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Oral Surgeons (oral + surgeon)
Selected AbstractsProsthodontic Management of Sulcoplasty and Sialodochoplasty with a Conforming Surgical StentJOURNAL OF PROSTHODONTICS, Issue 1 2008Robert W. Berg DMD Abstract This clinical report describes the management of chronic, proliferative inflammatory epithelial and fibrous hyperplasia following loss of a mandibular implant-retained prosthesis. A classic surgical technique was used. The patient was referred to the oral surgeon for sialodochoplasty and sulcoplasty. With a combination of surgery and prosthodontic management with a conforming surgical stent, a satisfactory denture foundation was created, allowing for fabrication of an implant-retained definitive prosthesis. [source] Long-term prognosis of crown-fractured permanent incisors.INTERNATIONAL JOURNAL OF PAEDIATRIC DENTISTRY, Issue 3 2000The effect of stage of root development, associated luxation injury Objectives. The aim of the present study was to investigate pulp healing responses following crown fracture with and without pulp exposure as well as with and without associated luxation injury and in relation to stage of root development. Patient material and methods. The long-term prognosis was examined for 455 permanent teeth with crown fractures, 352 (246 with associated luxation injury) without pulpal involvement and 103 (69 with associated luxation injury) with pulp exposures. Initial treatment for all patients was provided by on-call oral surgeons at the emergency service, University Hospital (Rigshospitalet), Copenhagen. In fractures without pulpal involvement, dentin was covered by a hard-setting calcium hydroxide cement (Dycal®), marginal enamel acid-etched (phosphoric acid gel), then covered with a temporary crown and bridge material. In the case of pulp exposure, pulp capping or partial pulpotomy was performed. Thereafter treatment was identical to the first group. Patients were then referred to their own dentist for resin composite restoration. Results. Patients were monitored for normal pulp healing or healing complications for up to 17 years after injury (x = 2·3 years, range 0·2,17·0 years, SD + 2·7). Pulp healing was registered and classified into pulp survival with no radiographic change (PS), pulp canal obliteration (PCO) and pulp necrosis (PN). Healing was related to the following clinical factors: stage of root development at the time of injury, associated damage to the periodontium at time of injury (luxation) and time interval from injury until initial treatment. Crown fractures with or without pulp exposure and no concomitant luxation injury showed PS in 99%, PCO in 1% and PN in 0%. Crown fractures with concomitant luxation showed PS in 70%, PCO in 5% and PN in 25%. An associated damage to the periodontal ligament significantly increased the likelihood of pulp necrosis from 0% to 28% (P < 0·001) in teeth with only enamel and dentin exposure and from 0% to 14% (P < 0·001) in teeth with pulp exposure. Conclusions. In the case of concomitant luxation injuries, the stage of root development played an important role in the risk of pulp necrosis after crown fracture. However, the primary factor related to pulp healing events after crown fracture appears to be compromised pulp circulation due to concomitant luxation injuries. [source] Rare benign tumours of oral cavity , capillary haemangioma of palatal mucosa: a case reportINTERNATIONAL JOURNAL OF PAEDIATRIC DENTISTRY, Issue 2 2000Aydan Açikgözsurname Haemangiomas are benign tumours composed of blood vessels, they are probably developmental rather than neoplastic in origin. Haemangiomas are often present at birth but may become more apparent during life. The tumours appear as a flat or raised reddish-blue lesions and are generally solitary. They are occasionally seen on the palatal mucosa. Haemangiomas are classified on the basis of their histological appearance as capillary, mixed, cavernous or a sclerosing variety that tends to undergo fibrosis. Their differential clinical diagnosis is based on appearance. The tumours may be slowly progressive, involving extensive portions of the superficial and deep blood vessels. Function may be affected where development of the lesion is extra-invasive. Colour change on pressure is a common finding with return to the original colour on withdrawal of pressure. The case presented here was referred because of swelling and recurrent periodontal bleeding. The lesion was diagnosed as a capillary haemangioma through histopathology. Although different therapeutic procedures have been reported, in this case surgical excision was carried out under general anaesthesia following hospitalization. Despite their benign origins and behaviour, haemangiomas in the region of oral cavity are always of clinical importance to the dental profession and require appropriate clinical management. Dental practitioners and oral surgeons need to be aware of these lesions because they may pose serious bleeding risks. [source] Dental management of patients at risk of osteochemonecrosis of the jaws: a critical reviewORAL DISEASES, Issue 8 2009S Fedele Osteonecrosis of the jaw bones is a complication of bisphosphonate (BP) drug usage characterised by trans-mucosal exposure of necrotic bone, often followed by infection and pain. Osteonecrosis is observed in cancer patients on high-potency intravenous BP more frequently than in osteoporotic individuals using low-potency oral BP. The management of osteonecrosis caused by BP is often unsatisfactory and control of risk factors is considered the most effective means of prevention. Surgical manipulation and dental infection of the jawbone are the major risk factors, hence it is suggested that careful management of oral health and relevant dental procedures may decrease the risk of osteonecrosis in individuals on BP. Recommendations for dentists and oral surgeons have been suggested by different groups of clinicians but they are often controversial and there is no clear evidence for their efficacy in reducing the likelihood of osteonecrosis development. This report critically reviews current dental recommendations for individuals using BP with the aim of helping the reader to transfer them into practice as part of pragmatic and non-detrimental clinical decisions making. [source] Bisphosphonates and oral surgeryORAL SURGERY, Issue 2 2009R. Oliver Abstract Osteonecrosis of the jaws, or the threat of it, because of the use of bisphosphonates, is an increasing problem facing all dentists and oral surgeons. The link is somewhat circumstantial but compelling and there are emerging risk factors that increase a patient's susceptibility to developing osteonecrosis including the use of intravenous bisphosphonates, length of time taking the drug, smoking and possibly a genetic predisposition. There is a lack of randomised trial evidence regarding the best strategies for prevention and treatment of the condition. This article discusses current evidence, largely from observational studies on the development, prevention and management of bisphosphonate-related osteonecrosis. [source] Evaluation of soft tissue around single-tooth implant crowns: the pink esthetic scoreCLINICAL ORAL IMPLANTS RESEARCH, Issue 6 2005Rudolf Fürhauser Abstract Aim: In this study, the reproducibility of a newly developed pink esthetic score (PES) for evaluating soft tissue around single-tooth implant crowns was assessed. The effect of observer specialization was another point of interest. Material and methods: Twenty observers (five prosthodontists, five oral surgeons, five orthodontists and five dental students) were given photographs of 30 single-tooth implant crowns. Seven variables were evaluated vs. a natural reference tooth: mesial papilla, distal papilla, soft-tissue level, soft-tissue contour, alveolar process deficiency, soft-tissue color and texture. Using a 0-1-2 scoring system, 0 being the lowest, 2 being the highest value, the maximum achievable PES was 14. Each observer was requested to make two assessments at an interval of 4 weeks. At the second assessment, the photographs were scored in the reverse order. Results: The mean PES of evaluations at the first assessment (n=600) was 9.46 (±3.81 SD), and 9.24 (±3.8 SD) at the second one. The difference between these two means was not significant statistically (P=0.6379). Implant-related mean PES for single-tooth implants varied from 2.28 to 13.8, with standard deviations between 0.46 and 3.51. Very poor and very esthetic restorations showed the smallest standard deviations. The mean total PES was 10.6 for the prosthodontists, 9.2 for the oral surgeons, 9.9 for the dental students and 7.6 for the orthodontists. Conclusions: The PES reproducibly evaluates peri-implant soft tissue around single-tooth implants. Thus, an objective outcome of different surgical or prosthodontic protocols can be assessed. Orthodontists were clearly more critical than the other observers. Résumé Dans cette étude la reproduction d'un nouveau Score d'Esthétique Rose (PES) pour l'évaluation des tissus mous autour des couronnes d'implants uniques a étéévaluée. L'effet de la spécialisation de l'observateur était un autre point d'intérêt. Vingt observateurs (cinq spécialistes en prothèse, cinq chirurgiens, cinq orthodontistes et cinq étudiants en médecine dentaire) ont reçu des photographies de 30 couronnes sur implant unique. Sept variables ont étéévaluées vs une dent de référence naturelle : papille mésiale, papille distale, niveau du tissu mou, couleur du tissu mou, perte du processus alvéolaire, couleur du tissu mou et texture. En utilisant un système 0,1,2, zéro étant le plus bas et deux étant la plus haute valeur, le score maximum PES était donc de 14. Chaque observateur a reçu comme instruction de réaliser deux évaluations à un intervalle de quatre semaines. A la seconde évaluation les photographies ont étéévaluées dans un ordre inverse. Les PES moyens des évaluations de la première fois (n=600) étaient de 9,46±3,81 et 9,24±3,80 la seconde fois. La différence entre ces deux moyennes n'était pas significative (P=0,6379). Le PS moyen en relation pour les implants sur dent unique variait de 2,28 à 13,8 avec des déviations standards de 0,46 à 3,51. Les restaurations de moindre qualité et les excellentes affichaient les plus petites déviations standards. Le PES total moyen était de 10,6 pour les spécialistes en prothèse, 9,2 pour les chirurgiens, 9,9 pour les étudiants et 7,6 pour les orthodontistes. Le PES évalue donc les tissus mous paraïmplantaires autour des implants uniques. Un aboutissement objectif de différents protocoles chirurgicaux ou prothétiques peut donc être estimé. Les orthodontistes étaient clairement plus critiques que les autres observateurs. Zusammenfassung Ziel: In dieser Arbeit wird die Reproduzierbarkeit eines neu entwickelten Pink Esthetic Index (PES) zur Evaluation vom Weichgewebe um Kronen auf Einzelzahnimplantaten untersucht. Zusätzlich interessierte der Einfluss des Spezialisierungsgrades eines Untersuchers. Material und Methoden: Man gab zwanzig Untersuchern (5 Prothetiker, 5 Oralchirurgen, 5 Orthodonten und 5 Zahnmedizinstudenten) Fotoaufnahmen von 30 Kronen auf Einzelzahnimplantaten. Sie hatten 7 Variabeln gegenüber einem natürlichen Referenzzahn zu beurteilen: mesiale Papille, distale Papille, Niveau der Weichgewebe, Form der Weichgewebe, Defizit an Alveolarkamm, Farbe und Struktur der Weichgewebe. Man definierte eine Bewertungsskala 0-1-2, wobei 0 für den schlechtesten und 2 für den besten Wert stehen, so dass man einen maximalen PES von 14 erreichen konnte. Jeder Untersucher war angehalten, im Abstand von 4 Wochen zwei Beurteilungen durchzuführen. Anlässlich des zweiten Untersuchungstermins wurden die Fotoaufnahmen in ungekehrter Reihenfolge beurteilt. Resultate: Der mittlere PES bei den Untersuchungen im ersten Umgang (n=600) betrug 9.46 (±3.81 SD) und 9.24 (±3.8 SD) im zweiten Umgang. Der Unterschied zwischen diesen zwei Mittelwerten war statistisch nicht signifikant (P=0.6379). Der mittlere implantatspezifische PES für die Einzelzahnimplantate variierte zwischen 2.28 und 13.8 mit Standardabweichungen zwischen 0.46 und 3.51. Sehr schlechte und sehr schöne Rekonstruktionen zeigten die kleinesten Standardabweichungen. Der mittlere Gesamt-PES war bei den Prothetikern 10.6, bei den Oralchirurgen 9.2, bei den Zahnmedizinstudenten 9.9 und bei den Orthodonten 7.6. Zusammenfassung: Der Pink Esthetic Index untersucht die periimplantären Weichgewebe um Einzelzahnimplantate und wird auf seine Reproduzierbarkeit überprüft. Damit kann man die Ergebnisse von verschiedenen chirurgischen und prothetischen Protokollen objektivieren. Die Orthodonten waren deutlich kritischer bei ihrer Beurteilung als die anderen Behandler. Resumen Intencion: En este estudio se valoró la reproductibilidad de una nueva Valor de Rosado Estético (PES) para evaluar el tejido blando alrededor de coronas de implantes unitarios. El efecto de la especialización del observador fue otro punto de interés. Material y metodos: Se entregó a veinte observadores (5 prostodoncistas, 5 cirujanos orales, 5 ortodoncistas y 5 estudiantes dentales) fotografías de 30 coronas de implantes unitarios. Se evaluaron 7 variables frente a dientes naturales de referencia: papila mesial, papila distal, nivel de tejido blando, contorno de tejido blando, deficiencia del proceso alveolar, color y textura del tejido blando. Usando un sistema de puntuación de 0-1-2, siendo 0 el valor más bajo, 2 el valor más alto, el PES más alto alcanzable era de 14. Se solicitó a cada observador que llevara a cabo dos valoraciones en un intervalo de 4 semanas. En la segunda valoración las fotografías se valoraron en orden inverso. Resultados: El PES medio de evaluaciones a la primera valoración (n=600) fue 9.46 (±3.81 SD) y 9.24 (±3.8 SD) en la segunda. La diferencia entre estas dos medias no fue estadísticamente significativo (P=0.6379). El PES medio relacionado al implante para implantes unitarios varió desde 2.28 a 13.8 con desviaciones estándar entre 0.46 y 3.51. Las restauraciones más pobres y más estéticas mostraron las desviaciones estándar más bajas. El PES total fue de 10.6 para los prostodoncistas, 9.2 para los cirujanos orales, 9.9 para los estudiantes dentales y 7.6 para los ortodoncistas. Conclusiones: Las Puntuaciones de Estética Rosa evalúa reproduciblemente el tejido blando periimplantario alrededor de implantes unitarios. De este modo, se puede valorar un resultado objetivo de diferentes protocolos quirúrgicos o prostodónticos. Los ortodoncistas fueron claramente más críticos que los otros observadores. [source] Artefacts produced by suture traction during incisional biopsy of oral lesionsCLINICAL OTOLARYNGOLOGY, Issue 6 2002J. Seoane The aim of this study is to compare the artefacts ascribed to the technique of incisional biopsy using a punch or scalpel and the influence of suture use for traction and delivery of the specimen. A total of 160 samples were obtained from 10 fresh pig tongues by four experienced oral surgeons. Handling artefacts (squeeze artefacts): crush, splits, fragmentation and pseudocysts were assessed. No differences were identified in terms of crush, fragmentation or pseudocysts between samples obtained with a punch or scalpel. Splits were more frequent in those biopsies taken with a scalpel (,2 = 9.26; P=,0.0023). Artefacts in the punch biopsy group were significantly less than in the group that combined punch and suture traction (P < 0.01). The scalpel and suture traction group showed significantly more artefacts than the group without suture. It is concluded the use of a stitch for traction in small incisional biopsies causes squeeze artefacts, so its use should be restricted to specimen orientation. [source] | ||||||||||