The Dental Practicality Index - to treat or not to treat.

The Dental Practicality Index (DPI) has been designed to describe, on a clinical level, the 'practicality' of restoring a tooth versus referring to secondary care or extraction.The systematic approach of DPI has been shown to improve decision-making and confidence in treatment planning when used by young dentists. In addition, there is good evidence demonstrating that it provides an accurate estimation of the outcome of treatment.

Vascularized free fibula flap oral rehabilitation using tissue engineered mucosa: Report of 3 cases.

The aim of this report is to introduce the use of the dermal substitute Integra® in the context of free fibula flap prelamination for mandibular reconstruction. Three cases of mandibular reconstruction with prefabricated and Integra-prelaminated vascularized fibula flaps are reported in this article. The patients reported in this case series presented with the following tumours: an extensive cemento-ossyfying fibroma, a multicystic ameloblastoma and an extensive calcifying epithelial odontogenic tumour.

Contemporary management of advanced midface malignancy in the age of Instagram - a parallel surgical and patient's perspective.

The internet and social media give our patients extraordinary access to information; in these unprecedented times of the COVID-19 pandemic, where so much of life takes place online, patients and professionals alike look to the internet more and more for information and (self-)diagnosis. This article details the treatment journey for a patient with a high-grade chondroblastic osteosarcoma of the right maxilla, paranasal area and zygoma, from misdiagnosis through to resection and full rehabilitation with free flap surgery and implant reconstruction. Uniquely, the article details the patient's treatment, in parallel with her own perception of the treatment, as shared on social media.

Management of Extraoral Complications in a Patient Treated with Four Zygomatic Implants.

This article details the significant complications associated with treatment of a patient who underwent maxillary reconstruction based entirely on zygomatic implants. The use of zygomatic implants is becoming increasingly widespread, and treatment has been shown to be predictable and generally free of surgical complications. However, extending from the maxillary alveolus, alongside or through the maxillary antrum, toward the zygoma or orbital rim, these long implants have the potential to create a range of complications that may be more serious than those encountered with conventional dental implants.

Percutaneous implant retention of a nasal prosthesis.

This report describes an approach to the simultaneous retention of a nasal prosthesis and an intraoral prosthesis for a patient who had undergone a total rhinectomy with resection of the upper lip and premaxilla. At the time of the nasal resection, 2 dental implants were placed adjacent to the resection margins in the first premolar positions. These were used to anchor an intraoral, milled titanium bar and overdenture to replace the missing anterior teeth and provide support for the upper lip, which had been reconstructed with a vascularized radial forearm free-flap.

A New Approach to Implant-Based Midface Reconstruction Following Subtotal Maxillectomy.

This case presentation describes the reconstruction of an extensive maxillary-orbital defect following subtotal resection of the maxilla en bloc with orbital exenteration in a young adult following the diagnosis of chondrosarcoma. A new approach to composite midface reconstruction with dental implants is described, in which computer-guided surgery (CGS) was used to obliquely position dental implants interradicularly in the residual maxilla, such that the implant tips lie in close proximity to the root apices of the remaining teeth. The implants were then used to fixate a milled-titanium bar, fabricated using computer-aided design and manufacture (CAD/CAM), and provided with attachments for the stabilization and retention of a maxillary obturator.

The reverse zygomatic implant: a new implant for maxillofacial reconstruction.

This case report describes the rehabilitation of a patient who had been treated with a hemimaxillectomy, reconstruction with a latissimus dorsi vascularized free flap, and radiotherapy for carcinoma of the sinus some years previously. Limited jaw opening, difficult access through the flap to the bony site, and the very small amount of bone available in which to anchor the implant inspired the development and use of a new "reverse zygomatic" implant. For this treatment, site preparation and implant insertion were accomplished using an extraoral approach.

Re-thinking 3D printing: A novel approach to guided facial contouring.

Rapid prototyped or three dimensional printed (3D printed) patient specific guides are of great use in many craniofacial and maxillofacial procedures and are extensively described in the literature. These guides are relatively easy to produce and cost effective. However existing designs are limited in that they are unable to be used in procedures requiring the 3D contouring of patient tissues.

'Sometimes the simplest interventions can make a big difference'.

London dentists Andrew Dawood and Susan Tanner speak to the BDJ ahead of their presentation at the 2013 British Dental Conference & Exhibition. The London practice owners talk about Channel 4's Embarrassing Bodies, facial reconstruction, implant inventions and more.

A new implant for nasal reconstruction.

Extraoral implants have been used for many years to anchor silicone nasal prostheses. This report describes the design and use of a specially engineered bifunctional implant, which is placed via an intraoral approach, to simultaneously anchor nasal and oral prostheses for an edentulous patient who has undergone a complete rhinectomy. The bifunctional implant was designed and milled from commercially pure titanium using computer-aided design/computer-assisted manufacturing (CAD/CAM) technology.

E.A.O. guidelines for the use of diagnostic imaging in implant dentistry 2011. A consensus workshop organized by the European Association for Osseointegration at the Medical University of Warsaw.

Diagnostics imaging is an essential component of patient selection and treatment planning in oral rehabilitation by means of osseointegrated implants. In 2002, the EAO produced and published guidelines on the use of diagnostic imaging in implant dentistry. Since that time, there have been significant developments in both the application of cone beam computed tomography as well as in the range of surgical and prosthetic applications that can potentially benefit from its use.

Computer guided surgery for implant placement and dental rehabilitation in a patient undergoing sub-total mandibulectomy and microvascular free flap reconstruction.

A 58-year-old patient presented with an extensive, destructive, recurrent pleomorphic adenoma occupying the mandibular body and the soft tissues of the mouth and neck. Resection of the mandible from right ramus to left condylar process, and implant rehabilitation in both jaws with fixed bridgework was planned. Comprehensive presurgical prosthetic work up was carried out to record the existing dental relationship and guide all stages of the reconstruction.