Oral Maxillofac Research Articles

Prediction of Early and Late Complications after Oral Mucosal Graft Harvesting: Multivariable Analysis from a Cohort of 553 Consecutive Patients

We investigated the early and late complications after oral mucosal graft harvesting, and reported the independent predictors of outcome via multivariable analysis. We performed a retrospective descriptive study of 553 patients from whom an oral mucosa graft was harvested for urethroplasty from single or bilateral cheeks. Patients who underwent oral mucosa harvesting from the lip, the tongue or from the cheek and lip at the same time were excluded from analysis. The oral graft was harvested in an ovoid shape with closure of the wound. Postoperative early and late complications were investigated using a self-administered, nonvalidated, semiquantitative questionnaire. There were 6 questions on early complications, and 13 questions investigated late complications and patient satisfaction. Descriptive statistics of categorical variables focused on frequencies and proportions. Univariable and multivariable analyses were used to predict early and late dissatisfaction of patients. Bleeding was reported in 3.4% of patients. Overall 53.2% of patients did not report any pain and 36.3% reported no swelling. Late complications analysis showed that 95.5% of patients declared that the surgical closure of the wound did not cause any difficulty in opening the mouth or problems with smiling (98.2%) and/or dry mouth (95.8%). Overall 98.2% of patients were satisfied with the procedure. Univariable and multivariable analyses revealed that bilateral graft harvesting was the only significant predictor of patient dissatisfaction (OR 2.85, p = 0.01 and OR 2.72, p = 0.02; respectively). Harvesting the oral mucosa ovoid graft from a single cheek with closure of the wound is a safe procedure with high rates of patient satisfaction.

Botulinum toxin type A: implications in wound healing, facial cutaneous scarring, and cleft lip repair

Botulinum toxin is a neurotoxin that has been utilized to induce chemo-denervation of muscles. Cutaneous wounds represent a special situation in which the tensile forces applied by these muscles on wound edges might have deleterious effects on the healing process. The aim of this review was to investigate such an effect and to review other mechanisms this toxin might have on the healing process. We also reviewed the role of botulinum toxin in the management of hypertrophic scars and cleft lip repair.

The importance of complementary exams for the diagnosis of temporomandibular joint disorders

The importance of complementary exams for the diagnosis of temporomandibular joint disorders

Short Implants Might be a Predictable Treatment Alternative to Long Implants Which Often Require Additional Augmentation Procedures

Article Title and Bibliographic Information Survival of short dental implants for treatment of posterior partial edentulism: a systematic review. Atieh MA, Zadeh H, Stanford CM, Cooper LF. Int J Oral Maxillofac Implants 2012;27(6):1323-31. Reviewers Sung-Kiang Chuang, DMD, MD, DMSc, Chun-Teh Lee, DDS, MS Purpose/Question The purpose of this study was to evaluate whether there was a significant difference in the survival of short implants (≤8.5 mm) and longer implants for the management of posterior partial edentulism Source of Funding Information not available (The authors declared no conflicts of interest in the acknowledgment section) Type of Study/Design Systematic review with meta-analysis of data Level of Evidence Level 2: Limited-quality, patient-oriented evidence Strength of Recommendation Grade Grade B: Inconsistent or limited-quality patient-oriented evidence

Evaluation of chemotherapy benefit in patients who continue to smoke: Preliminary experience.

e12534 Background: The smoking continuation during chemotherapy treatments affects positive results. As reported for instance by Mazza et al. in the review "Taking care of smoker cancer patients: a review and some recommendations" (Ann Oncol. 21(7):1404-9, 2010), nicotin seems to inhibit the potential of cisplatin in determining tumor cell death (Int J Oral Maxillofac Surg 2007; 36: 739–744), while some new anti-cancer drugs can give an excellent response only in people who have never smoked (Proc Natl Acad Sci U S A 2004; 101(36): 13306–13311). Methods: It is an observational monoistitutional analysis. The analysis covered 886 patients undergoing chemotherapy at the Veneto Oncology Institute of Padua during an observation period of six years (from 2006 to 2011). We have been taken into account all patients included in the Onco-AIFA national register for the monitoring of innovative anticancer drugs, focusing on the three big killer diseases: colon and rectum cancer (40% of the sample analyzed), lung cancer (36%) and breast cancer (24%). The Kaplen-Meier method was used to analyze the overall survival data. Results: Among the information collected, the aspect of smoking was taken into account: it was possible to extract the data for about half of the patients (n = 473), 48% of whom were non-smokers, 31% were smokers and the remaining 21% ex-smokers. Although there are three types of cancer that have three different natural histories, the study revealed that being a smoker or ex-smoker is a determinant of the OS of patients: in particular non-smokers showed a median survival of 27 months, ex-smokers of 18 and smokers of 13 (p <0.001). Conclusions: It should be noted then, that in the entirety of the sample smoking continuation reduces survival. Therefore, in addition to an increased risk, there is a reduced benefit in terms of clinical conditions and response since tobacco reduces the effects of anticancer chemotherapy. That being so, although the data are still preliminary, every effort must be made to ensure that a patient stops smoking during chemotherapy treatments as it has been demonstrated that the ex-smokers live an average 6 months longer.

Screw-wire osteo-traction (SWOT) in the reduction and fixation of frontonasal dysjunction in Le Fort II/III upper mid-facial fractures

Frontonasal dysjunction may occur as a component of Le Fort II or III fractures. Frontonasal reduction and fixation in upper midfacial fractures using a bicoronal flap for access is essential for effective management of the fracture, 1 Prein J. Manual of internal fixation in the cranio-facial skeleton. Springer, Berlin1998: 95-147 Crossref Google Scholar but conventional anatomical reduction and stability can be difficult to achieve before osteosynthesis. Screw-wire osteo-traction (SWOT) is a useful adjunctive method to secure precise anatomical reduction and maintain stability during osteosynthesis. A few published reports describe its use in the management of lower midfacial fractures, 2 Kim M.G. Yoo R.E. Chang H. et al. An intermaxillary fixation screw traction wire: an aid for facial bone fracture repair. Ann Plast Surg. 2009; 63: 71-73 Crossref PubMed Scopus (5) Google Scholar , 3 Moon S.H. Lee J.H. Oh D. et al. Reduction of zygomatic fracture segment with intermaxillary fixation screw. J Craniofac Surg. 2012; 23: 842-844 Crossref PubMed Scopus (6) Google Scholar , 4 O’Regan B, Devine M. Screw-wire traction technique. An aid to anatomical reduction of multi-segment mid-facial fractures. Br J Oral Maxillofac Surg, http://dx.doi.org/10.1016/j.bjoms.2012.10.016, in press. Google Scholar but we know of no reports of it being used in the management of frontonasal dysjunction in upper midfacial fractures.

Differential diagnosis of the complex regional pain syndrome

Differential diagnosis of the complex regional pain syndrome

Occlusal-view photograph of a cement-retained implant prosthesis as a permanent guide for access-hole preparation

Implant-supported fixed restorations can be screw-retained or cement-retained. Pjetursson et al 1 Pjetursson BE Brägger U Lang NP Zwahlen M Comparison of survival and complication rates of tooth-supported fixed dental prostheses (FDPs) and implant-supported FDPs and single crowns (SCs). Clin Oral Implants Res. 2007; 18: 97-113 Crossref PubMed Scopus (560) Google Scholar and Papaspyridakos et al 2 Papaspyridakos P Chen CJ Chuang SK Weber HP Gallucci GO A systematic review of biologic and technical complications with fixed implant rehabilitations for edentulous patients. Int J Oral Maxillofac Implants. 2012; 27: 102-110 PubMed Google Scholar observed that the most frequent technical complications with implant restorations were fracture or chipping of the veneer ceramic, abutment or screw loosening, screw fracture, and loss of retention. These complications necessitate the restorations to be removed, repaired, and reinserted as needed. For removal of cement-retained implant prostheses, it is necessary to access the abutment from the occlusal surface. Locating the site of entry for access-hole preparation to the abutment-screw has been described by several authors. 3 Doerr J Simplified technique for retrieving cemented implant restorations. J Prosthet Dent. 2002; 88: 352-353 Abstract Full Text Full Text PDF PubMed Scopus (41) Google Scholar , 4 Tarlow JL A modified technique to locate the abutment screw access opening of a cemented implant-supported restoration. J Prosthet Dent. 2012; 108: 58-59 Abstract Full Text Full Text PDF PubMed Scopus (17) Google Scholar , 5 Hill EE A simple, permanent index for abutment screw access for cemented implant-supported crowns. J Prosthet Dent. 2007; 97: 313-314 Abstract Full Text Full Text PDF PubMed Scopus (12) Google Scholar , 6 Schwedhelm ER Raigrodski AJ A technique for locating implant abutment screws of posterior cement-retained metal-ceramic restorations with ceramic occlusal surfaces. J Prosthet Dent. 2006; 95: 165-167 Abstract Full Text Full Text PDF PubMed Scopus (45) Google Scholar , 7 Figueras-Alvarez O Cedeño R Cano-Batalla J Cabratosa-Termes J A method for registering the abutment screw position of cement-retained implant restorations. J Prosthet Dent. 2010; 104: 60-62 Abstract Full Text Full Text PDF PubMed Scopus (26) Google Scholar Doerr 3 Doerr J Simplified technique for retrieving cemented implant restorations. J Prosthet Dent. 2002; 88: 352-353 Abstract Full Text Full Text PDF PubMed Scopus (41) Google Scholar and Tarlow 4 Tarlow JL A modified technique to locate the abutment screw access opening of a cemented implant-supported restoration. J Prosthet Dent. 2012; 108: 58-59 Abstract Full Text Full Text PDF PubMed Scopus (17) Google Scholar explained an access-gaining technique by using a vacuum-formed matrix with holes corresponding to abutment positions in which the clinician must preserve the original casts or a vacuum-formed matrix. Hill 5 Hill EE A simple, permanent index for abutment screw access for cemented implant-supported crowns. J Prosthet Dent. 2007; 97: 313-314 Abstract Full Text Full Text PDF PubMed Scopus (12) Google Scholar described preservation of a putty index for the same reason. Schwedhelm and Raigrodski 6 Schwedhelm ER Raigrodski AJ A technique for locating implant abutment screws of posterior cement-retained metal-ceramic restorations with ceramic occlusal surfaces. J Prosthet Dent. 2006; 95: 165-167 Abstract Full Text Full Text PDF PubMed Scopus (45) Google Scholar described a technique which requires placement of a small ceramic stain on the occlusal surface of the restoration during fabrication. Figueras-Alvarez et al 7 Figueras-Alvarez O Cedeño R Cano-Batalla J Cabratosa-Termes J A method for registering the abutment screw position of cement-retained implant restorations. J Prosthet Dent. 2010; 104: 60-62 Abstract Full Text Full Text PDF PubMed Scopus (26) Google Scholar advocated the preservation of a photograph in a computer file as part of the patient's permanent record; however, it involved using complex editing software to superpose 2 digital photographs of the definitive cast with and without the restoration.

Residents' journal review

Residents' journal review

Associated risk factors and prevention of bisphosphonate-induced osteonecrosis of the jaw

Bisphosphonates (BPs), in the past erroneously referred to as diphosphonates, were first synthesized in Germany, in 1865. BPs are stable analogs of pyrophosphate that are naturally occurring modulators of bone metabolism and have been synthesized and used since the 19th century; However, their in-vitro ability to inhibit the precipitation of calcium phosphate was applied clinically in the 1960s. Since then, the main clinical application was in the treatment of certain resorptive bone diseases (osteoporosis, Paget’s disease, and hypercalcemia associated with certain malignancies such as multiple myeloma and bone metastasis from the breast or prostate). Later on, in 2002, the Food and Drug Administration reviewed some cases of osteonecrosis of the jaw in cancer patients who had undergone BP therapy. In 2003, Marx introduced this clinical condition in the medical literature. BP-induced osteonecrosis of the jaw is related to the development of avascular necrosis or dead jaw bones and cannot easily be treated with conventional medical and/or surgical intervention. Because of the poor treatment outcomes, many studies focused on its preventive measures. In this study, we review the different risk factors and associated preventive measures against BRONJ. Egypt J Oral Maxillofac Surg 4:23–26 c 2013 The Egyptian Association of Oral & Maxillofacial Surgeons.

Lag Screw Fixation of Mandibular Symphysis Fractures Is Associated With Fewer Post-Operative Complications Compared to Plates and Screws

Article Title and Bibliographic Information Is lag screw fixation superior to plate fixation to treat fractures of the mandibular symphysis? Ellis E. J Oral Maxillofac Surg 2012;70:875-82. Reviewer Richard Oliver, BDS, BSc, PhD, FDSRCPS, FDS(OS)RCPS Purpose/Question The study examined the frequency and types of complications in two groups of patients having mandibular symphyseal fractures treated Source of Funding Information not available Type of Study/Design Cohort study (retrospective) Level of Evidence Level 2: Limited-quality, patient-oriented evidence Strength of Recommendation Grade Not applicable

Critical evaluation of the radiological and clinical features of adenomatoid odontogenic tumour

Free AccessLetter to the EditorCritical evaluation of the radiological and clinical features of adenomatoid odontogenic tumourMS Chavan, A Shete and N DiwanMS ChavanSearch for more papers by this author, A SheteSearch for more papers by this author and N DiwanSearch for more papers by this authorPublished Online:28 Jan 2014https://doi.org/10.1259/dmfr.20120410SectionsPDF/EPUB ToolsAdd to favoritesDownload CitationsTrack Citations ShareShare onFacebookTwitterLinked InEmail AboutIn reference to the article “Critical evaluation of the radiological and clinical features of adenomatoid odontogenic tumour”,1 we would like to congratulate the authors for an excellent critical evaluation. The authors took great effort in evaluating multiple factors for clinical and radiological features of adenomatoid odontogenic tumour (AOT). We wish to address certain aspects of the radiographic features of AOT not presented in the article.It is important to note that there are many radiographic variants of AOT which should have been included in the radiological analysis, as well as in the discussion, by the authors. The benign (hamartomatous) non-invasive AOT occurs in three clinicotopographic variants: (1) follicular, (2) extrafollicular and (3) peripheral. The follicular and extrafollicular variants are intrabony or central tumours and account for 97% of all AOTs, of which 73% are of the follicular type.2 The extrafollicular variety has four different manifestations on radiographs, which can be regarded as E1–E4 [E1, without relation to tooth structures either erupted or unerupted; E2, inter-radicular, adjacent roots diverge apically as a result of tumour expansion (mimicking a globulomaxillary cyst); E3, superimposed on the root at the apex level (mimicking a radicular cyst) and E4, superimposed at the mid-root level].2The differential diagnoses of radiolucencies that occur in the maxilla and mandible include a broad spectrum of cysts and tumours of odontogenic and non-odontogenic origin. Many can be diagnosed accurately based on the distinctive clinical, radiographic and histopathological aspects.3 The radiographic findings of AOT frequently resemble other odontogenic lesions, such as dentigerous cysts, calcifying odontogenic cysts, calcifying odontogenic tumours, globulomaxillary cysts, ameloblastomas, odontogenic keratocysts and periapical disease.4 AOT can mimic globulomaxillary cysts and periapical cysts (radicular cysts);2,4–7 both of these cysts should have been included in the differential diagnosis mentioned in the article.In addition, the authors have used radiological data of density, expansion, borders, locularity, size and impact on adjacent teeth to evaluate their cases, but the radiological views used by them for evaluation need to be mentioned. This is important to avoid confusion, as the authors have stated that panoramic radiography is often unable to demonstrate radio-opacities when calcification is minimal and intraoral radiography may be essential for correct radiographic interpretation of an AOT in the presence of minimal quantities of calcified deposits. Furthermore, one article stated that MRI can be useful to distinguish AOT from other lesions, even if it is difficult using periapical ordinal radiography.4References1 Becker T, Buchner A, Kaffe I. Critical evaluation of the radiological and clinical features of adenomatoid odontogenic tumour. Dentomaxillofac Radiol 2012; 41: 533–540. doi: 10.1259/dmfr/19253953 Link ISI, Google Scholar2 Philipsen HP, Srisuwan T, Reichart PA. Adenomatoid odontogenic tumor mimicking a periapical (radicular) cyst: a case report. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2002; 94: 246–248. Crossref Medline, Google Scholar3 Slootweg PJ. Lesions of the jaws. Histopathology 2009; 54: 401–418. Crossref Medline ISI, Google Scholar4 Konouchi H, Asaumi J, Yanagi Y, Hisatomi M, Kishi K. Adenomatoid odontogenic tumor: correlation of MRI with histopathological findings. Eur J Radiol 2002; 44: 19–23. Crossref Medline ISI, Google Scholar5 Curran AE, Miller EJ, Murrah VA. Adenomatoid odontogenic tumor presenting as periapical disease. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 1997; 84: 557–560. Crossref Medline, Google Scholar6 Kuntz AA, Reichart PA. Adenomatoid odontogenic tumor mimicking a globulo-maxillary cyst. Int J Oral Maxillofac Surg 1986; 15: 632–636. Crossref Medline ISI, Google Scholar7 Glickman R, Super S, SunderRaj M, Jain R, Chaudhry A. An adenomatoid nodontogenic tumor simulating globulo-maxillary cyst. J Oral Med 1983; 38: 26–30. Medline, Google Scholar Previous article Next article FiguresReferencesRelatedDetailsCited byDiagnostic Factors of Odontogenic Cysts in Iranian Population: A Retrospective Study over the Past Two Decades31 May 2015 | Iranian Red Crescent Medical Journal, Vol. 17, No. 5 Volume 42, Issue 2February 2013 © 2013 The Authors History Published onlineJanuary 28,2014 Metrics Download PDF

Post auricular dermoid cyst—a rare lump behind the ear

Dermoid cysts are benign developmental anomalies. They are postulated to originate from the congenital inclusion of germ layers in the deeper tissues along the lines of embryonic fusion (New and Erich Surg, Gynecol Obstet 65:48–55, 1937). Dermoid cysts can be divided into three types according to their histological characteristics, namely epidermoid, dermoid, and teratoid (Tuffin and Theaker, Int J Oral Maxillofac Surg 20:275, 1991). The majority of dermoid cysts arise in the ovaries. Those occurring in the cervicofacial region are uncommon, accounting for about 7% of all dermoids (De Souza et al., Plast Reconstr Surg 112(7):1972, 2003). Dermoid cysts around the auricular region are rare. To the best of our knowledge, there have been only four cases of post-auricular dermoid cyst reported in literature (Bauer et al., Arch Dermatol 130:913, 1994; De Souza et al., Plast Reconstr Surg 112(7):1972, 2003; Meagher and Morrison, Br J Plast Surg 54:336, 2001; Samper, Plast Reconstr Surg 106:947, 2000. We hereby report the fifth case of this rare condition.

Immediate Loading of Brånemark System TiUnite and Machined-Surface Implants in the Posterior Mandible, Part II: A Randomized Open-Ended 9-Year Follow-up Clinical Trial

To present clinical results with 9 years of follow-up of a protocol of immediately loaded implants with two different surfaces. A total of 44 patients received 66 Brånemark System TiUnite and 55 Brånemark machined implants, all immediately loaded. Control examinations were performed on the day of surgery and at 1-, 3-, and 9-year follow-up visits. All implant sites had intact buccal and lingual bone walls. The prefabricated provisional restorations showed an excellent fit. Three TiUnite and 8 machined implants failed within 7 weeks of loading, resulting in a cumulative survival rate of 95.5% and 85.5% respectively after 9 years of load. The survival rate for implants in a partial prosthesis was 98.8% and 92.2% for single restorations in the TiUnite group, and 87.8% and 83.2%, respectively, for partial and single resorations in the control group. The marginal bone resorption in the first year was on average 0.9 mm in the TiUnite group and 1.0 mm in the machined group; at the third year it was 0.4 and 0.5 mm, respectively. On examination at 9 years, there was a general settlement of the bone, with a negligible further loss in height. The unchanged survival rate and the low bone loss after 9 years confirm the feasibility of an immediate loading protocol in the mandible, which included flapless surgery. TiUnite implants obtained a 10% higher success rate compared with machined fixtures .

Quantitative Percussion Diagnostics and Bone Density Analysis of the Implant-Bone Interface in a Pre- and Postmortem Human Subject

It has been hypothesized that a correlation exists between the density of surrounding cortical bone and the stability of an implant under percussion loading that can be used to quantify the implant's osseointegration. The purpose of the present research was to explore whether quantitative percussion testing of dental implants gives reasonable indications of the level of osseointegration that are consistent with bone configuration and its influence on osseointegration quality. Data from percussion testing of a live human subject, obtained using the Periometer, were compared with corresponding bone density estimates from high-resolution computed tomography images and postmortem percussion probe data. The results confirm the hypothesis that the nature of an implant's response to percussion is determined by its cortical bone support. The findings suggest that the cortical bone supporting the crestal and apical regions of the implant is primarily responsible for structural stability.

Management of Isolated Fractures of the Medial Orbital Wall

The purpose of the present study was to retrospectively review the management and outcome of patients treated by the Australian Craniofacial Unit (ACFU) for isolated fractures of the medial orbital wall. A retrospective medical record review of patients treated between 2008 and 2012 was performed. Ethical approval was granted by the ethics committee of the Women's and Children's Hospital. Patient demographics, causes of injury, physical examination findings, management (conservative or surgical), and findings at follow-up were recorded. Computed tomographic scans were reviewed, and values for fracture area and volume of displaced tissue were calculated. Twenty-four patients with this injury were treated by the ACFU between 2008 and 2012. Eighteen were male, and 6 were female. Assault was the most common cause (15/24 patients). Fifteen patients were managed conservatively, and 9 were treated surgically. In those patients managed conservatively, the mean fracture area was 1.44 cm (0.47-2.47 cm), and the mean volume of displaced tissue was 0.48 mL (0.03-1.15 mL). In patients treated surgically, the mean fracture surface area was 2.32 cm (0.07-3.43 cm), and mean volume of displaced tissue was 0.94 mL (0.00-1.47 mL). No patients were found to have clinically significant enophthalmos at follow-up examination. The current practice of managing isolated fractures of the medial orbital wall at the ACFU has been successful in preventing significant enophthalmos. The thresholds for fracture area and, in particular, volume of displaced tissue, proposed by Jin et al (J Oral Maxillofac Surg 2000;58:617-620), show merit as a tool for determining patient management.

Using the Gap Arthroplasty to Treat Temporomandibular Joint Ankylosis may Result in Greater Mandibular Range of Motion Than Treating the Ankylosis Using Ankylosis Resection and Ramus–Condyle Reconstruction With Costochondral Grafting

Operative management of temporomandibular joint ankylosis: A systematic review and meta-analysis. Katsnelson A, Markewicz MR, Keith DA, Dodson TR. J Oral Maxillofac Surg 2012;70:531-6. O. Ross Beirne, DMD, PhD Does surgical treatment of patients with temporomandibular joint ankylosis using the gap arthroplasty result in greater range of mandibular movement than using ankylosis resection and ramus–condyle unit reconstruction with costochondral grafts? Supported in part by the Massachusetts General Hospital Department of Oral and Maxillofacial Surgery Education and Research Fund, the Center for Applied Clinical Investigation, and the Massachusetts General Physicians Organization Systematic review with meta-analysis Level 2: Limited-quality, patient oriented evidence Grade B: Inconsistent or limited-quality patient-oriented evidence

Regional odontodysplasia: Orthodontic treatment and transplantation of premolars

Regional odontodysplasia is a rare and unique dental anomaly involving both dentitions, but mostly the teeth of 1 quadrant. This report describes the combined surgical and orthodontic treatment of a boy with regional odontodysplasia. The mandibular right central and lateral incisors and the canine (as well as the deciduous predecessors) were affected. In a 2-step procedure, the maxillary right and left second premolars were autotransplanted to the affected area. The extraction sites in the maxilla were closed, and a good functional occlusion was established.

Rapid, Early-Onset Group A Streptococcus Infection After Impacted Third Molar Removal: A Review and Case Series

The overall postoperative infection rate for third-molar extraction is reported to range from 0.8% to 4.2%. 1 Bouloux G.F. Steed M.B. Perciaccante V.J. Complications of third molar surgery. Oral Maxillofac Surg Clin North Am. 2007; 19: 117 Abstract Full Text Full Text PDF PubMed Scopus (172) Google Scholar , 2 Haug R.H. Perrott D.H. Gonzalez M.L. et al. The American Association of Oral and Maxillofacial Surgeons age-related third molar study. J Oral Maxillofac Surg. 2005; 63: 1106 Abstract Full Text Full Text PDF PubMed Scopus (144) Google Scholar , 3 Bui C.H. Seldin E.B. Dodson T.B. Types, frequencies, and risk factors for complications after third molar extraction. J Oral Maxillofac Surg. 2003; 61: 1379 Abstract Full Text Full Text PDF PubMed Scopus (279) Google Scholar , 4 Sisk A.L. Hammer W.B. Shelton D.W. et al. Complications following removal of impacted third molars: The role of the experience of the surgeon. J Oral Maxillofac Surg. 1986; 44: 855 Abstract Full Text PDF PubMed Scopus (266) Google Scholar , 5 Benediktsdóttir I.S. Wenzel A. Petersen J.K. et al. Mandibular third molar removal: Risk indicators for extended operation time, postoperative pain, and complications. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2004; 97: 438 Abstract Full Text Full Text PDF PubMed Scopus (158) Google Scholar , 6 Chiapasco M. De Cicco L. Marrone G. Side effects and complications associated with third molar surgery. Oral Surg Oral Med Oral Pathol. 1993; 76: 412 Abstract Full Text PDF PubMed Scopus (226) Google Scholar , 7 de Boer M.P. Raghoebar G.M. Stegenga B. et al. Complications after mandibular third molar extraction. Quintessence Int. 1995; 26: 779 PubMed Google Scholar , 8 Goldberg M.H. Nemarich A.N. Marco W.P. Complications after mandibular third molar surgery: A statistical analysis of 500 consecutive procedures in private practice. J Am Dent Assoc. 1985; 111: 277 Abstract Full Text PDF PubMed Scopus (181) Google Scholar , 9 Osborn T.P. Frederickson G. Small I.A. et al. A prospective study of complications related to mandibular third molar surgery. J Oral Maxillofac Surg. 1985; 43: 767 Abstract Full Text PDF PubMed Scopus (269) Google Scholar It is unclear how the infection rate would be impacted by stratifying cases according to varying preoperative presentations, such as pericoronitis, caries, periodontal disease, abscess, impaction, partial impaction, and malposition. When considering only preoperatively noninfected third molars, the infection rate is unclear, although it may be lower than the overall reported infection rates. For example, Indresano et al 10 Indresano T. Haug R. Hoffman M. The third molar as a cause of deep space infections. J Oral Maxillofac Surg. 1992; 50: 33 Abstract Full Text PDF PubMed Scopus (36) Google Scholar looked at deep-space infections after third molar removal. Rafetto 11 Rafetto L.K. Removal of asymptomatic third molars: A supporting view. J Oral Maxillofac Surg. 2006; 64: 1811 Abstract Full Text Full Text PDF PubMed Scopus (7) Google Scholar observed that all of the postoperative infections in the study of Indresano et al were associated with teeth that had been infected before treatment. In a prospective cohort study of 100 patients with severe third molar complications, Kunkel et al 12 Kunkel M. Kleis W. Morbach T. et al. Severe third molar complications including death—Lessons from 100 cases requiring hospitalization. J Oral Maxillofac Surg. 2007; 65: 1700 Abstract Full Text Full Text PDF PubMed Scopus (40) Google Scholar correlated the majority of these complications with therapeutic removal of symptomatic third molars rather than removal of asymptomatic, impacted third molars.

The Relationship Between the Implant Angulation and the Labial Soft-Tissue Thickness

A minimum thickness (1.8 mm) of surrounding bone is needed for a successful implant placement 1 Spray J.R. Black C.G. Morris H.F. Ochi S. The influence of bone thickness on facial marginal bone response: stage 1 placement through stage 2 uncovering. Ann Periodontol. 2009; 5: 119-128 Crossref Scopus (368) Google Scholar ; otherwise, leading to a thin gingival biotype and gingival recession. Implant position and angulation are important and to avoid complications, palatally and apically placement of implants has been suggested. 2 Fu J.H. Lee A. Wang H.L. Influence of tissue biotype on implant esthetics. Int J Oral Maxillofac Implants. 2011; 26: 499-508 PubMed Google Scholar The objective of this study was to assess the relationship between the Labial Soft-Tissue Thickness (LSTT) and the angulations of implants.