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1/154. Occlusal rehabilitation using implants for orthodontic anchorage.

    osseointegration is defined as a direct interaction of bone to an implant surface. As a result, the implant fixture is immobilized in the bone and lends itself to function as an anchor for orthodontic tooth movements. When properly treatment-planned, these implants can also be used as prosthodontic abutments for single crowns, or removable or fixed partial dentures. This article describes how implant fixtures were surgically placed within the maxillary and mandibular arches of a partially edentulous patient, and used for orthodontic anchorage to reposition the remaining teeth into a more favorable arch position, creating increased posterior interocclusal space. The fixtures were then restored with fixed partial dentures to rehabilitate the patient into a mutually protected occlusion. ( info)

2/154. Design of a cast bar reinforced provisional restoration for the management of the interim phase in implant dentistry.

    Implant therapy is becoming the treatment of choice for the replacement of teeth in partially edentulous arches. The interim phase of implant treatment often presents particular problems because of the position of the remaining teeth, their periodontal status, and the loss of vertical dimension of occlusion. This case report will discuss the design and fabrication of a cast bar reinforced long-span provisional restoration based on a diagnostic wax-up to simplify the management of the interim phase. ( info)

3/154. Elongated stylohyoid process: a report of three cases.

    The stylohyoid process is part of the stylohyoid chain--the styloid process, the stylohyoid ligament, and the lesser cornu of the hyoid bone. The stylohyoid chain is derived from the second branchial arch. Mineralisation of the stylohyoid ligament and ossification at the tip may increase the length of the styloid process. An elongated stylohyoid or styloid process is considered to be the source of craniofacial and cervical pain commonly known as Eagle's syndrome. In some instances the stylohyoid process may be considerably elongated, yet remain asymptomatic. This paper reports three patients with elongated stylohyoid processes discovered incidentally on routine radiographic examination. ( info)

4/154. The role of orthognathic surgery in the treatment of severe dentoalveolar extrusion.

    BACKGROUND: When mandibular molars are not replaced after extraction, the long-term problem of inadequate interarch space for either a fixed or removable prosthesis can occur. In the past, practitioners needed to decide whether to shorten the teeth, extract the supererupted maxillary molars to recapture space or leave the area unrestored. The authors present another option. CASE DESCRIPTION: A 61-year-old man was referred to a periodontist by his general dentist for placement of mandibular implants in the posterior sextant. Extreme supereruption of the maxillary dentoalveolar segment prevented restoration of the opposing edentulous area. An oral and maxillofacial surgeon performed a segmental osteotomy of the posterior right maxilla to gain needed interarch space. After the osteotomy was stabilized, the periodontist placed implants that were subsequently restored with a fixed prosthesis. CLINICAL IMPLICATIONS: The role of orthognathic surgery in treatment planning should not be overlooked in the comprehensive management of severe extrusion. It offers patients the opportunity to gain both function and esthetics that might otherwise be impossible. ( info)

5/154. Short and sticky options in the treatment of the partially dentate patient.

    As we move into the twenty-first century, patterns of dental disease in adults are changing. Surveys of adult dental health indicate that more people are keeping their teeth for longer in life. In many cases, the ravages of dental disease and the cumulative effect of a lifetime of restorative dentistry lead to gradual tooth loss. For many of these patients, restoration of a complete dentition may not be feasible nor desirable. In recent years, functionally oriented treatment planning has become acceptable in light of recent research findings. Using this approach, treatment efforts and resources are directed principally at retaining the 'strategic' part of the dentition in the long term, ie, the anterior and premolar teeth. This paper describes, with the aid of treated cases, a means of combining a shortened dental arch strategy with resin bonded bridgework. With the aid of recent research in this area of clinical practice, some suggestions as to the use of the technique are also described. ( info)

6/154. Dental blood supply in the segmentally resected mandible.

    There are approximately 30,000 new cases of oral and pharyngeal carcinoma treated in the united states each year. A large number of these patients go on to receive segmental resection of the mandible, and have natural teeth remaining on the surgical side. To the best of our knowledge, there has not been a thorough discussion of the blood supply to these remaining teeth. Radiographic evidence of periapical pathology in these teeth is unusual, despite the compromised vascular supply. The purpose of this article is to report a case and review the literature on blood supply to teeth after segmental mandibulectomy. Microscopic examination was conducted on the pulpal tissue of a premolar retained on the side of, and anterior to, a segmental mandibular resection. Although abnormal, the pulp tissue showed evidence of a vascular supply 4 yr after mandibular surgery. A literature review was performed, and a discussion is given to explain the continued vascularity of the dentition through collateral and retrograde circulation. Despite the compromised dental circulation on the surgical side, unless radiographic evidence of periapical pathology occurs, endodontic therapy or extraction is not necessary. Due to the compromised nature of the circulation however, these teeth may be more susceptible to caries or restorative dental procedures that may lead to pulpal necrosis. ( info)

7/154. Fixed prosthodontics in skeletal Class III patients with partially edentulous jaws and age-related prognathism: the basal osseointegration procedure.

    Today, prognathism in the partially or completely edentulous jaw can be treated with endosteal implants and fixed prostheses. The preferred procedure uses basal osseointegration. If the distribution of available bone is favorable, the prosthodontic suprastructures can be loaded early, taking the various phases of bone regeneration into account. Invasive surgical interventions, specifically iliac crest transplants, are rarely indicated and can be avoided in most cases. patients are able to return to their everyday lives within a few days. ( info)

8/154. Alveolar distraction osteogenesis: a new alternative to bone grafts. Report of three cases.

    case reports of distraction osteogenesis of the alveolar bone, case selection, methods and follow-up of patients seen in the Oral Surgery Group office, new brunswick, NJ. ( info)

9/154. actinobacillus actinomycetemcomitans-associated peri-implantitis in an edentulous patient. A case report.

    BACKGROUND: peri-implantitis is a risk factor for implant loss. Late bacterial infection of the peri-implant tissues and loss of alveolar bone in edentulous patients is caused by commensal oral anaerobic bacteria. In partially edentulous patients, porphyromonas gingivalis and occasionally actinobacillus actinomycetemcomitans are associated with peri-implantitis lesions. AIMS: To investigate the microbiology of a peri-implantitis case in an edentulous patient. methods: Anaerobic culture techniques and selective culture techniques for A. actinomycetemcomitans were used to study the peri-implant microflora at sites with and without bone loss. RESULTS: An anaerobic peri-implant microflora with several putative periodontal pathogens was found at sites with bone loss. Furthermore, a metronidazole-resistant A. actinomycetemcomitans was isolated. The A. actinomycetemcomitans infection did not respond to systemic doxycycline therapy, despite good susceptibility in vitro. CONCLUSIONS: The present case of severe A. actinomycetemcomitans-associated peri-implantitis shows the importance of pre-operative infection control. The findings in this case show that remaining teeth affected by periodontitis can be a serious risk factor for peri-implantitis. ( info)

10/154. The Royal london Space Planning: an integration of space analysis and treatment planning: Part II: The effect of other treatment procedures on space.

    The Royal london Space Planning process is carried out in 2 stages. The first stage, assessing the space required to attain the treatment objectives, was described in Part I of this report, published earlier. In Part II, the process of integrating space analysis with treatment planning continues with consideration of the effects other treatment procedures have on space. These procedures include tooth enlargement or reduction, tooth extraction, the creation of space for prosthetic replacement, and mesial and distal molar movement. The effects of favorable and unfavorable growth are also considered. A brief case report is presented to demonstrate use of the Royal london Space Planning. ( info)
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