Libros

Oberkieferkompression und skelettale Klasse III bei Erwachsenen sind Dysgnathien, deren Behandlung komplex und umso schwieriger ist, je schwerer sie ausgeprägt sind und je älter der Patient ist. Für die Erweiterung des Oberkiefers bei Patienten mit partiell oder vollständig verknöcherter Gaumennaht stellt die chirurgisch unterstützte Gaumennahterweiterung (Surgically Assisted Rapid Palatal Expansion, SARPE) das erfolgssichere Verfahren der Wahl dar. Vor allem bei jüngeren Patienten besteht jedoch in einigen Fällen auch die Möglichkeit, die Gaumennahterweiterung mittels Verankerung im Oberkiefer (Maxillary Anchorage Rapid Maxillary Expansion, MARPE), das heißt, ohne adjuvante chirurgische Maßnahmen zu erreichen. In diesem Artikel zeigen wir ein Patientenbeispiel, in dem die Behandlung mit dem MARPE-Verfahren und mit temporären skelettalen Verankerungselementen (Temporary Anchorage Devices, TAD) erfolgte. Die skelettalen Probleme der 18-jährigen, erwachsenen Patientin mit transversal und sagittal unterentwickeltem Oberkiefer, Kippung der Okklusionsebene und einem retinierten Eckzahn konnten trotz ihres Alters ohne Rückgriff auf unterstützende chirurgische Maßnahmen korrigiert werden.Maxillary compression and skeletal class III in adults are complex malocclusions to treat and their difficulty increases according to their severity and the patient’s age. To achieve maxillary expansion in patients with the suture partially or totally closed, the success of the expansion is guaranteed by performing a SARPE (Surgically Assisted Maxillary Expansion). However, especially in young patients, the possibility of performing a MARPE (Maxillary Anchorage Rapid Maxillary Expansion) should be considered in some cases to achieve expansion of the maxilla without resorting to surgical treatment. Here we present a clinical case carried out with MARPE and TADs. The patient is a young (18 years old) with transversal and sagittal hypoplasia of the maxilla, canting of the occlusal plane and an impacted canine. The patient’s skeletal problems were corrected despite his age without resorting to surgery. Palabras clave: Oberkieferkompression, MARPE, Gaumennahterweiterung, skelettale Verankerung, temporäre skelettale Verankerungselemente, TAD

There are multiple designs of miniscrew-assisted rapid palatal expansion (MARPE) expanders currently available for the correction of transverse discrepancies. Many of these expanders can be used with or without surgically assisted rapid palatal expansion (SARPE). One of the most critical aspects of the design of these devices is that they achieve a sufficient and symmetric amount of expansion. The present study demonstrates the use of a Power Expander, a customised boneborne expander manufactured with 3D technology, which allows an effective force application on the maxilla and the nasomaxillary structures. This article details the fabrication and usage of this novel expander to correct a severe Class III malocclusion with maxillary transverse deficiency (MTD) and facial asymmetry, with a clinical example in the form of two case reports. Palabras clave: palatinal expansion, Class III, bone-borne anchorage, SARPE

The objective of this study was to compare patient-related outcomes of conventional protocols with computer-assisted implant planning and templateguided implant placement (CAIPP) protocols. Partially edentulous patients (N = 73) were assigned to either surgical planning based on two-dimensional radiographs and freehand implant placement (control; n = 26) or using threedimensional computer-tomography data and implant placement using a toothsupported surgical guide (test groups T1 [n = 24] and T2 [n = 23]). The two test groups differed from each other in digital data acquisition, software functionality, and the guide-manufacturing process. All surgeries were performed as openflap procedures. Patient-related outcome measures were evaluated using questionnaires. Statistical tests were performed to investigate differences between treatment groups. Before treatment, 53% of patients in the control group and 83% of patients in the test groups (T1: 88%, T2: 78%) were satisfied with their group allocation. In the control group, 37% of patients favored CAIPP technology, while only 11% in the test groups would have preferred a conventional procedure. After treatment, 50% of patients in the control and 86% in the test groups (T1: 76%, T2: 94%) were satisfied with their allocation. Twenty-one percent of controlgroup patients favored the CAIPP treatment, while 6% of the test-group patients would have preferred a conventional treatment. The quality-of-life parameters during and after surgery did not show significant differences between groups. More postoperative discomfort was reported after longer and more-complex surgeries including guided bone regeneration and surgeries with two surgical sites. Generally, patients preferred computer-based technologies. No differences in the intra- or postoperative discomfort were observed compared to control protocols. More-extensive surgical procedures negatively affected the intraand postoperative quality of life, irrespective of the treatment group allocation.

The application of laser as a monotherapy has been shown to reduce probing pocket depths and increase clinical attachment levels after treatment of patients suffering from chronic periodontitis. Its controversial use as an adjunct to scaling and root planing (SRP) is discussed. The present study aimed to evaluate the efficacy of adjunctive Er, Cr:YSGG laser application following conventional SRP. A total of 30 patients with chronic periodontitis were enrolled in the study. The quadrants of each patient were allocated to either SRP or SRP + laser. A total of 3,654 sites with pocket depths ≥ 4 mm were treated and evaluated at 6 weeks and 6 months postoperatively with respect to attachment gain. Both therapies resulted in improved probing pocket depths and clinical attachment levels. The adjunctive application of Er, Cr:YSGG laser following SRP did not improve probing pocket depth or attachment level compared with SRP alone.