BackgroundThe rehabilitation of the atrophic posterior mandible with dental implants often requires bone augmentation procedures. The aim of the present study is the systematic review of the literature concerning the success rate of Segmental Sandwich Osteotomy (SSO) of the posterior mandible in pre-implant surgery.Material and MethodsSystematic review of all clinical cases and clinical studies of SSO of the posterior mandible in pre-implant surgery with a minimum follow-up of 6 months after implant loading was performed, based on specific inclusion and exclusion criteria. The search strategy involved searching the electronic databases of MEDLINE, EMBASE, COCHRANE LIBRARY, Clinical Trials (www.clinicaltrials.gov) and National Research Register (www.controlled-trials.com), supplemented by a manual search, in August 2015. In every study, the intervention characteristics and the outcome were recorded.ResultsOut of the 756 initial results, only 17 articles fulfilled the predetermined inclusion and exclusion criteria. They consisted of 9 retrospective case reports or series and 8 prospective randomized clinical trials. Overall, the studies included 174 patients. In these patients, 214 SSO augmentation procedures were performed in the posterior mandible and 444 implants were placed. The follow-up period after implant loading ranged between 8 months and 5.5 years. The success rate of SSO ranged between 90% and 100%. The implant survival during the follow-up period ranged between 90.9% and 100%.ConclusionsSegmental Sandwich Osteotomy should be considered as a well documented technique for the rehabilitation of the atrophic posterior mandible, with long-term postsurgical follow-up. The success rates are very high, as well as the survival of the dental implants placed in the augmented area. Key words:Segmental osteotomy, dental implant, mandible, inlay graft.
Nasolabial cysts are rare non-odontogenic cysts of soft tissue that usually present as asymptomatic swellings beneath the ala of the nose. Their pathogenesis is uncertain. The presence of the lesion is perceived clinically and by the aid of radiological imaging. The usual treatment is surgical excision. Nasolabial cysts, when infected, are painful and mistreated occasionally as odontogenic defects. This article reports a case of a nasolabial cyst that was initially diagnosed and treated as a periapical abscess, which lead to the loss of a tooth. Complete enucleation of the cyst was performed under local anaesthesia and its identity was confirmed by histopathology. Follow-up over a year revealed no evidence of recurrence.
The occurrence of maxillary osteomyelitis is rare in immunologically normal hosts. The nature of such infections is mainly polymicrobial, commonly attributable to micro-organisms present in the oral cavity. A case of acute maxillary osteomyelitis with Escherichia coli and Enterococcus spp. infection is described in an otherwise healthy young female. Cases of maxillary osteomyelitis reported in immunocompetent individuals lacking any predisposing factors are also reviewed. The lesion presented as a painful bone swelling and incomplete wound healing after tooth extraction, showing radiolucency with irregular borders. The isolated microbial species were E. coli and Enterococcus spp. Contamination from an extra-oral source through the wound may be implicated in the pathogenesis. A combination of surgical and antibiotic treatment proved to be successful. Nine maxillary osteomyelitis cases have been reported in the literature in immunocompetent individuals. Isolation of enteric bacteria was not described in any of those cases. Osteomyelitis should be included in the differential diagnosis of maxillary osteolytic lesions even in healthy individuals. The microbiological diagnosis is important for the antimicrobial intervention. This review shows that the main causative infectious agents in osteomyelitis remain unclear, as various bacteria have been reported to be involved. Clinical relevanceThis report brings the total number of maxillary osteomyelitis cases affecting immunocompetent individuals reported in the English literature to 10. Despite its infrequent occurrence, this inflammatory condition is relevant to clinicians, as the identification of the microbial species in osteomyelitis is essential for the appropriate selection of treatment due to the risk of the infection spreading to the neighboring anatomic structures.
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