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Adverse changes after mandibular preprosthetic ridge reconstruction using hydroxylapatite
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022-B1 Temporomandibular joint & Preprosthetic surgery and implantology
11. Adverse Changes after Mandibular Preprosthetic Ridge Reconstruction Using Hydroxylapatite
Mercier, p.1, Bellavance, E 2, Yang, 1t. 3 1Maxillary Atrophy Clinic, St-Mary's Hospital, Montreal, Quebec, 2Department of Clinical Epidemiology, St-Mary's Hospital 3Department of Clinical Epidemiology, Royal Victoria Hospital, Montreal, Canada In a recent study that showed long term stability of H A in ridge reconstruction (MERCIER et al. J Oral Maxillofac Surg, August 1996), questions were raised in the related discussion on possible adverse esthetic changes, neurosensory alterations and status of oral skin grafts. The group under a 10 year study consists of 645 mandibular (59%) severe and extremely severe, 41% moderate) H A ridge augmentation followed by lowering of the floor of the mouth, vestibuloplasty and skin grafting. At 1 year follow-up the results were as follows: Aesthetic complaints: 95% none, 5% same or worse. (Before surgery: 64% aesthetic complaint, 36~ none). Sensory alterations: 88.8% none, 9.5% moderate (paraesthesia), 1.7% severe (anaesthesia, dysaesthesia). Skin graft donor site visibility: 71% none, 23% moderate, 6% severe. Oral hyperkeratosis: 85% none, 14.7% moderate, 0.3% severe. Oral keratolysis: 96.3% none, 3.4% moderate, 0.3% severe. At most recent observation (mean follow-up time 6.15_+2.6 years). Aesthetic complaints: 96% none, 4% same or worse. Sensory alterations: 95.5% none, 4% moderate, 0.5% severe. Skin graft donor site visibility: 91.3% none, 7.3% moderate, 1.4% severe. Hyperkeratosis: 89.2% none, 10.3% moderate, 0.5% severe. Keratolysis: 93% none, 5% moderate, 2% severe. Conclusion: A low incidence of severe complications was observed at one year and after 6 years in this group of patients which compares well with the results of other studies.
12. Implantation in the Edentulous Mandible with Previously Treated Hemangioma: A Case Report Shikimori, M., Fujita, E, Fukuda, 1t., Hashimoto, K.
Department of Oral & Maxillofac. Surg., Hamamatsu Univ. Sch. of Med., Hamamatsu, Japan Hemangioma may cause absorption and fragility of the alveolar bone, followed by loss of teeth. Hemangioma at the edentulous alveolus sometimes shows gingival bleeding when irritated by dentures. In this paper, implantation in the edentulous mandible with previously treated hemangioma is discussed. Case report: A 70-year-old female visited the Hamamatsu University Hospital in November, 1996, because of the decubitus caused by her denture. Her hemangioma was recognized at birth, and embolization was performed twice for the purpose of dental extractions. But decubitus or bleeding due to the irritation of her denture was subsequently seen. At the first visit, hemangioma was observed in her
right lower face, the right tongue, and the right lower alveoar ridge. Abnormal bleeding in the region of the treated hemangioma was not observed at the dental extractions, and there were no abnormal findings in her orthopantomograph. Accordingly, dental implantation was planned for her prosthetic treatment. On December 5, 1995, the bone at the treated hemangioma showed an adequate cortex with ring patterns and hardness consistent with the healthy area. Four fixtures were placed in the treated hemangioma, and two fixtures were placed in the normal alveolar ridge. The abutments were completely connected with the fixtures by Octo: ber 26, 1996. Finally, the upper structure was placed on the implants on December 2, 1996. At that time, her occlusion had fully recovered and has remained in good condition to the present day. Conclusion: We suspect that dental implantation is adaptable to alveolar ridges with previously treated hemangiomas.
13. A Study of IMZ Implants Applied in the Frontal Sinus in Dogs
Fujii. T.1, Manaka, N..1, Muramatsu, L 2, Abe, 1t. 2, Ogiuchi, H. 1 1Department of Oral and Maxillofacial Surgery, Tokyo Women's Medical College, Tokyo, Japan, 2Department of Oral and Maxillofacial Surgery, Tokyo Women's Medical College Daini Hospital, Tokyo, Japan Dental implants have been widely used for functional reconstruction following tooth loss. In recent years, especially, the indication is expanded for maxillae with low sinus floor, which were a complication of dental implant applications before. In these cases the implants are partially inserted into the paranasal sinus where no bony structure originally exists. The aim of this study is to clarify the histopathological reaction around implants under such circumstances. Methods: The largest paranasal sinus, the frontal sinus, in dogs was perforated, the mucous membrane in the sinus was removed, particulate porous hydroxyapatite (HAP) was consolidated, and IMZ implants EL=3.3_+8 mm in size were inserted. The specimens were obtained 2, 4, and 13 weeks after implantation for light and electromicroscopic examination. Results: In the early stage of postoperation the multiplication of fibroblasts with high alkaline phosphatase activity was found around the HAP or the implants. In week 13 new bone formation, even around the apical area of the implants, was observed.
022-B1 Temporomandibular joint & Preprosthetic surgery and implantology
11. Adverse Changes after Mandibular Preprosthetic Ridge Reconstruction Using Hydroxylapatite
Mercier, p.1, Bellavance, E 2, Yang, 1t. 3 1Maxillary Atrophy Clinic, St-Mary's Hospital, Montreal, Quebec, 2Department of Clinical Epidemiology, St-Mary's Hospital 3Department of Clinical Epidemiology, Royal Victoria Hospital, Montreal, Canada In a recent study that showed long term stability of H A in ridge reconstruction (MERCIER et al. J Oral Maxillofac Surg, August 1996), questions were raised in the related discussion on possible adverse esthetic changes, neurosensory alterations and status of oral skin grafts. The group under a 10 year study consists of 645 mandibular (59%) severe and extremely severe, 41% moderate) H A ridge augmentation followed by lowering of the floor of the mouth, vestibuloplasty and skin grafting. At 1 year follow-up the results were as follows: Aesthetic complaints: 95% none, 5% same or worse. (Before surgery: 64% aesthetic complaint, 36~ none). Sensory alterations: 88.8% none, 9.5% moderate (paraesthesia), 1.7% severe (anaesthesia, dysaesthesia). Skin graft donor site visibility: 71% none, 23% moderate, 6% severe. Oral hyperkeratosis: 85% none, 14.7% moderate, 0.3% severe. Oral keratolysis: 96.3% none, 3.4% moderate, 0.3% severe. At most recent observation (mean follow-up time 6.15_+2.6 years). Aesthetic complaints: 96% none, 4% same or worse. Sensory alterations: 95.5% none, 4% moderate, 0.5% severe. Skin graft donor site visibility: 91.3% none, 7.3% moderate, 1.4% severe. Hyperkeratosis: 89.2% none, 10.3% moderate, 0.5% severe. Keratolysis: 93% none, 5% moderate, 2% severe. Conclusion: A low incidence of severe complications was observed at one year and after 6 years in this group of patients which compares well with the results of other studies.
12. Implantation in the Edentulous Mandible with Previously Treated Hemangioma: A Case Report Shikimori, M., Fujita, E, Fukuda, 1t., Hashimoto, K.
Department of Oral & Maxillofac. Surg., Hamamatsu Univ. Sch. of Med., Hamamatsu, Japan Hemangioma may cause absorption and fragility of the alveolar bone, followed by loss of teeth. Hemangioma at the edentulous alveolus sometimes shows gingival bleeding when irritated by dentures. In this paper, implantation in the edentulous mandible with previously treated hemangioma is discussed. Case report: A 70-year-old female visited the Hamamatsu University Hospital in November, 1996, because of the decubitus caused by her denture. Her hemangioma was recognized at birth, and embolization was performed twice for the purpose of dental extractions. But decubitus or bleeding due to the irritation of her denture was subsequently seen. At the first visit, hemangioma was observed in her
right lower face, the right tongue, and the right lower alveoar ridge. Abnormal bleeding in the region of the treated hemangioma was not observed at the dental extractions, and there were no abnormal findings in her orthopantomograph. Accordingly, dental implantation was planned for her prosthetic treatment. On December 5, 1995, the bone at the treated hemangioma showed an adequate cortex with ring patterns and hardness consistent with the healthy area. Four fixtures were placed in the treated hemangioma, and two fixtures were placed in the normal alveolar ridge. The abutments were completely connected with the fixtures by Octo: ber 26, 1996. Finally, the upper structure was placed on the implants on December 2, 1996. At that time, her occlusion had fully recovered and has remained in good condition to the present day. Conclusion: We suspect that dental implantation is adaptable to alveolar ridges with previously treated hemangiomas.
13. A Study of IMZ Implants Applied in the Frontal Sinus in Dogs
Fujii. T.1, Manaka, N..1, Muramatsu, L 2, Abe, 1t. 2, Ogiuchi, H. 1 1Department of Oral and Maxillofacial Surgery, Tokyo Women's Medical College, Tokyo, Japan, 2Department of Oral and Maxillofacial Surgery, Tokyo Women's Medical College Daini Hospital, Tokyo, Japan Dental implants have been widely used for functional reconstruction following tooth loss. In recent years, especially, the indication is expanded for maxillae with low sinus floor, which were a complication of dental implant applications before. In these cases the implants are partially inserted into the paranasal sinus where no bony structure originally exists. The aim of this study is to clarify the histopathological reaction around implants under such circumstances. Methods: The largest paranasal sinus, the frontal sinus, in dogs was perforated, the mucous membrane in the sinus was removed, particulate porous hydroxyapatite (HAP) was consolidated, and IMZ implants EL=3.3_+8 mm in size were inserted. The specimens were obtained 2, 4, and 13 weeks after implantation for light and electromicroscopic examination. Results: In the early stage of postoperation the multiplication of fibroblasts with high alkaline phosphatase activity was found around the HAP or the implants. In week 13 new bone formation, even around the apical area of the implants, was observed.