1/70. Experiences on the sequela of maxillary sinusitis following closure of the causative oro-antral fistula. After describing the method of treating sinusitis in established oro-antral fistulae, which consists of irrigation of the maxillary sinus, antibiotic therapy and closure of the fistula, our experience gained on 75 cases checked postoperatively is presented. We found that a radical operation of the sinus, even later, was not necessary in most cases (present investigation of our clinical material showed 97.3 per cent). The inflammatorily a altered mucosa recovers after the elimination of the causative factor, which in this case is the closure of the oro-antral fistula. These findings thus correlate with those made by Obwegeser a and Tschamer (1957) and by Killey and Kay (1967). ( info) |
2/70. Three-layer closure of an oroantral-cutaneous defect. Reconstruction of oroantral defects, which are usually caused by tumor resection, is challenging. These defects become an even more difficult problem when they comprise multiple layers including oral mucosa, subcutaneous tissue, muscle and skin. This paper describes such a case in which a three-layer closure using a palatal flap, a buccal fat pad flap and a local skin flap was successfully performed. ( info) |
3/70. Team approach for closure of oroantral and oronasal fistulae. Oroantral and oronasal fistulas present with a broad range of causation, size, duration, and extent of infection involving the nose and paranasal sinuses. Accurate diagnosis of the extent of the disease with appropriate radiographic evaluation will guide the surgeon to select an approach that addresses all of the infected sites. When significant sinus disease is found, an endoscopic approach to restoring drainage in all of the involved sinuses can promote predictably successful closure of oroantral and oronasal fistulas. The multispecialty team approach to this disease, with the concomitant management of the sinusitis and fistula closure, is a significant advance in the successful management of this chronic condition. ( info) |
4/70. Inadequate implant angulation resulting from oroantral fistula: case report. Successful implant surgery is largely dependent on good treatment planning and careful surgery. A complete treatment plan must encompass both surgical and prosthetic considerations for the implant restoration. Some compromised implants are restorable, and the result can be acceptable if they can be adjusted into a more ideal position. The goals of the segmental osteotomy are the preservation of a healthy dental unit, the creation of a more ideal environment for dental restoration and occlusal reconstruction, the optimization of cost effectiveness, and the minimization of edentulous space. The purpose of this study is to present the segmental maxillary osteotomy to reposition the alveolar segment with its implant that was in a highly compromised situation. ( info) |
5/70. A modified technique of using the tongue tip for closure of large anterior palatal fistula. Anteriorly based dorsal tongue flaps are the most commonly used flaps for closure of difficult palatal fistulae. The author presents a patient in whom the palatal defect was thought to be too big to be closed by the standard tongue flap. The tongue tip was divided into equal dorsal and ventral flaps, and both flaps were used to reconstruct the palatal defect. Technical considerations, and advantages and disadvantages of the procedure are discussed. ( info) |
6/70. Odontogenic keratocyst of the maxilla presenting as periodontal abscess. This is a case report of an odontogenic keratocyst of the maxilla initially diagnosed and treated as a periodontal abscess. The occurrence of odontogenic keratocyst in the maxilla with involvement of the antrum is relatively rare. The radiological appearance of this lesion on both conventional and panoramic radiography can be misinterpreted and emphasizes the usefulness of the computed tomography in this region. ( info) |
7/70. Treatment of a persistent oro-antral fistula with a posteriorly based lateral tongue flap. Occasionally an oro-antral communication persists after vigorous standard therapy. This case report demonstrates the successful use of a posteriorly based lateral tongue flap in such a situation. ( info) |
8/70. Nasal cocaine abuse and centrofacial destructive process: report of three cases including treatment. We report 3 new cases of a centrofacial destructive process associated with chronic nasal abuse of cocaine. This complex first described in 1988 is a rare entity involving sinonasal tract necrosis after cocaine abuse. Of special interest in this report is a male patient with columella and lip involvement instead of the more usual rhinopalatal destruction. This cocaine abuse complex should be included in the differential diagnosis of centrofacial midline destructive processes in young patients as the first diagnostic possibility. We suggest a management strategy for these patients. ( info) |
9/70. Use of the buccal fat pad in maxillary and sinus grafting of the severely atrophic maxilla preparatory to implant reconstruction of the partially or completely edentulous patient: technical note. PURPOSE: To examine the use of the buccal fat pad (BFP) for correction of maxillary osseous defects, preliminary to dental implant reconstructions, and to present patients in whom this technique was used. MATERIALS AND methods: The blood supply of the BFP was investigated with a special laser Doppler flowmetry fiberoptic probe in situ before herniation and after placement of the pedicled BFP over maxillary bone grafts. RESULTS: The possibility of using the BFP pedicle flap to provide an immediate blood supply to a recipient site was confirmed, as it promotes rapid neo-vascularization of the grafted material over which it is placed. No complications were seen in the present patients. DISCUSSION: The BFP has an additional protective function of providing for a multiple-layer wound closure over all types of maxillary bone grafts, thereby preventing graft exposure and enhancing success. CONCLUSIONS: With its high blood flow, the BFP may offer protection and early blood supply to maxillary and sinus bone grafts. ( info) |
10/70. Bilateral oroantral fistulas following devitalization of teeth by arsenic trioxide: a case report. Although it is well known that prolonged application or leakage of arsenic trioxide can cause severe damage to the periodontal tissues, the substance is still used by some dentists. This paper describes a case of arsenical necrosis of the jaws affecting the right and the left side of the maxilla. As a result of leakage into the tissues of an arsenical paste from the pulp chamber of endodontically treated teeth, bilateral oroantral fistula (OAF) occurred. It is concluded that there is no justification, whatsoever, for the use of arsenic in modern dental practice. In the following case, buccal advancement flap and submucosal palatal island flap techniques were used for to close the OAF. The submucosal palatal island flap technique resulted in successful closure of the OAF. ( info) |