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BioMed Research International 2017The treatment of patients with atrophic ridge who need prosthetic rehabilitation is a common problem in oral and maxillofacial surgery. Among the various techniques...
The treatment of patients with atrophic ridge who need prosthetic rehabilitation is a common problem in oral and maxillofacial surgery. Among the various techniques introduced for the expansion of alveolar ridges with a horizontal bone deficit is the alveolar ridge split technique. The aim of this article is to give a description of some new tips that have been specifically designed for the treatment of atrophic ridges with transversal bone deficit. A two-step piezosurgical split technique is also described, based on specific osteotomies of the vestibular cortex and the use of a mandibular ramus graft as interpositional graft. A total of 15 patients were treated with the proposed new tips by our department. All the expanded areas were successful in providing an adequate width and height to insert implants according to the prosthetic plan and the proposed tips allowed obtaining the most from the alveolar ridge split technique and piezosurgery. These tips have made alveolar ridge split technique simple, safe, and effective for the treatment of horizontal and vertical bone defects. Furthermore the proposed piezosurgical split technique allows obtaining horizontal and vertical bone augmentation.
Topics: Adult; Alveolar Process; Alveolar Ridge Augmentation; Cortical Bone; Female; Humans; Male; Middle Aged; Osteotomy; Piezosurgery
PubMed: 28246596
DOI: 10.1155/2017/4530378 -
Clinical Oral Implants Research Sep 2021To test whether early implant placement with alveolar ridge preservation (ARP) results in different esthetic, clinical and patient-reported outcome measures (PROMs)... (Randomized Controlled Trial)
Randomized Controlled Trial
Early implant placement with or without alveolar ridge preservation in single tooth gaps renders similar esthetic, clinical and patient-reported outcome measures: One-year results of a randomized clinical trial.
OBJECTIVES
To test whether early implant placement with alveolar ridge preservation (ARP) results in different esthetic, clinical and patient-reported outcome measures (PROMs) compared with early implant placement without ARP.
MATERIAL AND METHODS
Seventy-five patients requiring single tooth extraction in the anterior maxilla were recruited. Following tooth extraction, the patients were randomly allocated to three groups: (a) ARP using demineralized bovine bone mineral containing 10% collagen (DBBM-C) covered by a collagen matrix (CM) (n = 25), (b) ARP using DBBM-C covered with a palatal graft (PG) (n = 25) and (c) spontaneous healing (control) (n = 25). Eight weeks after tooth extraction, a CBCT was taken and early implant placement was performed in all patients. Esthetic, clinical and PROMs were evaluated one year post-loading.
RESULTS
A total of 70 patients were available for re-examination at one year post-loading. The median mid-facial mucosal margin change amounted to -0.02 mm (IQR -0.27-0.46) in the CM group, -0.13 mm (IQR -0.44-0.25) in the PG group and -0.14 mm (IQR -0.29-0.07) in the control group, with no significant differences between the groups. Mean PES scores amounted to 7.0 ± 1.4 in the CM group, 7.1 ± 1.5 in the PG group and 7.3 ± 1.7 in the control group without significant differences between the groups. Plaque, bleeding on probing and probing depth did not differ between treatment groups. PROMs in general revealed no significant differences between the groups.
CONCLUSION
Early implant placement with ARP using either a collagen matrix or a palatal graft rendered similar esthetic, clinical and PROMs to early implant placement without ARP. When a failing tooth can be replaced with an implant within 2 months after tooth extraction, the added value of ARP might be clinically negligible.
Topics: Alveolar Process; Alveolar Ridge Augmentation; Animals; Cattle; Dental Implants; Esthetics; Humans; Patient Reported Outcome Measures; Tooth Extraction; Tooth Socket
PubMed: 34129708
DOI: 10.1111/clr.13796 -
International Journal of Implant... Mar 2021To minimize alveolar bone resorption, alveolar ridge preservation (ARP) has been proposed. Recently, interest in improving the feasibility of implant placement has...
BACKGROUND
To minimize alveolar bone resorption, alveolar ridge preservation (ARP) has been proposed. Recently, interest in improving the feasibility of implant placement has gradually increased, especially in situations of infection such as periodontal and/or endodontic lesions. The aim of this study was to investigate if ARP improves feasibility of implant placement compared with no ARP in periodontally compromised sites. Secondary endpoints were the necessity of bone graft at the time of implant placement and implant failure before loading at ARP compared with no ARP.
MATERIAL AND METHODS
This retrospective study was performed using dental records and radiographs obtained from patients who underwent tooth extraction due to chronic periodontal pathology. Outcomes including the feasibility of implant placement, horizontal bone augmentation, vertical bone augmentation, sinus floor elevation, total bone augmentation at the time of implant placement, and implant failure before loading were investigated. Multivariable logistic regression analysis was performed to examine the influence of multiple variables on the clinical outcomes.
RESULTS
In total, 418 extraction sites (171 without ARP and 247 with ARP) in 287 patients were included in this study. The ARP group (0.8%) shows significantly lower implant placement infeasibility than the no ARP group (4.7%). Horizontal and vertical bone augmentations were significantly influenced by location and no ARP. Total bone augmentation was significantly influenced by sex, location, and no ARP.
CONCLUSION
ARP in periodontally compromised sites may improve the feasibility of implant placement. In addition, ARP attenuate the severity of the bone augmentation procedure.
Topics: Alveolar Process; Alveolar Ridge Augmentation; Humans; Retrospective Studies; Sinus Floor Augmentation; Tooth Socket
PubMed: 33768356
DOI: 10.1186/s40729-021-00305-2 -
The Chinese Journal of Dental Research Mar 2023To evaluate the extension of canalis sinuosus (CS) into the alveolar crest for surgical reference in the anterior maxilla.
OBJECTIVE
To evaluate the extension of canalis sinuosus (CS) into the alveolar crest for surgical reference in the anterior maxilla.
METHODS
In this cross-sectional study, 485 CBCT images were evaluated in three orthogonal planes (axial, coronal and sagittal). The type of extension of CS into the alveolar ridge in the anterior maxilla was evaluated. The alveolar ridge was divided into four equal parts in a vertical and horizontal direction. In a vertical direction from apical to incisal and in a horizontal direction from labial to palatal, the four parts were designated as types 0, I, II and III, respectively. The extension of CS into the alveolar ridge was then traced.
RESULTS
CS was present in 380 subjects (78.35%), and the extension type was unilateral in 217 of them (57.11%) and bilateral in 163 of them (42.89%). There was no significant relationship between incidence of CS and sex. Regarding the distribution of vertical and horizontal types, type II (the third quadrant of the ridge from apical to incisal and from labial to palatal, respectively) was significantly more prevalent than other types.
CONCLUSION
The most common location of CS into the alveolar ridge in both horizontal and vertical directions was type II (which is not close to the cortex). Awareness about the presence and possible locations of CS helps to reduce the risk of unjustifiable postoperative complications.
Topics: Humans; Spiral Cone-Beam Computed Tomography; Cross-Sectional Studies; Cone-Beam Computed Tomography; Maxilla; Alveolar Process
PubMed: 36988064
DOI: 10.3290/j.cjdr.b3978675 -
Brazilian Oral Research Aug 2018This is a cross-sectional study that aimed to estimate maxillary sinus floor (MSF) pneumatization in single missing tooth of posterior maxilla, by using cone-beam...
This is a cross-sectional study that aimed to estimate maxillary sinus floor (MSF) pneumatization in single missing tooth of posterior maxilla, by using cone-beam computed tomography (CBCT). CBCT images were analyzed bilaterally and divided into 2 groups: edentulous site (EdS) - edentulous single region of upper second premolar, first or second molars; Tooth site (TS) - contralateral region homologous to the EdS region, with tooth present. Variables evaluated were: sinus height (SH), estimated sinus pneumatization (eSP: ∆ EdS - TS), healed ridge height (HR) and presence of localized sinus pneumatization (LSP) in molars teeth at TS. HR were categorized according to therapeutic option for posterior maxilla. 183 CBCT scans were included and it was observed that EdS presented a higher SH than the TS (p < 0.001) showing an eSP of 0.9 ± 2.93 mm. First molars presented the highest SH for both sides, although significant differences were detected when compared to second molars. First molars were mostly affected by LSP at TS (36 out of 43). Individuals with LSP at TS presented lower HR than the ones without LSP (p < 0.05). 54% of the cases presenting LSP obtained HR < 5 mm, which indicates sinus lift surgery. The present study showed that tooth loss in posterior maxilla favors sinus pneumatization and the identification of LSP at molar roots seems to indicate a greater necessity for sinus lift surgeries.
Topics: Adolescent; Adult; Aged; Aged, 80 and over; Alveolar Bone Loss; Alveolar Process; Analysis of Variance; Cone-Beam Computed Tomography; Cross-Sectional Studies; Female; Humans; Male; Maxillary Diseases; Maxillary Sinus; Middle Aged; Nasal Cavity; Palate; Reference Values; Retrospective Studies; Statistics, Nonparametric; Tooth Loss; Young Adult
PubMed: 30088551
DOI: 10.1590/1807-3107BOR-2018.vol32.0064 -
BioMed Research International 2018The alveolar ridge splitting technique enables reconstruction of atrophied alveolar ridges prior implantation. However, in cases of severe atrophy, there is an...
The alveolar ridge splitting technique enables reconstruction of atrophied alveolar ridges prior implantation. However, in cases of severe atrophy, there is an unpredictable risk of fracturing the buccal lamella during the expansion. Currently, there is no preoperative assessment to predict the maximum distraction of the lamella. The aim of this study was to develop a biomechanical model to mimic the alveolar ridge splitting and a finite element (FE) model to predict the experimental results. The biomechanical testing was conducted on porcine mandibles. To build the FE model high resolution peripheral quantitative computer tomography scans of one specimen was performed after the osteotomy outline, but before the lamella displacement. A servo-electric testing machine was used for the axial tension test to split the lamellae. Results showed, in line with clinical observations, that the lamellae broke primarily at the base of the splits with a median displacement of 1.27 mm. The FE model could predict fracture force and fracture displacement. Fracture force showed a nonlinear correlation with the height of the bone lamella. In conclusion, good correspondence between mechanical testing and virtual FE analysis showed a clinically relevant approach that may help to predict maximum lamella displacement to prevent fractures in the future.
Topics: Alveolar Process; Alveolar Ridge Augmentation; Animals; Biomechanical Phenomena; Finite Element Analysis; Fractures, Bone; Osteotomy; Sus scrofa; Tomography, X-Ray Computed
PubMed: 30406133
DOI: 10.1155/2018/3579654 -
Clinical Interventions in Aging 2017The morphology of the alveolar process determines the retention and stability of prosthetic restorations, thereby determining the result of the therapy. Considering that...
OBJECTIVES
The morphology of the alveolar process determines the retention and stability of prosthetic restorations, thereby determining the result of the therapy. Considering that the edentulous jaws may be affected by the atrophy process, it was hypothesized that the morphology of the alveolar process of the maxilla may be dependent on the anterior facial height and anatomy of the mandible.
SUBJECTS AND METHODS
Twenty-five healthy edentulous Caucasian individuals were randomly chosen. Each subject underwent a lateral cephalogram before and after prosthetic rehabilitation. During exposition, newly made prostheses were placed in the patient's mouth. Teeth remained in maximal intercuspidation. Morphological parameters were evaluated according to the Ricketts, McNamara, and Tallgren's method.
RESULTS
An inversely proportional association was observed between patient age and the distal part of the maxilla. A statistically significant connection was noted between the vertical dimension of alveolar ridge and anterior total and lower facial height conditioned by prosthetic rehabilitation.
CONCLUSION
The height of the lateral part of the alveolar ridge of the maxilla remains in connection with the anterior total and lower facial height obtained in the course of prosthetic rehabilitation. The vertical dimension of the alveolar ridge of the maxilla seems to be in close relationship with the morphology of the lower jaw.
Topics: Adult; Alveolar Process; Atrophy; Cephalometry; Dental Arch; Face; Female; Humans; Male; Mandible; Maxilla; Middle Aged; Mouth, Edentulous; Vertical Dimension
PubMed: 28979109
DOI: 10.2147/CIA.S140791 -
British Dental Journal Sep 2022Since its introduction in 1998, alveolar ridge preservation has become a popular technique, currently accounting for approximately 29% of all procedures involving bone...
Since its introduction in 1998, alveolar ridge preservation has become a popular technique, currently accounting for approximately 29% of all procedures involving bone substitute materials. The global cost of bone substitute materials for alveolar ridge preservation is estimated at $190 million annually and is expected to rise by approximately 11.4% per year.Numerous randomised controlled trials have compared alveolar ridge preservation to extraction alone. A recent Cochrane review reported that, in terms of socket dimensional change, the mean difference between alveolar ridge preservation and extraction alone is 1.18 mm horizontally and 1.35 mm vertically. The clinical impact of this is uncertain, for there is no significant difference in the need for graft procedures at implant placement between ridge preservation and extraction alone. There are no randomised controlled trials comparing aesthetic or functional outcomes.A systematic review of the histological outcomes of ridge preservation demonstrates that, compared to extraction alone, many bone substitute materials can significantly delay the bone healing process. No bone substitute material achieves statistically more new bone formation than extraction alone and many commonly used materials achieve significantly less bone formation. Grafted sites can demonstrate high levels of residual graft and granulation tissue.In the absence of good-quality clinical evidence to support alveolar ridge preservation, the technique must be questioned as the treatment of choice at extraction sites. This paper assesses recent systematic reviews and presents two case reports of late graft failure.
Topics: Alveolar Bone Loss; Alveolar Process; Alveolar Ridge Augmentation; Bone Substitutes; Esthetics, Dental; Humans; Tooth Extraction; Tooth Socket
PubMed: 36151171
DOI: 10.1038/s41415-022-4967-2 -
Journal of Periodontal Research Aug 2015Peri-implantitis has a prevalence of 11-47%, involves destruction of peri-implant bone and may lead to implant loss. A detailed understanding of the pathogenesis of... (Comparative Study)
Comparative Study
BACKGROUND AND OBJECTIVE
Peri-implantitis has a prevalence of 11-47%, involves destruction of peri-implant bone and may lead to implant loss. A detailed understanding of the pathogenesis of peri-implantitis is lacking. The objective of this study was to develop a murine model of experimental peri-implantitis.
MATERIAL AND METHODS
Machined, smooth-surface, screw-shaped titanium implants were placed in the healed alveolar bone of the left maxillary molars of C57BL/6J male mice, 8 wk after tooth extraction. Peri-implantitis was induced by securing silk ligatures around the head of the implant fixtures. Implant survival and peri-implant bone levels were analyzed by micro-computed tomography (micro-CT) scans and histology, 12 wk after ligature placement.
RESULTS
Implant survival was 60% (six of 10) for implants with ligatures and 100% (eight of eight) for controls. Micro-CT revealed significantly greater bone loss around the implants that received ligatures and that survived, compared with controls. The radiographic findings were confirmed via histology and toluidine blue staining.
CONCLUSION
This study describes a murine model of experimental peri-implantitis around screw-shaped titanium implants placed in the edentulous alveolar bone. This model should be a useful tool to dissect pathogenic mechanisms of peri-implantitis and evaluate potential treatment interventions.
Topics: Alloys; Alveolar Process; Animals; Coloring Agents; Dental Alloys; Dental Implants; Dental Prosthesis Design; Disease Models, Animal; Male; Maxilla; Mice; Mice, Inbred C57BL; Mice, Inbred Strains; Peri-Implantitis; Survival Analysis; Time Factors; Titanium; Tolonium Chloride; Tooth Socket; X-Ray Microtomography
PubMed: 25244403
DOI: 10.1111/jre.12234 -
Cell and Tissue Banking Dec 2015Increasingly dental surgeons face the challenge of reconstruction of the height and/or thickness of the alveolar ridge as more and more patients wish to have permanent... (Clinical Trial)
Clinical Trial
Increasingly dental surgeons face the challenge of reconstruction of the height and/or thickness of the alveolar ridge as more and more patients wish to have permanent restoration of their dental defects based on intraosseous implants. Evaluation of human allogeneic bone tissue grafts in reconstruction of atrophied alveolar ridge as a pre-implantation procedure. The material comprised 21 patients aged 19-63, treated between 2009 and 2012 by the same surgeon. Restoration of bone tissue defects was performed with allogeneic, frozen, radiation-sterilised, corticocancellous blocks. The study included 26 grafting procedures with 7 procedures consisting in reconstruction of the alveolar ridge in the mandible and 19 in the maxilla. In all the cases the atrophied alveolar ridge was successfully reconstructed, which allowed placement of intraosseous implants in compliance with the initial treatment plan. After the treatment was completed the patients reported for follow-up annually. The average time of follow-up amounted to 39 months (28-50 months). None of the implants was lost during the follow-up period. There was one case of gingival recession causing aesthetics deterioration of the prosthetic restoration. In three cases the connector became unscrewed partially, which was corrected at the same visit. Frozen, radiation-sterilised, allogeneic bone blocks constitute good and durable bone-replacement material allowing effective and long-lasting reconstruction of the atrophied alveolar ridge to support durable, implant-based, prosthetic restoration.
Topics: Adult; Alveolar Process; Alveolar Ridge Augmentation; Atrophy; Bone Transplantation; Cryopreservation; Female; Gamma Rays; Humans; Longitudinal Studies; Male; Mandible; Maxilla; Middle Aged; Poland; Postoperative Complications; Prevalence; Risk Factors; Sterilization; Transplantation, Homologous; Treatment Outcome
PubMed: 26162810
DOI: 10.1007/s10561-015-9512-y