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Chen X, Tang C, Zhang X, Chen Y, Huang P, Chen Z, Gao Y, Peng L. Autogenous bone ring augmentation around single tooth implantation in the esthetic zone: A retrospective case series study with 2-3 years of follow-up. J Dent Sci 2023; 18:1517-1526. [PMID: 37799880 PMCID: PMC10547987 DOI: 10.1016/j.jds.2023.03.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2023] [Revised: 03/06/2023] [Indexed: 03/28/2023] Open
Abstract
Background /purpose: Bone ring technique (BRT) is an effective method to reconstruct alveolar bone defects with simultaneous implant placement. This study aimed to evaluate the efficacy of the BRT in single maxillary anterior tooth implantation and its esthetic outcomes over 2-3 years of follow-up. Materials and methods Fifteen patients with single maxillary incisor loss received autogenous BRT with simultaneous implant placement. The vertical/horizontal bone gain, remaining vertical bone height (RVBH), remaining buccal bone width (RBBW), and vertical/horizontal bone resorption around implant over 2-3 years of follow-up were measured by using cone-beam computed tomography. Esthetic results including white esthetic score (WES), pink esthetic score (PES), and papilla index (PI) were evaluated by clinical recorded photographs. Results All implants showed evidence of osseointegration, and the mean vertical and horizontal bone gain of 14 sites was 5.55 ± 0.87 mm and 4.73 ± 0.70 mm, respectively. During 2-3 years of follow-up, all mean values of RBBW were more than 2 mm. Main vertical bone loss appeared within 4 months after surgery and the RVBH value decreased as the follow-up duration continued. Maximum buccal bone thickness resorption mostly appeared in the middle level of the implant during the primary two follow-up periods (P < 0.05). Esthetic results showed that the mean WES/PES was higher than 17, and more than half cases demonstrated relatively high PI (3 points) throughout the follow-up. Conclusion BRT could achieve excellent bone augmentation effect and can offer predictable esthetic outcomes for single tooth implant restoration in the esthetic zone.
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Affiliation(s)
- Xue Chen
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Implantology, West China Hospital of Stomatology, Sichuan University, Chengdu, China
- Stomatological Hospital of Chongqing Medical University, Chongqing Key Laboratory of Oral Diseases and Biomedical Science, Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing, China
| | - Chenxi Tang
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Implantology, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Xiaohan Zhang
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Implantology, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Yue Chen
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Implantology, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Peijun Huang
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Implantology, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Zhongren Chen
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Implantology, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Yuan Gao
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Endodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Lin Peng
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Implantology, West China Hospital of Stomatology, Sichuan University, Chengdu, China
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Wedge-Shaped Implants for Minimally Invasive Treatment of Narrow Ridges: A Multicenter Prospective Cohort Study. J Clin Med 2020; 9:jcm9103301. [PMID: 33066588 PMCID: PMC7602171 DOI: 10.3390/jcm9103301] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2020] [Revised: 10/11/2020] [Accepted: 10/13/2020] [Indexed: 11/17/2022] Open
Abstract
The present study aims to investigate clinical and patient-centered outcomes after the implant-supported rehabilitation of narrow ridges using a novel wedge-shaped implant. Forty-four patients were treated with the insertion of 59 tissue-level wedge implants (1.8 mm bucco-lingual width) in horizontally atrophic ridges (mean bone width 3.8 ± 0.4 mm). The main outcome measures were: implant stability quotient (ISQ), marginal bone loss (MBL) and patient morbidity. Fifty-eight implants were functioning satisfactorily after one year of loading (98.3% survival rate). ISQ values measured in the mesio-distal direction resulted significantly higher than those in the bucco-lingual direction at all time points (p < 0.001). Both mesio-distal and bucco-lingual ISQ values at 6-month follow-up resulted significantly higher than at 4-month follow-up (p < 0.001 for both). Mean MBL was 0.38 ± 0.48 mm at prosthesis delivery (6 months after implant insertion) and 0.60 ± 0.52 mm after one year of functional loading. The majority of patients reported slight discomfort related to the surgical procedure. Postoperative pain score was classified as mild pain on the day of surgery and the first postoperative day and no pain over the following five days. Within the limitations of the present study, the device investigated showed low morbidity and positive short-term clinical results in narrow ridges treatment.
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Teng F, Wei L, Yu D, Deng L, Zheng Y, Lin H, Liu Y. Vertical bone augmentation with simultaneous implantation using deproteinized bovine bone block functionalized with a slow delivery of BMP-2. Clin Oral Implants Res 2020; 31:215-228. [PMID: 31730250 DOI: 10.1111/clr.13558] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2018] [Revised: 09/01/2019] [Accepted: 10/30/2019] [Indexed: 11/28/2022]
Abstract
OBJECTIVE We hypothesized that a biomimetic calcium phosphate (CaP) coating which incorporates morphogenetic protein 2 (BMP-2) on the deproteinized bovine bone (DBB) blocks could be used to enhance the vertical alveolar ridge augmentation for the one-stage onlay surgery with simultaneous implants insertion. We aimed to test this hypothesis in vivo. MATERIAL AND METHODS Beagles dogs were used for the study (n = 6 specimens per group). One month after building the edentulous animal model, 4 mm vertical alveolar bone loss were surgically created and four groups of blocks (W × L × H: 7 mm × 10 mm × 4 mm) were randomly fixed onto the reduced alveolar ridge by implants: (a) DBB blocks alone (negative control group); (b) DBB blocks with superficial adsorption of 50 μg BMP-2 (ad.BMP-2 group); (c) DBB blocks coated by biomimetic CaP coating which incorporates 50 μg BMP-2 (inc.BMP-2 group); and (d) autologous bone blocks (positive control group). After 3 months of healing, samples were harvested for micro-CT and histomorphometric analyses. RESULTS In histomorphometry, the inc.BMP-2 group showed a significantly thicker (coronal-apically) and wider (buccal-lingually) augmented bone area, better bone-to-implant contact than the negative control group. In both the micro-CT and histomorphometry, the inc.BMP-2 group showed more mineralized tissue than the negative control group and the inc.BMP-2 group also showed significantly more newly formed bone and residual grafts than the negative control group in the upper half of the blocks. In micro-CT, the inc.BMP-2 group showed significantly more bone-to-graft contact percentage than the ad.BMP-2 group. In both micro-CT and histomorphometry, the inc.BMP-2 group showed significantly more percentage of mineralized tissue than the ad.BMP-2 group. No significant differences were found between the inc.BMP-2 group and the positive control group either in micro-CT or in histomorphometry. CONCLUSIONS The DBB blocks with coating-delivered BMP-2 significantly enhanced the efficacy of vertical alveolar bone augmentation, compared with the unloaded blocks and blocks with adsorbed BMP-2, in the one-stage onlay surgery with simultaneous implant insertion.
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Affiliation(s)
- Fei Teng
- The Affiliated Stomatology Hospital, Zhejiang University School of Medicine, Hangzhou, China.,Key Laboratory of Oral Biomedical Research of Zhejiang Province, Hangzhou, China.,Department of Oral Implantology and Prosthetic Dentistry, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit, Amsterdam, The Netherlands
| | - Lingfei Wei
- Department of Oral Implantology and Prosthetic Dentistry, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit, Amsterdam, The Netherlands.,Department of Oral Implantology, Yantai Stomatological Hospital, Yantai, China
| | - Dedong Yu
- 2nd Dental Center, Shanghai Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, Shanghai Key Laboratory of Stomatology and Shanghai Research Institute of Stomatology, National Clinical Research Center of Stomatology, Shanghai, China
| | - Liquan Deng
- School/Hospital of Stomatology, Zhejiang Chinese Medical University, Hangzhou, China
| | - Yuanna Zheng
- School/Hospital of Stomatology, Zhejiang Chinese Medical University, Hangzhou, China
| | - Haiyan Lin
- Hangzhou Dental Hospital, Hangzhou, China
| | - Yuelian Liu
- Department of Oral Implantology and Prosthetic Dentistry, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit, Amsterdam, The Netherlands
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Verdugo F, Uribarri A, D'Addona A. Autogenous bone block grafting provides facial implant tissue stability long-term. Clin Implant Dent Relat Res 2017; 19:478-485. [PMID: 28185382 DOI: 10.1111/cid.12476] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2016] [Revised: 12/26/2016] [Accepted: 01/10/2017] [Indexed: 12/26/2022]
Abstract
BACKGROUND Mucosal recession (MR) and bone loss can compromise anterior implant esthetics. PURPOSE To evaluate tissue stability and clinical outcomes of anterior implants augmented with autogenous block transplants long-term. MATERIALS AND METHODS This prospective cross-sectional clinical study analyzed facial tissue recession of anterior implants augmented with autogenous bone blocks and compared them to adjacent teeth in forty patients 52 months post-augmentation. Clinical parameters, MR and implant transparency, were assessed at delivery and follow-up. The hypothesis is that the facial mucosa of augmented implant sites is more resistant to trauma than the gingival margins of adjacent teeth. RESULTS Teeth were seven times more likely to present a facial recession than adjacent augmented implants at 52-month follow-up (RR: 7; P < .001; 95%CI: 2.7-18.0). Augmented implant sites were six times more likely to present "no-tissue-recession" than adjacent teeth (RR: 6.2; P < .001; 95%CI: 2.4-15.7). Mean tooth facial tissue recession was significantly higher than adjacent implants, 1.18 ± 1.05 mm (range: 0-3.5 mm) vs. 0.06 ± 0.2 mm (95%CI: 0.8-1.5; P < .0001). Thick biotype teeth were 2 times more resistant to recession than thin biotype teeth (RR: 2.03; P = .03; 95%CI: 1.2-3.5). Implant success rates were 100%. Lack of transparency and MR at facial implant sites lasted an average of 52 months and up to 144 without signs of inflammation or pocket formation regardless of the individual's biotype. Facial bone thicknesses of 2.2 mm seem optimal for tissue stability. CONCLUSIONS Autogenous bone block augmentation with staged implant placement seems to be a predictable, short-healing, reconstructive protocol in the esthetic zone maintaining stable peri-implant tissues long-term. Implant augmented sites seem more resistant to develop a recession than adjacent teeth.
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Affiliation(s)
- Fernando Verdugo
- Department of Periodontics, VA Hospital, Greater Los Angeles Healthcare System, CA, USA
| | - Agurne Uribarri
- Department of Oral Medicine, School of Medicine and Odontology, University of Basque Country, Leioa, Spain
| | - Antonio D'Addona
- Director of Odontology clinic, Catholic University Sacro Cuore, Rome, Italy
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Virtual Surgery Planning and Three-Dimensional Printing Template to Customize Bone Graft Toward Implant Insertion. J Craniofac Surg 2017; 28:e173-e175. [PMID: 28060095 DOI: 10.1097/scs.0000000000003386] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
Premaxillary tooth loss and bone deficiency or atrophy often occur in facial trauma. Onlay bone graft and implants have so far been the best means of restoring function and esthetic appearance. Void space between the graft and the jaw bone, over projection and mucosal trauma can cause mucosal dehiscence, bone exposure, or resorption and can compromise implant survival. Virtual surgical planning using 3-dimensional printing technology has improved the efficiency of craniofacial surgery. The drawbacks of this technology are its cost and time-consuming preparation. However, the democratization of high-performance 3-dimensional printing and open-source software have enabled surgeons to master the procedure. The authors applied this innovative technology to customize bone graft for insertion of a premaxillary implant. It enabled us to custom-make the bone graft on the template and to perfectly embed the graft in the gap with a reduce operating time and a good osteointegration.
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Alveolar Ridge Reconstruction with Titanium Meshes and Simultaneous Implant Placement: A Retrospective, Multicenter Clinical Study. BIOMED RESEARCH INTERNATIONAL 2016; 2016:5126838. [PMID: 27999799 PMCID: PMC5141311 DOI: 10.1155/2016/5126838] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/30/2016] [Accepted: 10/18/2016] [Indexed: 12/27/2022]
Abstract
Objective. To evaluate horizontal bone gain and implant survival and complication rates in patients treated with titanium meshes placed simultaneously with dental implants and fixed over them. Methods. Twenty-five patients treated with 40 implants and simultaneous guided bone regeneration with titanium meshes (i–Gen®, MegaGen, Gyeongbuk, Republic of Korea) were selected for inclusion in the present retrospective multicenter study. Primary outcomes were horizontal bone gain and implant survival; secondary outcomes were biological and prosthetic complications. Results. After the removal of titanium meshes, the CBCT evaluation revealed a mean horizontal bone gain of 3.67 mm (±0.89). The most frequent complications were mild postoperative edema (12/25 patients: 48%) and discomfort after surgery (10/25 patients: 40%); these complications were resolved within one week. Titanium mesh exposure occurred in 6 patients (6/25 : 24%): one of these suffered partial loss of the graft and another experienced complete graft loss and implant failure. An implant survival rate of 97.5% (implant-based) and a peri-implant marginal bone loss of 0.43 mm (±0.15) were recorded after 1 year. Conclusions. The horizontal ridge reconstruction with titanium meshes placed simultaneously with dental implants achieved predictable satisfactory results. Prospective randomized controlled trials on a larger sample of patients are required to validate these positive outcomes.
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Al Amri MD, Kellesarian SV. Crestal Bone Loss Around Adjacent Dental Implants Restored with Splinted and Nonsplinted Fixed Restorations: A Systematic Literature Review. J Prosthodont 2016; 26:495-501. [PMID: 27996179 DOI: 10.1111/jopr.12556] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/15/2016] [Indexed: 11/29/2022] Open
Abstract
PURPOSE The aim of this systematic review was to compare the crestal bone loss around splinted and nonsplinted adjacent implants. MATERIALS AND METHODS To address the focused question, "Is crestal bone loss around adjacent implants different with splinted from that with nonsplinted restorations?," indexed databases were searched from 1965 up to and including May 2016 using various combinations of the following keywords: "implant," "splinted," "nonsplinted," "unsplinted," "connected," "unconnected," "nonconnected," and "bone loss." Letters to the editor, commentaries, historic reviews, case reports, case series, animal studies, and studies on full-arch rehabilitation were excluded. RESULTS Six studies were included with titanium implants ranging from 114 to 1187 implants. All studies had nonsplinted and splinted restorations that ranged from 20 to 234 restorations and from 60 to 970 restorations, respectively. In all the studies, the follow-up period after the restoration placement ranged between 1 and 22 years, with a mean follow-up ranging between 3 and 10.18 ± 3.18 years. In all studies, the mean crestal bone loss for implants restored with nonsplinted restorations ranged between 0.30 ± 0.65 and 1.3 ± 0.2 mm, whereas the mean crestal bone loss for implants restored with splinted restorations ranged between 0.50 ± 0.8 and 1.22 ± 0.95 mm. CONCLUSION Within the limitations of this review it is concluded that adjacent implants restored with splinted and nonsplinted fixed restorations did not exhibit a difference in crestal bone loss. The evidence from this systematic review suggests further investigation.
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Affiliation(s)
- Mohammad D Al Amri
- Department of Prosthetic Dental Sciences, College of Dentistry, King Saud University, Riyadh, Saudi Arabia
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