Oral Rehabilitation of an Edentulous Patient Using Two-Segment Le Fort I Repositioning and Implant-Supported Fixed Prostheses.

Oral rehabilitation of an edentulous patient using two-segment le fort I repositioning and implant-supported fixed prostheses.

Int J Oral Maxillofac Implants. 2013 Mar-Apr; 28(2): e106-11
Abdel-Azim T, Fantuzzo J, Batalocco G, Cho S, Ercoli C, Morton D

Anteroposterior (AP) deficiencies present a restorative treatment challenge. Complex, multidisciplinary planning is necessary for the success of the treatment. This clinical report describes an approach to managing a complex complete oral rehabilitation of an edentulous patient with skeletal transverse and AP deficiencies with a history of facial trauma to the left zygomaticomaxillary complex. This was further complicated by a hopeless remaining dentition and pneumatization of the maxillary sinuses. Treatment included initial bony augmentation of the vertically and horizontally deficient maxilla, dental implant placement, provisional restoration in a Class III malocclusion with bilateral posterior crossbite, and Le Fort I osteotomy with transverse widening and advancement to correct the skeletal deficiency. Definitive restoration was accomplished with implant-supported fixed prostheses that provided ideal facial balance and occlusion. HubMed – rehab


Simultaneous sinus augmentation with implant placement: histomorphometric comparison of two different grafting materials. A multicenter double-blind prospective randomized controlled clinical trial.

Int J Oral Maxillofac Implants. 2013 Mar-Apr; 28(2): 543-9
Silvestri M, Martegani P, D’Avenia F, Farneti M, Capri D, Paolantoni G, Landi L

Purpose: Sinus elevation via the lateral approach for implant rehabilitation of atrophic posterior maxillae is considered a safe and predictable therapy. Several xenogeneic biomaterials of different biologic origin have been used as valid and predictable alternatives to autogenous bone. This multicenter randomized controlled double-blind prospective clinical trial aimed to compare histomorphometrically two xenogeneic grafting materials used for sinus elevation with simultaneous implant placement. Materials and Methods: Seven private practices in Italy were involved. Patients presenting at least one site with a residual bone crest height between 2 and 4 mm were treated. Control sites were grafted with 100% deproteinated particulated bovine bone (DPBB), while test sites were grafted with prehydrated corticocancellous porcine bone (PCPB). Root-form implants were placed simultaneously. Insertion torque and clinical stability were assessed and recorded. At 6 months, a biopsy specimen was harvested from each site, and histomorphometric analyses were performed. Results: Thirty-seven patients received 42 sinus elevations (24 test and 18 control). Eighty-two implants with adequate primary stability were placed. Fifty-five implants were placed in residual bone crests greater than 2 mm but less than 4 mm (average 2.7 mm) and achieved an average insertion torque of 22.8 ± 11.3 N/cm. Nineteen implants were placed in ridges greater than 3 mm but less than 5 mm, and eight were placed in ridges with more than 5 mm remaining. After 6 months, three implants had failed to integrate, leading to a survival rate of 96.34%. Forty-two specimens were analyzed histomorphometrically. No significant differences in total bone volume (PCPB 37.43%, DPBB 37.52%) or residual grafting material (PCPB 13.55%, DPBB 16.44%) were detected. Conclusions: In this study, PCPB compared well with DPBB as a grafting material for lateral sinus elevation. HubMed – rehab


Implant placement in the atrophic posterior maxilla with sinus elevation without bone grafting: a 2-year prospective study.

Int J Oral Maxillofac Implants. 2013 Mar-Apr; 28(2): 526-30
Rajkumar GC, Aher V, Ramaiya S, Manjunath GS, Kumar DV

Purpose: The purpose of this study was to evaluate changes in alveolar bone height after direct sinus elevation and simultaneous implant placement in the posterior edentulous maxilla. Materials and Methods: A prospective clinical study was conducted of patients undergoing sinus elevation for implant placement in the posterior maxilla to replace missing teeth. Residual alveolar bone height was between 4 and 7.5 mm. Lateral osteotomy of the maxillary sinus, followed by simultaneous implant placement without bone grafting, was performed under local anesthesia. Prosthetic restoration was completed 9 months later. The changes in alveolar bone height at the sinus floor were assessed radiographically after 1 week and 6, 9, 18, and 28 months after implant placement. Probing depths, implant mobility, and crestal bone loss were assessed at the same intervals. Results: Twenty-eight patients (17 women and 11 men) participated in the study. Forty-five implants were placed and followed after prosthetic rehabilitation. At 18 months after loading of the implants, alveolar bone height in the area of sinus elevation ranged from 7.40 to 11.55 mm. Increases in alveolar bone height at the sinus floor ranged from 2.05 to 5.40 mm at a minimum of 18 months after loading, a statistically significant gain. Crestal bone loss and changes in probing depths were not significant in any patients, and all implants remained clinically stable. The implant success rate was 100% without any complications after 18 to 28 months of follow-up. Conclusion: Placement of endosseous implants in the atrophic posterior maxilla in conjunction with sinus elevation without bone grafting resulted in a significant amount of bone formation around the implants at the sinus floor, resulting in successful restorations and eliminating the need for bone grafting. HubMed – rehab


The Field Expedient Extremity Tower (FEET).

Am J Orthop (Belle Mead NJ). 2013 Mar; 42(3): 132-4
Stinner DJ, Kerr GJ, Hsu JR

The field expedient extremity tower (FEET) is a versatile multipurpose radiolucent lower extremity positioner, which can be constructed from readily available external fixator parts and employed as an intraoperative aid for a variety of lower extremity cases. Examples include intramedullary nailing of the tibia, retrograde nailing of the femur, open or percutaneous plating of the distal femur and proximal tibia as well as skin grafting and wound debridements involving the posterior thigh, leg, and foot. In addition, it allows surgeons in austere environments to perform a wide variety of cases employing modern orthopedic techniques with this dual purpose liquid asset which can readily be broken down and reused as an external fixator if needed. HubMed – rehab



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