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Ding MC, Jing BY, Shi J, Yang L, Liu XD, Wang JF, Qu S, Liang JW, Tang ZH, Zhao JL, Tian L. A retrospective study of occlusal reconstruction in patients with old jaw fractures and dentition defects. Chin J Traumatol 2024:S1008-1275(24)00030-0. [PMID: 38514297 DOI: 10.1016/j.cjtee.2024.03.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2023] [Revised: 12/28/2023] [Accepted: 02/02/2024] [Indexed: 03/23/2024] Open
Abstract
PURPOSE This study evaluated the methods and clinical effects of multidisciplinary collaborative treatment for occlusal reconstruction in patients with old jaw fractures and dentition defects. METHODS Patients with old jaw fractures and dentition defects who underwent occlusal reconstruction at the Third Affiliated Hospital of Air Force Military Medical University from January 2018 to December 2022 were enrolled. Clinical treatment was classified into 3 phases. In phase I, techniques such as orthognathic surgery, microsurgery, and distraction osteogenesis were employed to reconstruct the correct three-dimensional (3D) jaw position relationship. In phase II, bone augmentation and soft tissue management techniques were utilized to address insufficient alveolar bone mass and poor gingival soft tissue conditions. In phase III, implant-supported overdentures or fixed dentures were used for occlusal reconstruction. A summary of treatment methods, clinical efficacy evaluation, comparative analysis of imageological examinations, and satisfaction questionnaire survey were utilized to evaluate the therapeutic efficacy in patients with traumatic old jaw fractures and dentition defects. All data are summarized using the arithmetic mean and standard deviation and compared using independent sample t-tests. RESULTS In 15 patients with old jaw fractures and dentition defects (an average age of 32 years, ranging from 18 to 53 years), there were 7 cases of malocclusion of single maxillary fracture, 6 of malocclusion of single mandible fracture, and 2 of malocclusion of both maxillary and mandible fractures. There were 5 patients with single maxillary dentition defects, 2 with single mandibular dentition defects, and 8 with both maxillary and mandibular dentition defects. To reconstruct the correct 3D jaw positional relationship, 5 patients underwent Le Fort I osteotomy of the maxilla, 3 underwent bilateral sagittal split ramus osteotomy of the mandible, 4 underwent open reduction and internal fixation for old jaw fractures, 3 underwent temporomandibular joint surgery, and 4 underwent distraction osteogenesis. All patients underwent jawbone augmentation, of whom 4 patients underwent a free composite vascularized bone flap (26.66%) and the remaining patients underwent local alveolar bone augmentation. Free gingival graft and connective tissue graft were the main methods for soft tissue augmentation (73.33%). The 15 patients received 81 implants, of whom 11 patients received implant-supported fixed dentures and 4 received implant-supported removable dentures. The survival rate of all implants was 93.82%. The final imageological examination of 15 patients confirmed that the malocclusion was corrected, and the clinical treatment ultimately achieved occlusal function reconstruction. The patient satisfaction questionnaire survey showed that they were satisfied with the efficacy, phonetics, aesthetics, and comfort after treatment. CONCLUSION Occlusal reconstruction of old jaw fractures and dentition defects requires a phased sequential comprehensive treatment, consisting of 3D spatial jaw correction, alveolar bone augmentation and soft tissue augmentation, and implant-supported occlusal reconstruction, achieving satisfactory clinical therapeutic efficacy.
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Affiliation(s)
- Ming-Chao Ding
- State Key Laboratory of Oral and Maxillofacial Reconstruction and Regeneration, National Clinical Research Center for Oral Diseases, Shaanxi Clinical Research Center for Oral Diseases, Department of Oral and Maxillofacial, School of Stomatology, The Fourth Military Medical University, Xi'an, 710032, China
| | - Bo-Ya Jing
- Department of Maxillofacial Trauma and Orthognathic Surgery, The Third Affiliated Hospital, The Air Force Military Medical University, Xi'an, 710038, China
| | - Jin Shi
- State Key Laboratory of Oral and Maxillofacial Reconstruction and Regeneration, National Clinical Research Center for Oral Diseases, Shaanxi Clinical Research Center for Oral Diseases, Department of Oral and Maxillofacial, School of Stomatology, The Fourth Military Medical University, Xi'an, 710032, China
| | - Liu Yang
- State Key Laboratory of Oral and Maxillofacial Reconstruction and Regeneration, National Clinical Research Center for Oral Diseases, Shaanxi Clinical Research Center for Oral Diseases, Department of Oral and Maxillofacial, School of Stomatology, The Fourth Military Medical University, Xi'an, 710032, China
| | - Xiang-Dong Liu
- State Key Laboratory of Oral and Maxillofacial Reconstruction and Regeneration, National Clinical Research Center for Oral Diseases, Shaanxi Clinical Research Center for Oral Diseases, Department of Oral and Maxillofacial, School of Stomatology, The Fourth Military Medical University, Xi'an, 710032, China
| | - Jing-Fu Wang
- State Key Laboratory of Oral and Maxillofacial Reconstruction and Regeneration, National Clinical Research Center for Oral Diseases, Shaanxi Clinical Research Center for Oral Diseases, Department of Oral and Maxillofacial, School of Stomatology, The Fourth Military Medical University, Xi'an, 710032, China
| | - Shuang Qu
- Department of Stomatology, 941th Hospital of People's Liberation Army Joint Logistic Support Force, Xining, 810000, China
| | - Jia-Wu Liang
- Department of Maxillofacial Trauma and Orthognathic Surgery, The Third Affiliated Hospital, The Air Force Military Medical University, Xi'an, 710038, China
| | - Zi-Hao Tang
- State Key Laboratory of Oral and Maxillofacial Reconstruction and Regeneration, National Clinical Research Center for Oral Diseases, Shaanxi Clinical Research Center for Oral Diseases, Department of Oral and Maxillofacial, School of Stomatology, The Fourth Military Medical University, Xi'an, 710032, China
| | - Jin-Long Zhao
- Department of Maxillofacial Trauma and Orthognathic Surgery, The Third Affiliated Hospital, The Air Force Military Medical University, Xi'an, 710038, China
| | - Lei Tian
- State Key Laboratory of Oral and Maxillofacial Reconstruction and Regeneration, National Clinical Research Center for Oral Diseases, Shaanxi Clinical Research Center for Oral Diseases, Department of Oral and Maxillofacial, School of Stomatology, The Fourth Military Medical University, Xi'an, 710032, China.
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Budak L, Sarao SK, Levin L. Fragment rehydration, splinting, and autotransplantation: A journey to better treatment for traumatized teeth. Dent Traumatol 2024; 40:1-4. [PMID: 38213107 DOI: 10.1111/edt.12919] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2024]
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La Monaca G, Di Giorgio G, Pranno N, Serafini G, De Biase A, Cristalli MP. Implant-Prosthetic Rehabilitation of Mandibular Posttraumatic Severe Dentoalveolar Loss With a Reconstructive Staged Approach: A Clinical Report With 3-Year Follow-Up. J ORAL IMPLANTOL 2023; 49:567-572. [PMID: 38279654 DOI: 10.1563/aaid-joi-d-23-00143] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2024]
Abstract
This clinical report describes the oral rehabilitation of a 25-year-old male patient who lost the lower incisors, right canine, and a significant amount of anterior mandibular bony and soft tissue following severe dentoalveolar trauma due to a car accident. The patient's young age, anterior esthetic zone in the lower jaw, previous mandibular fracture, and extended bony and soft-tissue defect hindering ideal 3-dimensional implant placement oriented the therapeutic plan toward a staged approach, with several reconstructive surgical procedures before implant rehabilitation. The treatment involved deepening the labiobuccal vestibule and lingual sulcus to correct cicatricial shrinkage due to previous surgical fixation of the mandibular fracture, vertical guided bony augmentation to regenerate adequate volumes of bone, free gingival graft to achieve sufficient height and thickness of peri-implant soft tissues, and a prosthetic-driven surgical procedure to place the implants in a good functional and esthetic position. This therapeutic approach restored function and esthetics and achieved outcome stability at 3-year follow-up.
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Affiliation(s)
- Gerardo La Monaca
- Department of Oral and Maxillo-Facial Sciences, Sapienza, University of Rome, Rome, Italy
| | - Gianni Di Giorgio
- Department of Oral and Maxillo-Facial Sciences, Sapienza, University of Rome, Rome, Italy
| | - Nicola Pranno
- Department of Oral and Maxillo-Facial Sciences, Sapienza, University of Rome, Rome, Italy
| | - Giorgio Serafini
- Department of Oral and Maxillo-Facial Sciences, Sapienza, University of Rome, Rome, Italy
| | - Alberto De Biase
- Department of Oral and Maxillo-Facial Sciences, Sapienza, University of Rome, Rome, Italy
| | - Maria Paola Cristalli
- Department of Oral and Maxillo-Facial Sciences, Sapienza, University of Rome, Rome, Italy
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Alqutaibi AY, Aljohani A, Alduri A, Masoudi A, Alsaedi AM, Al-Sharani HM, Farghal AE, Alnazzawi AA, Aboalrejal AN, Mohamed AAH, Zafar MS. The Effectiveness of Cold Atmospheric Plasma (CAP) on Bacterial Reduction in Dental Implants: A Systematic Review. Biomolecules 2023; 13:1528. [PMID: 37892210 PMCID: PMC10604822 DOI: 10.3390/biom13101528] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2023] [Revised: 09/27/2023] [Accepted: 10/06/2023] [Indexed: 10/29/2023] Open
Abstract
BACKGROUND The emergence of dental implants has revolutionized the management of tooth loss. However, the placement of clinical implants exposes them to complex oral environment and numerous microscopic entities, such as bacteria. Cold atmospheric plasma (CAP) is often used to treat the surfaces of dental implants, which alters morphological features and effectively reduces bacterial load. PURPOSE This systematic review aims to assess the existing literature on the bactericidal properties of CAP when used on various kinds of dental implant surfaces. REVIEW METHOD An in-depth examination of MEDLINE/PubMed and EMBASE was performed to identify relevant studies, with the most recent search conducted in May 2023. Studies were selected based on their exploration of CAP's effects on dental implants compared to control groups, focusing on CAP's bactericidal efficacy. However, studies that lacked a control group or that failed to measure bactericidal effects were excluded. RESULTS After applying the selection criteria, 15 studies were ultimately included in the systematic review. The collected data suggest that CAP can effectively reduce bacterial loads on dental implant surfaces, including pathogens like Streptococcus mitis and Staphylococcus aureus. Furthermore, CAP appears to combat biofilms and plaques that are key contributors to periimplantitis. CONCLUSION CAP emerges as a promising treatment option, exhibiting significant bactericidal activity on dental implant surfaces. CAP can decrease the rates of bacterial biofilm and plaque formation, leading to improved outcomes for dental implant patients.
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Affiliation(s)
- Ahmed Yaseen Alqutaibi
- Department of Substitutive Dental Science, College of Dentistry, Taibah University, Al Madinah 41311, Saudi Arabia; (A.E.F.); (A.A.A.)
- Prosthodontics Department, College of Dentistry, Ibb University, Ibb 70270, Yemen
| | - Abdulbari Aljohani
- College of Dentistry, Taibah University, Al Madinah 41311, Saudi Arabia; (A.A.); (A.A.); (A.M.); (A.M.A.)
| | - Abdullah Alduri
- College of Dentistry, Taibah University, Al Madinah 41311, Saudi Arabia; (A.A.); (A.A.); (A.M.); (A.M.A.)
| | - Abdulmajid Masoudi
- College of Dentistry, Taibah University, Al Madinah 41311, Saudi Arabia; (A.A.); (A.A.); (A.M.); (A.M.A.)
| | - Anas M. Alsaedi
- College of Dentistry, Taibah University, Al Madinah 41311, Saudi Arabia; (A.A.); (A.A.); (A.M.); (A.M.A.)
| | - Hesham Mohammed Al-Sharani
- National Center for Epidemiology and Population Health, ANU College of Health and Medicine, Canberra 2601, Australia;
| | - Ahmed E. Farghal
- Department of Substitutive Dental Science, College of Dentistry, Taibah University, Al Madinah 41311, Saudi Arabia; (A.E.F.); (A.A.A.)
| | - Ahmad Abdulkareem Alnazzawi
- Department of Substitutive Dental Science, College of Dentistry, Taibah University, Al Madinah 41311, Saudi Arabia; (A.E.F.); (A.A.A.)
| | | | - Abdel-Aleam H. Mohamed
- Physics Department, College of Science, Taibah University, Al Madinah 42353, Saudi Arabia;
- Physics Department, Faculty of Science, Beni-Suef University, Beni-Suef 62521, Egypt
| | - Muhammad Sohail Zafar
- Department of Restorative Dentistry, College of Dentistry, Taibah University, Al Madinah 41311, Saudi Arabia
- School of Dentistry, University of Jordan, Amman 11942, Jordan
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Sui BD, Zheng CX, Zhao WM, Xuan K, Li B, Jin Y. Mesenchymal condensation in tooth development and regeneration: a focus on translational aspects of organogenesis. Physiol Rev 2023; 103:1899-1964. [PMID: 36656056 DOI: 10.1152/physrev.00019.2022] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Revised: 12/26/2022] [Accepted: 01/16/2023] [Indexed: 01/20/2023] Open
Abstract
The teeth are vertebrate-specific, highly specialized organs performing fundamental functions of mastication and speech, the maintenance of which is crucial for orofacial homeostasis and is further linked to systemic health and human psychosocial well-being. However, with limited ability for self-repair, the teeth can often be impaired by traumatic, inflammatory, and progressive insults, leading to high prevalence of tooth loss and defects worldwide. Regenerative medicine holds the promise to achieve physiological restoration of lost or damaged organs, and in particular an evolving framework of developmental engineering has pioneered functional tooth regeneration by harnessing the odontogenic program. As a key event of tooth morphogenesis, mesenchymal condensation dictates dental tissue formation and patterning through cellular self-organization and signaling interaction with the epithelium, which provides a representative to decipher organogenetic mechanisms and can be leveraged for regenerative purposes. In this review, we summarize how mesenchymal condensation spatiotemporally assembles from dental stem cells (DSCs) and sequentially mediates tooth development. We highlight condensation-mimetic engineering efforts and mechanisms based on ex vivo aggregation of DSCs, which have achieved functionally robust and physiologically relevant tooth regeneration after implantation in animals and in humans. The discussion of this aspect will add to the knowledge of development-inspired tissue engineering strategies and will offer benefits to propel clinical organ regeneration.
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Affiliation(s)
- Bing-Dong Sui
- State Key Laboratory of Military Stomatology and National Clinical Research Center for Oral Diseases and Shaanxi International Joint Research Center for Oral Diseases, Center for Tissue Engineering, School of Stomatology, Fourth Military Medical University, Xi'an, Shaanxi, China
| | - Chen-Xi Zheng
- State Key Laboratory of Military Stomatology and National Clinical Research Center for Oral Diseases and Shaanxi International Joint Research Center for Oral Diseases, Center for Tissue Engineering, School of Stomatology, Fourth Military Medical University, Xi'an, Shaanxi, China
| | - Wan-Min Zhao
- State Key Laboratory of Military Stomatology and National Clinical Research Center for Oral Diseases and Shaanxi International Joint Research Center for Oral Diseases, Center for Tissue Engineering, School of Stomatology, Fourth Military Medical University, Xi'an, Shaanxi, China
| | - Kun Xuan
- State Key Laboratory of Military Stomatology and National Clinical Research Center for Oral Diseases and Shaanxi International Joint Research Center for Oral Diseases, Center for Tissue Engineering, School of Stomatology, Fourth Military Medical University, Xi'an, Shaanxi, China
- Department of Preventive Dentistry, School of Stomatology, Fourth Military Medical University, Xi'an, Shaanxi, China
| | - Bei Li
- State Key Laboratory of Military Stomatology and National Clinical Research Center for Oral Diseases and Shaanxi International Joint Research Center for Oral Diseases, Center for Tissue Engineering, School of Stomatology, Fourth Military Medical University, Xi'an, Shaanxi, China
| | - Yan Jin
- State Key Laboratory of Military Stomatology and National Clinical Research Center for Oral Diseases and Shaanxi International Joint Research Center for Oral Diseases, Center for Tissue Engineering, School of Stomatology, Fourth Military Medical University, Xi'an, Shaanxi, China
- Xi'an Institute of Tissue Engineering and Regenerative Medicine, Xi'an, Shaanxi, China
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FEM Analysis of Individualized Polymeric 3D Printed Guide for Orthodontic Mini-Implant Insertion as Temporary Crown Support in the Anterior Maxillary Area. Polymers (Basel) 2023; 15:polym15040879. [PMID: 36850161 PMCID: PMC9966125 DOI: 10.3390/polym15040879] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Revised: 01/13/2023] [Accepted: 02/07/2023] [Indexed: 02/12/2023] Open
Abstract
Either due to trauma, extraction or congenital factors, the absence of teeth has aesthetic, functional, financial and psychological consequences. The aim of the current study is to assess an individualized polymeric 3D printed digitally planned surgical guide designed to achieve precision and predictability in non-standard mini-implant orthodontic cases. Twenty-seven patient records with missing anterior teeth were selected from the database of a private clinic in Timisoara, Romania. Based on the analysis of the cases included in the research, a surgical guide for the insertion of mini-implants as provisional crown support was designed. An FEM simulation was performed using the Abaqus numerical analysis software. Finite element simulation revealed the maximum displacements and stresses that occur in the surgical guide. Mini-implant supported provisional crowns can be a simple and low-cost method to increase patient self-esteem and compliance with the orthodontic treatment. Computer aided mechanical simulation is a useful tool in analyzing different polymeric surgical guide designs before being used in clinical situations in order to avoid failure.
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