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Aljarmakani O, Assad M. Evaluation of the efficacy of using dental pulp graft in the healing of the alveolar bone after impacted canine extraction: a prospective cohort study. Ann Med Surg (Lond) 2024; 86:1283-1288. [PMID: 38463053 PMCID: PMC10923306 DOI: 10.1097/ms9.0000000000001729] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2023] [Accepted: 01/08/2024] [Indexed: 03/12/2024] Open
Abstract
Summary The purpose of this study was to evaluate the radiographic density of the alveolar bone of the maxilla after extraction of the impacted canines and using the pulp tissue as an autogenous graft. Materials and methods This prospective cohort study recruited 14 patients (8 females and 6 males) between 2021 and 2023, with an average age of 35 years. All participants had palatally impacted maxillary canines. The impacted teeth were extracted surgically. The extracted teeth were then used for autogenous grafting. The pulp tissue was removed, cut into small pieces, and placed on an absorbable gelatin sponge before being inserted into the extraction socket. The wound was subsequently closed meticulously. After 4 months, the bone density was assessed radiographically using the Hounsfield Scale on cone beam computed tomography scans. Results After 4 months, the mean radiographic bone density value in the extraction area was (652.77 ± 56.13 HU), while the average density of the original bone was (659.7 ± 39.6 HU). Conclusions Within the limits of this study, dental pulp tissue can be used to restore bony defects of the alveolar bone in the maxilla. However, further research is needed to confirm these findings.
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Affiliation(s)
- Omar Aljarmakani
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Tishreen University, Lattakia, Syria
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2
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Huang X, Lou Y, Duan Y, Liu H, Tian J, Shen Y, Wei X. Biomaterial scaffolds in maxillofacial bone tissue engineering: A review of recent advances. Bioact Mater 2024; 33:129-156. [PMID: 38024227 PMCID: PMC10665588 DOI: 10.1016/j.bioactmat.2023.10.031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2023] [Revised: 10/30/2023] [Accepted: 10/30/2023] [Indexed: 12/01/2023] Open
Abstract
Maxillofacial bone defects caused by congenital malformations, trauma, tumors, and inflammation can severely affect functions and aesthetics of maxillofacial region. Despite certain successful clinical applications of biomaterial scaffolds, ideal bone regeneration remains a challenge in maxillofacial region due to its irregular shape, complex structure, and unique biological functions. Scaffolds that address multiple needs of maxillofacial bone regeneration are under development to optimize bone regeneration capacity, costs, operational convenience. etc. In this review, we first highlight the special considerations of bone regeneration in maxillofacial region and provide an overview of the biomaterial scaffolds for maxillofacial bone regeneration under clinical examination and their efficacy, which provide basis and directions for future scaffold design. Latest advances of these scaffolds are then discussed, as well as future perspectives and challenges. Deepening our understanding of these scaffolds will help foster better innovations to improve the outcome of maxillofacial bone tissue engineering.
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Affiliation(s)
- Xiangya Huang
- Hospital of Stomatology, Guanghua School of Stomatology, Sun Yat-Sen University, Guangzhou, China
- Guangdong Provincial Key Laboratory of Stomatology, Guangzhou, China
| | - Yaxin Lou
- Hospital of Stomatology, Guanghua School of Stomatology, Sun Yat-Sen University, Guangzhou, China
- Guangdong Provincial Key Laboratory of Stomatology, Guangzhou, China
| | - Yihong Duan
- Hospital of Stomatology, Guanghua School of Stomatology, Sun Yat-Sen University, Guangzhou, China
- Guangdong Provincial Key Laboratory of Stomatology, Guangzhou, China
| | - He Liu
- Division of Endodontics, Department of Oral Biological and Medical Sciences, The University of British Columbia, Vancouver, British Columbia, Canada
| | - Jun Tian
- Hospital of Stomatology, Guanghua School of Stomatology, Sun Yat-Sen University, Guangzhou, China
- Guangdong Provincial Key Laboratory of Stomatology, Guangzhou, China
| | - Ya Shen
- Division of Endodontics, Department of Oral Biological and Medical Sciences, The University of British Columbia, Vancouver, British Columbia, Canada
| | - Xi Wei
- Hospital of Stomatology, Guanghua School of Stomatology, Sun Yat-Sen University, Guangzhou, China
- Guangdong Provincial Key Laboratory of Stomatology, Guangzhou, China
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3
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Yang L, Wang Q, Wang X, Yang Z, Ning Y, Guo Z. Horizontal ridge augmentation in the maxillary aesthetic region using the autogenous circular cortical-lamina anchoring technique: A case series study. Clin Implant Dent Relat Res 2024. [PMID: 38320956 DOI: 10.1111/cid.13311] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2023] [Revised: 01/18/2024] [Accepted: 01/19/2024] [Indexed: 02/08/2024]
Abstract
AIM This case series aimed to evaluate the effectiveness of the autologous circular cortical lamina-anchoring (CCA) technique for horizontal bone augmentation in the maxillary aesthetic region. MATERIALS AND METHODS A total of 25 patients with 28 implants underwent horizontal bone augmentation using CCA followed by implant placement and crown delivery. The primary outcome measures were alveolar ridge width (ARW) and buccal bone thickness (BBT), whereas the secondary outcome measures included marginal bone loss (MBL), mid-facial mucosal margin loss (MML), clinical assessment of peri-implant and aesthetic parameters, patient-reported outcome measures (PROMs), and implant survival rates. RESULTS All 25 patients with 28 implants completed the treatment, no dropouts occurred. After CCA, the mean ARW at 1, 2, and 4 mm below the alveolar crest significantly increased from 2.38 ± 0.48, 2.85 ± 0.51, and 3.21 ± 0.53 mm to 6.80 ± 0.48, 6.99 ± 0.50, and 8.08 ± 0.52 mm, respectively. At the 3-year follow-up, the mean BBT0 , BBT2 , and BBT4 slightly decreased from 2.51 ± 0.26, 2.63 ± 0.31, and 2.75 ± 0.29 mm to 2.43 ± 0.27, 2.51 ± 0.30, and 2.64 ± 0.28 mm, respectively. Although the overall MBL was <0.15 mm, the results were statistically significant. The mean MML at the 3-year follow-up was 0.02 mm. All implant sites showed acceptable peri-implant and aesthetic outcomes. Incisions healed without complications, and no significant differences in PROMs observed at any time point. The 3-year follow-up showed a 100% implant survival rate. CONCLUSION The autologous CCA technique is a useful method for increasing ARW and maintaining BBT in the maxillary aesthetic region.
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Affiliation(s)
- Liqing Yang
- Center of Oral Implantology, Stomatological Hospital, School of Stomatology, Southern Medical University, Guangzhou, P. R. China
| | - Qing Wang
- Department of Orthodontics, Stomatological Hospital, School of Stomatology, Southern Medical University, Guangzhou, P. R. China
| | - Xinyi Wang
- Center of Oral Implantology, Stomatological Hospital, School of Stomatology, Southern Medical University, Guangzhou, P. R. China
| | - Zijing Yang
- Stomatological Hospital, School of Stomatology, Southern Medical University, Guangzhou, P. R. China
| | - Yingyuan Ning
- Center of Oral Implantology, Stomatological Hospital, School of Stomatology, Southern Medical University, Guangzhou, P. R. China
| | - Zehong Guo
- Center of Oral Implantology, Stomatological Hospital, School of Stomatology, Southern Medical University, Guangzhou, P. R. China
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Salman SMA, Yaseen A, Leemani MJ, Ahmed N, Heboyan A. Improved ridge width with tenting screw bone augmentation using particulate and block grafts: A case report. SAGE Open Med Case Rep 2024; 12:2050313X241229586. [PMID: 38313040 PMCID: PMC10836133 DOI: 10.1177/2050313x241229586] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2023] [Accepted: 01/12/2024] [Indexed: 02/06/2024] Open
Abstract
The objective of this case report is to present the use of tenting screw bone augmentation technique for the rehabilitation of narrow horizontally deficient mandibular ridges and to evaluate the feasibility and outcomes of this approach in achieving sufficient bone volume for successful implant placement and Osseointegration. A 34-year-old woman with no significant medical history presented with bilaterally missing teeth in the lower arch. A comprehensive treatment plan was developed through assessment and Cone Beam Computed Tomography (CBCT) imaging to evaluate the ridge dimensions and plan the treatment accordingly accurately. The tenting screw technique, utilizing autogenous/autologous+allograft materials, was chosen for horizontal ridge augmentation. Bone augmentations were performed simultaneously bilaterally using tenting screws. After a 20-week healing period, CBCT scans revealed favorable bone regeneration with adequate width for successful implant placements. This case report demonstrates the potential of tenting screw bone augmentation in effectively rehabilitating mandibular ridges and achieving optimal dental implant outcomes. Further research is needed to validate these findings and assess the long-term stability and success of this technique.
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Affiliation(s)
| | - Aiman Yaseen
- Department of Prosthodontics, Altamash Institute of Dental Medicine, Karachi, Pakistan
| | | | - Naseer Ahmed
- Department of Prosthodontics, Altamash Institute of Dental Medicine, Karachi, Pakistan
| | - Artak Heboyan
- Department of Prosthodontics, Faculty of Stomatology, Yerevan State Medical University after Mkhitar Heratsi, Yerevan, Armenia
- Department of Research Analytics, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, India
- Department of Prosthodontics, School of Dentistry,Tehran University of Medical Sciences, North Karegar St, Tehran, Iran
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5
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Narde J, Ganapathy D, Pandurangan KK. Evaluation of the Success of Autogenous Block Grafting in Atrophic Maxillary and Mandibular Ridges Prior to and After Implant Placement. Cureus 2024; 16:e53829. [PMID: 38465098 PMCID: PMC10924432 DOI: 10.7759/cureus.53829] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2023] [Accepted: 02/03/2024] [Indexed: 03/12/2024] Open
Abstract
BACKGROUND Dental implantology's success relies on adequate bone volume and quality, necessitating bone augmentation for implant placement. Primary lateral bone augmentation, utilizing autogenous block grafts, addresses horizontal bone loss. OBJECTIVE This study aims to evaluate the efficacy of autogenous block grafting, specifically ramus and fibula blocks, in addressing severe atrophic ridges before and after implant placement. METHODS Twenty-one patients underwent block grafting, predominantly using the ramus technique (80/20 ratio). CBCT measurements assessed horizontal grafting outcomes. Implant success and bone volume changes were analyzed. RESULTS Post-grafting, bone width increased from 1.8-3.1 mm to 4.5-6 mm, exceeding critical thresholds. Implant success reached 95%, indicating the grafting techniques' effectiveness. CONCLUSION Autogenous block grafting, especially with ramus and fibula blocks, transforms severe atrophic ridges, enabling successful implant integration. Long-term follow-up is essential for a comprehensive evaluation. CLINICAL RELEVANCE This study provides crucial insights into autogenous block grafting's transformative impact on challenging cases, guiding future applications in reconstructive dentistry.
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Affiliation(s)
- Joshua Narde
- Department of Prosthodontics, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, IND
| | - Dhanraj Ganapathy
- Department of Prosthodontics, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, IND
| | - Kiran Kumar Pandurangan
- Department of Prosthodontics, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, IND
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Abedi M, Shafiee M, Afshari F, Mohammadi H, Ghasemi Y. Collagen-Based Medical Devices for Regenerative Medicine and Tissue Engineering. Appl Biochem Biotechnol 2023:10.1007/s12010-023-04793-3. [PMID: 38133881 DOI: 10.1007/s12010-023-04793-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/09/2023] [Indexed: 12/23/2023]
Abstract
Assisted reproductive technologies are key to solving the problems of aging and organ defects. Collagen is compatible with living tissues and has many different chemical properties; it has great potential for use in reproductive medicine and the engineering of reproductive tissues. It is a natural substance that has been used a lot in science and medicine. Collagen is a substance that can be obtained from many different animals. It can be made naturally or created using scientific methods. Using pure collagen has some drawbacks regarding its physical and chemical characteristics. Because of this, when collagen is processed in various ways, it can better meet the specific needs as a material for repairing tissues. In simpler terms, collagen can be used to help regenerate bones, cartilage, and skin. It can also be used in cardiovascular repair and other areas. There are different ways to process collagen, such as cross-linking it, making it more structured, adding minerals to it, or using it as a carrier for other substances. All of these methods help advance the field of tissue engineering. This review summarizes and discusses the current progress of collagen-based materials for reproductive medicine.
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Affiliation(s)
- Mehdi Abedi
- Pharmaceutical Science Research Center, Shiraz University of Medical Science, Shiraz, Iran.
- Research and Development Department, Danesh Salamat Kowsar Co., P.O. Box 7158186496, Shiraz, Iran.
| | - Mina Shafiee
- Research and Development Department, Danesh Salamat Kowsar Co., P.O. Box 7158186496, Shiraz, Iran
| | - Farideh Afshari
- Department of Tissue Engineering and Applied Cell Science, School of Advanced Medical Sciences and Technology, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Hamidreza Mohammadi
- Research and Development Department, Danesh Salamat Kowsar Co., P.O. Box 7158186496, Shiraz, Iran
| | - Younes Ghasemi
- Pharmaceutical Science Research Center, Shiraz University of Medical Science, Shiraz, Iran
- Department of Pharmaceutical Biotechnology, School of Pharmacy, Shiraz University of Medical Sciences, Shiraz, Iran
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Li Z, Yang C, Wang J, Zheng K, Luo W. The application of CGF combined with GBR in alveolar bone increment for patients with anxiety disorder: A rare case report and literature review. Medicine (Baltimore) 2023; 102:e35905. [PMID: 37960737 PMCID: PMC10637472 DOI: 10.1097/md.0000000000035905] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2023] [Accepted: 10/12/2023] [Indexed: 11/15/2023] Open
Abstract
RATIONALE Selective serotonin reuptake inhibitors (SSRIs), one of the commonly used anti-anxiety drugs, may have impacts on bone metabolism and potentially lead to drug-induced osteoporosis. The traditional approach of oral implantation in individuals with both anxiety disorder and drug-induced osteoporosis poses a significant challenge. To address this issue, concentrated growth factor (CGF) has been utilized in patients undergoing concurrent alveolar ridge augmentation during oral implantation, resulting in favorable clinical outcomes. Consequently, combining CGF with guided bone regeneration (GBR) in alveolar bone increment may represent a promising new surgical approach for such patients. In this report, we present a case study of a 25-year-old male with anxiety disorder and drug-induced osteoporosis, in who CGF combined with GBR was employed in alveolar bone increment. PATIENT CONCERNS This article reports the case of a 25-year-old male who underwent cone beam computed tomography (CBCT) due to the absence of his right lower second molar for a period of six months. The CBCT scan revealed significant bone defects, which were attributed to the tooth loss and prolonged use of anti-anxiety drugs. Consequently, the patient sought medical assistance from our department. DIAGNOSES Based on the patient's self-report, he was diagnosed with an anxiety disorder. Additionally, the CBCT scan confirmed the loss of the right mandibular second molar and revealed the presence of dental irregularity and an alveolar bone defect. INTERVENTIONS During the patient's course of treatment with anti-anxiety medication, a combination of CGF and GBR was employed for the simultaneous implantation of the missing right mandibular second molar, along with bone augmentation. OUTCOMES The patient had a follow-up visit two weeks after the surgical procedure, and the wound in the operation area had healed satisfactorily. Six months later, CBCT images revealed excellent osseointegration. The buccal and lingual width of the alveolar bone measured 6.95mm, which was an increase of 1.35mm compared to the pre-implantation stage. LESSONS This article presents a case study in which CGF combined with GBR were utilized to address alveolar bone augmentation during the implantation phase in patients taking anti-anxiety medication. The results demonstrated that CGF combined with GBR, as a cutting-edge platelet concentrate technique, could effectively stimulate bone tissue proliferation in individuals who have been on long-term anti-anxiety medication, specifically in oral implant areas. This approach can help prevent poor osseointegration, promote higher osseointegration rates, and facilitate wound healing.
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Affiliation(s)
- Zhixin Li
- Department of Stomatology, First Affiliated Hospital of Hainan Medical University, Haikou, China
- School of Stomatology, Hainan Medical University, Haikou, China
| | - Chao Yang
- Department of Stomatology, The People's Hospital of Longhua, Shenzhen, China
- Research and Development Department, Shenzhen Uni-medica Technology CO., Ltd, Shenzhen, China
| | - Jinrong Wang
- Department of Stomatology, First Affiliated Hospital of Hainan Medical University, Haikou, China
- School of Stomatology, Hainan Medical University, Haikou, China
| | - Kaiyue Zheng
- Department of Stomatology, First Affiliated Hospital of Hainan Medical University, Haikou, China
- School of Stomatology, Hainan Medical University, Haikou, China
| | - Wen Luo
- Department of Stomatology, First Affiliated Hospital of Hainan Medical University, Haikou, China
- School of Stomatology, Hainan Medical University, Haikou, China
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8
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Fekry YES, Mahmoud NR. Vertical ridge augmentation of atrophic posterior mandible with corticocancellous onlay symphysis graft versus sandwich technique: clinical and radiographic analysis. Odontology 2023; 111:993-1002. [PMID: 36853425 PMCID: PMC10492881 DOI: 10.1007/s10266-023-00794-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2022] [Accepted: 02/10/2023] [Indexed: 03/01/2023]
Abstract
Alveolar ridge augmentation of atrophic posterior mandibular ridge represents a challenge in oral and maxillofacial surgery to restore aesthetic and function. The aim of the study was to compare the clinical and radiographic outcomes of bone formation in atrophic posterior mandibles augmented using onlay symphysis cortico-cancellous bone block with that augmented using sandwich bone augmentation technique (Inlay). Twelve patients were selected with missing mandibular posterior teeth. CBCT were done for all patients preoperatively to assess the residual bone height, ranged between 5 and 7 mm from the inferior alveolar nerve with adequate sufficient alveolar ridge width more than 4 mm. Patients required bone augmentation procedure with autologous onlay chin graft (group I) versus those used as inlay sandwich technique (group II). Clinical and radiographic analysis were done to analyses the newly formed bone and bone height. Percent of change in bone height was also calculated and revealed that group I was higher than group II, however, statistically insignificant differences between the two groups were found regarding the percentage of newly formed bone. Vertical ridge augmentation procedures using onlay chin graft took lesser time than the interpositional grafting with fixation technique, however, both techniques are promising for vertical ridge augmentation.
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Affiliation(s)
- Yasser El-Sayed Fekry
- Lecturer of Oral and Maxillofacial Surgery, Oral and Maxillofacial Surgery Department, Faculty of Dentistry, October 6 University, Cairo, Egypt
| | - Nermine Ramadan Mahmoud
- Associated Professor of Oral and Maxillofacial Surgery, Oral and Maxillofacial Surgery Department, Faculty of Dentistry, October 6 University, Cairo, Egypt
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9
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Buser D, Urban I, Monje A, Kunrath MF, Dahlin C. Guided bone regeneration in implant dentistry: Basic principle, progress over 35 years, and recent research activities. Periodontol 2000 2023; 93:9-25. [PMID: 38194351 DOI: 10.1111/prd.12539] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2023] [Revised: 10/16/2023] [Accepted: 10/16/2023] [Indexed: 01/10/2024]
Abstract
Bone augmentation procedures are frequent today in implant patients, since an implant should be circumferentially anchored in bone at completion of bone healing to have a good long-term stability. The best documented surgical technique to achieve this goal is guided bone regeneration (GBR) utilizing barrier membranes in combination with bone fillers. This clinical review paper reflects 35 years of development and progress with GBR. In the 1990s, GBR was developed by defining the indications for GBR, examining various barrier membranes, bone grafts, and bone substitutes. Complications were identified and reduced by modifications of the surgical technique. Today, the selection criteria for various surgical approaches are much better understood, in particular, in post-extraction implant placement. In the majority of patients, biodegradable collagen membranes are used, mainly for horizontal bone augmentation, whereas bioinert PTFE membranes are preferred for vertical ridge augmentation. The leading surgeons are using a composite graft with autogenous bone chips to accelerate bone formation, in combination with a low-substitution bone filer to better maintain the augmented bone volume over time. In addition, major efforts have been made since the millenium change to reduce surgical trauma and patient morbidity as much as possible. At the end, some open questions related to GBR are discussed.
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Affiliation(s)
- Daniel Buser
- School of Dental Medicine, University of Bern, Bern, Switzerland
- Centre for Implantology Buser and Frei, Bern, Switzerland
| | - Istvan Urban
- Department of Periodontology and Oral Medicine, University of Michigan, Ann Arbor, Michigan, USA
| | - Alberto Monje
- Department of Periodontology and Oral Medicine, University of Michigan, Ann Arbor, Michigan, USA
- Department of Periodontology, UIC Barcelona, Barcelona, Spain
- Division of Periodontology, CICOM-Monje, Badajoz, Spain
- Department of Periodontology, University of Bern, Bern, Switzerland
| | - Marcel F Kunrath
- Department of Biomaterials, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Department of Dentistry, School of Health and Life Sciences, Pontifical Catholic University of Rio Grande do Sul (PUCRS), Porto Alegre, Brazil
| | - Christer Dahlin
- Department of Biomaterials, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Department of Oral, Maxillofacial Surgery and Research and Development, NU-Hospital Organisation, Trollhättan, Sweden
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Donos N, Akcali A, Padhye N, Sculean A, Calciolari E. Bone regeneration in implant dentistry: Which are the factors affecting the clinical outcome? Periodontol 2000 2023; 93:26-55. [PMID: 37615306 DOI: 10.1111/prd.12518] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2023] [Revised: 07/08/2023] [Accepted: 08/01/2023] [Indexed: 08/25/2023]
Abstract
The key factors that are needed for bone regeneration to take place include cells (osteoprogenitor and immune-inflammatory cells), a scaffold (blood clot) that facilitates the deposition of the bone matrix, signaling molecules, blood supply, and mechanical stability. However, even when these principles are met, the overall amount of regenerated bone, its stability over time and the incidence of complications may significantly vary. This manuscript provides a critical review on the main local and systemic factors that may have an impact on bone regeneration, trying to focus, whenever possible, on bone regeneration simultaneous to implant placement to treat bone dehiscence/fenestration defects or for bone contouring. In the future, it is likely that bone tissue engineering will change our approach to bone regeneration in implant dentistry by replacing the current biomaterials with osteoinductive scaffolds combined with cells and mechanical/soluble factors and by employing immunomodulatory materials that can both modulate the immune response and control other bone regeneration processes such as osteogenesis, osteoclastogenesis, or inflammation. However, there are currently important knowledge gaps on the biology of osseous formation and on the factors that can influence it that require further investigation. It is recommended that future studies should combine traditional clinical and radiographic assessments with non-invasive imaging and with patient-reported outcome measures. We also envisage that the integration of multi-omics approaches will help uncover the mechanisms responsible for the variability in regenerative outcomes observed in clinical practice.
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Affiliation(s)
- Nikolaos Donos
- Centre for Oral Clinical Research, Institute of Dentistry, Faculty of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - Aliye Akcali
- Centre for Oral Clinical Research, Institute of Dentistry, Faculty of Medicine and Dentistry, Queen Mary University of London, London, UK
- Department of Periodontology, Faculty of Dentistry, Dokuz Eylul University, Izmir, Turkey
| | - Ninad Padhye
- Centre for Oral Clinical Research, Institute of Dentistry, Faculty of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - Anton Sculean
- Department of Periodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - Elena Calciolari
- Centre for Oral Clinical Research, Institute of Dentistry, Faculty of Medicine and Dentistry, Queen Mary University of London, London, UK
- Department of Medicine and Dentistry, Dental School, University of Parma, Parma, Italy
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Bernatskiy BS, Puišys A. A Novel Approach for Implant Rehabilitation Combined with Immediate Bone and Soft-Tissue Augmentation in a Compromised Socket—A B2S Approach: Case Report with a 2-Year Follow-Up. Case Rep Dent 2023; 2023:1376588. [PMID: 37025607 PMCID: PMC10072960 DOI: 10.1155/2023/1376588] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2022] [Revised: 02/20/2023] [Accepted: 02/28/2023] [Indexed: 03/30/2023] Open
Abstract
In this case report, we aimed to describe a novel approach for aesthetic rehabilitation of the anterior maxilla that combined immediate implant installation with the “Bone2Soft Tissue Reconstruction” (B2S technique), which involves the use of a triple graft harvested from the maxillary tuberosity. The regeneration potential of a tuberosity graft appeared to surpass that of corticocancellous bone grafts harvested from other intraoral donor sites and allowed for quicker regeneration of both bone and soft tissue. The B2S technique extended the indications for immediate implant placement and ridge augmentation to cases involving severe bone resorption and other complex clinical scenarios. Owing to the good visualization facilitated by open-flap access, the surgical procedures can be completed in a single intervention, which will be beneficial for both doctors and patients.
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12
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Gallo P, Díaz‐Báez D, Perdomo S, Aloise AC, Tattan M, Saleh MHA, Pelegrine AA, Ravidà A, Wang H. Comparative analysis of two biomaterials mixed with autogenous bone graft for vertical ridge augmentation: A histomorphometric study in humans. Clin Implant Dent Relat Res 2022; 24:709-719. [PMID: 35916287 PMCID: PMC9804607 DOI: 10.1111/cid.13124] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2022] [Revised: 07/06/2022] [Accepted: 07/08/2022] [Indexed: 01/05/2023]
Abstract
BACKGROUND The vertical increase of the alveolar ridge dimension using allograft or xenograft mixed with autogenous bone graft and covered by a nonabsorbable high-density polytetrafluoroethylene (d-PTFE) membrane is well documented in the literature. PURPOSE The aim of this study was to assess vital mineralized tissue formation in vertical ridge augmentation (VRA) procedures using autogenous bone chips mixed either with an allograft or a xenograft. METHODS This prospective clinical trial recruited 16 partially edentulous patients to undergo vertical ridge augmentation in one or more sites, making up a total of 24 samples for histological evaluation. Patients were sequentially stratified into Group A (treated with a freeze-dried bone allograft [FDBA] mixed with autogenous bone) or to Group B (treated with a bovine xenograft mixed with autogenous bone). Histological samples were analyzed according to the biomaterial used for VRA. Histological samples were obtained on the same day of membrane removal and implant placement. RESULTS Thirty-three implants were placed in 16 sites of regenerated bone via VRA, 13 patients with ridge augmentation in the posterior mandible, and 3 patients with VRA in the anterior maxilla. Group A (FDBA + autogenous) and Group B (xenograft + autogenous) showed a percent vital mineralized tissue (VMT) area of 67.64 ± 16.84 and 60.93 ± 18.25, respectively. A significant difference between the two biomaterials was not observed. CONCLUSION When mixed with autogenous bone, either allografts or xenografts may provide a successful augmentation. Either mixture could serve as reliable alternative in VRA for obtaining a high percentage of VMT.
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Affiliation(s)
- Pier Gallo
- Department of Implant Dentistry, Faculdade São Leopoldo MandicInstituto de Pesquisas São Leopoldo MandicCampinasBrazil
| | - David Díaz‐Báez
- Researcher of Oral Basic Research Unit ‐UIBO, School of DentistryEl Bosque UniversityBogotáColombia
| | - Sandra Perdomo
- Researcher of Oral Basic Research Unit ‐UIBO, School of DentistryEl Bosque UniversityBogotáColombia
| | - Antonio Carlos Aloise
- Department of Implant Dentistry, Faculdade São Leopoldo MandicInstituto de Pesquisas São Leopoldo MandicCampinasBrazil
| | - Mustafa Tattan
- Department of PeriodonticsCollege of Dentistry, University of IowaIowa CityIowaUSA
| | - Muhammad H. A. Saleh
- Department of Periodontics and Oral MedicineUniversity of Michigan, School of DentistryAnn ArborMichiganUSA
| | - André Antonio Pelegrine
- Department of Implant Dentistry, Faculdade São Leopoldo MandicInstituto de Pesquisas São Leopoldo MandicCampinasBrazil
| | - Andrea Ravidà
- Department of Periodontics and Oral MedicineUniversity of Michigan, School of DentistryAnn ArborMichiganUSA
| | - Hom‐Lay Wang
- Department of Periodontics and Oral MedicineUniversity of Michigan, School of DentistryAnn ArborMichiganUSA
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13
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Bose BB, Natarajan PM, Kannan AL, Jebaraj JC, Jagannathan R, Balaji TM. Evaluation of Block Allograft Efficacy in Lateral Alveolar Ridge Augmentation. J Contemp Dent Pract 2022; 23:807-812. [PMID: 37283015 DOI: 10.5005/jp-journals-10024-3377] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
AIM The research was performed for the clinical and computerized tomography (CT) assessment of cortico-cancellous block allograft in the reconstruction of lateral alveolar ridge width deficiency prior to placement of dental implants. MATERIALS AND METHODS Ten patients who had atrophic mandibular ridge necessitating bone augmentation prior to implant placement were randomly selected, and corticocancellous block allografts were used to augment the lateral ridge deficiency. The grafted site was assessed clinically and with CT preoperatively and 6 months postoperatively. Surgical re-entry was done after 6 months for dental implant placement. RESULTS During the 6-month evaluation period, all the block allografts had integrated well with the host tissue. Clinically, all the grafts were found to be firm in consistency, well-incorporated, and vascularized. Both the clinical and CT measurements showed increase in bone width. The dental implants had good primary stability. CONCLUSION Bone-block allografts can be employed as a marked graft material for the management of lateral ridge defects. CLINICAL SIGNIFICANCE During precise and accurate surgical methods, this type of bone graft can be safely used in regions of implant placement as a convenient alternative to autogenous grafts.
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Affiliation(s)
- Bhuvaneswari Birla Bose
- Department of Periodontics, Tagore Dental College and Hospital, Chennai, Tamil Nadu, India, Phone: +91 9789912002, e-mail:
| | | | - Anitha Logaranjani Kannan
- Department of Periodontics, Sri Meenakshi Ammal Dental College & Hospital, Chennai, Tamil Nadu, India
| | | | | | - Thodur Madapusi Balaji
- Department of Periodontics, Tagore Dental College and Hospital, Chennai, Tamil Nadu, India
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14
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Lim J, Jun SH, Tallarico M, Park JB, Park DH, Hwang KG, Park CJ. A Randomized Controlled Trial of Guided Bone Regeneration for Peri-Implant Dehiscence Defects with Two Anorganic Bovine Bone Materials Covered by Titanium Meshes. MATERIALS 2022; 15:ma15155294. [PMID: 35955229 PMCID: PMC9369984 DOI: 10.3390/ma15155294] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/04/2022] [Revised: 07/17/2022] [Accepted: 07/21/2022] [Indexed: 12/10/2022]
Abstract
The aim of this study is to compare two low-temperature sintered anorganic bovine bone materials (ABBMs), Bio-Oss (Geistlich, Wolhusen, Switzerland) and A-Oss (Osstem, Seoul, Korea), for GBR in dehiscence defects. A single implant was placed simultaneously with GBR in the buccal or bucco-proximal osseous defect by double-layering of inner allograft and outer ABBM, covered by a preformed ultrafine titanium mesh and an absorbable collagen membrane. Grafted volume changes were evaluated by cone-beam computed tomography, taken preoperatively (T0), immediately after implant surgery (T1), after re-entry surgery (T2), and after delivery of the final restoration (T3). The density of the regenerated bone was assessed by measuring the probing depth on the buccal mid-center of the mesh after removing the mesh at T2. Postoperative sequelae were also recorded. Grafted volume shrinkage of 46.0% (0.78 ± 0.37 cc) and 40.8% (0.79 ± 0.33 cc) in the Bio-Oss group (8 patients) and A-Oss group (8 patients), respectively, was observed at T3 (p < 0.001). There were no significant differences in grafted volume changes according to time periods or bone density between the two groups. Despite postoperative mesh exposure (3 patients), premature removal of these exposed meshes and additional grafting was not necessary, and all implants were functional over the 1-year follow-up period. Both ABBMs with titanium meshes showed no significant difference in the quantity and density of the regenerated bone after GBR for peri-implant defects.
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Affiliation(s)
- JaeHyung Lim
- Department of Oral and Maxillofacial Surgery, Korea University Ansan Hospital, Ansan-si 15355, Korea;
| | - Sang Ho Jun
- Department of Oral and Maxillofacial Surgery, Korea University Anam Hospital, Seoul 02841, Korea;
| | - Marco Tallarico
- Department of Medicine, Surgery, and Pharmacy, University of Sassari, 07100 Sassari, Italy;
| | - Jun-Beom Park
- Department of Periodontics, College of Medicine, The Catholic University of Korea, Seoul 06591, Korea;
| | - Dae-Ho Park
- Division of Oral & Maxillofacial Surgery, Department of Dentistry, College of Medicine, Hanyang University, Seoul 04763, Korea; (D.-H.P.); (K.-G.H.)
| | - Kyung-Gyun Hwang
- Division of Oral & Maxillofacial Surgery, Department of Dentistry, College of Medicine, Hanyang University, Seoul 04763, Korea; (D.-H.P.); (K.-G.H.)
| | - Chang-Joo Park
- Division of Oral & Maxillofacial Surgery, Department of Dentistry, College of Medicine, Hanyang University, Seoul 04763, Korea; (D.-H.P.); (K.-G.H.)
- Correspondence: ; Tel.: +82-2-2290-8646
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15
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Wang J, Luo Y, Qu Y, Man Y. Horizontal ridge augmentation in the anterior maxilla with in situ onlay bone grafting: a retrospective cohort study. Clin Oral Investig 2022; 26:5893-5908. [PMID: 35583662 DOI: 10.1007/s00784-022-04547-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2022] [Accepted: 05/08/2022] [Indexed: 02/08/2023]
Abstract
OBJECTIVES This study aimed to introduce a digitally guided in situ autogenous onlay grafting technique and compare its effectiveness with the conventional (ex situ) onlay technique in augmenting horizontal bone defects of the anterior maxilla. MATERIALS AND METHODS This retrospective cohort study included 24 patients who had received autogenous onlay bone grafts combined with guided bone regeneration (GBR) in the anterior maxilla. Fourteen patients were recruited into the in situ onlay grafting group (EG), and 10 were recruited into the ex situ onlay group (CG), defined by the donor sites. The clinical parameters, radiographic changes, micro-CT, and histological processes were evaluated after a mean follow-up period of 1.7 years. RESULTS The horizontal bone width reflected significant bone modeling over time (p < 0.001) in the first 6 months. Multivariable analysis showed that the treatment modality (grouping) was a critical factor positively associated with vertical bone height alteration. However, neither the alteration rate of horizontal bone width nor the bone volume was associated with the treatment modality. The number of periosteal screws per graft positively affected horizontal contour maintenance (p < 0.05). No significant differences were observed between the groups in the clinical parameters (complications, success rate, and peri-implant parameters). The micro-CT and histological outcomes were similar between the groups. CONCLUSION Despite the limitations of this study, in situ onlay grafting combined with GBR was an effective and reliable approach for horizontal bone augmentation in the anterior maxilla and appeared to demonstrate better stability in vertical bone remodeling. CLINICAL RELEVANCE This study introduces a modified and minimally invasive technique of onlay grafting for horizontal bone augmentation. This in situ onlay grafting demonstrates superior stability in vertical bone remodeling. The trial registration number is ChiCTR2100054683.
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Affiliation(s)
- Jing Wang
- State Key Laboratory of Oral Diseases and National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, No. 14, 3rd Section, Renmin Nan Road, Chengdu, 610041, Sichuan, China.,Department of Oral Implantology, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Yilin Luo
- State Key Laboratory of Oral Diseases and National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, No. 14, 3rd Section, Renmin Nan Road, Chengdu, 610041, Sichuan, China.,Department of Oral Implantology, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Yili Qu
- State Key Laboratory of Oral Diseases and National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, No. 14, 3rd Section, Renmin Nan Road, Chengdu, 610041, Sichuan, China.,Department of Prosthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Yi Man
- State Key Laboratory of Oral Diseases and National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, No. 14, 3rd Section, Renmin Nan Road, Chengdu, 610041, Sichuan, China. .,Department of Oral Implantology, West China Hospital of Stomatology, Sichuan University, Chengdu, China.
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16
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Arnal HM, Angioni CD, Gaultier F, Urbinelli R, Urban IA. Horizontal guided bone regeneration on knife-edge ridges: A retrospective case-control pilot study comparing two surgical techniques. Clin Implant Dent Relat Res 2022; 24:211-221. [PMID: 35167184 DOI: 10.1111/cid.13073] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Revised: 01/04/2022] [Accepted: 01/31/2022] [Indexed: 12/21/2022]
Abstract
INTRODUCTION Studies evaluating guided bone regeneration (GBR) on knife-edge ridges using absorbable membranes with staged approaches have reported various horizontal bone gains. This study compared the horizontal bone gain obtained via a conventional technique of GBR and a recently-reported technique. Bone loss during the healing process was also measured. METHODS Consecutive patients who underwent GBR on knife-edge ridges via a conventional technique (control group) or the Sausage Technique (test group) were included in this study. GBR was performed using a collagen membrane and deproteinized bovine bone mineral combined with an autogenous graft at a 1:1 ratio. Cone-beam computed tomography (CBCT) was performed preoperatively, postoperatively, and after the patient healed. Horizontal bone width was measured on CBCT images 2 mm apical from the top of the crest. The preoperative CBCT and posthealing CBCT were superimposed to calculate the bone gain after healing, and the preoperative and postoperative CBCT scans were superimposed to calculate the bone gain after surgery. Bone loss during healing was calculated by subtracting the width of the ridge after healing from the postoperative width. RESULTS The mean horizontal bone gain was significantly lower in the control group (2.7 ± 1.8 mm; 83.2%) than in the test group (5.3 ± 2.3 mm; 216.8%) (p = 0.003). The average horizontal bone loss between regeneration and implant placement was 0.9 mm in the control group (27.9%) and 2.1 mm in the test group (29.4%). While the absolute bone loss was significantly different (p = 0.012), the percentage of bone resorption was not (p = 0.608). CONCLUSION The new technique resulted in significantly more bone gain than a conventional GBR technique. The rate of graft resorption during healing was stable regardless of the amount of grafted material.
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Affiliation(s)
- Helene M Arnal
- Department of Oral Medicine and Oral Surgery, APHP Henri Mondor Hospital, University of Paris, Paris, France.,Cabinet de chirurgie dentaire Villiers, Paris, France
| | - Charles D Angioni
- Cabinet de chirurgie dentaire Villiers, Paris, France.,Department of Periodontics, APHP Henri Mondor Hospital, University of Paris, Paris, France
| | - Frederick Gaultier
- Department of Oral Medicine and Oral Surgery, APHP Henri Mondor Hospital, University of Paris, Paris, France
| | | | - Istvan A Urban
- Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, Michigan, USA.,School of Dentistry, University of Szeged, Szeged, Hungary.,Urban Regeneration Institute, Budapest, Hungary
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17
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Safety and feasibility assessment of biodegradable poly (l-lactic acid/ε-caprolactone) membrane for guided bone regeneration: A case series of first-in-human pilot study. J Dent Sci 2022; 17:368-376. [PMID: 35028060 PMCID: PMC8739751 DOI: 10.1016/j.jds.2021.08.015] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2021] [Revised: 08/05/2021] [Indexed: 11/26/2022] Open
Abstract
Background/purpose Guided bone regeneration (GBR) is the most popular technique for alveolar ridge augmentation in implant dentistry, and resorbable cell barrier membrane, made of collagen, is widely used. We tried to develop a new resorbable cell barrier membrane from an animal-free product. This study aimed to investigate the safety and feasibility for clinical application of poly (l-lactic acid/ε-caprolactone) [P (LA/CL)] membrane, a novel biodegradable synthetic material used for GBR. Materials and methods Patients who required horizontal bone augmentation (≥3 mm implant exposure) for implant treatment were included in the study. P (LA/CL) membrane was used simultaneously with implant placement to achieve bone augmentation by GBR. The occurrence of adverse events was assessed until the follow-up period of a second surgical procedure. The amount of bone augmentation was assessed by means of cone-beam computed tomography, and implant stability was assessed by measuring the implant stability quotient (ISQ). Student's t-test was used and the level of significance was set at p < 0.05. Results This first-in-human study comprised five participants. Adverse events were observed in three of five patients, and a cause-and-effect relationship of the membrane could not be denied in one of them. Good bone formation was observed in the GBR region of all five patients. The ISQ during the second surgical procedure indicated good osseointegration in all the patients. Conclusion The application of P (LA/CL) membrane for bone augmentation with GBR made it possible to maintain the augmented bone volume without causing any irreversible adverse events. However, further investigations on humans are required to confirm the safety of this biomaterial.
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18
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Tallarico M, Xhanari E, Lumbau AMI, Alushi A, Ieria I, Fiorillo L, Famà F, Meto A, Baldoni E, Meloni SM, Cicciù M. Histological and Histomorphometric Evaluation of Post-Extractive Sites Filled with a New Bone Substitute with or without Autologous Plate Concentrates: One-Year Randomized Controlled Trial. MATERIALS (BASEL, SWITZERLAND) 2021; 15:ma15010254. [PMID: 35009400 PMCID: PMC8746213 DOI: 10.3390/ma15010254] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/01/2021] [Revised: 11/20/2021] [Accepted: 12/23/2021] [Indexed: 05/04/2023]
Abstract
The purpose of the present study was to evaluate the histological and histomorphometric characteristics of post-extraction sites grafted with decellularized bovine compact bone from bovine femur, mixed and unmixed with leukocyte- and platelet-rich fibrin after four months of healing. This study was designed as a randomized controlled trial of parallel groups. Patients in need of a single, implant-supported restoration to replace a hopeless tooth were recruited for tooth extraction and implant placement four months after socket preservation procedure. After tooth extraction, patients were randomly allocated to receive decellularized bovine compact bone from bovine femur, mixed and unmixed with leukocyte- and platelet-rich fibrin. After four months of healing, tapered implants were inserted with an insertion torque between 35 and 45 Ncm. Two months later, implants were loaded with screw-retained definitive crowns. Outcome measures were implant (ISR) and prosthesis (PSR) survival rates, complications, histological and histomorphometric analyses, radiographic marginal bone-level changes, and patients' satisfaction. Clinical data were collected up to one year after tooth extraction and socket preservation procedures. Thirty patients were consecutively enrolled in the trial (15 in each group). Unfortunately, due to the COVID-19 pandemic, bone samples were collected only in 19 patients. Two implants failed before definitive prosthesis delivery (ISR 93.3%). No prosthesis failed (PSR 100%). Three complications were experienced in the control group. The mean bone percentage was 40.64 ± 18.76 in the test group and 33.40 ± 22.38 in the control group. The difference was not statistically significant (p = 0.4846). The mean soft tissue percentage was 32.55 ± 19.45 in the test group and 55.23 ± 17.64 in the control group. The difference was statistically significant (p = 0.0235). The mean residual graft was 24.59 ± 18.39 in the test group and 11.37 ± 12.12 in the control group. The difference was not statistically significant (p = 0.0992). Mean marginal bone loss, as well as patient satisfaction, showed no differences between groups. With the limitations of the present study, socket preservation with L-PRF mixed with decellularized bovine compact bone demonstrated favorable results, comparing with decellularized bovine compact bone from bovine femur alone. Further studies with larger sample size and longer follow-up are needed to confirm these preliminary results.
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Affiliation(s)
- Marco Tallarico
- School of Dentistry, University of Sassari, 07021 Sassari, Italy; (M.T.); (A.M.I.L.); (E.B.); (S.M.M.)
- Department of Implantology, Faculty of Dentistry, University of Aldent, 1031 Tirana, Albania; (E.X.); (A.A.); (A.M.)
| | - Erta Xhanari
- Department of Implantology, Faculty of Dentistry, University of Aldent, 1031 Tirana, Albania; (E.X.); (A.A.); (A.M.)
| | | | - Adela Alushi
- Department of Implantology, Faculty of Dentistry, University of Aldent, 1031 Tirana, Albania; (E.X.); (A.A.); (A.M.)
| | | | - Luca Fiorillo
- Department of Implantology, Faculty of Dentistry, University of Aldent, 1031 Tirana, Albania; (E.X.); (A.A.); (A.M.)
- Department of Biomedical, Dental Science and Morphological and Functional Images, University of Messina, 98122 Messina, Italy;
- Multidisciplinary Department of Medical-Surgical and Odontostomatological Specialties, University of Campania “Luigi Vanvitelli”, 81100 Naples, Italy
- Correspondence:
| | - Fausto Famà
- Department of Human Pathology in Adulthood and Childhood “G. Barresi”, University Hospital “G. Martino” of Messina, Via Consolare Valeria 1, 98125 Messina, Italy;
| | - Agron Meto
- Department of Implantology, Faculty of Dentistry, University of Aldent, 1031 Tirana, Albania; (E.X.); (A.A.); (A.M.)
| | - Edoardo Baldoni
- School of Dentistry, University of Sassari, 07021 Sassari, Italy; (M.T.); (A.M.I.L.); (E.B.); (S.M.M.)
| | - Silvio Mario Meloni
- School of Dentistry, University of Sassari, 07021 Sassari, Italy; (M.T.); (A.M.I.L.); (E.B.); (S.M.M.)
| | - Marco Cicciù
- Department of Biomedical, Dental Science and Morphological and Functional Images, University of Messina, 98122 Messina, Italy;
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19
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Gašperšič R, Cmok Kučič A, Volk Gašperšič K, Kosem R. Peri-implant soft tissue contour after stepwise replacement of missing and ankylotic central maxillary incisors in young adult: A clinical case report. Clin Case Rep 2021; 9:e04960. [PMID: 34667613 PMCID: PMC8511884 DOI: 10.1002/ccr3.4960] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2020] [Revised: 05/31/2021] [Accepted: 09/25/2021] [Indexed: 11/25/2022] Open
Abstract
Replantation and retention of ankylosed tooth after pubertal growth spurt enables stepwise replacement of both central incisors with implants. Partial extraction contributes to natural gingival contour.
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Affiliation(s)
- Rok Gašperšič
- Department of Periodontology, Faculty of MedicineUniversity of LjubljanaLjubljanaSlovenia
| | | | | | - Rok Kosem
- Department of Paediatric DentistryUniversity Medical Centre LjubljanaLjubljanaSlovenia
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20
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Bienz SP, Payer M, Hjerppe J, Hüsler J, Jakse N, Schmidlin PR, Hämmerle CHF, Jung RE, Thoma DS. Primary bone augmentation leads to equally stable marginal tissue conditions comparing the use of xenograft blocks infused with BMP-2 and autogenous bone blocks: A 3D analysis after 3 years. Clin Oral Implants Res 2021; 32:1433-1443. [PMID: 34543475 PMCID: PMC9293361 DOI: 10.1111/clr.13843] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2020] [Revised: 05/26/2021] [Accepted: 07/07/2021] [Indexed: 11/28/2022]
Abstract
Objectives To test whether or not primary bone augmentation using xenograft blocks infused with BMP‐2 or autogenous bone blocks lead to similar results regarding the implant survival and 3D marginal soft tissue contours. Methods Twenty‐four patients with an insufficient ridge width for implant placement in need of primary augmentation were randomly assigned to either a block of deproteinized bovine bone mineral infused with rhBMP‐2 (BMP) or an intraorally harvested block of autogenous bone (ABB). At 4 months, 1–4 dental implants were placed in the regenerated area. After crown insertion and at 3 years, peri‐implant tissue parameters, two‐ and three‐dimensional radiographic parameters, and soft tissue contour changes were evaluated. Explorative mixed model analyses were performed. The level of significance was set at 5%. Results At the 3‐year follow‐up, 23 patients with 40 implants were evaluated. The implant survival rate was 100% in both groups. At baseline, the marginal hard tissue levels amounted to −0.4 ± 0.8 mm (mean ± standard deviation) in the BMP group and −0.7 ± 1.0 mm in the ABB group. At 3 years, these values were −0.2 ± 0.4 mm (BMP) and −0.6 ± 1.0 mm (ABB). At baseline, the thickness of the buccal hard tissue at the level of the implant shoulder measured 1.1 ± 1.1 mm (BMP) and 1.4 ± 1.0 mm (ABB). At 3 years, it measured 0.9 ± 0.9 mm (BMP) and 0.7 ± 0.6 mm (ABB). Conclusions The present study demonstrated excellent implant survival rates and stable marginal hard tissue levels in both augmentation groups, 3 years after crown insertion. In addition, the clinical stability of soft and hard tissues was demonstrated in both groups.
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Affiliation(s)
- Stefan P Bienz
- Clinic of Reconstructive Dentistry, University of Zurich, Zurich, Switzerland
| | - Michael Payer
- Department of Oral Surgery and Radiology, School of Dentistry, Medical University Graz, Graz, Austria
| | - Jenni Hjerppe
- Clinic of Reconstructive Dentistry, University of Zurich, Zurich, Switzerland
| | - Jürg Hüsler
- Clinic of Reconstructive Dentistry, University of Zurich, Zurich, Switzerland
| | - Norbert Jakse
- Department of Oral Surgery and Radiology, School of Dentistry, Medical University Graz, Graz, Austria
| | - Patrick R Schmidlin
- Clinic of Preventive Dentistry, Periodontology and Cariology, University of Zurich, Zurich, Switzerland
| | | | - Ronald E Jung
- Clinic of Reconstructive Dentistry, University of Zurich, Zurich, Switzerland
| | - Daniel S Thoma
- Clinic of Reconstructive Dentistry, University of Zurich, Zurich, Switzerland.,Department of Periodontology, College of Dentistry, Research Institute for Periodontal Regeneration, Yonsei University, Seoul, Korea
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21
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Durrani F, Nahid R, Pandey S, Singh P, Pandey A. One-piece implants: Careful approach for complex rehabilitation. Natl J Maxillofac Surg 2021; 12:266-270. [PMID: 34483588 PMCID: PMC8386274 DOI: 10.4103/njms.njms_191_20] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2020] [Revised: 11/23/2020] [Accepted: 01/09/2021] [Indexed: 11/15/2022] Open
Abstract
It is understood that one-piece implant design is a stronger concept as there is no connection between implant and abutment. The absence of a microgap can lead to minimal peri-implant bone loss. Furthermore, there is a reduction of mechanical complications such as screw loosening and abutment fractures. These implants can be immediately placed and can be put through instant function because of their high cortical stabilization. This immediate function protocol has advantages over two-stage surgical placement. Other benefits are fewer surgical appointments, reduced treatment time, and minimal trauma. It is suggested that one-piece implant can be an alternative to conventional implants for edentulous arches where there is a resorbed bone in width and height. Initially, one-piece implants were used as transitional or provisional implants. However, because of biological osseointegration, their removal often became difficult. Several manufacturers obtained approval for its use in defined situations. Proper treatment planning avoided comorbidity associated with augmentation procedures and acceptable esthetic result was achieved.
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Affiliation(s)
- Farhan Durrani
- Department of Periodontology, Faculty of Dental Science, Institute of Medical Science, Banaras Hindu University, Varanasi, Uttar Pradesh, India
| | - Rakhshinda Nahid
- Department of Periodontology, Faculty of Dental Science, Institute of Medical Science, Banaras Hindu University, Varanasi, Uttar Pradesh, India
| | - Samidha Pandey
- Department of Periodontology, Faculty of Dental Science, Institute of Medical Science, Banaras Hindu University, Varanasi, Uttar Pradesh, India
| | - Preeti Singh
- Department of Periodontology, Faculty of Dental Science, Institute of Medical Science, Banaras Hindu University, Varanasi, Uttar Pradesh, India
| | - Aishwarya Pandey
- Department of Periodontology, Faculty of Dental Science, Institute of Medical Science, Banaras Hindu University, Varanasi, Uttar Pradesh, India
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22
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Tissue Recession around a Dental Implant in Anterior Maxilla: How to Manage Soft Tissue When Things Go Wrong? PROSTHESIS 2021. [DOI: 10.3390/prosthesis3030021] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Dental implants represent the gold standard for the treatment of single edentulism, even in anterior areas. Today, the basic criteria for implant success has changed from mobility, pain, radiolucency, and peri-implant bone loss (>1.5 mm) to prosthetic level success, aesthetics, soft tissue parameters, as well as patient satisfaction. This case report documents a combination of surgical and prosthetic procedures for the treatment of gingival recessions in the anterior maxilla, appearing after tooth extraction, socket preservation, and staged guided implant placement. Prosthetic management of the temporary restoration, orthodontic treatment, and a connective tissue graft were performed. The decision-making process and step-by-step execution of the treatments are presented to describe the entire clinical and surgical management of the reported case. Finally, good aesthetic outcomes, patient satisfaction, and recovery of the soft tissue recession were observed with the combination of these techniques.
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23
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Sánchez-Sánchez J, Pickert FN, Sánchez-Labrador L, GF Tresguerres F, Martínez-González JM, Meniz-García C. Horizontal Ridge Augmentation: A Comparison between Khoury and Urban Technique. BIOLOGY 2021; 10:biology10080749. [PMID: 34439981 PMCID: PMC8389589 DOI: 10.3390/biology10080749] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/26/2021] [Revised: 07/23/2021] [Accepted: 08/02/2021] [Indexed: 11/16/2022]
Abstract
Simple Summary With the emergence of novelty regeneration techniques in the implant dentistry field, the professional may have some queries about which one to use in their daily practice. No systematic review, to date, analyzes the horizontal gains achievable with the two main procedures for bone regeneration: the Khoury technique, which uses split blocks obtained from the patient himself, or the Urban technique, which employs membranes to contain the biomaterials. Regarding this paper, the reader will be able to decide if any of these options is adequate for the indication required. Abstract Purpose. The objective of this systematic review was to evaluate and compare the clinical efficacy of horizontal alveolar ridge augmentation techniques described by Khoury and Urban. Methods. A systematic electronic search in the MEDLINE databases, SCOPUS, WOS, and the Cochrane Central Register of Controlled Trials (CENTRAL) as well as a manual search, were conducted independently by two reviewers up to July 2021. Results. Six studies met the pre-established inclusion criteria and were included in the descriptive analysis. Due to the heterogeneity found across the included studies, meta-analysis could not be performed. Horizontal bone gain was between 3.93 ± 0.9 mm and 5.02 ± 0.8 mm with the Khoury technique and between 3.9 ± 0.9 mm and 5.68 ± 1.42 mm with the Urban technique. Similar complication rates were reported in both groups: infection (7%), in the Khoury technique, and membrane exposure (3.2–13.6%), in the Urban technique, being the most frequent events. Conclusions. Both techniques were found to be effective, in terms of clinical bone gain, for horizontal alveolar ridge gain. Nevertheless, available literature is limited, and there is a lack of comparative studies to better evaluate the results.
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Song YW, Jung HJ, An YZ, Jung UW, Lee JS. Addition of autogenous bone chips to deproteinized bovine bone mineral does not have additional benefit in lateral ridge augmentation-A preclinical in vivo experimental study. Clin Oral Implants Res 2021; 32:1105-1114. [PMID: 34219293 DOI: 10.1111/clr.13805] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2021] [Revised: 06/17/2021] [Accepted: 06/20/2021] [Indexed: 12/17/2022]
Abstract
OBJECTIVE To compare the outcome after extensive lateral guided bone regeneration using deproteinized bovine bone mineral (DBBM) with or without autogenous bone chips in a canine model of chronic horizontal alveolar ridge defect. MATERIALS AND METHODS The second, third and fourth lower premolars of both sides were extracted, and the buccal bone walls were completely removed in five beagle dogs. After 4 weeks, DBBM particles mixed with autogenous bone chips at a ratio of 1:1 were grafted at one side (DBBM/Auto group), while DBBM particles alone were grafted at the contralateral side (DBBM group). The graft materials on both sides were covered by a resorbable collagen membrane and fixation pins. Microcomputed tomographic volume and histomorphometric analyses were performed at 16 weeks post-surgery. RESULTS The ridges of both groups were recovered horizontally, but new bone formation beyond the original ridge contour at the defect site was not found. The DBBM group exhibited a larger total radiographic augmented volume and new bone volume compared with the DBBM/Auto group, but the differences were minimal (p > .05). Histologically, the regenerated area and new bone area were also slightly larger without any statistical significance in the DBBM group than in the DBBM/Auto group (p > .05). CONCLUSION The addition of autogenous bone chips to DBBM for lateral ridge augmentation may confer no advantage over grafting DBBM alone with respect to both space maintenance and de novo bone formation in dogs.
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Affiliation(s)
- Young Woo Song
- Department of Periodontology, Research Institute for Periodontal Regeneration, Yonsei University College of Dentistry, Seoul, Korea.,Department of Oral Medicine, Infection, and Immunity, Harvard School of Dental Medicine, Boston, MA, USA
| | - Hyun-Jun Jung
- Department of Periodontology, Research Institute for Periodontal Regeneration, Yonsei University College of Dentistry, Seoul, Korea
| | - Yin-Zhe An
- Department of Periodontology, Research Institute for Periodontal Regeneration, Yonsei University College of Dentistry, Seoul, Korea.,Key Laboratory of Oral Medicine, Guangzhou Institute of Oral Disease, Affiliated Stomatology Hospital of Guangzhou Medical University, Guangzhou, China
| | - Ui-Won Jung
- Department of Periodontology, Research Institute for Periodontal Regeneration, Yonsei University College of Dentistry, Seoul, Korea
| | - Jung-Seok Lee
- Department of Periodontology, Research Institute for Periodontal Regeneration, Yonsei University College of Dentistry, Seoul, Korea.,Innovation Research and Support Center for Dental Science, Yonsei University Dental Hospital, Seoul, Korea
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Herber V, Okutan B, Antonoglou G, Sommer NG, Payer M. Bioresorbable Magnesium-Based Alloys as Novel Biomaterials in Oral Bone Regeneration: General Review and Clinical Perspectives. J Clin Med 2021; 10:jcm10091842. [PMID: 33922759 PMCID: PMC8123017 DOI: 10.3390/jcm10091842] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2021] [Revised: 04/15/2021] [Accepted: 04/19/2021] [Indexed: 02/07/2023] Open
Abstract
Bone preservation and primary regeneration is a daily challenge in the field of dental medicine. In recent years, bioresorbable metals based on magnesium (Mg) have been widely investigated due to their bone-like modulus of elasticity, their high biocompatibility, antimicrobial, and osteoconductive properties. Synthetic Mg-based biomaterials are promising candidates for bone regeneration in comparison with other currently available pure synthetic materials. Different alloys based on Mg were developed to fit clinical requirements. In parallel, advances in additive manufacturing offer the possibility to fabricate experimentally bioresorbable metallic porous scaffolds. This review describes the promising clinical results of resorbable Mg-based biomaterials for bone repair in osteosynthetic application and discusses the perspectives of use in oral bone regeneration.
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Affiliation(s)
- Valentin Herber
- Department of Dentistry and Oral Health, Division of Oral Surgery and Orthodontics, Medical University of Graz, Billrothgasse 4, 8010 Graz, Austria; (G.A.); (M.P.)
- Department of Orthopaedics and Traumatology, Medical University of Graz, Auenbruggerplatz 5/6, 8036 Graz, Austria; (B.O.); (N.G.S.)
- Correspondence:
| | - Begüm Okutan
- Department of Orthopaedics and Traumatology, Medical University of Graz, Auenbruggerplatz 5/6, 8036 Graz, Austria; (B.O.); (N.G.S.)
| | - Georgios Antonoglou
- Department of Dentistry and Oral Health, Division of Oral Surgery and Orthodontics, Medical University of Graz, Billrothgasse 4, 8010 Graz, Austria; (G.A.); (M.P.)
| | - Nicole G. Sommer
- Department of Orthopaedics and Traumatology, Medical University of Graz, Auenbruggerplatz 5/6, 8036 Graz, Austria; (B.O.); (N.G.S.)
| | - Michael Payer
- Department of Dentistry and Oral Health, Division of Oral Surgery and Orthodontics, Medical University of Graz, Billrothgasse 4, 8010 Graz, Austria; (G.A.); (M.P.)
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Ding Y, Wang L, Su K, Gao J, Li X, Cheng G. Horizontal bone augmentation and simultaneous implant placement using xenogeneic bone rings technique: a retrospective clinical study. Sci Rep 2021; 11:4947. [PMID: 33654142 PMCID: PMC7925558 DOI: 10.1038/s41598-021-84401-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2020] [Accepted: 02/15/2021] [Indexed: 11/09/2022] Open
Abstract
This study evaluated the use of bone ring technique with xenogeneic bone grafts in treating horizontal alveolar bone defects. In total, 11 patients in need of horizontal bone augmentation treatment before implant placement were included in this retrospective study. All patients received simultaneous bone augmentation surgery and implant placement with xenogeneic bone ring grafts. We evaluated the postoperative efficacy of the bone ring technique with xenogeneic bone grafts using radiographical and clinical parameters. Survival rates of implants were 100%. Cone-beam computed tomography revealed that the xenogeneic bone ring graft had significantly sufficient horizontal bone augmentation below the implant neck platform to 0 mm, 1 mm, 2 mm, and 3 mm. It could also provide an excellent peri-implant tissue condition during the 1-year follow-up after loading. The bone ring technique with xenogeneic bone ring graft could increase and maintain horizontal bone mass in the region of the implant neck platforms in serious horizontal bone defects.
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Affiliation(s)
- Yude Ding
- Department of Stomatology, Zhejiang Provincial People's Hospital, People's Hospital of Hangzhou Medical College, Hangzhou, 310014, Zhejiang, People's Republic of China
| | - Lianfei Wang
- Department of Stomatology of Bengbu Medical College, Bengbu, Anhui, People's Republic of China
| | - Kuiwei Su
- Department of Stomatology of Bengbu Medical College, Bengbu, Anhui, People's Republic of China
| | - Jinxing Gao
- Department of Stomatology, Zhejiang Provincial People's Hospital, People's Hospital of Hangzhou Medical College, Hangzhou, 310014, Zhejiang, People's Republic of China
| | - Xiao Li
- Department of Stomatology of Bengbu Medical College, Bengbu, Anhui, People's Republic of China
| | - Gang Cheng
- Department of Stomatology, Zhejiang Provincial People's Hospital, People's Hospital of Hangzhou Medical College, Hangzhou, 310014, Zhejiang, People's Republic of China.
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27
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Lumbau AI, Meloni SM, Tallarico M, Melis L, Spano G, Baldoni E, Koshovari A, Pisano M. Implant Placement Following Crestal Sinus Lift with Sequential Drills and Osteotomes: Five Years after Final Loading Results from a Retrospective Study. J Funct Biomater 2021; 12:jfb12010010. [PMID: 33557297 PMCID: PMC7930954 DOI: 10.3390/jfb12010010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2020] [Revised: 01/24/2021] [Accepted: 01/29/2021] [Indexed: 11/16/2022] Open
Abstract
The aim of this retrospective study was to clinically evaluate the five-year outcomes of implants placed following a combined approach to the sinus, consisting of sequential drills and osteotomes. Medical records of patients with implants placed in combination with crestal sinus lift using sequential drills and osteotomes, with a residual alveolar bone crest between 4 to 8 mm, and a follow-up of at least five years after final loading, were evaluated. Outcomes were implant and prosthetic survival and success rates, any complication, and marginal bone loss. Data from 96 patients (53 women and 43 men; mean age 54.7 years; range 23-79 years) were collected. A total of 105 single implants were analyzed. After five years of function, two implants were lost and two prostheses failed. No major biological or prosthetic complications occurred. At the five-year examination, the marginal bone loss was 1.24 ± 0.28 mm. Within the limitations of this retrospective study it can be concluded that implants placed following a combined approach to the sinus consisting of sequential drills and osteotomes seem to be a viable option for the treatment of posterior atrophic edentulous maxilla.
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Affiliation(s)
- Aurea Immacolata Lumbau
- School of Dentistry, University of Sassari, 07100 Sassari, Italy; (A.I.L.); (S.M.M.); (G.S.); (E.B.)
| | - Silvio Mario Meloni
- School of Dentistry, University of Sassari, 07100 Sassari, Italy; (A.I.L.); (S.M.M.); (G.S.); (E.B.)
| | - Marco Tallarico
- School of Dentistry, University of Sassari, 07100 Sassari, Italy; (A.I.L.); (S.M.M.); (G.S.); (E.B.)
- Correspondence:
| | - Luca Melis
- Private Practice, 07100 Sardinia, Italy; (L.M.); (M.P.)
| | - Giovanni Spano
- School of Dentistry, University of Sassari, 07100 Sassari, Italy; (A.I.L.); (S.M.M.); (G.S.); (E.B.)
| | - Edoardo Baldoni
- School of Dentistry, University of Sassari, 07100 Sassari, Italy; (A.I.L.); (S.M.M.); (G.S.); (E.B.)
| | - Alba Koshovari
- Department of Implantology and Prosthetic Aspects, Aldent University, 1022 Tirana, Albania;
| | - Milena Pisano
- Private Practice, 07100 Sardinia, Italy; (L.M.); (M.P.)
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28
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Meloni SM, Melis L, Xhanari E, Tallarico M, Spano G, Pisano M, Baldoni E, Cervino G, Tullio A, Lumbau AI. Three-Year Retrospective Comparative Study between Implants with Same Body-Design but Different Crest Module Configurations. Dent J (Basel) 2020; 8:dj8040135. [PMID: 33333998 PMCID: PMC7765458 DOI: 10.3390/dj8040135] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2020] [Revised: 12/02/2020] [Accepted: 12/10/2020] [Indexed: 11/16/2022] Open
Abstract
Crest module can be defined as the portion of a two-piece implant designed to retain the prosthetic components and to allows the maintenance of the peri-implant tissues in the transition zone. AIM To evaluate the three-year after loading clinical and radiographic data, collected from patients that received a prosthetic rehabilitation on conical connection implants with partial machined collar (PMC; CC Group) and same body-designed implants, with flat-to-flat connection and groovy neck design (FC Group). MATERIALS AND METHODS A retrospective chart review of previously collected data, including documents, radiographs, and pictures of patients who received at least one implant-supported restoration on NobelReplace CC PMC or NobelReplace Tapered Groovy implants was performed. Patients with at least three years of follow-up after final loading were considered for this study. Outcomes measures were implant and prosthesis failures, any biological or technical complications, marginal bone loss. RESULTS Eight-two patients (44 women, 38 men; average age 55.6) with 152 implants were selected and divided in two groups with 77 (CC group) and 75 (FC group), respectively. Three years after final loading, one implant in CC group failed (98.7% survival rate), while no implants failed in FC group (100% survival rate). One restoration failed in CC group (98.7% survival rate) with no restoration failing in the FC one (100% survival rate). Differences were not statistically significant (p = 1.0). Three years after final loading, mean marginal bone loss was 0.22 ± 0.06 mm (95% CI 0.2-0.24) in CC group and 0.62 ± 0.30 mm (95% CI 0.52-0.72) in FC group. The difference was statistically significant (0.40 ± 0.13 mm; 95% CI 0.3-0.5; p = 0.003). CONCLUSION with the limitation of this retrospective comparative study, implants with conical connection and partial machined collar seem to achieve a trend of superior outcomes if compared with implants with flat connection and groovy collar design.
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Affiliation(s)
- Silvio Mario Meloni
- School of Dentistry, University of Sassari, 07100 Sardinia, Italy; (S.M.M.); (G.S.); (E.B.); (A.I.L.)
| | - Luca Melis
- Private Practice, 07100 Sardinia, Italy; (L.M.); (M.P.)
| | - Erta Xhanari
- Dentistry Program, Aldent University, 1022 Tirana, Albania;
| | - Marco Tallarico
- School of Dentistry, University of Sassari, 07100 Sardinia, Italy; (S.M.M.); (G.S.); (E.B.); (A.I.L.)
- Correspondence: ; Tel.: +39-3280758769
| | - Giovanni Spano
- School of Dentistry, University of Sassari, 07100 Sardinia, Italy; (S.M.M.); (G.S.); (E.B.); (A.I.L.)
| | - Milena Pisano
- Private Practice, 07100 Sardinia, Italy; (L.M.); (M.P.)
| | - Edoardo Baldoni
- School of Dentistry, University of Sassari, 07100 Sardinia, Italy; (S.M.M.); (G.S.); (E.B.); (A.I.L.)
| | | | - Antonio Tullio
- School of Dentistry, University of Perugia, 06123 Perugia, Italy;
| | - Aurea Immacolata Lumbau
- School of Dentistry, University of Sassari, 07100 Sardinia, Italy; (S.M.M.); (G.S.); (E.B.); (A.I.L.)
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Tay JRH, Lu XJ, Lai WMC, Fu JH. Clinical and histological sequelae of surgical complications in horizontal guided bone regeneration: a systematic review and proposal for management. Int J Implant Dent 2020; 6:76. [PMID: 33241468 PMCID: PMC7688776 DOI: 10.1186/s40729-020-00274-y] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2020] [Accepted: 10/27/2020] [Indexed: 12/11/2022] Open
Abstract
It is not uncommon to encounter post-surgical complications after horizontal guided bone regeneration (GBR). The primary aim of this review was to evaluate the incidence and types of complications that occur after horizontal GBR and propose management strategies to deal with these clinical situations. A secondary aim was to conduct a histomorphometric review of the wound healing process at sites that experienced post-surgical complications after GBR. A keyword search of MEDLINE, EMBASE, and the Cochrane Central Register of Controlled Trials for studies published in English from January 2015 to January 2020 was conducted for the primary aim and 23 studies were selected. A second search addressing the secondary aim was conducted, and five studies were included. Site-level analysis showed that the weighted mean incidence proportion of minor wound dehiscence and minor infections occurring at the augmented site was 9.9% [95% CI 6.4, 13.9, P < 0.01] and 1.5% [95% CI 0.4, 3.1, P = 0.21) respectively. Patient-level analysis showed minor and major complications occurring at a weighted mean incidence proportion of 16.1% [95% CI 11.9, 20.8, P = 0.01] and 1.6% [95% CI 0.0, 4.7, P < 0.01] respectively, while neurosensory alterations at the donor site was 7.0% [95% CI 1.3, 15.5, P < 0.01]. Subgroup analysis also revealed that the use of block grafts increased the incidence proportion of minor post-surgical complications, whereas a staged GBR procedure increased the incidence proportion of both minor and major post-surgical complications. Although exposure of the barrier membrane is often associated with less bone regeneration and graft resorption, the type of membrane used (resorbable or non-resorbable) had no statistically significant influence on any post-surgical complication. Histologically, a layer of fibrous connective tissue instead of bone is commonly observed at the interface between the native bone at the recipient site and the regenerated bone in cases with membrane exposure after GBR procedure. Minor wound dehiscence was the highest incidence proportion of post-surgical complications. Methods ranging from daily application of antiseptics, use of systemic antimicrobials, regular reviews, and total removal of the non-integrated biomaterials are commonly prescribed to manage these post-surgical complications in attempt to minimise the loss of tissue at the surgical site.
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Affiliation(s)
- John Rong Hao Tay
- Discipline of Periodontics, National University Centre for Oral Health Singapore, 9 Lower Kent Ridge Road, Singapore, 119085, Singapore.,Department of Restorative Dentistry, National Dental Centre Singapore, 5 Second Hospital Ave, Singapore, 168938, Singapore
| | - Xiaotong Jacinta Lu
- Discipline of Periodontics, National University Centre for Oral Health Singapore, 9 Lower Kent Ridge Road, Singapore, 119085, Singapore
| | - Wei Ming Clement Lai
- Statistics Unit, National University Centre for Oral Health Singapore, 9 Lower Kent Ridge Road, Singapore, 119085, Singapore
| | - Jia-Hui Fu
- Discipline of Periodontics, National University Centre for Oral Health Singapore, 9 Lower Kent Ridge Road, Singapore, 119085, Singapore.
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30
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Roca-Millan E, Jané-Salas E, Estrugo-Devesa A, López-López J. Evaluation of Bone Gain and Complication Rates after Guided Bone Regeneration with Titanium Foils: A Systematic Review. MATERIALS 2020; 13:ma13235346. [PMID: 33255825 PMCID: PMC7728364 DOI: 10.3390/ma13235346] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/29/2020] [Revised: 11/15/2020] [Accepted: 11/23/2020] [Indexed: 02/07/2023]
Abstract
Guided bone regeneration techniques are increasingly used to enable the subsequent placement of dental implants. This systematic review aims to analyze the success rate of these techniques in terms of bone gain and complications rate using titanium membranes as a barrier element. Electronic and hand searches were conducted in PubMed/Medline, Scielo, Scopus and Cochrane Library databases for case reports, case series, cohort studies and clinical trials in humans published up to and including 19 September 2020. Thirteen articles were included in the qualitative analysis. Bone gain both horizontally and vertically was comparable to that obtained with other types of membranes more commonly used. The postoperative complication rate was higher that of native collagen membranes and non-resorbable titanium-reinforced membranes, and similar that of crosslinked collagen membranes and titanium meshes. The survival rate of the implants was similar to that of implants placed in native bone. Due to the limited scientific literature published on this issue, more randomized clinical trials comparing occlusive titanium barriers and other types of membranes are necessary to reach more valid conclusions.
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Affiliation(s)
- Elisabet Roca-Millan
- Faculty of Medicine and Health Sciences (School of Dentistry), University of Barcelona, 08907 Barcelona, Spain;
| | - Enric Jané-Salas
- Oral Health and Masticatory System Group-IDIBELL, Faculty of Medicine and Health Sciences (School of Dentistry), Odontological Hospital University of Barcelona, University of Barcelona, 08907 Barcelona, Spain; (E.J.-S.); (A.E.-D.)
| | - Albert Estrugo-Devesa
- Oral Health and Masticatory System Group-IDIBELL, Faculty of Medicine and Health Sciences (School of Dentistry), Odontological Hospital University of Barcelona, University of Barcelona, 08907 Barcelona, Spain; (E.J.-S.); (A.E.-D.)
| | - José López-López
- Oral Health and Masticatory System Group-IDIBELL, Faculty of Medicine and Health Sciences (School of Dentistry), Odontological Hospital University of Barcelona, University of Barcelona, 08907 Barcelona, Spain; (E.J.-S.); (A.E.-D.)
- Correspondence: or
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31
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Aprile P, Letourneur D, Simon‐Yarza T. Membranes for Guided Bone Regeneration: A Road from Bench to Bedside. Adv Healthc Mater 2020; 9:e2000707. [PMID: 32864879 DOI: 10.1002/adhm.202000707] [Citation(s) in RCA: 64] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2020] [Revised: 07/28/2020] [Indexed: 12/14/2022]
Abstract
Bone resorption can negatively influence the osseointegration of dental implants. Barrier membranes for guided bone regeneration (GBR) are used to exclude nonosteogenic tissues from influencing the bone healing process. In addition to the existing barrier membranes available on the market, a growing variety of membranes for GBR with tailorable physicochemical properties are under preclinical evaluation. Hence, the aim of this review is to provide a comprehensive description of materials used for GBR and to report the main industrial and regulatory aspects allowing the commercialization of these medical devices (MDs). In particular, a summary of the main attributes defining a GBR membrane is reported along with a description of commercially available and under development membranes. Finally, strategies for the scaling-up of the manufacturing process and the regulatory framework of the main MD producers (USA, EU, Japan, China, and India) are presented. The description of the regulatory approval process of GBR membranes is representative of the typical path that medium- to high-risk MDs have to follow for an effective medical translation, which is of fundamental importance to increase the impact of biomedical research on public health.
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Affiliation(s)
- Paola Aprile
- LVTS INSERM U1148 X. Bichat Hospital Université de Paris Université Sorbonne Paris Nord Paris F‐75018 France
| | - Didier Letourneur
- LVTS INSERM U1148 X. Bichat Hospital Université de Paris Université Sorbonne Paris Nord Paris F‐75018 France
| | - Teresa Simon‐Yarza
- LVTS INSERM U1148 X. Bichat Hospital Université de Paris Université Sorbonne Paris Nord Paris F‐75018 France
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32
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Tallarico M, Park CJ, Lumbau AI, Annucci M, Baldoni E, Koshovari A, Meloni SM. Customized 3D-Printed Titanium Mesh Developed to Regenerate a Complex Bone Defect in the Aesthetic Zone: A Case Report Approached with a Fully Digital Workflow. MATERIALS 2020; 13:ma13173874. [PMID: 32887390 PMCID: PMC7503418 DOI: 10.3390/ma13173874] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/11/2020] [Revised: 08/31/2020] [Accepted: 08/31/2020] [Indexed: 12/22/2022]
Abstract
Alveolar-ridge augmentation, anterior aesthetics, and digital technologies are probably the most popular topics in the dental-implant field. The aim of this report is to present a clinical case of severe atrophy of the anterior maxilla in a younger female patient, treated with a titanium membrane customized with computer-aided design/computer-aided manufacturing (CAD/CAM), simultaneous guided implant placement, and a fully digital workflow. A young female patient with a history of maxillary trauma was treated and followed-up for 1 year after implant placement. A narrow implant was inserted in a prosthetically driven position with the aid of computer-guided surgery. In the same surgical section, a customized implantable titanium mesh was applied. The scaffold was designed according to the contralateral maxillary outline in order to recreate a favorable maxillary bone volume. Finally, highly aesthetic, CAD/CAM, metal-free restorations were delivered using novel digital technologies.
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Affiliation(s)
- Marco Tallarico
- Department of Periodontology and Implantology, University of Sassari, 07021 Sassari, Italy; (A.I.L.); (E.B.); (S.M.M.)
- Correspondence: ; Tel.: +39-3280758769
| | - Chang-Joo Park
- Division of Oral and Maxillofacial Surgery, Department of Dentistry, College of Medicine, Hanyang University, Seoul 04763, Korea;
| | - Aurea Immacolata Lumbau
- Department of Periodontology and Implantology, University of Sassari, 07021 Sassari, Italy; (A.I.L.); (E.B.); (S.M.M.)
| | | | - Edoardo Baldoni
- Department of Periodontology and Implantology, University of Sassari, 07021 Sassari, Italy; (A.I.L.); (E.B.); (S.M.M.)
| | - Alba Koshovari
- Department of Implantology and Prosthetic Aspects, Aldent University, 1022 Tirana, Albania;
| | - Silvio Mario Meloni
- Department of Periodontology and Implantology, University of Sassari, 07021 Sassari, Italy; (A.I.L.); (E.B.); (S.M.M.)
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33
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Kloss FR, Offermanns V, Donkiewicz P, Kloss‐Brandstätter A. Customized allogeneic bone grafts for maxillary horizontal augmentation: A 5-year follow-up radiographic and histologic evaluation. Clin Case Rep 2020; 8:886-893. [PMID: 32477540 PMCID: PMC7250966 DOI: 10.1002/ccr3.2777] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2019] [Revised: 01/20/2020] [Accepted: 02/06/2020] [Indexed: 12/14/2022] Open
Abstract
We report the histological evaluation of an individualized allogeneic bone block 5 years after alveolar ridge augmentation. The biopsy showed a well-vascularized lamellar bone with fatty incorporations without any avital allograft remnants. The presence of osteocytes, lining cells, macrophages, and blood vessels indicated a healthy and vital bone tissue.
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Affiliation(s)
| | - Vincent Offermanns
- Department of Cranio‐, Maxillofacial and Oral SurgeryMedical University InnsbruckInnsbruckAustria
| | - Phil Donkiewicz
- Department of Oral Surgery and Dental Emergency CareFaculty of HealthSchool of Dentistry Witten/Herdecke UniversityWittenNorth Rhine‐WestphaliaGermany
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34
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Errors in Implant Positioning Due to Lack of Planning: A Clinical Case Report of New Prosthetic Materials and Solutions. MATERIALS 2020; 13:ma13081883. [PMID: 32316361 PMCID: PMC7215328 DOI: 10.3390/ma13081883] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/14/2020] [Revised: 04/01/2020] [Accepted: 04/14/2020] [Indexed: 12/17/2022]
Abstract
The achievement of the optimal implant position is a critical consideration in implant surgery, as it can facilitate the ideal prosthesis design and allow adequate oral hygiene maintenance. The switch from bone-driven to prosthetic-driven implant placement, through a comprehensive diagnosis and adequate treatment plan, is a prerequisite for long-term successful implant-based therapy. The aim of the present case report is to describe a step-by-step prosthetic retreatment of a patient with primary treatment failure due to incorrect dental implant placement. Although dental implants achieve high survival rates, the success of implant prosthetic therapy significantly relies on an appropriate implant position. Malpositioned implants can cause damage to vital structures, like nerves or vessels. Moreover, improper implant positioning can result in esthetic, biological, and technical complications and can, in extreme situations, render the desired prosthetic rehabilitation impossible to achieve.
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35
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Yuan S, Mu Z, Huang Y, Bai S, Xu P, Chen T. Comparison of in-situ bone ring technique and tent-pole technique for horizontally deficient alveolar ridge in the anterior maxilla. Clin Implant Dent Relat Res 2020; 22:167-176. [PMID: 32022425 DOI: 10.1111/cid.12887] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2019] [Revised: 12/05/2019] [Accepted: 01/21/2020] [Indexed: 12/14/2022]
Abstract
BACKGROUND Limited studies focused on the bone profile maintenance at the alveolar ridge crest applying horizontal bone augmentation. PURPOSE A novel approach named as "in-situ bone ring technique" was introduced to be compared with tent-pole technique to evaluate their horizontal bone gain, resorption, and postoperative perception. MATERIALS AND METHODS A total of 30 patients were included in this retrospective cohort study. All patients required horizontal bone augmentation at anterior site. Accordingly, quantitative and qualitative analyses were conduct radiographically and histologically between in-situ bone ring (ring group) and tent-pole technique (tent group). Moreover, the visual analog scale (VAS) was introduced to assess the patients' perception toward both treatments. RESULTS Cone-beam computed tomography results showed great significant difference regarding horizontal bone width at 0 mm and 3 mm from alveolar ridge crest between two groups (P < .05). On the basis of histological outcomes, delightful bony fusion was shown 6-month postoperatively in ring group. The VAS ratings for pain and swelling reflected similar results between two groups. CONCLUSIONS In-situ bone ring technique evidently increased and maintained horizontal bone mass at the alveolar ridge crest compared to tent-pole technique, which might be favorable for implant rehabilitation in anterior area. Meanwhile, no further discomfort was caused according to VAS scoring between two groups.
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Affiliation(s)
- Shuai Yuan
- Laboratory of Oral Diseases and Biomedical Sciences, Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing Medical University, Chongqing, People's Republic of China
| | - Zhixiang Mu
- Laboratory of Oral Diseases and Biomedical Sciences, Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing Medical University, Chongqing, People's Republic of China
| | - Yuanding Huang
- Laboratory of Oral Diseases and Biomedical Sciences, Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing Medical University, Chongqing, People's Republic of China
| | - Shi Bai
- Laboratory of Oral Diseases and Biomedical Sciences, Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing Medical University, Chongqing, People's Republic of China
| | - Peng Xu
- Laboratory of Oral Diseases and Biomedical Sciences, Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing Medical University, Chongqing, People's Republic of China
| | - Tao Chen
- Laboratory of Oral Diseases and Biomedical Sciences, Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing Medical University, Chongqing, People's Republic of China
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Horizontal Ridge Augmentation and Contextual Implant Placement with a Resorbable Membrane and Particulated Anorganic Bovine Bone-Derived Mineral. Case Rep Dent 2019; 2019:6710340. [PMID: 31637061 PMCID: PMC6766170 DOI: 10.1155/2019/6710340] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2019] [Accepted: 08/27/2019] [Indexed: 11/29/2022] Open
Abstract
Alveolar ridge deficiency is considered a major limitation for successful implant placement. Various approaches have been developed to horizontal augmentation of bone volume. This case report presents the medium-term results of one-stage guided bone augmentation using an anorganic bovine bone (70%) and autologous bone (30%), placed in layers, in association with resorbable collagen membrane for a subsequent implant placement. The patient presented with a localized horizontal ridge defect in the posterior zone of the jaw. The clinical and radiographic presentations, as well as relevant literature, are presented.
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