Contribution of piezocision in oral surgery: the example of the acceleration of orthodontic movements

Introduction Patients are more demanding of short or less invasive interventions. Piezocision responds well to this demand, particularly in the case of piezo-guided corticotomy to accelerate orthodontic movements. Different surgical approaches are described to shorten orthodontic procedures. Corticotomy is a surgical process where osteotomies are realized at the level of the cortical part of the bone. Objective The aim of this work is to review the contribution of piezocision in oral surgery, using as example a review over the current results of piezocision on the acceleration of orthodontic movements. Data sources The articles referenced and used in this article come from the PubMed database. The searched keywords were "piezocision" alone or in combination with "orthodontics". Study selection This search resulted in 44 available articles. Subsequently, 6 randomized controlled trials were selected based on relevance, journal, and publication date. Four Randomized Controlled Trials and two Controlled Clinical Trials were studied. Data extraction The reviewer assessed each article for their relevance and methodology. The 6 studies compared the time savings between conventional orthodontic treatment (control group) and orthodontic treatment combined with piezocision surgery (test group). Data synthesis Piezocision corticotomy reduces the operation and the postoperative period and increases the acceptance of corticotomies and their indications.

Cone beam tomography and panoramic radiography in localization of impacted maxillary canine and detection of root resorption

ntroduction The aim of this study was to evaluate cases of impacted maxillary canines (IMC) using cone beam tomography (CBCT) and panoramic images in an attempt to assess if panoramic radiographs can provide information compatible with CBCT results regarding canine position and root resorption. Methodology Fifty-six impacted maxillary canines from 48 patients were radiographically evaluated. The positions of the canine teeth were classified by Sector localization on panoramic radiographs and the same teeth were also analyzed by KPG on CBCT. Root resorptions in maxillary lateral incisors were also evaluated on CBCT. The relationships between panoramic and CBCT findings were compared by Chi-square test and Fischer’s exact test. Results Statistically significant correlations were found between panoramic Sectors and KPG indexes (p<0.001). KPG index values of 1, 3 and 4 corresponded to the panoramic Sectors 1, 4 and 5, respectively; but KPG index 2 matched the panoramic Sectors 3 and more often 2. Mid-alveolar impaction generally coincided with score 1 for both KPG index and panoramic Sector. In palatally IMC, this score value was generally 2 or 3 for the KPG index and 4 for the panoramic Sector (p≤0.001). Root resorptions in maxillary lateral incisors showed significant differences according to Sector localization and KPG index (p<0.05), namely they coincided with 2 and 3 in Sector evaluation and 2, 3 and 4 in KPG index. Conclusions Sector location on OPG is found to be related to KPG index on CBCT, and it can help evaluate mainly certain positions of impacted canines; thus, unnecessary CBCT scans are not requested.

Selecting an appropriate occlusal scheme when fabricating implant- supported fixed dental prostheses: a systematic review

Background Dental implants are ankylosed in the bone without a periodontal ligament resulting in a lack of micro-mobility during chewing. Consequently, occlusion with dental implants may be at greater risk, specifically when the teeth come into contact in lateral excursive movements. Objective A systematic review of the literature was performed to identify occlusal concepts that were most favorable for implant-retained fixed restorations. Data Sources A search of the literature was conducted using PubMed and EndNote literature online software databases. Keywords were used to assist in the identification of the literature. Study Selection The literature search identified 49 articles using PubMed and 33 articles using the author created EndNote database. Data Extraction Two occlusal concepts were identified, namely mutually protected occlusion and group function unilateral occlusion. None of the articles demonstrated clear scientific evidence to identify superiority of one concept over the other. Data Synthesis Based upon the systematic review of the literature, no scientific evidence was identified favoring any specific occlusal concept.

A multidisciplinary approach for the rehabilitation of a patient with chondrosarcoma: prosthetically-driven digital workflow for maxillary reconstruction and implant treatment

Aim To describe a comprehensive digital therapy oriented towards the final restoration for treating an oral maxillofacial defect caused by maxillary chondrosarcoma. Summary The prosthetically-driven multidisciplinary approach was applied to achieve perfectly functional-aesthetic reconstruction for a male patient with maxillary chondrosarcoma. The complete tumor resection was ensured by the design of virtual osteotomy and surgical guide plate. A reverse engineering technique was used to reconstruct the bone defect in the maxillary aesthetic area, which offered reference for a three-dimensional printing guide plate to shape and fix the free vascularized iliac bone flap. On the solid basis of previous treatment, the implant placement was performed under the guidance of the prosthetic-driven implant plate. Vestibular extension and tissue graft were performed to increase keratinized gingiva width to improve implant-supported fixed prosthesis effect. Key learning points 1. A multidisciplinary approach including maxillofacial surgery, prosthodontic and periodontal treatment can provide better esthetic and functional results for complex rehabilitation of a patient with oral maxillofacial defect. 2. Predictability of maxillary reconstruction and implant restoration can be increased with prosthetic-driven treatment plan. 3. Applying preoperative virtual design and personalized guide plate is beneficial to achieve an ideal outline of reconstructed upper jaw. 4. Obtaining comprehensive aesthetic parameters of the expected restoration is one of the key principles of upper anterior teeth rehabilitation. 5. Digital technology provides an opportunity for consistency between the primary treatment design and the final restoration outcome.

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Condylographic recording of masticatory function: explorative study on occlusal parameters and chewing performance with natural food and a standard food model

Introduction Loss of teeth defines oral health status and chewing abilities. Caries and periodontal disease have been associated with systemic diseases, however they may contribute to cognitive impairment too. Mastication assessment appears to possess broad significance, and is needed to create background knowledge for chewing harmony. The aim of this study was to evaluate chewing performance and the characteristics of condylographic recordings, during mastication of Natural Food (NF) and a Standard Food Model (SFM), in subjects with different occlusal parameters. Methodology Twenty-three adult subjects’ mastication was assessed with a standardized recording protocol, when chewing onto SFM and NF in three different textures. Detailed occlusal characteristics, condylographic recording data and condylographic patterns during mastication were all analyzed and compared. Results Bilateral Crossbites, Missing Molars and Asymmetric Molar Class were related to higher disharmony and transversal displacement during chewing. Missing and unreplaced molars showed dysfunctional patterns and so did worn out occlusal surfaces. Molar Class alone did not prove to be a useful predictor in chewing test results. Conclusion Increasing evidence indicates that oral health has an impact on Individual and Public Health. It is important to understand that oral health and its functional status are to be maintained during one’s lifetime, and that preventive, therapeutic measures at all ages should have a common functional target to grant neurobiological health as well as nutritional goals of Mastication. Further studies are needed to better understand the relevance of additional parameters such as Occlusal Plane Inclination, Curve of Spee, and three-dimensional asymmetries.