Rafael Ortega-Lopes

Prospective Clinical Assessment of Morbidity After Chin Bone Harvest

AbstractThe aim of this prospective research was to assess soft tissue morbidity in the symphyseal region after bone graft harvesting. Thirty patients, with average age 45 years, underwent symphyseal bone graft harvesting followed up for a period of 12 months. Follow-up involved neurosensory testing of 2-point discrimination, static light touch, brush directional stroke, pinprick, and thermal discrimination to cold and hot; the statistical analysis was performed using McNemar test and Friedman test with P < 0.05. The results showed that 50% of patients had postoperative morbidity in the first month after surgery showing statistical positive relation with surgery (P < 0.05); at 6 months, this situation diminished to 23%, and at the end of the monitoring period (1 year); the neurosensory tests revealed no persistent morbidity. In conclusion, all neurosensory tests revealed high morbidity in the first month with total resolutions at 1-year follow-up; however, this complication associated to surgery is indispensable to discharge the patient properly.

Segmental osteotomy with interpositional bone grafting in the posterior maxillary region

Tooth loss is followed by a natural bone resorption process that often leads to defects in the alveolar ridge, making the installation of dental implants unfeasible. Correction of such bone defects, especially loss of height of the ridge or associated loss of thickness, is a great challenge to dental surgeons. The technique of segmental osteotomy accompanied by interpositional bone grafting has been shown to be a viable option for addressing the problem. This report describes a successful application of the technique in the treatment of vertical dimension deficiency in the posterior maxillary region. Four months after graft surgery, 3 implants were successfully placed in accordance with the original reverse planning.

Estudio Radiográfico Prospectivo de la Reparación Ósea en Sínfisis Mandibular Posterior a la Remoción Ósea de Mentón

El retiro de hueso de sinfisis mandibular ha sido utilizado ampliamente para diferentes procedimientos reconstructivos maxilofaciales. El objetivo de esta investigacion fue establecer la existencia de la reparacion osea en el defecto creado en sinfisis debido al retiro de hueso. Treinta pacientes (22 mujeres, 8 hombres) de entre 21 y 65 anos fueron operados para retirar hueso de menton que fue posteriormente aplicado en reconstruccion osea alveolar; las cirugias fueron realizadas por dos cirujanos maxilofaciales y los pacientes fueron evaluados con telerradiografias en la etapa preoperatoria, postoperatoria inmediata (PIn) y postoperatoria tardia (PTar), donde se realizaron medidas horizontales y verticales del defecto oseo; los valores fueron estudiados con la prueba t de Student con valor de p<0,05. Luego del retiro oseo se observo un defecto vertical promedio de 12,80±1,99 y horizontal de 8,33±1,77; luego de un ano, se obtuvo una disminucion de 32,8% en el sentido vertical y 50,3% horizontal, presentando significancia estadistica en relacion al PIn. Se concluye que existe reparacion osea del defecto originado en sinfisis siendo proximo al 30%-50% en la evaluacion de un ano posterior a la cirugia.

Repositioning Implants Through Sandwich Osteotomy with the Interposition of Lyophilized Bovine Bone

The satisfactory positioning of an implant during dental surgery is essential to the success of the treatment. However, accidents can occur during the period of osseointegration, leading to implant movements that hinder or may even prevent prosthetic rehabilitation. Implants can be repositioned through sandwich osteotomy, which has been labeled a versatile, viable and predictable technique in the literature. The aim of the present study was to report a case involving the esthetic displacement of an implant, caused by a sports accident, which was repositioned using sandwich osteotomy, with the interposition of lyophilized bovine bone between the osteotomized segments. In order to adequately perform this repositioning, the authors devised a guide to assist with the positioning process.

Sandwich Osteotomies to Treat Vertical Defects of the Alveolar Ridge.

Purpose: To evaluate the vertical bone gain after osteotomy sandwich. Materials and Methods: Fourteen patients (mean age, 41 years) underwent 17 procedures of osteotomy sandwich. Of these 17 procedures, 15 involved reconstructive surgery and 2 involved the repositioning of implants. The patients were submitted to computed tomography before the surgical procedure and 4 months after the completion of the graft, with measurements taken to assess the vertical gain that had been achieved. Results: The results confirmed a satisfactory vertical gain in all cases (mean, 5.12 mm). The use of autogenous graft or biomaterial particles (in isolation) between the osteotomized segments proved to be viable. Three patients reported postoperative paresthesia, which healed spontaneously after 3 months. One patient exhibited dehiscence due to not following the postoperative recommendations. Forty implants were installed in the grafted regions, and 2 implants were repositioned. Conclusion: The technique of sandwich osteotomy was found to be effective for height gain, and different materials can be used between the osteotomized segments.

Tratamento da Atrofia Vertical Posterior de Mandíbula Através de Osteotomia Sandwich: Série de Casos

1Doutor em CTBMF pela UNICAMP e Diretor do Instituto Braga de Odontologia e Pesquisa (IBOP/SP). 2Doutor em CTBMF pela UNICAMP e Coordenador do curso de aperfeiçoamento em Implantodontia da APCD Piracicaba/SP. 3Mestre em Implantodontia pelo ILAPEO Curitiba e Coordenador da Especialização em Implantodontia CIODONTO/RO. 4Especialista em Implantodontia pela CIODONTO/RO e Professora da Especialização em Implantodontia CIODONTO/RO. 5 Especialista em Implantodontia pela CIODONTO/RO e Professor da Especialização em Implantodontia CIODONTO/RO.