With two episodes of right retromandibular angle subcutaneous emphysema during right upper molar crown preparation:A case report

BACKGROUND Subcutaneous emphysema is a well-known complication of oral surgery,especially during mandibular wisdom tooth extraction.However,subcutaneous emphysema secondary to dental procedures such as crown preparation is rare.The main symptom of emphysema is swelling and crepitus on palpation.Uncontrolled emphysema may spread along the fascial planes and cause deep space infections or a pneumomediastinum.CASE SUMMARY In this paper,we report a 34-year-old female who underwent upper molar tooth preparation for crowns and subsequently developed extensive subcutaneous emphysema on the retromandibular angle on two different occasions.The treatment plan for this patient involved close observation of the airway,and administration of dexamethasone and antibiotics via intravenous drip or orally.Ice bag compression was quickly applied and medication was prescribed to alleviate discomfort and promote healing.Although the main reason is unclear,the presence of a fissure in the molar is an important clue which may contribute to the development of subcutaneous emphysema during crown preparation.It is imperative for dental professionals to recognize such pre-disposing factors in order to minimize the risk of complications.CONCLUSION This case highlights the need for prompt diagnosis and management of subcutaneous emphysema because of the risk of much more serious complications.Awareness of relatively“benign”subcutaneous emphysema during any dental procedure is critical not only for inexperienced dentists,but also for those who work in rural and remote settings as members of surgical teams.In this study,we review the clinical presentation,mechanism,and differential diagnosis of subcutaneous emphysema.

Correlation between the Bizygomatic Distance and the Width of the Upper Central Incisor in the Cameroonian Melanoderma Adult

Bizygomatic distance is a relevant reference used to assist and to guide the choice of antero superior prosthetic teeth, especially when no information about the natural teeth was available. The aim of the present paper was to determine the distance between the canine tips from a bizygomatic distance and to estimate the width of the upper central incisor in normal-dental-facial indices of Cameroonians. Materials and methods: A cross-sectional study of 900 normal Cameroonians of both sexes was conducted. Measurements of bizygomatic distance, distance between the two upper pointers and the mesio-distal width of the upper central incisor were made with a manual and a digital caliper respectively. The equation for calculating the distance of higher canine pointers from the bizygomatic distance was DCT = 0.081 (BZD) + 26.201. The width prediction of the central incisor was obtained by the following formula: WUCI = 6.252 + 0.019 (BZD) + 0.035(DCT) + 0.062 (Reg cul) + (?0.479) sex. Reg.cul represents the cultural region of origin. Results: Female sex was represented by 56.6% against 43.30% males. The average age was 37± (32 SD) years. The average value of the bizygomatic distance was 130.23 mm, the width of the upper central incisor was 9.39 mm while the distance between the two upper canine pointers was 36.70 mm. Significant correlations between bizygomatic distance, the distance between the two canine pointers, and the width of the upper central incisor were found (P = 0.000). Conclusion: The width of the central incisor and the distance between the two upper canine pointers may be determined by the non-invasively method of the bizygomatic distance in the perspective of choosing the teeth for dental prosthesis.

Class III Reversion with Immediate Complete Denture and Immediate Implant-Retained Overdenture: Case Report

With the increased life expectancy, complete dentures have been used in the treatment of edentulism progressively. It restores stomatognathic system functions, providing improvements in chewing, aesthetics, and phonetics. The aim was to report an oral rehabilitation of a patient with severe aesthetic and functional impairment, with Angle’s class III malocclusion. The patient sought the extension project of the School of Dentistry of the Federal University of Minas Gerais with aesthetic complaints. After clinical and radiographic evaluation, the proposed planning was immediate complete denture maxilla and immediate implant-retained overdenture in mandible. During clinical evaluation it was observed that the patient was Angle’s III. The rehabilitation was performed as proposed and at the end of the treatment, it was possible to revert the class III occlusal pattern to Angle’s I. The excellent maxillomandibular relationship was achieved, which ensured optimal facial aesthetics and functional condition. It was concluded that the immediate complete dentures and immediate implant-retained overdenture might be beneficial for restoring the aesthetics and function of patients with Angle’s class III malocclusion.

Simultaneous Upper and Lower Jaw Extractions, Autogenous Bone Augmentation and Temporary Implant Placement with Immediate Loading

Aims: We expanded the known technique for simultaneously augmenting an atrophic maxilla and placement of immediate provisional implants (IPI), followed by immediate loading by performing surgery in both jaws simultaneously. Feasibility of this new technique, implant survival and success were evaluated as well as prosthetic success. Materials and Methods: All patients undergoing simultaneous bone grafting and IPI placement with immediate loading at our institute between the 1st of June 2016 and the 30th of May 2018 were included and followed up for at least one year postoperatively. Results: 3 patients were followed for a mean period of 25.67 months (20 - 29 months). 33 IPIs were placed. All were immobile at second stage surgery without signs of infection. No provisional bridges were lost and no infections were noted. After second stage surgery, none of these 36 final dental implants were lost. There was some bone loss at one implant. In all patients, good functional and aesthetic results were obtained without any unforeseen complications. This renders the implant survival at 100% and the success rate at 97%. Conclusion: The technique is complex due to the intricate step-by-step process that is required and depends on a dedicated team to ensure a proper workflow. When performed correctly, the protocol shows good and predictable results.

A retrospective study of occlusal reconstruction in patients with old jaw fractures and dentition defects

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 3-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±standard deviation and compared using independent samplet-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.

The evaluation of the carbon fiber post system on restoration of teeth defect in children

Background Post and post-core systems are used to restore extensively damaged teeth. Among these systems, cast alloy post and core, prefabricated threaded alloy post and prefabricated simple alloy post are most frequently applied in China nowadays. In Europe and North America a combined application of the fiber post, resin-core and crown has been applied to restore seriously destructed teeth with satisfactory results in recent years. This study was intended to evaluate the clinical effect of carbon fiber post system on restoration of child anterior tooth defect after root canal therapy, based on 3-5 years＇ observation.

Fatigue cyclic loading test of an auro-galvanoforming ceramic bridge

Background In dental clinics, dentition defects are commonly restored with conventional porcelain-fused-to-metal fixed bridges. However, Ni-Cr alloy ceramic fixed bridges are known to have several drawbacks such as marginal coloration of the neck, low casting precision and, most seriously, poor biocompatibility. These problems could be circumvented by using noble metal ceramic bridges; however, one negative issue related to the conventional noble metal ceramic bridges is its high price due to the use of a large amount of gold for pontic. Therefore, an auro-galvanoforming ceramic bridge would be ideal to retain the advantages of a conventional material, yet reduce the amount of noble metal used. This study aimed to investigate whether any destructive changes occur to the auro-galvanoforming ceramic bridge under a fatigue cyclic loading test. Methods On standard models which the left maxillary first premolar is lost and with the cuspid teeth and the second premolar as the fixed bridge abutment teeth, six maxillary auro-galvanoforming ceramic bridges and six corresponding nichrome ceramic jointed crowns were made as group A, six nichrome ceramic bridges and six corresponding nichrome ceramic jointed crowns were made as group B （control group）. And then all specimens were fixed and tested on a fatigue cyclic loading machine; the changes occurring to the surfaces of occlusal contact with large functional area and to the porcelain-metal interfaces of the nichrome primary copings margins were observed through a scanning electron microscope （SEM）. Results In 120 hours＇ continual observation, none of the specimens had porcelain coating fractures or scraping occurrence and all of the porcelain coatings had been kept intact under sinusoidal cyclic loading with the load range of 120-200 N and frequency of 5 Hz. Conclusions Auro-galvanoforming ceramic bridges exhibited excellent fatigue strength in the fatigue cyclic loading test and may satisfy the clinical demand in theory, while the practical application shall be evaluated by observations in long-term clinical usage.

Clinical follow-up of ceramic bridges with auro-galvanoforming primary coping and Ni-Cr pontic for restoration of dentition defects

Background Alternatives to the conventional auro-galvanoforming ceramic bridge need to be evaluated in long-term longitudinal studies before being recommended for restoration of dentition defects. This study aimed to evaluate the clinical performance of a ceramic bridge with auro-galvanoforming primary coping and Ni-Cr pontic for restoration of dentition defects. Methods In total, 114 ceramic bridges with auro-galvanoforming （primary coping and Ni-Cr pontic） were placed in 112 patients with dentition defects. Among them, 83 bridges in 82 patients were available for follow-up after 7 years. We evaluated marginal integrity, color match, gingival inflammation, fracture of ceramic bridges, and recurrent caries. Results Marginal integrity of the ceramic bridges was perfect in all patients. Most ceramic bridges maintained their original color. Fracture was found in three bridges; the rest were free of fracture, breakage, and loosening. Recurrent abutment caries were not found. Ceramic bridges with auro-galvanoforming （primary coping and Ni-Cr pontic） produced satisfactory clinical outcomes -- equivalent to the conventional porcelain-fused-to-metal restoration. This technique is especially useful for dentition defects of the molar area and is cheaper than restoration with noble metal bridges. Conclusions Ceramic bridges with auro-galvanoforming （primary coping and Ni-Cr pontic） performed well for the restoration of dentition defects during this follow-up period. More studies are warranted to further evaluate this technique as an alternative to the conventional porcelain-fused-to-metal restoration.