The aim of this study was to investigate deformation and stress distribution in the buccal lamellar bone via finite element analysis (FEA) in the application of alveolar ridge-splitting/expansion ...technique (ARST) in atrophic maxilla and mandible.
Three-dimensional (3D) solid models of maxilla and mandible were formed using computer software, with an alveolar ridge thickness of 4 mm in the right first molar region. In both models, one horizontal and two releasing vertical osteotomies were made in the atrophic region. Vertical forces varying from 50 N to 1000 N were continuously applied on the midpoint of the horizontal osteotomy and then the axial and total deformation and von Mises stress distribution in the buccal lamellar bone was assessed by FEA.
The degrees of axial deformation and total deformation and the maximum von Mises stress value under a 50 N force were 0.22 mm, 0.23 mm, and 4.52 MPa in the maxillary buccal lamellar bone and were 0.04 mm, 0.06 mm, and 5.90 MPa in the mandibular buccal lamellar bone, respectively. Similarly, under a 1000 N force, the values were 4.44 mm, 4.75 mm, and 90.49 MPa in the maxillary buccal lamellar bone and were 0.96 mm, 1.1 mm, and 118.02 MPa in the mandibular buccal lamellar bone, respectively.
These findings implicate that the ARST used for implant placement or alveolar augmentation can be achieved with the application of lower amounts of force in the maxilla compared to the mandible. It was also revealed that in ARST, the maximum von Mises stress value was lower in the maxillary buccal lamellar bone than in the mandibular buccal lamellar bone. Based on these findings, we consider that the administration of ARST could be biomechanically more stable in the maxilla than in the mandible.
Central giant cell tumours are rare, accounting for less than 7% of all jaw tumours. These tumours are usually observed in women, occur most often in the mandible, and are more common in the second ...decade of life. Treatment consists of local removal, partial resection, or total resection. In this case, a 32-year-old female patient presented in our clinic with pain in the anterior mandible. No cervical lymphadenopathy was detected upon physical examination. No ulceration was observed during the intraoral examination, but sensitivity was found in the vestibular area. However, no sensation loss in any teeth or in the lips was detected. This case report presents a 32-year-old female patient with central giant cell tumour causing extensive bone loss in the mandible base that was treated with partial resection.
ABSTRAK Terdapat kurang dari 15% kasus fraktur wajah pada kelompok usia anak yang mana kejadiannya semakin meningkat disaat anak mulai sekolah dan mencapai puncaknya saat anak memasuki masa remaja. ...Fraktur mandibula merupakan fraktur yang paling sering diantara semua fraktur wajah pada anak. Seorang anak perempuan berusia 10 tahun dengan penurunan kesadaran disertai dengan perdarahan aktif yang keluar dari mulut setelah kecelakaan lalu lintas. Kurang lebih dialami 3 jam sebelum masuk Rumah Sakit saat pasien menyeberang jalan tiba-tiba datang sepeda motor dengan kecepatan tinggi menabrak pasien, lalu pasien terjatuh dengan mekanisme yang tidak diketahui. Riwayat mual dan muntah disangkal, ditemukan perdarahan dari mulut, tidak ditemukan perdarahan hidung dan telinga. Dari hasil pemeriksaan primary survey, dijumpai gargling, bentuk dan gerak dada simetris Vesicular Breath Sound kanan sama dengan kiri, respirasi 22 kali per menit nadi 90, GCS 9 (E2M4V3). Pasien didiagnosis dengan cedera kepala sedang dengan fraktur mandibula. Penatalaksanaan yang diberikan adalah Intra Vena Fluid Drip (IVFD) Ringer Solution 10 tetes/menit (makro), mannitol drips 70cc/6jam, inj. Ceftriaxon 500mg/12jam, inj. ranitidine 25mg/12jam, paracetamol drips 500mg/8jam dan ORIF sebagai penatalaksanaan fraktur mandibula. Diagnosis fraktur mandibula ditegakkan berdasarkan temuan klinis. Tujuan penatalaksanaan fraktur mandibula adalah mengatur oklusi gigi, memerlukan stabilisasi dan mengembalikan maksilomandibular pretraumatik. ORIF pada kasus fraktur simfisis dan parasimfisis berupa pemasangan miniplat dan skrup untuk fiksasi berhasil mengembalikan fungsi estetik dan pengunyahan. Kata kunci: anak, cedera kepala, fraktur mandibula, penatalaksanaan ABSTRACT There are less than 15% cases of facial fractures in childen where the incidence increases when the child starts school and reaches its peak when the child enters adolescence. Mandibular fracture is the most common fracture among all facial fractures in children. A 10-years-old girl with decreased consciousness with active bleeding from mouth after a traffic accident. Approximately 3 hours before entering the hospital when the patient crossed the road suddenly came a motorcycle with high speed crashing into the patient, then the patient fell with an unknown mechanism. History of nausea and vomiting is denied, bleeding from mouth detected, no sign of nose and ear bleeding. From the results of the primary survey, there were gargling, Vesicular Breath Sound, right and left chest symmetrical movement, respiration 22 times per minute, pulse 90, GCS 9 (E2M4V3). Patients are diagnosed with moderate head injury with mandibular fractures. Management given is IVFD Ringer Solution 10 drops / minute (macro), mannitol drips 70cc / 6 hours, inj. Ceftriaxon 500mg / 12h, inj. ranitidine 25 mg / 12 hours, paracetamol drips 500 mg / 8 hours and ORIF as a mandibular fracture management. Diagnosis of mandibular fractures is based on clinical findings. The purpose of managing mandibular fracture is to regulate dental occlusion, requiring stabilization and restoring pretraumatic maxillomandibular. Open Reduction and Internal Fixation (ORIF) in the case of symphysis and parasymfisis fractures in the form of miniplate and screw for fixation managed to restore aesthetic and masticatory functions. Keywords: child, head injury, mandibular fracture, management.
Background: Hemisection is an endodontic surgery performed by removing one or more roots and existing crown structures to increase retention of the remaining teeth and to correct defected dental ...roots that are not possible to maintain. This study aims to evaluate the treatment of hemisection in the lower left first molar in the mesial tooth root with the restoration of the splint crown end with tooth 35 as retention at Sanglah General Hospital, Bali, Indonesia. Case Description: Male patient aged 21 years, in tooth 36 there is a cavity with a temporary restoration accompanied by a periodontal abscess. Teeth are sensitive to percussion tests and palpation, mobility is normal. Radiographic features appear to be perforated in the furcation section, and furcation involvement. Diagnosis of teeth 36 pulp necrosis is accompanied by abscess periodontal. During the first visit periodontal abscess drainage was performed, followed by functional crown lengthening in the periodontia. After one week of observation, there were no complaints, continued treatment of the distal root canal until the root canal filling. The next visit was carried out hemisection surgery in the form of separation of root bifurcation and extraction of mesial roots to the existing crown structure. Two months after the surgical procedure was evaluated, there was a good increase in bone density and no complaints. Then, the tapered serrated post was accompanied by the manufacture of composite core and final restoration using PFM crown splint with tooth 35 as retention. Conclusion: Surgical treatment of hemisection is a reliable alternative solution and has a good prognosis because it can maintain dental and periodontal tissue as long as possible without tooth extraction.
The objective of this article is to describe the diagnosis and treatment of a peripheral osteoma, causing an asymetry on the posterior region of the mandible, and to review the present peripheral ...osteoma cases in the literature. A 52 year old female patient referred to our clinic for the treatment of a swelling localized on her left side of the posterior region of the mandible. After the clinical and radiographical examination, the prediagnosis of lesion was said to be a peripheral osteoma. The lesion was completely excised under local anesthesia and histological examination was performed. The final diagnosis of the lesion was made as a peripheral osteoma. As being rare, peripheral osteomas could be localized on the mandible and should be taken into account during differential diagnosis of other lesions causing asymmetry on the mandible. ÖZET Bu makalenin amacı, mandibula posterior bölgesinde lokalize olup asimetriye neden olan bir periferal osteoma vakasının teşhis ve tedavisinin anlatılması ve literatürde rapor edilmiş olan vakaları incelemektir. 52 yaşında bir bayan hasta, mandibulasının sol posterior bölgesindeki şişliğin tedavisi amacı ile kliniğimize başvurdu. Yapılan klinik ve radyografik muayene sonucunda şişliğe sebep olan lezyonun ön tanısı osteoma olarak konuldu. Lezyonun tamamı, lokal anestezi altında eksize edilerek histolojik inceleme yapıldı. Lezyonun kesin tanısı periferal osteoma olarak kondu. Periferal osteomalar nadir de olsa mandibulada gelişebildiğinden, bu bölgede lokalize olan ve asimetri oluşturan diğer lezyonlardan ayırt edilmeleri gerekmektedir. Anahtar Kelimeler: mandibula, osteoma
The aim of this in vitro study is to evaluate the accuracy of implant position using mucosal supported surgical guides, produced by a desktop 3D printer.
Ninety implants (Bone Level Roxolid, 4.1 mm × ...10 mm, Straumann, Villerat, Switzerland) were placed in fifteen mandibular casts (Bonemodels, Castellón de la Plana, Spain). A mucosa-supported guide was designed and printed for each of the fifteen casts. After placement of the implants, the location was assessed by scanning the cast and scan bodies with an intra-oral scanner (Primescan
, Dentsply Sirona, York, PA, USA). Two comparisons were performed: one with the mucosa as a reference, and one where only the implants were aligned. Angular, coronal and apical deviations were measured.
The mean implant angular deviation for tissue and implant alignment were 3.25° (SD 1.69°) and 2.39° (SD 1.42°) respectively, the coronal deviation 0.82 mm (SD 0.43 mm) and 0.45 mm (SD 0.31 mm) and the apical deviation 0.99 mm (SD 0.45 mm) and 0.71 mm (SD 0.43 mm). All three variables were significantly different between the tissue and implant alignment (
< 0.001).
Based on the results of this study, we conclude that guided implant surgery using desktop 3D printed mucosa-supported guides has a clinically acceptable level of accuracy. The resilience of the mucosa has a negative effect on the guide stability and increases the deviation in implant position.
Bleeding can be one of the severe complications during implant placement or other surgeries. Presurgical assessment of the area should be performed precisely. Thus, we examined lingual vascular ...canals of the mandible using dental computerized tomography (CT); define the anatomical characteristics of canals and the relationship with mandibular bone.
One thousand sixty-one foramina in 639 patients, in 5 dental clinics, were included in this multicenter study. Distance between crest and lingual foramen, tooth apex and lingual foramen, distance from mandibular border, diameter of lingual foramen, canal type, anastomosis, and location of foramen were examined.
Foramen was 18.33 ± 5.45 mm below the bony crest and 17.40 ± 7.52 mm from the mandibular border, with men showing larger measurements. The mean diameter of lingual foramina was 0.89 ± 0.40 mm; 76.8% canal type was mono; 51.8% patients presented with median lingual canal-foramen (MLC) and 21.1% with lateral lingual foramen. Diameter of MLC was statistically larger.
With a large sample group, results represented that lingual foramina could be visualized with dental CT, providing useful data for mandibular implant surgeries. Findings suggest that vascular canals and several anastomoses exist in the anterior mandible extending through premolar and molar regions as well. It is imperative to consider these vessels with the dental CT before and during the mandibular surgery to prevent threatening hemorrhage.
An 80-year-old woman with a history of breast cancer 16 years ago presented with malnutrition, swelling, and paresthesia of the right cheek. Computed tomography revealed diffuse osteosclerosis ...without lysis and adjacent soft tissue swelling on the right mandible. These radiological findings were more compatible with primary chronic osteomyelitis than metastasis from breast cancer, and biopsy was necessary for diagnosis. This report describes breast cancer metastasis mimicking primary chronic osteomyelitis 16 years after diagnosis and its differential diagnosis in the mandible.
Cysts and tumors are common lesions in the jaws. To be able to retain a good volume of the alveolar ridge during healing as well as strengthening the angle and body of the mandible and provide an ...instant improved support for adjacent teeth, reliable long-term bone regeneration is needed. The purpose of this prospective study was to promote bone regeneration by filling bony defects in the upper or lower jaw with granules of the bioactive glass S53P4 (BAG), which have osteostimulative and antimicrobial properties.The authors treated 20 patients (21 defects) surgically; benign tumors, cysts, or infection related to impacted teeth in the maxilla or mandible. The tumor or cyst was removed or enucleated and thorough cleaning of the infected area was performed. The bone cavity was filled with granules of the BAG S53P4 despite signs of chronic infection in the area at the time of surgery. The patients were followed up for an average of 34 months clinically and with cone beam computerized tomography for 28 months. In 20 defects the final outcome was successful. Despite infection at the time of surgery in 65% of the patients, no material associated infection was seen during the follow-up. The BAG S53P4 granules were radiologically remodeled into bone after 2 years follow-up. The use of granules of the BAG S53P4 in the treatment of large bone defects provides infection-free reliable bone regeneration despite chronic infection at the time of surgery, which improves the prognosis of adjacent teeth.
Objectives: The aim of this study was to evaluate the demographics and characteristics of the patients treated for traumatic bone cyst (TBC). Materials and Methods: A retrospective review was ...conducted to determine the radiological, clinical and demographic characteristics of patients with TBC who were surgically treated over a 2-year period using data retrieved from computerized databases. Results: The study sample consisted of 22 patients (24 lesions in total) with mean age of 22.9 years. All lesions were located in the mandible (16 in anterior mandible, 8 in posterior mandible) and diagnosed incidentally during routine dental examinations. There was no statistically significant difference between male and female patients in demographic characteristics. All patients were followed up for 6-18 months with uneventful healing. Conclusions: TBCs should be kept in mind during examination of radiolucent lesions of the mandible particularly in younger patients. Along with the histopathological examination, clinical and radiological findings, symptoms of the patients, and surgeon’s experience should be considered for a definitive diagnosis.
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