Re-Mee Doh

Implant displacement into the mandible: an unusual complication during implant surgery.

In contrast with problems regarding initial stability of dental implants in the posterior maxilla, heat generation during bone drilling is one of the complications that can occur in the mandible which is usually composed of dense bone. This report presents an unusual case of implant displacement into the mandibular posterior area of a middle-aged woman. This problem was presumably caused by poor bone density, loss of cortical bone engagement, and differences in bone quality between the alveolar bone and the basal bone.

Teriparatide therapy for bisphosphonate-related osteonecrosis of the jaw associated with dental implants

This report describes a case of teriparatide (TPTD) therapy for bisphosphonate (BP)-related osteonecrosis of the jaw induced after implant placement. A 75-year-old woman taking oral BP was referred with uncontrolled osteonecrosis of the mandible related to the implant placement. With conservative treatment, BP was suspended and daily subcutaneous injections of 20 μm/d TPTD were started. After 4 months of the therapy, fixture removal and sequestrectomy were performed. Histological analysis revealed necrotic lamellar bone and empty osteocytic lacunae. In contrast, multiple irregular reversal lines of the lamellar bone and active osteoblasts were noted adjacent to the lesion. There was a significant increase in serum C-terminal telopeptide cross-link of type 1 collagen and serum osteocalcin after commencement of the therapy. After 7 months off therapy, the serum levels of the 2 markers remained at a high level compared with the baseline.

Dislodgement resistance of modified resin-bonded fixed partial dentures utilizing tooth undercuts: an in vitro study

STATEMENT OF PROBLEM Over the years, resin-bonded fixed partial dentures (RBFPDs) have gone through substantial development and refinement. Several studies examined the biomechanics of tooth preparation and framework design in relation to the success rate of RBFPDs and considered retention and resistance form essential for increase of clinical retention. However, these criteria required preparations to be more invasive, which violates not only the original intentions of the RBFPD, but may also have an adverse effect on retention due to loss of enamel, an important factor in bonding. PURPOSE The object of this in vitro study was to compare the dislodgement resistance of the new types of RBFPDs, the conventional three-unit fixed partial denture, and conventional design of RBFPD (Maryland bridge). MATERIAL AND METHODS Fifty resin mandibular left second premolars and second molars were prepared on dentiforms, according to the RBFPD design. After model fabrication (five group, n = 10), prostheses were fabricated and cemented with zinc phosphate cement. After cementation, the specimens were subjected to tensile loading at a cross head speed of 4 mm/min in a universal testing machine. The separation load was recorded and analyzed statistically using one-way analysis of variance followed by Duncans multiple range test. RESULTS Group V, the pin-retained RBFPDs, had the highest mean dislodgement resistance, whereas specimens of group II, the conventional RBFPDs, exhibited a significantly lower mean dislodgement resistance compared to the other 4 groups (P < .05). There were no significant differences between group I, III, and IV in terms of dislodgement resistance (P > .05). Group V had the highest mean MPa (N/mm2) (P < .05). There was no significant difference between groups I, II, III and IV (P > .05). CONCLUSION Within the limits of the design of this in vitro study, it was concluded that: 1. The modified RBFPDs which utilizes the original tooth undercuts and requires no tooth preparation, compared with the conventional design of RBFPDs, has significantly high dislodgement resistance (P < .05). 2. The modified RBFPDs which utilizes the original tooth undercuts and requires minimal tooth preparation, compared with the conventional FPDs, has significantly no difference in retention and dislodgement resistance)(P > .05). 3. The pin-retained FPDs showed a high dislodgement resistance compared to the conventional three-unit FPDs (P < .05).

Preservation of Hypermobile Teeth by Establishing Posterior Occlusal Support Using Implant Prostheses: A 5-Year Follow-Up

For patients with periodontally compromised, hypermobile teeth, implant-supported fixed dental prostheses (FDPs) or removable dentures are often used after extracting mobile teeth. The loss of native teeth may carry social consequences, depending upon the patients age, state of health, and degree of social functioning. This report represents successful stabilization and preservation of questionable, hypermobile teeth that have been damaged by traumatic occlusion due to the loss of posterior support with a cross-arch splinted FDP, as well as the implementation of posterior support using implant-supported prostheses.

Precise Implant Placement With a Computer-Assisted Surgical Guide in Cleft Lip and Palate Patients.

It is very common for cleft lip and palate patients to have congenitally missing teeth. Insufficient buccopalatal bone volume, a shallow vestibule, and lack of soft tissue resulting from previous surgical scarring render it difficult for clinicians to place implants in the missing area. This report describes guide surgery that represents a treatment option for cases in which implants need to be placed in tight spaces with minimal bone space, to minimize as far as possible manual placement errors.

Delayed paresthesia of inferior alveolar nerve after dental surgery: case report and related pathophysiology

Paresthesia is an altered sensation of the skin, manifesting as numbness, partial loss of local sensitivity, burning, or tingling. The inferior alveolar nerve (IAN) is the third branch of the trigeminal nerve and is very important in dental treatment. IAN paresthesia may occur after various dental procedures such as simple anesthetic injections, surgical procedures, and endodontic treatment, and is reported to range from 0.35% to 8.4%. The altered sensation usually follows immediately after the procedure, and reports of late onset of nerve involvement are rare. This report presents a rare case of delayed paresthesia after dental surgery and discusses the pathophysiology of IAN delayed paresthesia.

Full mouth rehabilitation of a patient with Sturge- Weber syndrome using a mixture of general and sedative anesthesia

Issues related to the control of seizures and bleeding, as well as behavioral management due to mental retardation, render dental treatment less accessible or impossible for patients with Sturge-Weber syndrome (SWS). A 41-year-old man with SWS visited a dental clinic for rehabilitation of missing dentition. A bilateral port-wine facial nevus and intraoral hemangiomatous swollen lesion of the left maxillary and mandibular gingivae, mucosa, and lips were noted. The patient exhibited extreme anxiety immediately after injection of a local anesthetic and required various dental treatments to be performed over multiple visits. Therefore, full-mouth rehabilitation over two visits with general anesthesia and two visits with target-controlled intravenous infusion of a sedative anesthesia were planned. Despite concerns regarding seizure control, bleeding control, and airway management, no specific complications occurred during the treatments, and the patient was satisfied with the results.

Effect of premolar extraction and presence of the lower third molar on lower second molar angulation in orthodontic treatment

OBJECTIVE To evaluate the change in mandibular second-molar (M2) angulation in orthodontic treatment with premolar extraction and lower third molar (M3). STUDY DESIGN Panoramic radiographs were evaluated in 3 groups of 129 participants: (1) control, no orthodontic treatment (n = 65); (2) extraction, orthodontic treatment with premolar extraction (n = 30); and (3) nonextraction, orthodontic treatment without premolar extraction (n = 34). The angular difference and ratio of M2 to the first molar (M1), the change in the angulation of M2 between pre- and postorthodontic treatment, and the distal bone level of M2 were assessed. RESULTS The angular difference and ratio of M2 to M1, the angulation change of M2 between pre- and postorthodontic treatment, and the distal bone level of M2 were higher in the nonextraction group than in the control and extraction groups. CONCLUSIONS The successful orthodontic alignment of the M2 may not be achieved in nonextraction cases when the M3s are present.