Chin block graft for reconstructive surgery and esthetic rehab of teeth

| Posted in: Science

Journal name: Journal of Indian Society of Periodontology
Original article title: Reconstructive surgery with chin block graft and esthetic rehabilitation of missing anterior tooth
The Journal of Indian Society of Periodontology (JISP) publishes original scientific articles on periodontology (the study of supporting structures of teeth) and oral implantology. It is a bimonthly open-access journal with special issues for specific occasions.
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Original source:

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Author:

Preetika Bansal, Pardeep Bansal


Journal of Indian Society of Periodontology:

(A bimonthly open-access journal)

Full text available for: Reconstructive surgery with chin block graft and esthetic rehabilitation of missing anterior tooth

Year: 2014 | Doi: 10.4103/0972-124X.131354

Copyright (license): CC BY-NC-SA


Summary of article contents:

Introduction

The restoration of the periodontium after infection or trauma is a significant goal in regenerative therapy, particularly in managing periodontal osseous defects. Among the various treatment strategies available, bone grafts are one of the most commonly employed methods. In cases involving periodontally compromised anterior teeth, the reconstruction of the ridge combined with a natural tooth pontic not only serves functional purposes but also addresses aesthetic concerns. This case report discusses the successful extraction of a periodontally compromised lower central incisor, subsequent autogenous chin grafting, retrograde surgery, and replacement with a natural tooth pontic.

Importance of Autogenous Bone Grafting

Autogenous bone grafts are recognized for their osteoconductive, osteoinductive, and osteogenic properties, making them ideal for periodontal repair. The case highlights how such grafts, particularly block bone grafts harvested from the symphysis, can effectively restore bone structure in localized alveolar defects. Following the extraction of the compromised tooth, the procedure involved careful harvesting of bone and augmentation of the ridge. The use of a natural tooth pontic following augmentation allowed for both immediate aesthetic improvement and preservation of the patient’s dental functionality. After a follow-up period of six months, the patient demonstrated significant clinical improvement and satisfactory bone fill, indicating the effectiveness of this combined treatment approach.

Conclusion

The success of using a natural tooth pontic alongside autogenous bone grafting in this case underscores the potential of these techniques for immediate and aesthetic restoration post-extraction, particularly in the anterior region. Not only did the procedures lead to a significant improvement in both soft and hard tissue appearance, they also provided the patient with an interim solution that preserved the natural crown structure and offered flexibility in further treatment decisions. The findings advocate for careful patient selection and treatment planning to optimize outcomes, emphasizing the regenerative capabilities of autogenous bone grafting in periodontal therapies.

FAQ section (important questions/answers):

What is the significance of restoring the periodontium after trauma?

Restoring the periodontium following infection or trauma is crucial for regenerative therapy, as it enhances dental functionality and stability. Effective restoration prevents further complications and promotes patient satisfaction through improved aesthetics and health.

What methods were used to treat the patient's periodontal condition?

The patient underwent autogenous chin grafting after tooth extraction. This was followed by retrograde surgery of the extracted tooth and replacement with a natural tooth pontic, achieving significant regenerative and aesthetic outcomes.

What are the benefits of using a natural tooth pontic?

Natural tooth pontics provide excellent aesthetic results, preserve the natural crown structure, and require no laboratory work. They also reduce psychological impact on the patient, allowing time to explore permanent restoration options.

How effective is autogenous bone grafting for alveolar defects?

Autogenous bone grafting is ideal due to its osteoconductive and osteogenic properties. It significantly improves bone fill and stability in the alveolar region while minimizing morbidity at donor sites compared to other graft types.

What key factors influence the success of the natural tooth pontic procedure?

Success depends on patient factors such as occlusion, parafunctional habits, available space for bonding, and aesthetic expectations. Proper patient selection and precise placement also contribute to achieving the desired outcomes.

Glossary definitions and references:

Scientific and Ayurvedic Glossary list for “Chin block graft for reconstructive surgery and esthetic rehab of teeth”. This list explains important keywords that occur in this article and links it to the glossary for a better understanding of that concept in the context of Ayurveda and other topics.

1) Table:
In this context, a table refers to a method of organizing and presenting data associated with the case report or study. Tables can effectively summarize research findings, treatment protocols, or clinical results, enabling easy comparison and analysis. They enhance readability and comprehension, particularly in scientific papers.

2) Relative:
The term 'relative' pertains to the relationship between various factors in the study, possibly impacting treatment outcomes. It may refer to the relative effectiveness of different grafting techniques, comparisons of patient responses, or the relationship between clinical findings and patient demographics, such as age or sex.

3) Harvesting (Harvest):
Harvesting refers to the process of obtaining graft material from the patient, which in this paper involves taking autogenous bone from the chin. This step is crucial in regenerative therapy as it provides essential biological materials, like osteoconductive cells, necessary for successful bone augmentation and healing.

4) India:
India is likely referenced as the location where the clinical procedure took place. The geographical context can be significant for understanding the availability of resources, cultural practices in dentistry, and the population demographics, affecting the study's implications and the generalizability of the findings.

5) Composite:
Composite materials refer to resin-based substances used in dental applications, especially for bonding and aesthetics. In the case report, composite is significant as it is used to secure the natural tooth pontic to adjacent teeth, enhancing stability and improving the visual outcome of the restoration.

6) Grafting:
Grafting is a surgical procedure involving the transplantation of tissue to restore lost structure, in this case, bone. Bone grafting is central to the case report, facilitating the reconstruction of the alveolar ridge, essential for proper restoration of the lost anterior tooth and achieving functional esthetics.

7) Post:
The term post could relate to postoperative evaluations or management. In dental procedures, post care is crucial for monitoring healing, managing complications (like infections), and ensuring that the graft integrates properly into the surrounding tissue, which ultimately assists in the success of the treatment.

8) Pur:
Poor in this study context likely describes the inadequate bone support or overall condition of the patient’s dental structure. This is critical because the assessment of 'poor' conditions dictates the treatment approach and the need for interventions such as grafting to restore dental function and aesthetics.

9) Male:
The word male describes the gender of the patient. Understanding gender differences in dental health and treatment responses is important for tailoring specific treatment plans and improving outcomes. Gender can influence patient behavior, anxiety levels, and even postoperative healing, making it a factor in clinical decision-making.

10) Discussion:
Discussion refers to the section in the study where results are interpreted, implications are drawn, and the findings are contextualized within the existing literature. This part is essential for understanding the significance of the study, examining limitations, and proposing future research directions based on outcomes.

11) Antibiotic (Antibacterial):
Antibiotic pertains to medications prescribed to prevent or treat infections, particularly post-surgery. The case emphasizes the importance of antibiotics in ensuring patient safety during healing, reducing the risk of complications, and enhancing outcomes. Proper antibiotic use is a key part of postoperative management in dentistry.

12) Fixation:
Fixation refers to the process of securely placing the bone graft in the appropriate location to ensure stability during the healing process. This is essential for successful integration of the graft into the host tissue and supports the long-term success of the reconstructive surgery performed.

13) Dressing:
Dressing in the context of surgery pertains to the materials used to protect a surgical wound postoperatively. Proper dressing helps prevent infection, supports healing, and provides a barrier against external contaminants, ensuring the integrity of the surgical site during the recovery period.

14) Incision:
Incision refers to the surgical cut made in the tissue to perform the grafting procedure. The location and technique of the incision are crucial for access to the surgical site and impact both the success of the operation and the patient’s postoperative recovery experience.

15) Mineral:
Mineral in this context relates to the essential elements found in bone that contribute to its structural integrity and strength. The mineral content of bone grafts is important for promoting osteogenesis, which is critical for successful healing and reconstruction of the dental arch after grafting.

16) Filling (Filled):
Filled refers to the act of placing a material, such as gutta-percha and sealer, in a dental cavity or during a root canal procedure. This term is significant as it emphasizes the importance of ensuring that the internal dental structure is compromised for successful long-term outcomes.

17) Anxiety:
Anxiety indicates the emotional state that may affect patients before, during, and after dental procedures. Addressing anxiety is crucial for improving patient cooperation and comfort, which can lead to more successful outcomes in dental treatments, especially invasive procedures like bone grafting or extractions.

18) Surface:
Surface refers to the exposed area of dental structures where dental materials interact, like bonding agents on teeth or grafts. The surface quality is vital for effective adhesion, influencing the longevity and success of the restorative procedure, especially in terms of aesthetic results in visible areas.

19) Repair:
Repair indicates the restoration of damaged or lost tissue, which is a key focus of the study. Effective repair in dentistry involves both biological functions like healing and aesthetic outcomes like maintaining the appearance of the patient's smile, particularly in visible regions like the anterior teeth.

20) Edema (Oedema):
Edema refers to the swelling that can occur following surgical treatment, such as dental extractions or graft placements. Managing edema is important for patient comfort and overall recovery, and it can indicate the extent of healing or complications that may arise postoperatively.

21) Visit:
Visit outlines patient appointments for evaluations and follow-ups post-procedure. Regular visits are essential for monitoring healing, detecting any complications early, and ensuring that the treatment is progressing as planned, contributing to long-term success and patient satisfaction with the treatment outcomes.

22) Study (Studying):
Study refers to the examination and collection of data throughout the patient’s treatment, which assists in drawing conclusions regarding effectiveness and outcomes of different techniques used. It underlines the importance of providing evidence-based practices in dentistry and contributes to the body of knowledge in dental research.

23) Tori (Dhori):
Tori refer to bony growths in the oral cavity that can be relevant when planning surgical procedures like grafting. Understanding the presence of tori helps determine safe harvesting sites and avoid anatomical complications during grafting procedures, influencing the surgical strategy and overall outcomes.

24) Pain:
Pain refers to the physical discomfort often experienced after dental procedures and a significant factor in patient management. Addressing pain through medications and counseling is essential for improving patient experience during recovery and can impact the overall success of dental interventions.

Other Science Concepts:

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Discover the significance of concepts within the article: ‘Chin block graft for reconstructive surgery and esthetic rehab of teeth’. Further sources in the context of Science might help you critically compare this page with similair documents:

Clinical picture, Informed consent, Long-term treatment, Surgical Procedure, Clinical Follow-Up, Patient satisfaction, Antibiotics and Analgesics, Recipient site, Mucoperiosteal flap, Bone augmentation, Bone graft, Esthetic Zone.

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