Treatment Outcomes for Temporomandibular Joint Reconstruction After Proplast- Teflon Implant Failure

Temporomandibular joint disc replacement made by tissue-engineered growth of cartilage☆

Statement of problem Porcelain fused to zirconia prostheses are widely used. However, porcelain chipping, spalling, fracture, and delamination are common clinical problems. Residual stresses of thermal origin have received attention, but clear data and firing guidelines remain absent. Purpose The purpose of this study was to measure the influence of heating and cooling protocols on the strength of porcelain fused to zirconia. Material and methods A modified 4-point flexural testing technique was used to measure strength, and porcelain buttons were bonded to the beam between the 2 central loading points. Beams (n=54) were made of a tetragonal polycrystalline zirconium dioxide that was partially stabilized with an yttria core and a feldspathic dental porcelain. Three different heating rates and 3 different cooling regimens were used during firing. Two-way analysis of variance (ANOVA) was used to evaluate the 2 main effects of the heating and cooling regimens and their interaction with the delamination force (α=.05). The Tukey multiple comparisons test was used to identify differences among heating or cooling regimens. Results During loading, the porcelain buttons separated from the zirconia beams because of delamination within the porcelain, which was close to the porcelain to zirconia interface. ANOVA revealed that the effects of the cooling regimen and heating rate had statistically significant effects on failure load ( P Conclusions Slow cooling and slow heating regimens should be used when firing porcelain to zirconia. Cooling regimens were found to be more influential than heating rates. Failure was localized to the porcelain adjacent to the porcelain-zirconia interface, not to the interface itself, indicating that the residual stresses of thermal origin within the porcelain dominated. The preparation of zirconia with 50 μm aluminum oxide at a pressure of 0.34 MPa was sufficient to prevent interfacial failure.

The use of slow heating and slow cooling regimens to strengthen porcelain fused to zirconia

The management of frontal sinus fractures.

Long-term viability of the temporalis muscle/fascia flap used for temporomandibular joint reconstruction

Reconstruction of the temporomandibular joint with cryopreserved cartilage and freeze-dried dura: a preliminary report.

The objective in treating patients with injuries sustained in craniofacial trauma is to reinstate preinjury facial projection and function. The capability of providing spatially related facial reconstruction is predicated on basic craniofacial surgical principles, generally accepted as the standard of care. These principles include early surgical intervention, immediate bone grafting, and the use of internal rigid fixation. The introduction of osseointegrated dental implants has significantly improved the overall reconstruction of patients with cranio-maxillofacial injuries, including soft tissue repair and cosmetic surgery. The purpose of this article is to review the utilization of dental implants in the context of maxillofacial trauma, using three cases to document the clinical procedure.

The use of osseointegrated implants in craniofacial trauma

Frontal sinus fractures have been reported in 2 to 12 percent of all cranial fractures and, according to one study, in 8 percent of all facial fractures. Although immediate frontal bone reconstruction is not universally accepted, it is rapidly becoming the standard of care in treating cranial facial fractures, even in the face of gross contamination. This article presents a historical overview of fracture management, a review of the relevant anatomy, and a discussion of appropriate management principles. Three case studies are presented to demonstrate appropriate techniques for the management of frontal sinus fractures.

Stuart N. Kline

Papers

Reconstruction of the temporomandibular joint with cryopreserved cartilage and freeze-dried dura: a preliminary report.

The use of osseointegrated implants in craniofacial trauma

Management of frontal sinus fractures.

A modification of the Irby Head Frame.

Carcinoma and the mandibular staple