- Email: [email protected]
Management of mandibular fracture with ethylene-vinyl acetate sheet vacuum splint and circumferential wiring in children
Free Papers—Poster Presentations of the cysts, age, sex, site of the cysts and systemic disease was evaluated using the General repeated measure and MannWhitney test. Results: Analyses of two-dimensional radiographs showed that the recovery of radiopacity after 12 months was more than 97% on average in defected areas that were smaller than 3 × 4 cm, which was considered to be complete bone regenerations. In the defected areas that were larger than 3 × 4 cm, considerable portion showed recovery of radiopacity, which could be clinically interpreted as spontaneous bone regenerations. No statistically significant change was observed in bone density according to the type of cysts (P > 0.05). Young patients under 20 years of age with highly active metabolism presented more significant bone regeneration than patients over 20 years of age (P < 0.05). Bone regeneration was more hampered in patients who had medical illness, compared with patients who did not have any (P < 0.05). No statistically significant change was seen in bone density according to sex (P > 0.05). Changes in bone density according to the site of cysts such as maxilla, mandible, anterior or posterior region were not considered to be significant (P > 0.05). Unicystic ameloblastomas which had normal enucleation procedures showed a similar healing process that could be observed in normal enucleation cases. Conclusion: Analyses of two-dimensional radiographs suggest that in approximately 12 months after the enucleation of cysts, clinically acceptable spontaneous bone regeneration can be observed even though normal bone graft procedures have not been applied. However, this conclusion should be interpreted with caution considering the possible inaccuracy of the values of radiopacity, caused by factors such as image superimposition or the three-dimensional nature of maxilla and mandible. Taking these possibilities into account, further research using computed tomography and histological evaluation is needed to obtain more reliable results. doi:10.1016/j.ijom.2009.03.594
P122 Effects of atelocollagen sponge (Teruplug® ) insertion on the periodontal healing of second molars after impacted mandibular third molar extraction J.H. Chung ∗ , J.W. Nam, K.W. Kim
Department of Oral and Maxillofacial Surgery, Dankook Dental Hospital, Sinbu-dong, Dongnam-gu,Cheonan-si, Chungnam, Korea
Background and Objectives: Mandibular impacted third molars generally should be considered for removal because they adversely affect the health of adjacent teeth. Secondary healing can be occurred voluntary on extraction site unless infections were. But secondary wound healing can cause bone loss, loss of attachment and root exposure distal to the second molar. The developments of alternative options, for example, bone graft using various materials have been done, but have use limitations and disadvantages. Recently, in many studies, many substitutes have been reported. Extracellular matrix (ECM) is known to function as a reservoir of endogenous growth factors, can be an effective delivery system of growth factor that easily lost bioactivity in solution. Fibrillar collagens like type I collagen, are the major constituent of the ECM and structural protein of bone. Also, it can be a scaffold for osteoblast migration, so study of collagen insertion on the tooth socket has been reported. The purpose of this study was to compare the effects of absorbable atelocollagen sponge (Teruplug® ) insertion in tooth extraction sites on periodontal healing of the mandibular second molar after the extraction of the impacted third molar. Methods: The study population comprised 31 cases that were scheduled for surgical removal of impacted mandibular third molars. All patients were in good general health and were not using any medication that would influence wound healing after surgery. In the control group (15 cases), none was inserted into the tooth extraction site. In the experimental groups (16 cases), Teruplug® was inserted into the tooth extraction site. We evaluated tooth mobility, pocket depth, gingival margin level preoperatively and 1 week, 2 weeks, 4 weeks, and 3 months postoperatively. The change was compared with two groups using Mann-Whitney test. A P value < 0.05 was considered statistically significant. We observed during 3 months. Results: There was no significant change of tooth mobility on both groups. There was tendency of decreasing of previous pocket depth causing tooth extraction on both groups. On gingival margin level, there were various changes according to initial swelling and loss of attachment on both groups. There was tendency of decreasing of gingival margin level on both groups because of removal of inflammation and decreasing of previous pocket depth.
567
There was large change of pocket depth on buccal middle, distal, lingual distal area because of tooth extraction and bone reduction. Compared with the control group and experimental group, we observed significant difference during some periods. Conclusion: The results of this study suggest that absorbable atelocollagen sponge (Teruplug® ) is relatively favourable bone void filler with prevention of tissue collapse, food packing and enhance periodontal healing. doi:10.1016/j.ijom.2009.03.595
P123 Management of mandibular fracture with ethylene-vinyl acetate sheet vacuum splint and circumferential wiring in children F. Meliawaty ∗ , M. Affandi Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Padjadjaran University, Bandung, Indonesia
Background and Objectives: In childhood, the greatest problem of mandibular fractures management due to the difficulty of mandibular fixation. The teeth of children are too small for bar fixation, the roots are either resorb or are incomplete. The teeth of 5–8-year-old children are mixed, so installation of screws and plates are unavailable due to the possibility of teeth bud damage. This problem is mostly overcome with mandibular Gunning-type splint. The aim of this case report is to show a simplified method of Gunning-type splint by using the ethylene-vinyl acetate sheet. Methods: Patient dentition is mold and then a cast of plaster made. Reposition of fracture segment and occlusion done on plaster cast. Second cast made base on the repositioned cast. The splint made of ethylene-vinyl acetate vacuumed to the second cast. Splint installed to the mandible teeth under general anaesthesia, and then the circumferential wire is placed to the left, right and midline mandible for the fixation. Results: After splint removal at fifteenth day, normal occlusion and stable position can be achieved. In control, panoramic photo showed unification of mandible bone at fracture area. Conclusion: Management of mandibular fracture with ethylene-vinyl acetate sheet Gunning-splints and circumferential wire is easy, simple, economical, and fast process with good result. doi:10.1016/j.ijom.2009.03.596
P122 Effects of atelocollagen sponge (Teruplug® ) insertion on the periodontal healing of second molars after impacted mandibular third molar extraction J.H. Chung ∗ , J.W. Nam, K.W. Kim
Department of Oral and Maxillofacial Surgery, Dankook Dental Hospital, Sinbu-dong, Dongnam-gu,Cheonan-si, Chungnam, Korea
Background and Objectives: Mandibular impacted third molars generally should be considered for removal because they adversely affect the health of adjacent teeth. Secondary healing can be occurred voluntary on extraction site unless infections were. But secondary wound healing can cause bone loss, loss of attachment and root exposure distal to the second molar. The developments of alternative options, for example, bone graft using various materials have been done, but have use limitations and disadvantages. Recently, in many studies, many substitutes have been reported. Extracellular matrix (ECM) is known to function as a reservoir of endogenous growth factors, can be an effective delivery system of growth factor that easily lost bioactivity in solution. Fibrillar collagens like type I collagen, are the major constituent of the ECM and structural protein of bone. Also, it can be a scaffold for osteoblast migration, so study of collagen insertion on the tooth socket has been reported. The purpose of this study was to compare the effects of absorbable atelocollagen sponge (Teruplug® ) insertion in tooth extraction sites on periodontal healing of the mandibular second molar after the extraction of the impacted third molar. Methods: The study population comprised 31 cases that were scheduled for surgical removal of impacted mandibular third molars. All patients were in good general health and were not using any medication that would influence wound healing after surgery. In the control group (15 cases), none was inserted into the tooth extraction site. In the experimental groups (16 cases), Teruplug® was inserted into the tooth extraction site. We evaluated tooth mobility, pocket depth, gingival margin level preoperatively and 1 week, 2 weeks, 4 weeks, and 3 months postoperatively. The change was compared with two groups using Mann-Whitney test. A P value < 0.05 was considered statistically significant. We observed during 3 months. Results: There was no significant change of tooth mobility on both groups. There was tendency of decreasing of previous pocket depth causing tooth extraction on both groups. On gingival margin level, there were various changes according to initial swelling and loss of attachment on both groups. There was tendency of decreasing of gingival margin level on both groups because of removal of inflammation and decreasing of previous pocket depth.
567
There was large change of pocket depth on buccal middle, distal, lingual distal area because of tooth extraction and bone reduction. Compared with the control group and experimental group, we observed significant difference during some periods. Conclusion: The results of this study suggest that absorbable atelocollagen sponge (Teruplug® ) is relatively favourable bone void filler with prevention of tissue collapse, food packing and enhance periodontal healing. doi:10.1016/j.ijom.2009.03.595
P123 Management of mandibular fracture with ethylene-vinyl acetate sheet vacuum splint and circumferential wiring in children F. Meliawaty ∗ , M. Affandi Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Padjadjaran University, Bandung, Indonesia
Background and Objectives: In childhood, the greatest problem of mandibular fractures management due to the difficulty of mandibular fixation. The teeth of children are too small for bar fixation, the roots are either resorb or are incomplete. The teeth of 5–8-year-old children are mixed, so installation of screws and plates are unavailable due to the possibility of teeth bud damage. This problem is mostly overcome with mandibular Gunning-type splint. The aim of this case report is to show a simplified method of Gunning-type splint by using the ethylene-vinyl acetate sheet. Methods: Patient dentition is mold and then a cast of plaster made. Reposition of fracture segment and occlusion done on plaster cast. Second cast made base on the repositioned cast. The splint made of ethylene-vinyl acetate vacuumed to the second cast. Splint installed to the mandible teeth under general anaesthesia, and then the circumferential wire is placed to the left, right and midline mandible for the fixation. Results: After splint removal at fifteenth day, normal occlusion and stable position can be achieved. In control, panoramic photo showed unification of mandible bone at fracture area. Conclusion: Management of mandibular fracture with ethylene-vinyl acetate sheet Gunning-splints and circumferential wire is easy, simple, economical, and fast process with good result. doi:10.1016/j.ijom.2009.03.596