Bony Cuts Research Articles

A histologic evaluation of bone response to bur cutting with and without water coolant

Thirty-six bony cuts were made in the lateral aspect of the mandibles of mongrel dogs. Irrigation was employed in eighteen cuts, while the remaining eighteen were cut without irrigation. Histologic specimens were obtained at 1 hour, 1 day, 3 days, 1 week, and 3 weeks. Early specimens showed marked clot retraction from the bony walls in the nonirrigated cuts, while irrigated cuts demonstrated more firmly adherent and better organized clots. In later specimens, bone formation was less mature in the defects made without irrigation. inflammation and necrosis of bone were minimal or absent in all sections. Defects made without irrigation exhibited delayed healing in this study.

Prosthetic management of the maxillectomy patient

If maximal preservation of appearance and function are to be achieved for the maxillectomy patient, preoperative dental impressions should be obtained, and clear communication should be established between the surgeon and the prosthodontist. The immediate surgical splint, which can be used for edentulous as well as dentulous patients, provides numerous advantages for the patient and the surgeon. Surgical procedures that enhance the fit and comfort of a prosthesis include (1) making the mucosal incision 0.5 cm lateral to the bony cut, (2) extracting the first tooth on the resected side before making the bony cut, (3) preserving the premaxillary segment, (4) creating a skin-graft mucosal-scar band, (5) removing the entire velum when the surgical procedure requires resection of more than one-half of the velum, and (6) evaluating the possible removal of the coronoid process.

Modification of the muco-periosteal flap design in anterior maxillary osteotomies

A modification of the mucoperiosteal flap planning for anterior maxillary osteotomy operations is suggested. This approach involves a total reflection of the labial mucoperiosteal flap, with the advantages of direct vision of the operative field thus providing easy and precise execution of the operative bony cuts, avoiding damage to the adjacent teeth and reduction of operating time. Sufficient blood supply to the mobilised segment is maintained through the palatal blood vessels. Corrective periodontal surgery may also be carried out at the same time.

Osseous healing in dog mandibles with and without decortication

T he most widely accepted and frequently used technique for ~&cd correction of mandibular prognathism is the performance of bilateral vertical osteotomies of the mandibular rami. Caldwell and Letterman1 advocated starting the bony incision at the lowest point of the sigmoid notches inferiorly, passing over the lateral aspects of the mandibular foramina, and ending at the inferior border of the mandible. They decorticated the lateral aspect of the distal fragments and drilled holes t,hrough both cortices of the proximal fragments, a,fter which they lapped the proximal over the distal fragments and wired the segments together securely. Robinson, 2a 3 Hinds4 and Thomas5 describe similar procedures in which the bony cuts are made from the sigmoid notches down to hhe gonial angles and the fragments are overlapped without decortication. Osseous healing occurs with either method, but there is no evidence in the literature to demonstrate which leads to quicker healing. The opinions of oral surgeons regarding healing are derived from clinical experience. For this reason, it seemed desirable to make a direct comparison of the healing of mandibles approximated in the two ways described above.