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Free grafting of autogenous coronoid process

Oral and maxillofacial surgery Free grafting of autogenous coronoid process for condylar reconstruction in patients with temporomandibular joint ankylosis Song-song Zhu DDSa, Jing Hu DDS, PhDb, , , Jihua Li DDSb, En Luo DDSa, Xinhua Liang DDSb and Ge Feng PhDa aResearch Fellow, State Key Laboratory of Oral Diseases, Sichuan University, Chengdu, China bFaculty, Department of Oral and Maxillofacial Surgery, West China College of Stomatology, Sichuan University, Chengdu, China Objective This article describes the clinical effects of condylar reconstruction by free grafting of autogenous coronoid process in patients with temporomandibular joint (TMJ) ankylosis. Study design Fifteen cases of uni- or bilateral TMJ ankylosis during a 3-year period from March 2004 to March 2007 were surgically treated, and the average observation period was 22 months. All patients were treated by condylar reconstruction of immediate autogenous coronoid process grafts. Temporal muscle myofascial flaps or native articular disc was used as an interpositional tissue. Clinical examination, radiographs, and photographs were used postoperatively to evaluate the grafts and TMJ function. Results Satisfactory mouth opening was achieved in 14 cases, and 1 patient showed signs of reankylosis of the joint (20 mm mouth opening). Radiographic examination showed that bone union occurred between the grafts and the ramus in all cases. Some bony resorption of the grafted coronoid process was observed in all patients, but no occlusal changes were noted. Conclusion Satisfactory clinical outcomes are obtained after the condylar reconstruction by free grafting of autogenous coronoid process. Therefore, autogenous coronoid process may be a suitable bone resource for condylar reconstruction in patients with TMJ ankylosis. Management of atrophic maxilla in severe osteoporosis treated with bisphosphonates: a case report Jesús Torres DDS, PhDa, , , Faleh Tamimi DDS, PhDb, Ignacio García DDS, PhDa, Jose Luis Cebrian DDS, PhDa, Enrique López-Cabarcos MD, DDS, PhDc and Antonio Lopez MD, DDS, PhDd aAssistant Professor, Department of Health Sciences III, Faculty of Health Sciences, Rey Juan Carlos University.Madrid, Spain bResearch Fellow, Department of Health Sciences III, Faculty of Health Sciences, Rey Juan Carlos University, Madrid, Spain cProfessor, Department of Physical Chemistry. Faculty of Pharmacy, Complutense University, Madrid, Spain dProfessor, Department of Health Sciences III, Faculty of Health Sciences, Rey Juan Carlos University, Madrid, Spain Studies investigating whether osteoporosis is a risk factor for using implants have revealed no correlation between possible implant failure and the severity of osteoporosis. However, osteoporotic patients frequently require bone regeneration techniques, because they do not fulfil optimum conditions for implant placement owing to the diminished bone structure and rapid resorption of the alveolar bone. We present a successful case of advanced implant therapy using platelet-rich plasma in a patient with severe osteoporosis who had been previously treated with bisphosphonates. We are not aware that this technique has been previously described in literature.

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