Implant prosthodontic rehabilitation of a patient with nevoid basal cell carcinoma syndrome: a clinical report

Clinical Outcomes of Pterygoid and Maxillary Tuberosity Implants: A Systematic Review

Background: This study aimed to assess the survival of implants placed in the maxillary tuberosity or in the pterygomaxillary region of the maxilla, based on a systematic review of the literature. Methods: An electronic search was undertaken in three databases. The cumulative survival rate (CSR) was calculated. The log-rank (Mantel-Cox) test was used to compare the survival distributions between some groups. Results: Thirty-eight studies were included, reporting 3446 implants (3053 pterygoid, 393 tuberosity) in 2245 patients, followed up for a mean ± SD of 61.0 ± 36.3 months (min-max, 1-144). A total of 208 pterygoid and 12 tuber implants failed, with a clear concentration of failures in the first year of follow-up and a 10-year CSR of 92.5% and 96.9%, respectively. The survival of pterygoid implants was lower than that of implants in the maxillary tuberosity (p = 0.006; log-rank test), and the survival of implants submitted to early/delayed loading was lower than that of immediately loaded implants (p < 0.001; log-rank test). Non-splinted implants presented higher failure rates. Few cases of intra- or postoperative complications were reported. Conclusions: Implants placed in the pterygoid process/maxillary tuberosity present a high 10-year CSR, although with lower survival for pterygoid in comparison to tuber implants. Pterygoid/tuber implants that are splinted with other implants may present higher survival rates than those that are not splinted.

Imaging of Gorlin-Goltz syndrome: Series of 2 cases

Gorlin-Goltz syndrome (GGS) is a rare autosomal dominant disorder with multisystemic involvement. It is characterized by the triad of multiple baso-cellular epitheliomas, odontogenic keratocysts (OKC) in the jaws and skeletal anomalies. Later, it was found that calcification of falx is also highly specific. We present radiological findings in case series of two cases, one with multiple OKC, calcified falx, skin lesions, and fibrous dysplasia of sphenoid and second with multiple OKC, calcified falx, vertebral anomaly and medulloblastoma.

Multidisciplinary oral rehabilitation of an adolescent suffering from juvenile Gorlin-Goltz syndrome - a case report

Background

The Gorlin-Goltz syndrome is an autosomal dominant disorder characterized by keratocystic odontogenic tumors in the jaws, multiple basal cell carcinomas and skeletal abnormities. Frequently, the manifestation of the syndrome occurs in the adolescent years.

Case presentation

An 11-year-old boy was referred to our clinic due to the persistence of the lower deciduous molars. The further diagnosis revealed bilateral keratocystic odontogenic tumors in the region of teeth 33 and 45 representing a symptom of a Gorlin-Goltz syndrome. This case of the oral rehabilitation of an adolescent with bilateral keratocystic odontogenic tumors shows the approach of a multidisciplinary treatment concept including the following elements: Enucleation and bone defect augmentation using a prefabricated bone graft; distraction osteogenesis to extend the graft-block vertically after cessation of growth; accompanying orthodontic treatment, guided implant placement and prosthetic rehabilitation. Six months after implant insertion, a new keratocystic odontogenic tumor in the basal part of the left sinus maxillaris had to be removed combined with the closure of the oroantral fistula. During the follow-up period of 18 months in semi-annual intervals, the patient showed no sign of pathology.

Conclusion

In the presented case could be shown that distraction osteogenesis of prefabricated bone blocks is possible. With a multidisciplinary approach in a long-term treatment a sufficient oral rehabilitation of the patient suffering from extended keratocystic odontogenic tumors was possible.

Radiological features of familial Gorlin-Goltz syndrome

Gorlin-Goltz syndrome is an autosomal dominant disorder principally characterized by cutaneous basal cell carcinomas, multiple keratocystic odontogenic tumors, and skeletal anomalies. This syndrome may be diagnosed early by dentist because keratocystic odontogenic tumors are usually one of the first manifestations of the syndrome. Early diagnosis and treatment are of utmost importance in reducing the severity of long term sequelae of this syndrome. This report presents a rare event of Gorlin-Goltz syndrome occurring in a 39-year-old male and his 8-year-old daughter. The clinical and investigative features of this familial disorder has been described in detail.

Implant-retained overdenture following hemiglossectomy: a 10-year clinical case report

A clinical evaluation of an implant-supported overdenture placed in the edentulous mandible after hemiglossectomy is described. The deltopectoral flap covering the mandibular ridge was replaced with a free mucosal graft. Four Brånemark system implants were inserted into the anterior part of the mandible, but one of the four fixtures did not show osseointegration. The superstructure was designed as a spaced round bar-attachment supported by three implants so as to retain the complete overdenture. In addition to the metal clip, a silicone-based soft denture liner material was applied in the female portion of the attachment so as to prevent the attachment from making a clattering noise upon mastication. Although the overdenture required adjustment at regular intervals, the treatment was successful both aesthetically and functionally for up to at least 10 years.