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Oral Abstract Session 2

matic implants were inserted in the healthy non-oper-ated bone, extending the body of fixture into the poorbone quality area. The zygomatic implant was used tobypass the junction site between the well-vascularizedbone and the grafting emerging 5 to 10 mm away fromthe bony union, into the grafting area. Regular dentalimplants were used to complete the anchorage in themandibular body to allow proper distribution and ade-quate biomechanics utilizing hybrid screw retained pros-thesis. The short zygoma implants were utilized as re-placement of the inclined lateral fixtures in the all-on-4concept.

Method of Data Analysis: All patient�s records in-cluded clinical, radiographs and photographs analysis,pre- and postoperative; all patients were followed for aminimum of 12 months. Also, prosthodontist and sur-geon clinical evaluations were obtained and charts filledwith information on dental occlusion, range of mandib-ular motion, tissue health around fixtures, level of theimplant related to soft tissue, rehabilitation stability, hy-giene, nasal airway and patient satisfaction.

Results: All patients were dentally rehabilitated imme-diately with functional and esthetic hybrid denturesbased on either acrylic or porcelain on a metal structure,using 37 zygomatic implants and 40 standard fixtures.Immediate provisional prosthesis was installed intra-op-eratively using provisional abutments. Patients were in-structed to maintain excellent hygiene and periodontalcontrol every 3 months.

Conclusions: All patients were adequately rehabili-tated, avoiding the need of new major grafting or dis-traction osteogenesis. This group of patients representsa major challenge after the initial reconstruction, wherethere is bone continuity, but the quality was unaccept-able for standard dental implants; secondary surgeries inthe compromised hostage bone would compromise thefinal outcome and would require further unpredictablesurgeries. The zygoma fixture is an excellent possibilityin the immediate loading concept for mandibular dentalrehabilitation.

References:

Brånemark P-I. The Osseointegration Book From Calvarium to Cal-aneus. Berlin: Quintessence Books 2005.Guerrero C. Sabogal A. Zygoma Implants: atlas of surgery and pros-

hetics. Madrid: Ripano 2010.

Tongue Flaps for Closure of LargePalatal Fistulas in Cleft Lip andPalate PatientsR. Marques da Silva: Department of Oral andMaxillofacial Surgery, University of Oslo, Norway andDepartment of Oral and Maxillofacial Surgery, Centerfor Integral Assistance of Cleft Lip and Palate Patients(CAIF), Curitiba, Brazil, C. Biron, K. Ulbricht Gomes,

J. Carlini

AAOMS • 2011

Statement of the Problem: Palatal fistulas may occurin patients who have undergone cleft palate surgery.Small palatal fistulas may not be symptomatic, but largepalatal fistulas produce various symptoms, including re-gurgitation of fluids into the nasal cavity and interferencewith normal speech. Treatment of these large fistulas isusually complex and difficult to be achieved by tradi-tional local flaps. In such cases, tongue flaps may be analternative option for treatment.

Materials and Methods: Between 2005 and 2010, 7cleft lip and palate patients were treated with a tongueflap procedure for closure of large anterior palatal de-fects. All palatal fistulas were larger than 2 x 1.5 cm indiameter and all patients had a bilateral complete cleftlip and palate. The fistulas were treated with the sametechnique, using the anterior two-thirds of the tongue toclose the fistula. The flap pedicle remained connected tothe tongue for 3 weeks, in order to maintain enoughvascularization and to avoid flap necrosis. After this pe-riod, the patients were submitted to a new surgicalprocedure to free the flap from the tongue, and to closethe remaining posterior fistula.

Results of Investigation: All 7 flaps (100%) survived,and complete closure was obtained in all patients. Nodonor site complications were encountered.

Conclusion: Our results demonstrate that the tongueflap is a safe and reliable technique for closure of largeanterior palatal fistulas, particularly when repair is notachieved using other methods.

References:

Guerrero-Santos J, Altamarino JT. The use of lingual flaps in repair ofstulas of the hard palate. Plast Reconstr Surg 1986;38:123-128.Kim MJ, Lee JH, Choi JY, Kang N, Lee JH, Choi WJ. Two-stage

econstruction of bilateral alveolar cleft using Y-shaped anterior-basedongue flap and iliac bone graft. Cleft Palate Craniofac J 2001;38:432-37.

Pharmacological Manipulation ofProstaglandins in Third Molar SurgeryP. Mehra: Boston University, U. Reebye, D. Cottrell,M. Nadershah

Statement of the Problem: Double-blind random-ized clinical trial to assess the effect of four pharmaco-logical regimens on the levels of prostaglandin E2(PGE2) in urine and saliva and correlate the findings tothe clinical postoperative course after removal of im-pacted lower third molars.

Materials and Methods: ASA 1 patients requiringsurgical removal of bilateral full-bony impacted lowerthird molars were included in the study and underwentsurgery by a single surgeon under intravenous ambula-tory general anesthesia using a standard technique. Pa-tients were randomly divided into the following four

groups (20 patients per group): Group 1: received im-

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