Abstract
Background: Augmentation of the edentulous atrophic anterior region is a challenging situation. The purpose of this article was to evaluate the effectiveness of a collagenated cortical bone lamina of porcine origin for horizontal ridge augmentation in patients with inadequate alveolar ridge width undergoing immediate post-extraction implantation in the anterior sites, and to report on implant survival rates/complications. Materials and methods: The cases were extracted electronically from a large database according to these specific inclusion criteria: patients with inadequate alveolar ridge width in the anterior maxilla or mandible, who underwent immediate post-extraction implant placement and simultaneous alveolar bone reconstruction using xenogeneic cortical bone lamina. An additional layer of palatal connective tissue graft was inserted between lamina and the vestibular mucosa, for improving soft tissue healing. A collagenated bone substitute was additionally placed in the gap between the lamina and implant surface in all patients. The main outcomes were implant survival and complications. Results: Forty-nine patients with 65 implants were included. Patients’ mean age at the time of implant surgery was 60.0 ± 13.6 years. The mean follow-up was 60.5 ± 26.6 months after implant placement. The implant survival was 100%. Four postoperative complications occurred in four patients. No specific factor was found to be associated with complication occurrence. Conclusion: The use of collagenated cortical bone lamina can be considered as a successful option for alveolar reconstruction in immediate post-extraction implant insertion procedures in anterior regions with inadequate alveolar ridge width.
Highlights
Reconstruction of atrophic jaws is still a challenging situation for surgeons [1,2], especially in the esthetic area where the treatment of anterior defects is essential to restore function and esthetics of the whole face [3,4]
A large personal database of patients was evaluated, and patients were extracted electronically according to the inclusion criteria strategy described in materials and methods
Cases where the augmentation with the bone lamina or the soft tissue and the implantation were in different areas), 177 patients were excluded
Summary
Reconstruction of atrophic jaws is still a challenging situation for surgeons [1,2], especially in the esthetic area where the treatment of anterior defects is essential to restore function and esthetics of the whole face [3,4]. Adequate integrity and volume of the alveolar bone are fundamental to successful implant-supported rehabilitation in any clinical situation, and a diversity of grafting materials were proposed in literature to re-establish the lost functions and esthetics [5,6,7,8,9,10,11]. Among these options, xenogeneic bone substitutes are among the most popular methods due to many advantages such as osteoconductivity and avoidance of donor site morbidity [9,10,11].
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