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Original Research Article
ABSTRACT
Introduction: The retromolar area is a commonly utilized donor site for autogenous bone grafts in oral and maxillofacial surgery. However, the close proximity of the mandibular canal (MC) poses a risk of neurovascular injury. A thorough understanding of anatomical variations in the position of the MC with respect to sex and age is essential to ensure safe surgical interventions. This study aimed to assess the position of the MC using cone-beam computed tomography
(CBCT) and to identify potential safe zones for bone harvesting in the retromolar region. Materials and Methods: A total of 100 CBCT scans were analyzed. Key measurements included the vertical distance from the cementoenamel junction to the MC, canal depth at the transition zone between the mandibular ramus and body, and the buccal bone thickness overlying the MC. The data were categorized by sex and age group and statistically compared. Results: Male subjects demonstrated significantly greater buccal bone thickness (mean difference: 1.5 mm) and canal depth compared to females. Younger individuals (Group 1) presented with increased bone thickness and greater canal depth at the level of the first molar. At the second molar level, canal depth was significantly higher in males. Conclusion: The transition zone between the mandibular ramus and body emerges as the most favorable area for safe retromolar bone harvesting, owing to its increased canal depth and lingual positioning of the MC. However, no absolute safe zone was identified, underscoring the importance of patient-specific radiological assessment prior to grafting procedures.
Original Research Article
ABSTRACT
The discrepancy between the Centric Relation (CR) position and the Maximum Intercuspation (MI) position is known as centric slide. This happens in occasions where the occlusion is not stable in the CR position and a displacement towards the more stable MI is generated, it differs a lot depending on the clinical use, most authors are in favor of the CR in the planning of occlusal rehabilitation and orthodontics. For this reason, it was decided to provide a retrospective study correlating the amount of condylar distraction prior to orthodontic treatment to analyze whether the hyperdivergent or hypodivergent facial pattern presents a greater amount of distraction in the 3 axial dimensions. The study was conducted by reviewing patient records from the orthodontic postgraduate program at the Mexicali School of Dentistry, which treats adolescents and adults. Subjects were initially selected based on age, followed by Jarabak cephalometric measurements of facial-skeletal characteristics to generate 2 matched groups of 10 subjects each: dolichofacial pattern and brachyfacial pattern. The final sample selected consisted of 20 patients between the ages of 14 and 32 years, with a mean age of 21.25 years. The data obtained from the present study conclude that the facial biotype where the greatest condylar distraction was observed in terms of the three axes; vertical, horizontal and transversal prior to orthodontic treatment, was in the dolichofacial pattern.
ABSTRACT
Flabby ridges are a common challenge in the prosthetic rehabilitation of edentulous patients. These mobile, hyperplastic tissues compromise denture stability and retention, leading to patient discomfort and functional limitations. This case report describes the management of an 81-year-old edentulous patient presenting with flabby maxillary tissues. The proposed treatment included a combined surgical and prosthetic approach. A specific impression technique was used to accurately record the flabby tissues with minimal displacement, employing selective pressure. Surgical intervention involved vestibuloplasty and excision of the hyperplastic mucosa, guided by a transparent duplicate of the prosthesis serving as a surgical guide. Post-surgical stabilization was achieved using a tissue conditioner applied to the final prosthesis, which was placed immediately after surgery. The healing process was monitored at regular intervals, and satisfactory outcomes were obtained with prosthesis stability, and patient satisfaction. This case illustrates the value of a multidisciplinary approach combining careful diagnosis, patient-specific impression techniques, and surgical precision to manage flabby ridges effectively and restore prosthetic function in edentulous patients.
ABSTRACT
This is the case of a 60-year-old patient who required implant rehabilitation in the posterior sector of the maxilla. Given the presence of an atrophic bone ridge, a two-stage surgical approach was chosen. In the first phase, post-extraction alveolar preservation of tooth #16 was performed using the Bartee technique, placing a bone graft in the alveolus and covering it with a non-resorbable polytetrafluoroethylene (PTFE) membrane to maintain graft stability. Closure was achieved with a 5-0 nylon cross suture. Seven months following the preservation and after a computed tomographic evaluation (CBCT), a vertical deficiency of the bone crest was identified that required a maxillary sinus elevation using the lateral window technique. The lateral sinus wall was accessed with piezoelectric instruments, a bony window was created, and the sinus membrane was carefully elevated. Bone graft material covered with a resorbable membrane was placed in the resulting space to facilitate healing and stability of the graft. This case highlights the importance of sequential management of atrophic ridge bone as a key factor in optimizing bone volume and enabling predictable dental implant placement, especially in anatomically compromised posterior maxillary regions.
ABSTRACT
Introduction: Lingual gingival recession is an uncommon condition that can lead to dentin hypersensitivity, impaired oral hygiene, and a risk of progression, including root surface exposure, clinical attachment loss, and reduction of keratinized mucosa width. Due to the anatomical complexity of the lingual area, its treatment poses a significant challenge. Currently, there are no standardized surgical protocols specifically designed for this condition, and the literature on the topic remains limited. Objective: To achieve root coverage of lingual gingival recessions using a minimally invasive full-thickness tunneling technique combined with a subepithelial connective tissue graft and coronal advancement of the flap. Case Report: A 35-year-old male patient, ASA I, presented with RT1-type lingual gingival recessions in teeth 33 to 43. The treatment involved a full thickness tunneling technique with a subepithelial connective tissue graft and coronal flap advancement. Complete root coverage was achieved, along with increased gingival thickness and resolution of dentin hypersensitivity. Conclusion: The full-thickness tunneling technique combined with a connective tissue graft represents a safe and effective treatment option for the management of lingual gingival recessions.
ABSTRACT
After tooth loss, the alveolar ridge collapses. Tooth absence often involves defects in soft tissue and hard tissue thickness. Localized defects in alveolar ridge are often found in partially edentulous patients. Soft tissue augmentation procedures have been developed. This case study presents a 50-year-old female patient who sought rehabilitation of a missing maxillary fisrt premolar (tooth 24) lost due to trauma. After diagnosing periodontal health and confirming the absence of tooth 24 through clinical and radiographic examinations, a comprehensive treatment plan was developed. The initial periodontal phase involved biofilm control and mechanical debridement, followed by a re-evaluation after two weeks, confirming periodontal health. The surgical phase included soft tissue management using the roll-flap technique after guided implant placement using a Straumann Bone Level Tapered implant (4.1mm x 10mm). A provisional restoration was placed to sculpt the emergence profile over four months. The technique resulted in excellent implant stability, that improved gingival thickness and contour.
ABSTRACT
A rare adenomatoid odontogenic tumor (AOT) was reported by a young 14-year-old female student that was associated with missing teeth. The patient did not have any significant medical or dental abnormalities except for a swelling in the right side of the face. Radiographic investigations showed a mixed radiolucent and radiopaque lesion associated with few missing teeth. The maxillary sinus was obliterated. The lesion was surgically excised, and a histopathological examination confirmed the diagnosis of AOT. The patient was later successfully rehabilitated with a removable partial prosthesis.