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  • Author: Balint Bogozi x
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Open access

Alina Iacob and Bálint Bögözi

Abstract

Background: In the medical literature there are multiple reconstructive procedures for small and medium size defects of the lower lip, but only a few methods for larger defects involving the whole lower lip. Choosing the repairing procedure for larger lower lip defects must take into account two aspects: flap or flaps used should be local flaps, and suture lines should correspond to the natural facial creases or follow the functional lines of different facial aesthetic units. Finally, the flap or flaps should be large enough to restore the entire postexcisional defect. However, the more tissue is lost from the lower lip, the more challenging the reconstruction is from a functional and cosmetic point of view.

Material and methods: During the last 2 years in the Oral and Maxillofacial Surgery Department of the County Emergency Clinical Hospital in Tîrgu Mureș, the unilateral Fujimori technique has been successfully used for the reconstruction of large lower lip defects in 4 patients with extended, neglected squamous cell carcinomas involving almost the whole lower lip tissue. These patients underwent complex surgical and oncological treatment. Surgery was performed in two stages: first, excision of the tumor and immediate lip reconstruction, and then removal of submandibular lymph nodes (level I), in the second stage.

Results: The aesthetic and functional recovery of these patients was very good, with no need of other subsequent surgical corrections.

Conclusions: The postoperative reconstruction of large defects of the lower lip is far from optimal, but it is very important to restore an adequate muscle function, the lip continence and a satisfactory facial appearance.

Open access

Alina Ormenișan, Alina Iacob, Daniel Szava, Balint Bogozi and Adina Coșarcă

Abstract

Introduction: The imaging method of cone beam is an improved, extremely accurate computed tomography applicable in the whole field of dentistry. Due to its ability to locate the exact position of the impacted teeth, CBCT software has an important role in the management of difficult cases of impacted third molar. In some situations, the lower third molar is quite near to the inferior alveolar nerve that the surgical extraction can present a high risk of post-operative sensitive impairs of the skin and mucosa of the lower lip and chin on the same side. Presentation of case series: Our study tried to assess the contribution of CBCT in the pre-operative evaluation and further treatment of patients with impacted third molars in mandibular bone with high risk of inferior alveolar nerve injury. The paper presents three clinical cases showing positive signs on standard OPG, which exhibit indicators of a potential contact between the inferior alveolar nerve and the impacted lower third molars. For an improved exploration Dental CT Scan, DICOM image acquisition program, and 3D reconstruction with a special software were used. Conclusions: The study showed that compared with panoramic radiography, CBCT improve the evaluation of the surgical risk and allow a more accurate planning of surgery.

Open access

Dániel-Tamás Száva, Alina Ormenișan, Emese Markovics, Bálint Bögözi and Krisztina Mártha

Abstract

Background: Inserting dental implants in severely atrophied jawbones is a great challenge for the dental practitioner. There are an increasing number of patients who choose dental implantanchored prosthetic restorations despite compromised bone quality and quantity. There have been numerous attempts in adapting implant design for the atrophic crestal bone. One-piece, needle-type basal implant design is a typical design for these cases. These implants are inserted in the remaining compact bone located in the basal aspect of the jawbones. If high primary stability is achieved, these implants are used for immediate loading protocol. From many points of view, this technique is based on contradictory principles compared to classic implant surgery and loading protocols. The aim of this study was to investigate the long-term success of basal one-piece short-diameter dental implants used for immediate loading protocol.

Materials and methods: A total of 56 dental implants were included in this study. Peri-implant bone loss was measured on orthopantomographs. Bone resorption was measured in millimeters in the first 6 and 12 months of functional loading.

Results: There were no failing implants in this period; average bone resorption was 1.59 mm after 6 months of functional loading and 2.05 mm after 12 months. Bone resorption was slightly higher in the mandible than in the maxilla.

Conclusions: Immediate implant loading protocol might be an attractive solution for fixed fullarch restoration using short-diameter one-stage basal implants, but long-term effects require further investigations.