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Alveoloplasty
The Experts below are selected from a list of 198 Experts worldwide ranked by ideXlab platform
Hwa Sung Chae – 1st expert on this subject based on the ideXlab platform
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Alveolar bone remodeling during maxillary incisor intrusion and retraction
Progress in Orthodontics, 2019Co-Authors: Seok Yoon Hong, Jeong Won Shin, Christine Hong, Vania Chan, Un-bong Baik, Hwa Sung ChaeAbstract:Background Maxillary incisor protrusion is a prevalent dental deformity and is often treated by upper incisor intrusion and retraction. The mechanical loading triggers the resorption and apposition of the bone. Alveolar bone remodeling is expected to follow orthodontic tooth movement in a one-to-one relationship. However, in many cases, the outcomes are different. Alveolar bone might still remain thick causing lip protrusion and other aesthetic problems after treatment. Additional corrective procedures such as Alveoloplasty. On the other hand, if the labial bone becomes too thin, periodontal problems like gingival recession might occur. The unpredictability of the treatment result and the risk of requiring corrective procedures pose significant challenges to both the providers and patients. The aim of this study is to determine factors that can help to predict the alveolar bone reaction before maxillary incisor intrusion and retraction. Methods The cohort included 34 female patients (mean age 25.8 years) who were diagnosed with skeletal class II malocclusion with upper incisor protrusion. These patients underwent extraction and orthodontic treatment with upper incisor intrusion and retraction. Lateral cephalograms at pre-treatment and post-treatment were taken. Linear and angular measurements were analyzed to evaluate the alveolar bone changes based on initial conditions. Results The study found that the relative change, calculated as change in alveolar bone thickness after treatment divided by the initial alveolar thickness, was inversely correlated with the initial thickness. There was a significant increase of labial alveolar bone thickness at 9-mm apical from cementoenamel junction (B3) ( P < 0.05) but no statistically significant change in the thickness at other levels. In addition, the change in angulation between the incisor and alveolar bone was inversely correlated with several initial angulations: between the initial palatal plane and upper incisor angle, between the initial palatal plane and upper incisor labial surface angle, and between the initial palatal plane and bone labial surface angle. On the other hand, the change in labial bone thickness was neither significantly correlated with the initial thickness nor significantly correlated to the amount of retraction. Conclusion The unpredictability of alveolar bone remodeling after upper incisor intrusion and retraction poses significant challenges to treatment planning and patient experience. The study showed that the initial angulation between the incisor and alveolar bone is correlated with the change in angulation after treatment, the initial thickness of the alveolar bone was correlated with the relative change of the alveolar bone thickness (defined as change in thickness after treatment divided by its initial thickness), and the amount of intrusion was correlated with the alveolar bone thickness change at 9-mm apical from the cementoenamel junction after treatment. The results of the present study also revealed that the change in labial alveolar bone thickness was neither significantly correlated with the initial thickness nor significantly correlated to the amount of retraction.
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Alveolar bone remodeling during maxillary incisor intrusion and retraction
Progress in Orthodontics, 2019Co-Authors: Seok Yoon Hong, Jeong Won Shin, Christine Hong, Vania Chan, Un-bong Baik, Hwa Sung ChaeAbstract:Maxillary incisor protrusion is a prevalent dental deformity and is often treated by upper incisor intrusion and retraction. The mechanical loading triggers the resorption and apposition of the bone. Alveolar bone remodeling is expected to follow orthodontic tooth movement in a one-to-one relationship. However, in many cases, the outcomes are different. Alveolar bone might still remain thick causing lip protrusion and other aesthetic problems after treatment. Additional corrective procedures such as Alveoloplasty. On the other hand, if the labial bone becomes too thin, periodontal problems like gingival recession might occur. The unpredictability of the treatment result and the risk of requiring corrective procedures pose significant challenges to both the providers and patients. The aim of this study is to determine factors that can help to predict the alveolar bone reaction before maxillary incisor intrusion and retraction. The cohort included 34 female patients (mean age 25.8 years) who were diagnosed with skeletal class II malocclusion with upper incisor protrusion. These patients underwent extraction and orthodontic treatment with upper incisor intrusion and retraction. Lateral cephalograms at pre-treatment and post-treatment were taken. Linear and angular measurements were analyzed to evaluate the alveolar bone changes based on initial conditions. The study found that the relative change, calculated as change in alveolar bone thickness after treatment divided by the initial alveolar thickness, was inversely correlated with the initial thickness. There was a significant increase of labial alveolar bone thickness at 9-mm apical from cementoenamel junction (B3) (P < 0.05) but no statistically significant change in the thickness at other levels. In addition, the change in angulation between the incisor and alveolar bone was inversely correlated with several initial angulations: between the initial palatal plane and upper incisor angle, between the initial palatal plane and upper incisor labial surface angle, and between the initial palatal plane and bone labial surface angle. On the other hand, the change in labial bone thickness was neither significantly correlated with the initial thickness nor significantly correlated to the amount of retraction. The unpredictability of alveolar bone remodeling after upper incisor intrusion and retraction poses significant challenges to treatment planning and patient experience. The study showed that the initial angulation between the incisor and alveolar bone is correlated with the change in angulation after treatment, the initial thickness of the alveolar bone was correlated with the relative change of the alveolar bone thickness (defined as change in thickness after treatment divided by its initial thickness), and the amount of intrusion was correlated with the alveolar bone thickness change at 9-mm apical from the cementoenamel junction after treatment. The results of the present study also revealed that the change in labial alveolar bone thickness was neither significantly correlated with the initial thickness nor significantly correlated to the amount of retraction.
S C-n Chang – 2nd expert on this subject based on the ideXlab platform
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Periodontal regeneration using ex vivo autologous stem cells engineered to express the BMP-2 gene: an alternative to alveolaplasty
Gene Therapy, 2008Co-Authors: Y-l Chen, P K-t Chen, L-b Jeng, C-s Huang, L-c Yang, H-y Chung, S C-n ChangAbstract:The regeneration of the periodontal attachment apparatus remains clinically challenging because of the involvement of three tissue types and the complexity of their relationship. Human recombinant bone morphogenic protein-2 (rhBMP-2) can accelerate the regeneration of bone and cementum and the insertion of periodontal ligament fibers but may lead to a deranged periodontal relationship, ankylosis and root resorption. This study evaluated a novel approach to regeneration of the periodontal attachment apparatus using a combination of ex vivo autologous bone marrow mesenchymal stem cells (MSCs) engineered by replication-defective adenovirus to express the BMP-2 gene and Pluronic F127 (PF127). Twenty-four periodontal defects were surgically created in 12 New Zealand white rabbits and randomly assigned to three experimental groups with MSCs: the adv BMP-2 group; the adv βgal group; the MSC group and one control group: PF127 only. The regenerated periodontal attachment apparatus was assessed histologically and the total regenerated bone volume was calculated from three-dimensional computed tomography analysis.This approach regenerated not only cementum with Sharpey’s fiber insertion, but also statistically significant quantities of bone, re-establishing a more normal relationship among the components of the regenerated periodontal attachment apparatus, which is beneficial for the maintenance of periodontal health. Ex vivo gene transfer using stem cells as vectors may provide an advantage of slower BMP-2 release, increasing cementogenesis. There is regeneration of the periodontal attachment apparatus, whereas direct usage of the protein (rhBMP-2) yields unhinged periodontal relationship. Thus, this approach may represent an alternative means for periodontal alveolar bone graft in clinical settings.
Avinash S Bidra – 3rd expert on this subject based on the ideXlab platform
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Consequences of insufficient treatment planning for flapless implant surgery for a mandibular overdenture: A clinical report
Journal of Prosthetic Dentistry, 2011Co-Authors: Avinash S BidraAbstract:Flapless implant surgery is an emerging modality of treatment in implant dentistry that is known to offer several advantages. However, this procedure is inadvisable for situations where there is an absence of labial/buccal bone, reduced width of alveolar ridge, or a need for Alveoloplasty to create prosthetic space. This clinical report describes the biologic and prosthodontic consequences of placing implants through flapless surgery and without preoperative treatment planning. Importance of proper treatment planning and a detailed discussion of prosthetic/restorative space analysis are discussed.
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surgical and prosthodontic consequences of inadequate treatment planning for fixed implant supported prosthesis in the edentulous mandible
Journal of Oral and Maxillofacial Surgery, 2010Co-Authors: Avinash S BidraAbstract:Treatment planning for mandibular fixed implant-supported prostheses requires close communication between surgeons and restorative dentists. Improper implant positioning can result in significant difficulty for patient comfort and fabrication of a functional prosthesis. This case report describes the consequences of placing implants with no preoperative planning with regard to the implant position based on the final restorative plan. A 46-year-old male had all of his remaining maxillary and mandibular teeth extracted, and had 5 implants placed immediately in the interforaminal region of the mandible with the intent of providing a fixed prosthesis. Six weeks later, the patient was referred for prosthodontic care. The patient had no prostheses at that time and was in severe pain due to impingement of the lower lip by one of the implants. The implants were deemed to be in unfavorable positions and angulations. Thereafter, the case was treatment-planned systematically, requiring 2 additional surgical procedures—removal of one of the implants and Alveoloplasty of posterior mandible for creation of space for prosthetic components. The remaining 4 implants with unfavorable angulations posed a prosthodontic challenge for fabrication of a prosthesis. The situation was eventually managed by fabrication of a screw-retained metal-resin fixed prosthesis over the remaining 4 implants. Although the situation was managed successfully, it resulted in increased time and treatment expenses, additional appointments, and elaborative steps for correction. Prosthodontics-driven treatment planning concepts and guidelines for prevention of such situations are described in this article.