Clinical patterns, causes, and treatment of torus palatinus

There are two types of tori, including torus palatinus and torus mandibularis. Evidence shows that these lesions usually progress slowly, and a spontaneous growth stop is usually another characteristic. Affected patients are usually asymptomatic. However, symptoms might be reported in edentulous patients and cases when the lesion is huge. In the present study, we elaborated on the causes, clinical patterns, and treatment of torus palatinus. The etiology of the condition is unclear, and different theories were reported in the literature, suggesting that the etiology of these cases is usually attributed to environmental and genetic predisposition. It has been defined as a benign tumor that presents in the maxillary bone and is usually asymptomatic. Therefore, the diagnosis of the condition is usually easy. However, it is recommended to conduct a differential diagnosis with other relevant malignant lesions in this area. Surgical interventions are not usually needed as the condition is usually discovered accidentally. However, in cases of tori-related prosthetic or functional discomfort, surgery can be conducted.

Anatomical Patterns of the Nasopalatine Canal and Incisive Foramen in an African Setting – a Cross-sectional Study

Purpose: Surgical procedures revolving around the anterior maxilla are of great interest due to their debilitating facial aesthetics and nerve injury effects if complications arise. Hence, sufficient knowledge concerning the morphology and morphometry of the nasopalatine canal (NPC) and incisive foramen (IF) is necessary to prevent such complications from arising. Materials and Methods: Measurements of the NPC and the IF were carried out on 150 CBCT scans. The maxillary bone thickness anterior to the NPC was measured at 3 levels. Independent t-test and chi-square test were performed to determine the presence of sexual dimorphism. Results: The presence of one Stenson’s foramen was most prevalent. The mean length of NPC was 13.21 ± 3.25 mm with significantly longer canals in males. The most prevalent shape of NPC was cylindrical in sagittal view and a single canal in coronal view. The mean angulation of NPC was 118.42° to the horizontal plane. The average dimensions of the IF were 3.53 mm and 3.07 mm in the anteroposterior and mediolateral diameter respectively while the most common shape was round. The anterior maxillary bone was thicker in males and generally reduced in thickness from the anterior nasal spine superiorly towards the alveolar crest inferiorly. Conclusion: This study highlights the anatomical characteristics of the NPC and IF, with significant sexual dimorphism observed regarding the number of Stenson’s foramina, length of NPC, shapes of the NPC and IF as well as alveolar bone thickness anterior to NPC.

Fluid Dynamic Transcrestal Sinus Floor Elevation Using a New Surgical Instrument, Flusilift and Hyaluronic Acid as Only Biomaterial: A Case Report

Despite validated surgical techniques and the development of biomaterials, the procedures aimed at increasing the maxillary bone volume by sinus floor elevation have complications with various degrees of relevance. The perforation of the Schneiderian membrane is one of the most frequent events while performing the detachment of the membrane and it can increase the risk of iatrogenic sinusitis, impairment of functional homeostasis, dispersion of the graft material in the antral cavity as well as its bacterial colonization with a subsequential failure of the procedure. This report presents a case where transcrestal sinus lift was performed using Flusilift (Sweden & Martina, Due Carrare PD), a new instrument that allows fluid dynamic elevation of the sinus floor using saline solution to detach the Schneider’s membrane in an atraumatic way without using a sinus elevator and obtain an adequate alveolar ridge regeneration using hyaluronic acid in gel formulation to support an implant placement. Hyaluronic acid seems to play a key role in wound healing and contributes to a faster bone neoformation in bone regeneration procedures.

Application of Recombinant Human BMP-2 with Bone Marrow Aspirate Concentrate and Platelet-Rich Fibrin in Titanium Mesh for Vertical Maxillary Defect Reconstruction prior to Implant Placement

Recombinant human bone morphogenetic protein 2 (rhBMP-2) is an alternative bone substitute for extensive maxillary bone defects which avoids the disadvantages associated with other grafting materials. This report details a case of a 32-year-old female with a severe vertical and horizontal maxillary bony defect that developed after tumor removal. She underwent two unsuccessful regenerative surgeries with an iliac bone graft. Reconstruction of the maxillary defect was planned by offlabel use of rhBMP-2/absorbable collagen sponge (ACS) combined with a bone marrow aspirate concentrate (BMAC) and allograft in a titanium mesh covered in platelet-rich fibrin (PRF). Clinical and radiographic evaluations showed good quality and quantity of bone formation, and she was rehabilitated with dental implants and prosthodontic treatment. Based on this case, the use of rhBMP-2 as a graft material appears encouraging with a satisfying outcome. The present case is aimed at reporting the clinical and radiographic effectiveness of rhBMP-2/ACS in combination with PRF and a titanium mesh for severe maxillary bone defects. Future investigations will be required to ascertain the long-term survival of implants in areas grafted with rhBMP-2.

Examination of the stresses of the implants applied to the atrophic edentulous maxilla on the maxillary bone

Aim: In advanced atrophy of the posterior maxilla, applied zygoma implants increase the success of the surgical procedure by reducing morbidity and procedure time. In our study, using tomographic records, a model with posterior atrophy was obtained in a computer environment, and zygomatic and dental implants in different numbers and localizations were applied to this model. The aim of our study was to choose the most accurate surgical planning according to the stresses arising from the applied forces. Methodology: In our study, one zygoma implant on the right and left in Group 1, two zygoma implants in Group 2, one zygoma implant in Group 3 and one dental implant in the first premolar tooth area, one zygoma implant in Group 4 and one dental implant in the lateral tooth area and one zygoma implant in Group 5 and one dental implant in the lateral and a first premolar tooth area were applied. 150 N were applied vertically to the prosthetic superstructure from the lateral tooth, 1st premolar tooth, 1st molar tooth and 2nd molar tooth. As a result of the applied forces, the maximum stress values ​​in the maxilla molar region were examined by finite element stress analysis. Results: In our study, it was observed that Group 1 had the highest stress value, followed by Group 3. Stress values in Groups 2, 4 and 5 were low and they were measured close to each other. Conclusion: As a result of our study, it was seen that zygomatic and dental implants applied in addition to the zygomatic implant reduce stress and the localization of dental implants affect the stress values. How to cite this article: Gülsün B, Çetindağ A. Examination of the stresses of the implants applied to the atrophic edentulous maxilla on the maxillary bone. Int Dent Res 2021;11(Suppl.1):210-5. https://doi.org/10.5577/intdentres.2021.vol11.suppl1.30 Linguistic Revision: The English in this manuscript has been checked by at least two professional editors, both native speakers of English.

Positional Relationship Between Lacrimal Sac and Skull Base: Implication of Risk of Cerebrospinal Fluid Leakage During Dacryocystorhinostomy

Cerebrospinal fluid (CSF) leakage is a rare but severe complication during dacryocystorhinostomy (DCR). Understanding the details of the anatomy of the lacrimal drainage system and skull base is essential to avoid this complication. We examined the positional relationship between the lacrimal sac and skull base using 16 cadavers (22 sides) and computed tomographic images taken in 81 patients (81 sides). Consequently, the frontal sinus intervened between the lacrimal sac and skull base in 81.8–90.1% of cases. The lacrimal sac fundus and posterior lacrimal crest were far from the skull base/cribriform plate, and the skull base above the lacrimal sac was considerably thick. These results indicate that the risk of skull base injury and following CSF leakage during DCR is extremely low. However, surgeons should be cautious of this complication by indirect injury due to a twisting movement of a bone rongeur applied to the maxillary bone during the creation of a bony window in patients with no interposition of the frontal and ethmoid sinuses between the lacrimal sac and skull base.

DENTOMAXILAR DISCREPANCY AND CROWDING. LITERATURE REVIEW

Dentomaxillary anomalies are alterations in the spatial relationships between teeth teeth and their maxillary bone bases that in most cases “result from a relative discrepancy between the size of the teeth and the bones, regarding the analysis of the discrepancies, we can find that the teeth could be associated with the appearance of diastemas (in case the discrepancy is positive), crowding (when the discrepancy has a negative value) or a discrepancy in tooth size, called a discrepancy of Bolton. This review emphasizes the importance of including these measurements in the diagnosis in order to avoid a result with a poor predictable future.