Resorption of grafted alveolar bone associated with abnormal dental follicle: is it a rare incident or not?
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Biomedical subjects
Publications and source records attributed to M E el Deeb.
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An electric pulp tester (EPT) was used to evaluate the pulpal response of erupted canines in 75 patients: 16 patients with unilateral cleft palate who received autogenous bone grafts to correct their alveolar cleft defects before canine eruption; 35 patients without cleft palate whose canines erupted spontaneously, but who required orthodontic treatment for alignment; and 24 patients without clefts whose canines required surgical uncovering and orthodontic assistance for eruption. Thirty-one percent of the erupted canines in the patients with grafted unilateral clefts did not respond to EPT, whereas all canines in the contralateral noncleft side responded to EPT. There was no clinical or radiographic evidence of pulpal pathosis of the canines that had erupted through the grafted alveolar clefts. However, these teeth had a high incidence of nonresponsiveness to pulp stimulation, therefore necessitating close follow-up in case they show eventual signs of pulpal degeneration that may require endodontic intervention.
Porous hydroxylapatite (PHA) blocks and granules were used in the augmentation of 30 maxillary and mandibular ridges in 28 patients. The postoperative evaluation period was 2 years in all cases. The patients were evaluated clinically and radiographically, and by patient questionnaires. An increased incidence of dehiscence was noted with the blocks as compared with the granules. Overall prosthodontic assessment showed 95% improvement among the granule cases when compared with the preoperative ridge, and 88% improvement noted among the block cases. Patient rating of their general satisfaction with their dentures showed 82% improvement in the granule patients, and 55% in the block cases. Radiographically, the granules showed an average decrease of 8%. The results of this study show that PHA granules can be used as satisfactory alveolar ridge augmentation material, while the blocks show an increased number of complications and should be used only in very selected cases.
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The purpose of this study was to evaluate the use of nonporous hydroxylapatite (HA) granules as an extracranial and extranasal augmentation material in dogs. Clinical evaluation revealed that the HA granules became stable within 6 weeks and lost some of the augmented height. Histologic evaluation revealed no evidence of inflammation, bone resorption, or bone formation; also the granules were separated from other granules and the cranial surface by a layer of collagen fibers. This study concluded that nonporous HA granules are a practical extracranial and extranasal augmentation material, but its final augmentation contour is difficult to predict and control because of the consistency of the material. Either researchers need to develop a better method to stabilize HA granules in extracranial and extranasal applications or they need access to an HA block material that maintains better augmented contour.