technique yielded a high degree of osseointegration. It is suggested that the displacement of buccal bony plates of 1 mm thickness is preferable compared with that of wider dimensions.

Alveolar ridge augmentation with the perforated and nonperforated bone grafts

Purpose: Autogenous bones are frequently used because of their lack of antigenicity, but good osteoconductive and osteoinductive properties. This study evaluated the biological behavior of perforated and nonperforated cortical block bone grafts.Methods: Ten nonsmoking patients who required treatment due to severe resorption of the alveolar process and subsequent implant installation were included in the study. The inclusion criteria was loss of one or more teeth; the presence of atrophy of the alveolar process with the indication of reconstruction procedures to allow rehabilitation with dental implants; and the absence of systemic disease, local infection, or inflammation. The patients were randomly divided into two groups based on whether they received a perforated (inner surface) or nonperforated graft. After a 6-month healing period, a biopsy was performed and osseointegrated implants were installed in the same procedure.Results: Fibrous connective tissue was evident at the interface in patients who received nonperforated grafts. However, full union between the graft and host bed was visible in those who had received a perforated graft.Conclusions: We found that cortical inner side perforations at donor sites increased the surface area and opened the medullary cavity. Our results indicate an increased rate of graft incorporation in patients who received such perforated grafts.

A famacocinética e os efeitos sedativos e comportamentais dos cloridratos de xilazina e de detomidina, administrados por diferentes vias, em asininos Nordestinos (Equus sinus)

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Maxillary molar intrusion with zygomatic anchorage in open bite treatment: lateral and oblique cephalometric evaluation

Purpose We aimed to use lateral and oblique radiographs to evaluate dental and skeletal changes arising from maxillary molar intrusion with zygomatic anchorage in open bite patients. Methods We conducted a pilot study including nine patients (six females and three males; mean age, 18.7±5.1 years) with skeletal open bite treated with titanium miniplates for posterior dentoalveolar intrusion. Lateral and oblique (right and left, 45°) radiographs were obtained before (T1) and 6 months after intrusion (T2). A paired t test was used for statistical evaluation. Results The maxillary posterior teeth were intruded 2.03± 0.87 mm (p<0.01) with 450×g of force, which resulted in counterclockwise rotation of the mandible (1.57°, p=0.02) and clockwise rotation of the occlusal plane (4.27±2.66°, p=0.01). Anterior facial height decreased by a mean of 1.79±1.51 mm (p<0.01). No significant change in the palatal plane or in anteroposterior molar movement was observed. Conclusion The oblique radiograph at 45° was useful for the assessment of molar intrusion and anteroposterior displacement. The treatment of anterior open bite with skeletal anchorage provided intrusion of molars and counterclockwise rotation of the mandible, resulting in open bite closure.

Frontal sinus obliteration with iliac crest bone grafts: review of 8 cases

This study evaluated postoperative results of 8 cases of frontal sinus fractures treated by frontal sinus obliteration with autogenous bone from the anterior iliac crest. Patients and methods: The medical charts of patients sequentially treated for frontal sinus fractures by obliteration with autogenous cancellous iliac crest bone in the Oral and Maxillofacial Surgery Division of this institution were reviewed. From those, eight had complete records and adequately described long-term follow-up. All were operated by the same surgical team. Those patients were recalled and independently evaluated by 2 examiners. Radiographs and/or CT scans were available for this evaluation. Associated fractures and complications were noted. The average postoperative follow-up was 7 years, ranging from 3 to 16 years. The main complication was infection. Four patients (50%) had uneventful long-term follow-ups and four (50%) experienced complications requiring reoperation. Based on the studied sample studied the authors conclude that the obliteration with autogenous bone presented a high percentage of complications in this series.

Frontal sinus obliteration with iliac crest bone grafts

This study evaluated postoperative results of 8 cases of frontal sinus fractures treated by frontal sinus obliteration with autogenous bone from the anterior iliac crest.

Aesthetic rehabilitation of a complicated crown-root fracture of the maxillary incisor: combination of orthodontic and implant treatment

The aim of this paper is to present a complex rehabilitation, of fractured tooth, with implants in anterior region considering the orthodontics extrusion to clinical success. At 7 years old, the patient fractured the maxillary left central incisor and the dentist did a crown with the fragment. Twenty years later, the patient was referred to a dental clinic for orthodontic treatment, with the chief complaint related to an accentuated deep bite, and a professional started an orthodontic treatment. After sixteen months of orthodontic treatment, tooth 21 fractured. The treatment plan included an orthodontic extrusion of tooth 21 and implant placement. This case has been followed up and the clinical and radiographic examinations show excellence esthetic results and satisfaction of patient. The forced extrusion can be a viable treatment option in the management of crown root fracture of an anterior tooth to gain bone in a vertical direction. This case emphasizes that to achieve the esthetic result a multidisciplinary approach is necessary.

Fragment reattachment after atypical crown fracture in maxillary central incisor

Background. Fracture by trauma is one of the most common types of dental injury in the permanent dentition among children and teenagers. Aim. The aim of this study was to report the treatment performed to an atypical dental trauma case in a maxillary central incisor of a young patient by means of reattachment of the tooth fragment. Case Description. A 12-year-old male patient suffered a vertical crown fracture to the maxillary right central incisor. After clinical and radiographic examinations, a conservative restorative treatment which consisted in the reattachment of the tooth fragment with flow resin was performed in order to preserve the dental element and to obtain maximum aesthetics. Conclusion. The reattachment of fractured fragment is a fast and easy technique that can be used successfully as an option to restore dental element which suffered trauma. Clinical Significance. This technique restores the aesthetics and function of the dental element with minimal discomfort to the patient.

Pharyngeal airway space cephalometric evaluation in transverse maxillary deficient patients after SARME

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)