Augmentation Procedures Research Articles

Arthroscopic lateral ligament reconstruction for isolated chronic lateral ankle instability is associated with longer recovery compared to arthroscopic Broström repair and inferior extensor retinaculum augmentation.

Patients with chronic lateral ankle instability (CLAI) can be managed with arthroscopic Broström repair and inferior extensor retinaculum augmentation or arthroscopic assisted lateral ligament reconstruction using ipsilateral semitendinosus autograft, with good functional outcomes in patients. It is unclear whether one offers better outcome that the other. This retrospective analysis of prospectively collected data compared the outcomes of repair and reconstruction. Patient treated for CLAI by arthroscopic Broström repair and inferior extensor retinaculum augmentation (Repair/augmentation Group; n=39) and lateral ligament reconstruction (Reconstruction Group; n=23) procedures with a minimum follow-up of 24 months were enrolled. The operative time, American Orthopedic Foot and Ankle Society (AOFAS) scores, Karlsson Ankle Functional Score (KAFS), Tegner score, Anterior Talar Translation (ATT), Active Joint Position Sense (AJPS), and the time of the patients return to sports activities were assessed. The operative time was longer in the Reconstruction Group. The patients in the Reconstruction Group experienced more pain. At 3 months after surgery, the patients in Repair/augmentation Group gained better AOFAS, KAFS, Tegner, and AJPS scores. At 6 months after surgery, better KAFS and AJPS were observed in Repair/augmentation Group. At 1 and 2 years, patients in the Reconstruction Group recorded better functional outcomes (AOFAS and KAFS) compared to the Repair/augmentation Group. The mean time of the patients return to sports activities was 10.42 ± 7.77 weeks (range, 8-56 weeks) in the Repair/augmentation Group, compared to 14.18± 5.34 weeks (range, 8-24 weeks) in the Reconstruction Group (p = 0.049). In CLAI patients, arthroscopic reconstruction yields better outcomes in terms of ATT, AOFAS, and KAFS in the mid-term; however, it is associated with a longer intraoperative time, delayed return to sports, and an extended duration to resume normal ankle function compared to the arthroscopic Broström repair and inferior extensor retinaculum augmentation procedure.

Impact of Two Flap Advancement Techniques and Periosteal Suturing on Graft Displacement During Guided Bone Regeneration.

This preclinical exvivo porcine study aimed to evaluate the effects of two flap advancement techniques and periosteal suturing (PS) on graft material displacement during primary wound closure in guided bone regeneration (GBR). Secondary objectives included assessing flap advancement and the impact of soft tissue characteristics on graft displacement. Standardized two-walled horizontal bone defects were created in second premolar sites of pig hemimandibles. Sites were randomized to using either full-thickness flaps with modified periosteal releasing incisions (MPRI) or combination flaps using the mucosal detachment technique (MDT), both with and without PS. Cone-beam computed tomography was used to measure changes in graft material thickness (GMT) at seven incremental levels (L0-L6) relative to the implant platform, before and after primary wound closure. Keratinized mucosa width (KMW), flap thickness (FT), and flap advancement (FA) were also recorded. Sixty-eight horizontal bone augmentation procedures were performed on 34 pig hemimandibles, divided into four groups (MDT+PS, MDT-PS, MPRI+PS, MPRI-PS). Mean overall change in GMT at L0 was -24.5% ± 14.0% for MPRI and - 23.0% ± 14.3% for MDT (p ≥ 0.085). PS reduced graft displacement (-14.2% ± 11.5%) compared with no PS (-33.2% ± 16.9%, p < 0.001). FA was 8.3 ± 1.1 mm (MPRI) and 8.3 ± 1.5 mm (MDT). The mean KMW was 6.8 ± 0.9 mm, and FT ranged from 0.8 to 1.6 mm. PS significantly reduced graft material displacement during primary wound closure, while flap advancement techniques and soft tissue characteristics had no impact on graft stability. Both surgical techniques provided sufficient flap advancement for primary wound closure.

Current surgical treatment concepts for traumatic fractures of the thoracic and lumbar spine with osteoporotic bone substance

Osteoporosis-related vertebral fractures are among the most frequent fracture entities in geriatric patients. They are associated with far-reaching individual and socioeconomic consequences. Adequate diagnostics and treatment are therefore essential. The osteoporotic fracture (OF) score is acentral element in determining the right treatment. Although the majority of fractures can be healed with conservative treatment, achange of treatment should be considered in good time in cases of failure. Isolated cement augmentation procedures are particularly suitable for reducing pain in primarily stable osteoporotic vertebral fractures with apreserved framework structure (OF types 1-3) and alargely intact posterior edge. Dorsal cement-augmented stabilization with cementing of the fractured vertebral body leads to good results in unstable OF types 3and 4fractures. Dorsoventral procedures with cement-augmented internal fixator from the dorsal side and vertebral body replacement from the ventral side play amore subordinate role. Purely ventral procedures should be avoided in this patient group.

Zirconia Barriers in Bone Regeneration Procedures: A Scoping Review.

To identify the current status and development of zirconia barriers in bone augmentation procedures in the maxillofacial area of adult human patients. Two independent reviewers conducted an electronic literature search in PubMed/MEDLINE, Web of Science, Scopus, EBSCO, the Cochrane Library, and LILACS databases, as well as a manual search to identify eligible clinical studies up to April 15, 2024. The protocol was designed in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews guidelines. The initial electronic search resulted in 240 studies. The systematic application of inclusion and exclusion criteria resulted in 6 articles that met the purpose of the study. The included articles were 5 clinical case series and 1 case report, published between 2016 and 2023. Only 4 articles reported histological studies. A total of 40 sites regenerated with zirconium barriers were reported in 30 patients. Results were obtained with variability in bone gain values, between 0.9-8.0 mm horizontally and 1.4-12.0 mm vertically, in addition to a 30% complication rate. Although the results obtained in the studies included in this scoping review are favorable with respect to the amount of bone formation and the reduced surgical time required, the number of complications is considered high. Moreover, due to a limited number of patients included in the case series and the short duration of follow-up, additional studies including a control group are required.

USO DE SUBSTITUTOS ÓSSEOS EM IMPLANTODONTIA E SUAS APLICABILIDADES

Osseintegrable implants are increasingly becoming a safe option for the rehabilitation of total or partial edentulous patients. There are a variety of bone substitutes available with different mechanical and biological properties. They can be classified into the following three groups: Autogenous, from the same individual; Allogeneic, of different individuals but the same species; Xenogenous, the different species, and Synthetic or Alloplastic which is produced synthetically. Bone substitute materials have increased in popularity and replace autografts in bone augmentation procedures, in order to overcome limitations related to their use. Not all patients are willing to donate their own bone, so bone substitutes have been developed to overcome these problems. The ideal bone graft is one that has a limited source, lack of morbidity at the donor site, does not offer a risk of disease transmission, has efficient bone repair, immediate stability, versatility, easy handling, adequate life span and affordable cost. The objective of this bibliographic review was to make a critical analysis of the different types of grafts that have been used in the restoration of bone defects in implantology.

Bone expansion as a horizontal alveolar ridge augmentation technique: a systematic review and meta-analysis.

Bone expansion is one of the quickest, simplest, and most reliable methods of alveolar ridge augmentation for implant placement. This systematic review is designed to investigate the outcomes of the bone expansion technique for horizontal ridge augmentation. The protocol of study has been prospectively registered into PROSPERO (CRD42023414686). Pubmed, Embase, Web of Science, and Scopus databases were searched. Human original articles utilizing different bone expansion procedures for horizontal ridge augmentation without the use of bone materials or combined with vertical ridge augmentation techniques were included in the study. Qualitative and quantitative synthesis have been conducted. I-squared was used to assess heterogeneity. Meta-regression, forest plots random-effect model, and weighted mean difference were used for analysis. Leave-one-out influence analysis for finding outliers. Egger's publication bias test and Funnel plots were used to address publication bias. 3291 records were identified. Ten articles were included in this study after screening. The survival and complication rates of implants placed simultaneously with bone expansion was 100% 100% (95% CI: 99-100%) and 0% (95% CI: 0-1%), respectively. The meta-regression revealed that by each month passing from the implant placement the survival probability would be decreased significantly by 0.08% (95% CI: 0.009-0.15%; P = 0.03). The weighted mean ridge width difference before and after the osseodensification was 1.55mm (95% CI: 0.92-2.17mm). Based on the study's limitations it can be concluded that the bone expansion procedure can be considered an efficient and safe method regarding the survival and complication rates of placed implants. N/A.

A Bayesian Approach to Produce Subnational Population Estimates Using a Population Base Statistical Register

Subnational Population Estimates (SPE) in Latin America are useful to implement new public policies in subnational areas with internal armed conflicts or difficult to access. In this work, we propose to combine a Population Base Statistical Register (PBSR) and the Official Population Projections (OPP) using a Bayesian approach to produce SPE. Our proposed procedures are useful for computing SPE of the population size or the SPE of the population size in percentage SPE (%). However, we focused on SPE (%) due to some data restrictions and to ensure data confidentiality. In this article, the PBSR is constructed using multiple administrative sources with registers from the health, education, vital statistics systems, tax registration, and, more importantly, the registers of the victims of the current internal armed conflict in Colombia. We also propose new fast Markov chain Monte Carlo algorithms to produce SPE (%) using data augmentation procedures to address the complications caused by the resulting joint posterior containing gamma functions. We implement our proposal to compute SPE (%) by age and sex groups in the municipality of Jamundí in Colombia which is currently affected by poverty, forced displacement, and the internal armed conflict and evaluate the accuracy with a Population Census.

Biomechanical Outcomes of Glenoid Bone Graft Fixation Techniques: A Systematic Review.

The Latarjet and other bony augmentation procedures are commonly used to treat anterior shoulder instability in the setting of significant glenoid bone loss. Although several fixation strategies have been reported, the biomechanical strength of these techniques remains poorly understood. To perform a systematic review of the biomechanical strength of glenoid bony augmentation procedures for anterior shoulder instability. Systematic review; Level of evidence, 4. A systematic search of the Medline, Embase, Web of Science, and Cochrane Library databases was performed to identify biomechanical studies evaluating various fixation strategies for coracoid and other bone transfer procedures for anterior shoulder instability. Biomechanical results included load to failure with both compression and traction forces, stiffness, and cyclic displacement. The quality of included articles was assessed based on the Quality Appraisal for Cadaveric Studies (QUACS) scale. A total of 21 biomechanical studies comprising 486 specimens were included. The number of screws used and the addition of washers were found to significantly increase rigidity and load to failure. The comparison of fixation techniques demonstrated mixed results in load to failure between screw and alternative constructs including suture buttons and suture anchors. However, studies that tested graft displacement consistently found more graft displacement in buttons compared with screws. The median and mean of the QUACS scale were both 12, with a range of 10-13. Biomechanical studies consistently demonstrated that when glenoid bone grafts were fixed with screws, the number of screws and use of washers significantly increased construct rigidity and load to failure. Different metal screw materials and sizes did not consistently demonstrate a significant difference in biomechanical strength. There are mixed results when comparing suture buttons to screw fixation. The evaluated studies revealed that all double metal screw constructs and the majority of suture button and anchor constructs were able to withstand the glenohumeral load reflective of activities of daily living using a 150-N threshold.

Simultaneously Modified Onlay Soft Tissue Graft and Apically Positioned Flap for Implant Phenotype Modification: A Case Series.

Bone augmentation procedures often leads to coronal displacement of the mucogingival junction, a deficiency of keratinized mucosa, and a reduction in soft tissue height. These challenges complicate the achievement of an ideal peri-implant phenotype. It is known that addressing both the quantity and quality of soft tissue is crucial for the long-term success and aesthetics of implants. This paper introduces a novel technique for peri-implant phenotype modification following bone augmentation, which combines a modified onlay graft (MOG) with an apically positioned flap (APF) performed simultaneously with implant placement. Two clinical cases are presented to demonstrate this approach, highlighting the restoration of the soft tissue environment through a single surgical intervention. The technique resulted in successful outcomes, including increased vestibular depth, keratinized tissue width, and vertical soft tissue volume. The modified onlay graft technique effectively manages soft tissue in post-bone augmentation scenarios, providing an ideal peri-implant phenotype and leading to stable, aesthetic, and functional implant restorations. This method requires fewer surgical interventions than traditional alternatives, minimizing patient discomfort and enhancing overall treatment outcomes.

Vascularized Iliac Crest Bone Graft for the Reconstruction of Anterior Vertebral Corpus Defects: A Literature Review and Cadaveric Feasibility Study.

Vertebral body defects pose a significant challenge in spinal reconstructive surgery. Compression fractures of the vertebral corpus are typically treated with vertebral augmentation procedures. There are significant risks associated with the introduction of foreign material in the spine, including infection and pseudarthrosis. Vascularized bone grafts (VBGs) have become a popular alternative for spinal reconstruction in the last decade thanks to their robust blood supply and autologous nature. VBGs have been described predominantly for the reconstruction of posterior vertebral defects. The objective of this study is to describe a novel procedure for the reconstruction of vertebral corpus defects in the lumbar and distal thoracic spine. This is a cadaveric anatomy study. The authors performed the novel surgical technique on an anonymized cadaveric donor in the prone position and recorded the procedure through clinical photography. Consent for the procedure and photography was obtained from the Center for Procedural Innovation. A 5-cm-long posterior iliac crest VBG (IC-VBG) was successfully harvested on a pedicle of the quadratus lumborum muscle. The VBG was rotated and mobilized anteromedially to the vertebral corpus. In this donor, the IC-VBG could be inset with minimal tension anywhere along the vertebral bodies of the spine from the L5 to the T9 level. A rotated, anteromedially mobilized IC-VBG represents a novel technique for reconstruction of the anterior vertebral corpus of the lumbar and distal thoracic spine with a lower risk of infection and pseudarthrosis than reconstruction with foreign materials.

The Impact of Posterior Maxillary Teeth on Maxillary Sinus: Insights From Cone-Beam Computed Tomography Analysis.

Background Odontogenic maxillary sinusitis arises mainly from dental origins, emphasizing the connection between dental health and sinus issues. Understanding these relationships is crucial for implant planning, sinus augmentation procedures, and managing post-extraction complications. This knowledge can help clinicians make informed decisions about treatment timing and approach. In this study, the influence of tooth periapical and periodontal conditions on maxillary sinus mucous membrane thickening using cone-beam computed tomography (CBCT) imaging was evaluated. Methods In this retrospective cross-sectional study, 124 patients who underwent CBCT for dental treatment covering 248 maxillary sinuses and 992 teeth were examined.Coronal and sagittal sections were examined to assess the maxillary sinus mucosal thickening (MT), the periodontal bone loss for maxillary posterior teeth, and their proximity to the maxillary sinus (RPMS). The mean ± standard deviation of quantitative variables was compared using a one-way ANOVA test. Multivariable logistic regression analysis was used to assess the relation between the different independent variables and MT of the maxillary sinus. P < 0.05 was considered to be statistically significant. Results MT was detected in 90 (72.6%) patients. We found 42 (33.9%) patients bilaterally. Grade 1 mucosal thickness was the most prevalent grade (72.5%), followed by Grade 2 (19.2%). Almost half the teeth examined were not in contact with the cortical borders of the sinus (56.0%). Most of the teeth showed mild to moderate periodontal bone loss (80.2%).Logistic regression analysis showed that the variables significantly associated with higher oddsof MTof maxillary sinus occurrence were tooth location (second molar vs. first premolar AOR = 2.30, 95% CI: 1.29-2.79, first molar vs. first premolar AOR = 3.79, 95% CI: 1.82- 3.10, and second premolar vs. first premolar AOR = 1.57, 95% CI: 1.27-2.84), the relation of roots of posterior maxillary teeth to the sinus floor (Type 2 vs. Type 0AOR = 2.27, 95% CI: 1.38-3.34, and Type 1 vs. Type 0 AOR = 2.24, 95% CI: 1.54-3.26), periodontal bone loss (severe vs. non-periodontitis AOR = 2.75, 95%CI: 1.29-5.86, and mild-moderate periodontitis vs. non-periodontitis AOR = 1.68, 95%CI: 1.19-4.93), and periapical and periodontal tooth condition (periapical lesion vs. extracted AOR = 32.7, 95% CI: 4.53-83.61, and no periapical lesion vs. extracted AOR = 19.8, 95% CI: 8.18-74.23). Conclusions Second molars, severe periodontal bone loss, and periapical lesions were associated with increased sinus MT risk, highlighting the need for dental health consideration in maxillary sinus management.

Image-Guided Musculoskeletal Interventional Radiology in the Personalised Management of Musculoskeletal Tumours.

Musculoskeletal image-guided interventional radiology plays a key role in diagnosing and treating a range of conditions. Recent advances have yielded a wide variety of procedures that can be applied selectively and enable the personalisation of patient care. This review aims to outline the indications, applications, and techniques of subspecialist musculoskeletal oncology interventional procedures that were used at our tertiary referral centre with a focus on how these may be used to personalise patient management. The applications of a range of diagnostic and therapeutic image-guided interventional procedures including different methods of bone and soft tissue sampling, ablation, and augmentation procedures across different types of patients and pathologies are reviewed. To supplement the reviewed literature, we included our own experience and radiology images retrospectively collected from our Picture Archiving and Communication System (PACS). We demonstrate how the range of musculoskeletal image-guided interventions provide flexibility in the diagnosis and management of different tumours across different patient populations. This study provides the musculoskeletal interventional radiologist with insight into how to appropriately utlilise different techniques to optimise the diagnosis, treatment and palliation of tumours.

SOFT TISSUE EXPANSION FOR TENSION FREE CLOSURE OF FLAP DURING GUIDEDBONE REGENERATION - A CASE REPORT

The compromised alveolar ridges preclude the placement of dental implants. The major problem with the regenerative procedures like block grafting, guided bone regeneration is flap opening during the initial healing period and exposure of the regenerative compartment. There is necessity for the tension free closure of the flap without relieving the periosteum or mucosa is required for the successful regeneration. The self-inflating osmotic tissue expander (Osmed) is used to expand the tissue prior to augmentation procedure. This report elaborates about the use of self-filling osmotic expander in severely compromised alveolar ridge defect cases (combined defect) prior to the augmentation procedure. The report concludes that the self-filling osmotic expander is a valuable tool in the efficient management of soft tissues prior to augmentation of severely compromised alveolar ridge cases.

Tunnel Technique in Bone Augmentation Procedures for Dental Implant Rehabilitation: A Systematic Review.

Background/Objectives: This systematic review aimed to compare the tunnel technique for pre-implant bone regeneration with traditional flap techniques also involving a crestal incision, in terms of procedure success, graft healing, postoperative course, patient satisfaction, and implant follow-up. Methods: A systematic search was conducted on MEDLINE/PubMed, EMBASE, and the Cochrane Central Register of Controlled Trials following PRISMA guidelines, searching for comparative prospective and retrospective studies in English, published between January 2002 and April 2024. The population of interest consisted of patients with edentulous ridge atrophy requiring pre-implant bone regeneration. The primary outcome was the success of the procedure. The secondary outcomes included complications, patient comfort, graft resorption, bone gain, primary implant stability, implant success/survival, peri-implant bone level change, and operative time. The risk of bias was assessed using RoB2 and ROBINS-I. Results: The search and selection process yielded one randomized controlled trial and three comparative observational studies, all with serious/high risk of bias. A narrative synthesis was conducted due to the small number of studies and the heterogeneity in key features. The tunnel technique might provide some advantages in terms of the success of the procedure, but the findings were not statistically significant. Conflicting findings or non-significant differences were reported in terms of the secondary outcomes. Conclusions: This review suggested some potential advantages of the tunnel technique for bone augmentation over traditional techniques involving a crestal incision, but the limited quality and amount of data precluded any definitive conclusions.

Anomalous Crystalline-Electromagnetic Responses in Semimetals

We present a unifying framework that allows us to study the mixed crystalline-electromagnetic responses of topological semimetals in spatial dimensions up to D=3 through dimensional augmentation and reduction procedures. We show how this framework illuminates relations between the previously known topological semimetals and use it to identify a new class of quadrupolar nodal line semimetals for which we construct a lattice tight-binding Hamiltonian. We further utilize this framework to quantify a variety of mixed crystalline-electromagnetic responses, including several that have not previously been explored in existing literature, and show that the corresponding coefficients are universally proportional to weighted momentum-energy multipole moments of the nodal points (or lines) of the semimetal. We introduce lattice gauge fields that couple to the crystal momentum and describe how tools including the gradient expansion procedure, dimensional reduction, compactification, and the Kubo formula can be used to systematically derive these responses and their coefficients. We further substantiate these findings through analytical physical arguments, microscopic calculations, and explicit numerical simulations employing tight-binding models. Published by the American Physical Society 2024

The Use of the Facial Sinus Wall as Bone Shell Onlay Graft for Maxillary Posterior Ridge Reconstruction: A Retrospective Case Series.

To evaluate the performance and clinical outcome of vertical and horizontal bone augmentation (VHBA) in posterior maxillary regions combining lateral window sinus floor elevation (LWSFE) with a horizontal bone shell technique applying the maxillary facial sinus wall as a bone plate. In 18 patients, LWSFE was combined with a horizontal bone shield augmentation procedure utilizing the maxillary facial sinus bone wall as a lateral bone plate. Both the sinus cavity and the lateral bone box created were grafted with a mixture of autogenous bone/venous blood and bovine bone mineral. The primary aim was to assess the performance of combined techniques enabling subsequent implant placement. Using radiographic measurements (preoperative, after VHBA, at implant placement, and at follow-up), bone gain/reduction of augmented horizontal ridge width (HRW) and vertical bone height (VBH) were evaluated. Additionally, clinical outcome assessing implant survival/success rate, marginal bone loss (MBL), and implant health (mucositis/peri-implantitis) was evaluated. For the combined VHBA techniques, HRW and VBH increased significantly (p < 0.001) from preoperative 3.5 ± 1.4 mm/3.6 ± 2.1 mm to 9.7 ± 1.9 mm/18.0 ± 1.6 mm post-augmentation. However, HRW and VBH dimensions decreased up to 8.9 ± 1.8 mm/17.1 ± 1.4 mm at implant placement and 8.6 ± 1.7 mm/16.7 ± 1.3 mm at follow-up evaluation (3.8 ± 1.8 years; p < 0.001, respectively). Augmented bone reduction was significantly higher (-7.7%) between the augmentation procedure and implant placement than in the post-implant-placement period (-2.5%). All implants survived (100%) representing peri-implant MBL of -0.9 ± 0.7 mm, pocket depth of 3.4 + 1.8 mm, and prevalences of 5%/0% for peri-implant mucositis/peri-implantitis. The combination of horizontal bone augmentation using local bone shield transfer from the maxillary facial sinus wall with LWSFE enables sufficient reconstruction of maxillary posterior ridge.

Fluoroscopy Dose and Time During Vertebral Augmentation for Spine Pain Due to Malignant Fractures

Background: Vertebral augmentation (VA) procedures are used to treat painful vertebral fractures caused by malignancies, but there are few data on the radiation exposure for patients and proceduralists during these VA procedures. We retrospectively examined the radiation dose exposure during VA procedures and defined the characteristics of patients who underwent such procedures. Methods: We conducted a retrospective observational cohort study including patients with cancer who experienced axial back pain from compression fractures caused by malignancies. Participants were identified using an electronic medical records database and must have had evidence of stable vertebral compression fractures upon imaging and documentation of a clinical evaluation. We collected data on patient demographics, fluoroscopy time (FT) and dose (FD) during the procedure, the volume of polymethylmethacrylate injected, and reported complications. Results: Overall, 140 patients were included. Their median age was 69, and they were mostly men (n = 79). The most common diagnosis was multiple myeloma (41.4%). Most patients had a single-level compression fracture of the thoracolumbar spine. The mean FT was 233.80 s, with higher FTs for patients with an elevated body mass index and patients younger than 60 years. The average FD was 157.98 mGy, with higher FDs for patients with an elevated BMI and for male patients. Pain relief was not associated with FT or FD. Conclusions: Patients with cancer who underwent VA experienced longer FT and higher FD compared to their non-cancer counterparts in the literature. However, we found multiple confounders for this relationship.

Does alveolar ridge preservation reduce the need for sinus floor elevation: A comparative study to spontaneous healing.

In cases of atrophy in the maxillary posterior region, characterized by reduced vertical bone volume, implant placement becomes challenging. Augmentation procedures like sinus lifts are often needed to address insufficient bone volume. This study aims to explore if alveolar ridge preservation, using a bovine bone substitute and a porcine collagen membrane, significantly decreases the need for sinus lifts compared to natural wound healing after tooth extraction. In this comparative clinical study, 40 patients requiring a total of 53 extractions were assigned to one of the following groups: a test group with bovine bone substitute material (Straumann® XenoFlex) and a porcine collagen membrane (Jason® membrane), or a control group with spontaneous socket healing. After 6 months, digital volume tomography was performed for implant planning. For seven patients from the control group (n = 22 extracted sites) sinus lift augmentations were performed while only four sinus lift procedures were performed in the test group (n = 31 extracted sites), indicating a higher need for sinus augmentation procedures in the control group, however not statistically different on a p value of 0.05 (p = 0.168). In the control group, the mean value of the radiographically measured bone height (mesial and distal) was 11.13 ± 2.12 mm preoperatively before tooth extraction, while it was 11.3 ± 2.17 mm postoperatively after implant placement. In contrast, the mean value in the test group was 11.78 ± 3.09 mm preoperatively and 11.92 ± 2.79 mm postoperatively. Statistical analysis revealed no significant difference between the two groups (odds ratio 0.32; 95% CI: 0.08, 1.26; p = 0.951). The implant survival rate in the control group was 100%, compared to 96.77% in the test group. Within the limits of this study, the use of bovine bone substitute and a porcine resorbable membrane after tooth extraction in the posterior maxilla seems to reduce the need for sinus augmentation in comparison to spontaneous healing although the difference was not statistically significant. Additionally, the Alveolar Ridge Preservation in the test group made external sinus floor elevation unnecessary compared to the control group. The change in radiographically measured bone height pre- and postoperatively showed no significant difference between the two groups.

Cone beam computed tomography outcomes in patients diagnosed with compromised bone health undergoing dental implant therapy and bone augmentation

Studies examining mid-term treatment outcomes of implant placement with bone augmentation in patients with compromised bone health are lacking. The purpose of this prospective, nonrandomized cohort study was to evaluate the cone bean computed tomography (CBCT) outcomes of implant placement with bone augmentation in postmenopausal women. For this best practice, standard of care study, 78 participants received 1 test implant along with 1 or a combination of 3 bone augmentation procedures: particulate graft, expansion, or block graft. Participants were categorized as healthy (n=49) or bone compromised (n=29). Using CBCT scans made preoperatively, immediately postoperatively, and 2 years postoperatively, the augmented alveolar ridge widths were measured in a buccolingual (BL) dimension 2mm and 6mm apical to the coronal aspect of the implant's rough surface. Additionally, peri-implant bone height was measured on the mesial and distal implant surfaces at the mid-alveolar aspect of the ridge using a coronal panoramic view. Both study groups exhibited an increase in horizontal BL measurements at the 2-mm and 6-mm landmarks from preoperative to immediate postoperative time points and a minimal decrease from intermediate postoperative to 2 years postoperative. The mean proximal height decreased over time in healthy participants but did not show a significant change in participants with compromised bone. The linear mixed effects model results revealed that the mean difference between groups significantly decreased over time at the 2-mm landmark (P<.05); however, no significant group-time interactions were found for the BL width at the 6-mm landmark and proximal height measurements (P=.627). Mid-term CBCT measurements showed significant bone augmentation immediately after surgery and 2 years after surgery and stable proximal bone adjacent to implants in postmenopausal women diagnosed with compromised bone health.

Survival Rates and Risk Factors of Resorbable Blast Media Surface Dental Implants: A Retrospective Cohort Study with an Average 60-Month Follow-Up.

This retrospective cohort study aimed to evaluate the survival rates and risk factors associated with Resorbable Blast Media (RBM) surface dental implants. The study involved 1,130 implants placed in 260 patients, with a follow-up ranging from a minimum of 26 months to a maximum of 120 months, for an average of 60 months. 1,130 RBM surface implants with hybrid macro-geometry were placed in 260 patients. Implant survival and failure rates were analyzed over an average 60-month follow-up. Failure rates were examined based on implant length, patient gender, and sinus lift procedures. Additional factors, including patient age, implant placement timing (immediate vs. delayed), guided bone regeneration (GBR), implant diameter, and implant location, were assessed to determine their impact on long-term implant success. The overall survival rate for the implants was 94.4%, with most failures occurring within the first 12 months postplacement. Male patients experienced significantly higher failure rates (7.36%) than female patients (4.0%). Short implants (8 mm) were particularly vulnerable to failure, with an 8.65% failure rate. Sinus augmentation procedures also presented an increased risk, with 10% failure for lateral sinus augmentation and 9.78% for crestal sinus elevation. In contrast, factors such as patient age, timing of implant placement, GBR, implant diameter, and implant location did not significantly influence failure rates. Notably, narrow-diameter implants (3.3 and 3.7 mm; n=97) in the molar region did not increase the risk of failure, with only 5 experiencing failure. Failures post-prosthetic loading were most common after about 3 years. This study confirms the long-term viability of RBM surface implants, with high survival rates when early failures are mitigated. Short implants and sinus lift procedures pose greater risks of failure, particularly in the early stages. However, simultaneous GBR and sinus procedures did not significantly impact long-term outcomes, affirming the safety and efficacy of these complex interventions.