Introduction: Surgical extraction of impacted third molars has become a routine procedure in most of dental clinics. Tissue adhesives based on Nbutyl cyanoacrylate are employed as a non-suture method for intra-oral postsurgical wound closure. Objectives: Evaluation of the clinical post-operative complications after the use of N-butyl cyanoacrylate soft tissue adhesive in closure of mucoperiosteal flaps after the surgical extraction of impacted mandibular third molars compared to the use of conventional silk sutures. Materials and methods: This study was conducted on twenty patients of both sexes ranging from 20 to 30 years of age.Patients were divided equally into two groups (Study and control groups) each with mesioangular impacted mandibular third molar (class II position B according to Pell and Gregory's classification). After the surgical extraction of impacted teeth the flaps were closed using PeriAcryl 90 (Glustitch corporation, Delta, BC, Canada) soft tissue adhesive in the study group and using 3/0 silk sutures in the control group. Patients were evaluated for pain, bleeding, trismus, facial swelling, wound dehiscence and local reaction. Results: There was a statistically significant reduction of pain, bleeding, trismus, wound reaction on using the N-butyl cyanoacrylate (PeriAcryl 90) compared to sutures , concerning wound dehiscence and facial swelling , the results of both materials were nearly the same. Conclusion: The use of the N-butyl cyanoacrylate (PeriAcryl 90) for the closure of mucoperiosteal flaps is a reliable method that can overcome most of complications faced on using conventional silk sutures in addition to ease of manipulation , time saving and safety factors.
INTRODUCTION: The use of biodegradable screws has a number of limiting factors including poor mechanical stability, difficult handling properties, and time-consuming fixation. A new application system by welding a special configured resorbable pin through ultrasound may overcome the disadvantages of thread tapping. OBJECTIVES: Was to evaluate resorbable plates with ultrasonic welded pins in management of midface fracture. MATERIALS AND METHODS: Was conducted clinically on 20 midface fracture cases fixed with resorbable plates with ultrasonic welded pins, histologically on 4 healthy adult mongrel dogs, and biomechanically on 15 specimens tested for tension, bending, and torsion stiffness of this system. RESULTS: Clinically intraoperative handling showed 13% failure rate for the total number of pins placed for all cases, with stability failure in 10% of cases, and mean time needed for fixation of each plate was 10.6 minutes, however postoperative clinical results were normal with no significant complications. Radiographically; adequate bone healing with delayed resorption of pins was observed during follow-up phase which was continued till 12 th week postoperatively. Histological study revealed woven bone growing in the defect area and development of new bone, osteocytes and osteoblasts seen on bone surface. Biomechanical study showed mean tensile stiffness 498.982 N/mm while mean bending stiffness was 1.176 N/mm and mean torsion stiffness was 0.342 N/mm. CONCLUSIONS: This retrospective study shows the general feasibility, sufficient mechanical stability, and efficient intraoperative handling of resorbable plates with ultrasonic welded pins in management of midface fractures.
INTRODUCTION:The orbital floor fracture results in disruption of bony continuity, enophtalmos, diplopia and herniation of orbital content which lead to a restriction in eye movement. Auotogenous bone graft remains as the gold standard for reconstruction of orbital floor defects, the anterolateral wall of maxillary sinus is considered as one of the donor site used in the reconstruction of the orbital floor defects, which has many advantages such as biocompatibility, strength, vascularization and has no immune reaction. In addition, its contour fits exactly the orbital floor defect, a simple harvesting technique from an intraoral donor site which minimizes its morbidity. OBJECTIVE: We aimed in the present study to evaluate the use of anterolateral wall of maxillary sinus clinically and radiographically in the reconstruction of orbital floor defects in ten patients. MATERIALS AND METHODS: All operated patients had more or less one or more signs and symptoms of orbital floor fracture as diplopia, enophthalmos, limitation of eye movements and progressive infraorbital nerve hypoesthesia. The graft harvested with peizosurgery from contralateral side of the fracture, the donor site is covered by a collagen membrane to prevent soft tissue infiltration. The harvested bone graft is adapted to the defect with no other means of fixation. The follow-up schedule was 3 days postoperatively then once weekly for two weeks and then monthly for 3 months. RESULTS: All patients with preoperative diplopia had significant improvement postoperatively. 8 patients out of 9 with preoperative ocular restriction had improvement in the postoperative follow up visits. 6 patients with preoperative enophthalmos showed improvement in the postoperative follow up visits. 7 patients with infra orbital nerve paresthesia preoperatively, all of them showed improvement in the follow up visits. CONCLUSION:The study concluded that the anterolateral wall of the maxillary sinus is a suitable material for orbital floor reconstruction, especially in cases of small to medium defects (< 3 cm2).
INTRODUCTION: Traumatic loss of teeth in the esthetic zone commonly results in significant loss of buccal bone. This leads to reduced esthetics, problems with phonetics and reduction in function. Single tooth replacement has become an indication for implant-based restoration. In case of lack of bone volume the need of surgical reconstruction of the alveolar ridge is warranted. Several bone grafting techniques have been described to ensure sufficient bone volume for implantation. OBJECTIVES: Evaluation of using the zygomatic buttress as an intraoral bone harvesting donor site for pre-implant grafting. MATERIALS AND METHODS: Twelve patients were selected with limited alveolar ridge defect in the esthetic zone that needs bone grafting procedure prior to dental implants. Patients were treated using a 2-stage technique where bone blocks harvested from the zygomatic buttress region were placed as onlay grafts and fixed with osteosynthesis micro screws. After 4 months of healing, screws were removed for implant placement RESULTS: Harvesting of 12 bone blocks were performed for all patients indicating a success rate of 100% for the zygomatic buttress area as a donor site. Final rehabilitation with dental implants was possible in 11 of 12 patients, yielding a success rate of 91.6%. Three patients (25%) had postoperative complications at the donor site and one patient (8.3%) at the recipient site. The mean value of bone width pre-operatively was 3.64 ± .48 mm which increased to 5.47 ± .57 mm post-operatively, the increase in mean value of bone width was statistically significant (p < 0.001). CONCLUSIONS: Harvesting of intraoral bone blocks from the zygomatic buttress region is an effective and safe method to treat localized alveolar ridge defect before implant placement.
INTRODUCTION: Bone defects in the human mandible are common. They are mostly determined by premature loss of teeth due to periodontal disease or traumas. They usually cause reduction of alveolar bone volume, which becomes inconsequence, inadequate for standard treatments with Osseo integrated implants. The predictability of the implant survival and the maintenance of long-term stability of implants in function are directly associated with the quality and quantity of the available bone for implant placement. In the case of alveolar ridges with insufficient bone volume vertical, horizontal or sagittal inter-maxillary relationships, additional surgical procedures can be necessary to reconstruct and augment the deficiency. Bone block graft is the preferred method for many types of augmentation procedures, since it secures both a source of osteogenic cells and a rigid structure for mechanical support. In addition, bone block graft conserves its volume better than particulate grafting. OBJECTIVES: This study provides a clinical, radiographic, analysis of the use of mandibular ramus block autografts for vertical alveolar ridge augmentation. The suitability of the bone will be harvested to provide sufficient bone volume to facilitate implant insertion at a second stage. MATERIALS AND METHODS: The present study was conducted on 12 patients with age ranged from20-50 years seeking implantation of their lost posterior mandibular teeth, and have limited bone height. Patients were selected on the basis of history, clinical examination and radiographic examination using panoramic radiography and CBCT. RESULTS: in this study 10 patient out of 12 showed successful vertical bone augmentation with autogenous bone graft harvested from the ramus of the mandible with 83.33% success rate. CONCLUSIONS: using ramus autogenous bone graft in augmentation of vertical bone defects in the posterior area of the mandible has significant success.
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