Bone Augmentation Research Articles

Efficacy of Alveolar Ridge Preservation in Periodontally Compromised Molar Extraction Sites: A Systematic Review and Meta-Analysis.

To investigate the efficacy of alveolar ridge preservation (ARP) in periodontally compromised molar extraction sites. An electronic search was performed on 10th November 2023 across five databases, seeking randomised/non-randomised controlled trials (RCTs/NCTs) that included a minimum follow-up duration of four months. The RoB2 and Robins-I tools assessed the risk of bias for the included studies. Data on alveolar ridge dimensional and volumetric changes, keratinized mucosal width, and need for additional bone augmentation for implant placement were collected. Subsequently, a meta-analysis was carried out to derive the pooled estimates. Six studies were incorporated in the present review, and a total of 135 molar extraction sockets in 130 subjects were included in the meta-analysis. ARP was undertaken in 68 sites, and 67 sites healed spontaneously. The follow-up time ranged from 4 to 6 months. The meta-analysis of both RCTs and NCTs showed significant differences in mid-buccal ridge width changes at 1 mm level below ridge crest with a mean difference (MD) of 3.80 (95% CI: 1.67-5.94), mid-buccal ridge height changes (MD: 2.18; 95% CI: 1.25-3.12) and volumetric changes (MD: 263.59; 95% CI: 138.44-388.74) in favour of ARP, while the certainty of evidence is graded low to very low. Moreover, ARP appeared to reduce the need for additional sinus and bone augmentation procedures at implant placement with low certainty of evidence. Within the limitations of this study, alveolar ridge preservation in periodontally compromised extraction sites may, to some extent, preserve the ridge vertically and horizontally with reference to spontaneous healing. However, it could not eliminate the need for additional augmentation for implant placement. Further, longitudinal studies with large sample sizes and refined protocols are needed.

Quantitative analysis of change in bone volume 5 years after sinus floor elevation using plate-shaped bone substitutes: a prospective observational study

PurposeTricalcium phosphate (TCP) has osteoconductive ability and reportedly offers similar clinical results as autogenous bone grafts in dental implant treatment. However, few reports quantify temporal changes in augmented bone volume after sinus augmentation. We aimed to establish a three-dimensional (3D) quantification method to assess bone volume after sinus augmentation and to evaluate biocompatibility of the TCP plate.MethodsMaxillary sinus floor augmentation was performed employing the lateral window technique, and plate-shaped β-TCP (TCP plate) was used instead of granular bone grafting materials. After lifting the sinus membrane, the TCP plate was inserted and supported by dental implants or micro-screws. The changes in bone volumes in the maxillary sinus before and after surgery were recorded using cone-beam computed tomography, saved as Digital Imaging and Communications in Medicine-formatted files, and transformed to Standard Triangle Language (STL)-formatted files. Pre- and post-operative STL data of bone volume were superimposed, and the augmented bone volume was calculated. Moreover, changes in bone volumes, TCP plate resorption rates, and bone heights surrounding the implants were three dimensionally quantified.ResultsFifteen implants in nine subjects were included in this study. TCP plates secured long-term space making, with results similar to those of granular bone substitutes. Newly formed bone was identified around the implant without bone graft material. TCP plate was absorbed and gradually disappeared.ConclusionsA novel 3D quantification method was established to evaluate changes in bone volume. Clinical application of TCP plate in sinus augmentation could be a better procedure in terms of prognosis and safety.

Risk Factors for Early Implant Failure and Selection of Bone Grafting Materials for Various Bone Augmentation Procedures: A Narrative Review.

Implant therapy is now an established treatment with high long-term success and survival rates. However, early implant failure, which occurs within one year of superstructure placement, occurs at a higher rate than late failure, which is represented by peri-implantitis caused by bacterial infection. Furthermore, various risk factors for early failure have been reported, including patient-related factors, such as systemic diseases, smoking, and bone quality and quantity, as well as surgery-related factors, such as surgeons' skill, osteogenesis technique, and selection of graft material, and implant-related factors, such as initial implant fixation and implant length diameter. Due to the wide variety of relevant factors reported, it is difficult to identify the cause of the problem. The purpose of this review is to discuss the risk factors associated with various types of bone augmentation which have a close causal relationship with early implant failure, and to determine the optimal bone grafting material for bone augmentation procedures to avoid early implant failure.

A 3D printed magnesium ammonium phosphate/polycaprolactone composite membrane for Guided bone regeneration

Guided bone regeneration (GBR) is a widely utilized technique for alveolar bone augmentation and the GBR membrane plays a crucial role in this procedure. However, developing a membrane that possesses both mechanical property and biodegradability still remains a challenge. In this study, MgNH4PO4·6H2O (MNP) and polycaprolactone (PCL) were utilized to prepare a novel MNP-PCL composite GBR membrane via 3D printing method, and five different radios of MNP were included (5, 10, 15, 20, 25 wt%). All samples were well prepared into 25 mm × 25 mm square membranes with a thickness of about 0.8 mm. The membranes exhibited promising interconnected network structure with great distribution uniformity, mechanical properties, and biodegradability. Additionally, the membranes also possessed the capacities of sustained magnesium ions release (4 weeks at least) and weakly alkaline environment maintainance (pH 8.0–––8.5), which might be beneficial for promoting bone formation, this hypothesis was then confirmed by in vitro and in vivo studies that the adhesion, proliferation, osteogenic differentiation of MC3T3-E1 and new bone formation were signicantly enhanced on 10 % and 15 % MNP-PCL surfaces. In summary, the MNP-PCL membrane may providing a new approach for the development of GBR membranes in the future.

Orthodontic Implant Site Development Using Labial Root Torque: A Case Series with CBCT Analysis.

This case series assessed the efficacy of Orthodontic Implant Site Development with Labial Root Torque (OISD-LRT) as a nonsurgical technique for addressing labial bone deficiencies in seven patients. The procedure involved strategically placing a multi-bracket of 2-3 mm apically on the hopeless teeth, gradually shifting them with Ni-Ti wires at the rate of 2 mm per month and maintaining overcorrection for 2 months before extraction. OISD-LRT consistently augmented tissue for flapless guided implant surgery, with an average treatment duration of 404Å}311.7 days. Cone-beam computed tomography (CBCT) scans at various stages revealed increases in both vertical and horizontal bone dimensions, especially in the sockets with complete labial bone loss. Despite inevitable post-extraction reductions in bone height and width, sufficient dimensions were maintained to ensure long-term implant stability. This case series highlights the effectiveness of OISD-LRT as a valuable method for horizontal bone augmentation, particularly in patients with labial bone deficiency. This approach provides a robust foundation for subsequent implant placement, showcasing its success in addressing challenging anatomical conditions and contributing to the broader field of implant dentistry.

Augmentation techniques for the treatment of osteoporosis-associated fractures of the extremities

The current demographic development is leading to an increasing number of cases of osteoporosis-related fractures. Affected individuals are typically part of avulnerable, predominantly geriatric patient group with limited physical resources. Additionally, the pathophysiological characteristics of osteoporotic bones with reduced bone quality and quantity, pose asignificant challenge to the osteosynthesis techniques used. Achieving rapid postoperative mobilization and stable weight-bearing osteosynthesis to prevent postoperative medical complications are the main goals of the surgical management. In recent years augmentation techniques have gained in importance in the treatment of osteoporosis-related fractures by significantly enhancing the stability of osteosyntheses and reducing mechanical complication rates. The main options available are polymethyl methacrylate (PMMA) augmentation and various bioresorbable bone substitute materials with different properties. Implant augmentations can be applied at various locations in the extremity bones and standardized procedures are now available, such as for the proximal humerus and femur. When used correctly, low complication rates and promising clinical outcomes are observed. This article aims to provide an overview of available techniques and applications based on the current literature. Guidelines and substantial scientific evidence are still limited.

Changes in the Maxillary Sinus Membrane Thickness and Sinus Health Following Lateral Sinus Floor Elevation: Comparing Preoperative Mucosal Thicknesses of Less than and Greater than 5 Millimeters.

To investigate the effect of lateral sinus floor elevation (LSFE) on sinus membrane (SM) thickness and sinus health in mucosa thickness less and more than 5 mm. LSFE was performed in a prospective controlled clinical trial on two groups with less than and more than 5 mm (group A & B) SM thickness and followed for 6 months. Using preoperative and 6-month postoperative CBCT and clinical evaluation, SM thickness changes (primary outcome variable), sinus health, augmented bone height, and length (augmentation adequacy), membrane-related variables, and operation time were measured. Forty unilateral sinus augmentations (A:20, B:20) with simultaneous installation of 52 fixtures were performed on 40 subjects (72.5% males, mean age of 48.8±7.6). The mean preoperative and 6- month SM thicknesses in group A and group B were 1.4±0.9 and 1.3±0.6 mm, and 6.8±1.0 and 3.4±1.7 mm, respectively. The mean postoperative SM thickness significantly decreased (P<0.001) only in group B. The mean SM thickness changes also revealed a noticeable difference between the two groups (P<0.001). Augmentation adequacy and membrane perforation rate were similar in both groups. Clinical and radiographic rhinosinusitis was not detected in any of the patients. Bleeding during separation and resistance to elevation in group B were significantly higher than in group A (P=0.003, P=0.001). Surgical time in group B (12.08 ± 8.26 minutes) was longer than in group A (8.64 ± 3.70 minutes), without reaching a significant level (P=0.097). LSFE in thickened mucosa (≤10 mm) and thinner mucosa (≤5 mm) does not cause abnormal changes in the sinus membrane and sinus health. LSFE in thickened mucosa results in adequate sinus augmentation. Thickened SM also shows a significant thickness reduction. The thickened membrane does not appear to be a contraindication to SFE.

Evaluation of the Success of Autogenous Block Grafting in Atrophic Maxillary and Mandibular Ridges Prior to and After Implant Placement.

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. 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. 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. 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. 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. This study provides crucial insights into autogenous block grafting's transformative impact on challenging cases, guiding future applications in reconstructive dentistry.

Horizontal ridge augmentation in the maxillary aesthetic region using the autogenous circular cortical-lamina anchoring technique: A case series study.

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. 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. 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. The autologous CCA technique is a useful method for increasing ARW and maintaining BBT in the maxillary aesthetic region.

Retrospective study on the effect of adipose stem cell transplantation on jaw bone regeneration

PurposeIn patients with jaw bone atrophy, dental implant therapy requires bone augmentation on the alveolar ridge. Common methods are autologous bone transplantation or bone substitutes. The latter technique is less surgically invasive because it does not require bone harvesting; however, blood supply from the surrounding tissues and local differentiation of osteoblasts are not guaranteed, so adequate bone regeneration for dental implant therapy is often not achieved. Therefore, at our hospital we introduced a bone regenerative medicine technique that uses adipose stem cells (ASCs) from adipose tissue. The new approach is less surgically invasive and appears to have a better effect on bone regeneration. The current retrospective study aimed to demonstrate the efficacy of ASC transplantation in patients who underwent alveolar ridge bone augmentation at our hospital.MethodsWe compared medical records, postoperative radiographic findings, and histological results from patients treated between January 2018 and March 2022 by augmentation of the jaw bone with bone substitutes (carbonate apatite) mixed with ASCs (ASCs+ group) and those treated with bone substitutes (carbonate apatite) alone (ASCs− group).ResultsAfter 6 months, the survival rate of augmented bone and the gray scale value in dental cone beam computed tomography (a bone density index) were significantly higher in the ASCs+ group than in the ASCs− group. Histological analysis at 6 months showed more adequate bone tissue regeneration in the ASCs+ group.ConclusionsThe findings suggest the effectiveness of using ASCs in bone augmentation on the alveolar ridge in patients with jaw bone atrophy.

Eleven- to fifteen-year outcome for two-piece implants with an internal tube-in-tube connection: a cross-sectional analysis of 245 implants.

The aim of this retrospective study was to evaluate the outcomes of a two-piece implant system with a tube-in-tube internal connection after up to 15years of clinical use. A retrospective follow-up examination of patients treated with internal tube-in-tube implants between 2003 and 2006 was conducted. The implant survival rates, peri-implant conditions (marginal bone loss, bleeding on probing, plaque index, probing depth), and technical complications were determined. In total, 312 dental implants were placed in 152 patients. Of the original 152 patients enrolled, 245 implants in 112 patients were available for a follow-up evaluation after 11 to 15years (mean observation time, 12.9 ± 1.1years). The overall implant survival rate was 93.9%. Outcomes for MBL (1.49 ± 1.23mm), PI (24.3 ± 22.2%), BOP (18.3 ± 28.7%), and PD (2.74 ± 1.21mm) were observed. Selected parameters (time after implant surgery, smoking habits, bone augmentation (GBR)) showed an influence on MBL and PD. The internal tube-in-tube implant system showed favorable long-term results. The correlation of MBL and PD with the patient-specific factor smoking habit is in accordance with other studies. Camlog Root-Line implants with a tube-in-tube implant-abutment connection and a 1.6-mm polished neck configuration have demonstrated favorable long-term outcomes in daily clinical practice. However, it is important to note that these implants are no longer available on the market.

In Situ Photo-Crosslinkable Protein Bioadhesive for Bone Graft Fixation

Bone grafting is a fundamental dental surgery procedure widely used for implant placement and periodontal disease management treatments. Despite its broad applications, vertical bone augmentation presents unique challenges, including the risk of graft displacement due to gravitational and masticatory forces. Traditional physical stabilization methods introduce additional complexities and risks, underscoring the need for innovative fixation technologies. This study aimed to develop an in situ photo-crosslinkable bioadhesive hydrogel (iPBAH) as a multifunctional bone graft binder to enhance the process of bone reconstruction. The bioadhesive is composed of mussel-derived adhesive protein (MAP) fused with the cell-adhesive peptide RGD. The numerous tyrosine residues in MAP facilitate rapid photo-crosslinking, enabling efficient hydrogel formation using visible blue light. Subsequently, iPBAH underwent comprehensive characterization to evaluate its suitability as a multifunctional bone graft binder. iPBAH efficiently underwent in situ crosslinking through harmless exposure to visible light within minutes and displayed several exceptional properties, including a microporous structure, underwater adhesion, extended durability, high compressive strength, and biocompatibility. In vivo assessments, using male Sprague-Dawley rats, demonstrated that iPBAH binder significantly enhanced bone regeneration in a rat calvarial bone defect model. The in situ crosslinking of the iPBAH binder during bone graft transplantation can effectively fill irregular and complex defect shapes while simultaneously preventing graft material leakage. The improved physical attributes of the bound graft material can enhance its resistance to external forces, thereby ensuring sustained retention over time. Moreover, the interaction between iPBAH and surrounding tissues promotes adhesion and integration of the graft material with host tissues in the defect area. In addition, the included RGD peptide in iPBAH can augment inherent cell recruitment, adhesion, and growth, consequently expediting osteogenesis.

Peri-implant mucosal fenestration and histologic observation of bone xenograft material 7 years after implant installation: A case report.

Bone augmentation is often required before the installation of dental implants. Here, we report a case for a patient who previously received bone augmentation at the upper right jaw using a xenogenic graft, followed by successful implant installation. Seven years later, the patient presented with mucosal fenestration with bone exposure at the area and gave a history of a recent diagnosis of cutaneous lichen planus. Several attempts were made to manage the situation, and finally, we resorted to connective tissue graft placement at the site. A piece of bone was sent for histologic evaluation, where the results indicated the presence of un-resorbed graft material surrounded by inflammatory cells, with no evidence of bone formation in the area. The case presents histologic evidence for the lack of new bone formation using xenograft over the evaluation period. The case also shows lichen planus, a possible cause for oral complication for patients undergoing augmentation and implant installation.

The development of non-resorbable bone allografts: Biological background and clinical perspectives.

Bone grafts are typically categorized into four categories: autografts, allografts, xenografts, and synthetic alloplasts. While it was originally thought that all bone grafts should be slowly resorbed and replaced with native bone over time, accumulating evidence has in fact suggested that the use of nonresorbable xenografts is favored for certain clinical indications. Thus, many clinicians take advantage of the nonresorbable properties/features of xenografts for various clinical indications, such as contour augmentation, sinus grafting, and guided bone regeneration, which are often combined with allografts (e.g., human freeze-dried bone allografts [FDBAs] and human demineralized freeze-dried bone allografts [DFDBAs]). Thus, many clinicians have advocated different 50/50 or 70/30 ratios of allograft/xenograft combination approaches for various grafting procedures. Interestingly, many clinicians believe that one of the main reasons for the nonresorbability or low substitution rates of xenografts has to do with their foreign animal origin. Recent research has indicated that the sintering technique and heating conducted during their processing changes the dissolution rate of hydroxyapatite, leading to a state in which osteoclasts are no longer able to resorb (dissolve) the sintered bone. While many clinicians often combine nonresorbable xenografts with the bone-inducing properties of allografts for a variety of bone augmentation procedures, clinicians are forced to use two separate products owing to their origins (the FDA/CE does not allow the mixture of allografts with xenografts within the same dish/bottle). This has led to significant progress in understanding the dissolution rates of xenografts at various sintering temperature changes, which has since led to the breakthrough development of nonresorbable bone allografts sintered at similar temperatures to nonresorbable xenografts. The advantage of the nonresorbable bone allograft is that they can now be combined with standard allografts to create a single mixture combining the advantages of both allografts and xenografts while allowing the purchase and use of a single product. This review article presents the concept with evidence derived from a 52-week monkey study that demonstrated little to no resorption along with invitro data supporting this novel technology as a "next-generation" biomaterial with optimized bone grafting material properties.

Evaluation of Surgical Outcomes of Zygomatic Implant-Supported Rehabilitation of Atrophic Maxillary Arches - A Prospective Study.

Prosthetic rehabilitation with implants in the atrophic edentulous maxilla often requires a bone augmentation procedure to enable implant placement and integration. However, rigid anchorage can also be achieved using long zygomatic implants. The aim of this study was to evaluate the surgical outcomes of rehabilitation of atrophic posterior maxillary ridges with zygomatic implants using the zygomatic success code (ZSC) and derive the success grade for the procedure based on the observed results. A total of eight implants were placed in an extrasinus technique based on the zygomatic anatomy-guided approach. The following were evaluated postoperatively - primary stability, maxillary sinus pathology, soft-tissue healing and prosthetic offset. The ZSC score was calculated, and success grading was given with ZSC based on Aparacio et al.,'s guidelines. One implant had Grade 1 mobility and partial maxillary sinus opacification, 25% (n = 2) revealed a mild recession exposing the implant head and 12.5% (n = 1) showed significant recession up to 7 mm. The prosthetic offset of zygomatic implants was scored -1 for all eight implants. Five implants were given a success code of 1/1/1/1 and a success grade of Grade I, two implants were given code 1/1/2/1 with Grade II and one implant 2/2/3/1 and grade III. The results imply that zygomatic implants can be a successful option in maxillary rehabilitation. The zygomatic implants, as a graft less and promising solution to the rehabilitation of atrophied maxillary arches, have excellent surgical outcomes with varied advantages.

The response of human osteoblasts on bovine xenografts with and without hyaluronate used in bone augmentation

The aim of the in vitro study was to asses the effect of hyaluronate in conjunction with bovine derived xenografts on the viability, proliferation on day 4, 7 and 10, expression of early osteogenic differentiation marker Alkaline phosphatase on day 14 and 21, collagen, calcium deposition on day 14, 21 and 28 and cellular characteristics, as assessed through live cell image analysis, confocal laser scanning microscopy and scanning electron microscopy, in primary human osteoblasts compared to three bovine xenografts without hyaluronate. All experiments were performed in triplicates. Data were compared between groups and timepoints using one-way analysis of variance (ANOVA). Bonferroni post hoc test were further used for multiple comparison between groups (p < .05) An increase in cell viability (p < .05) and enhanced ALP activity was observed in all xenografts. Specimens containing hyaluronate showed a highest significant difference (23755 ± 29953, p < .0001). The highest levels of calcium (1.60 ± 0.30) and collagen (1.92 ± 0.09, p < .0001) deposition were also observed with hyaluronate loaded groups. The osteoblasts were well attached and spread on all xenograft groups. However, a higher number of cells were observed with hyaluronate functionalized xenograft (76.27 ± 15.11, (p < .0001) in live cell image analysis and they migrated towards the graft boundaries. The biofunctionalization of xenografts with hyaluronate improves their in vitro performance on human osteoblasts. This suggests that hyaluronate might be able to improve the bone regeneration when using such xenografts.

Low-Temperature Calcium Phosphate Ceramics Can Modulate Monocytes and Macrophages Inflammatory Response In Vitro.

Creating bioactive materials for bone tissue regeneration and augmentation remains a pertinent challenge. One of the most promising and rapidly advancing approaches involves the use of low-temperature ceramics that closely mimic the natural composition of the extracellular matrix of native bone tissue, such as Hydroxyapatite (HAp) and its phase precursors (Dicalcium Phosphate Dihydrate-DCPD, Octacalcium Phosphate-OCP, etc.). However, despite significant scientific interest, the current knowledge and understanding remain limited regarding the impact of these ceramics not only on reparative histogenesis processes but also on the immunostimulation and initiation of local aseptic inflammation leading to material rejection. Using the stable cell models of monocyte-like (THP-1ATRA) and macrophage-like (THP-1PMA) cells under the conditions of LPS-induced model inflammation in vitro, the influence of DCPD, OCP, and HAp on cell viability, ROS and intracellular NO production, phagocytosis, and the secretion of pro-inflammatory cytokines was assessed. The results demonstrate that all investigated ceramic particles exhibit biological activity toward human macrophage and monocyte cells in vitro, potentially providing conditions necessary for bone tissue restoration/regeneration in the peri-implant environment in vivo. Among the studied ceramics, DCPD appears to be the most preferable for implantation in patients with latent inflammation or unpredictable immune status, as this ceramic had the most favorable overall impact on the investigated cellular models.

Surgical Treatment of Multiple Bone Cysts Using a Platelet-Rich Fibrin and BoneAlbumin Composite Graft: A Case Report

Promising research results have been obtained on the tissue-regeneration properties of PRF (platelet-rich fibrin) in dentistry and maxillofacial surgery. PRF presumably promotes healing and accelerates ossification. In this case report, the patient had a history of Gorlin–Goltz syndrome, also called nevoid basal cell carcinoma syndrome, an autosomal dominant neurocutaneous disease that was known for many years. As a consequence, cysts were detected in both the mandible and maxilla. We performed decompression on this 37-year-old patient, followed by a cystectomy on an extensive lesion in the right angle of the mandible. One cyst from each side of the body mandible and one from the maxilla were completely enucleated, as determined using an intraoral exploration. The resulting bone defect was filled with a composite graft composed of a mixture of A-PRF and a serum albumin-coated bone allograft (BoneAlbumin). The wound was then covered with a PRF membrane. The surgical sites were closed per primam. The postoperative period was uneventful. Biopsies were performed after three and six months of healing for histological micromorphometry analyses. Dental implants were placed at the sampling site. Three months after the implantation, the ossified implants were fitted with superstructures. To date, no complications have appeared with the bone augmentation. The authors interpret from the findings that the combination of A-PRF and BoneAlbumin can be validated as a prosperous bone substitute. It can be safely implanted after a 3-month ossification period.

Clinical outcomes and risk factor analysis of dental implants inserted with lateral maxillary sinus floor augmentation: A 3- to 8-year retrospective study.

To evaluate the 3- to 8-year outcomes of dental implants placed with lateral sinus floor augmentation (LSFA) and to identify factors affecting implant survival. This retrospective study was performed by screening all implants placed with LSFA procedures, which were conducted between January 2012 and December 2016. Subantral bone gain (SABG) and apical bone height (ABH) were assessed using panoramic radiographs. The cumulative survival rate of implants was analysed using life-table analysis and Kaplan-Meier survival curves. The influential risk factors affecting survival were assessed using univariate log-rank tests and multivariable mixture cure rate model. Implant complications were recorded. Based on the established criteria, a total of 449 patients (760 implants) were included in this study. In the 3- to 8-year follow-up (mean ± SD, 5.81 ± 1.33 years), 15 implants in 14 patients failed, with a CRS of 96.81% on an implant basis and 95.07% on a patient basis. A history of periodontitis and poor compliance with supportive periodontal treatment was associated with a significantly higher risk of implant failure at both implant and patient levels. Significant decreases in ABH occurred during each yearly interval except for 3 years. A similar trend has been observed for SABG at 1, 2, 6 and 8 years. The total complication rate was 31.84% on implant basis, with peri-implant mucositis (21.58%) being the most frequent biologic complication and porcelain cracking (5.00%) being the most common technical complication. Implant with LSFA is a reliable treatment option in atrophic maxilla. A history of periodontitis without regular supportive periodontal treatment was identified as a predictor for implant failure. Slight but significant shrinkage of vertically augmented bone can be observed after implant placement.

Multidimensional 3D-Printed Scaffolds for Ridge Preservation and Dental Implant Placement: A Systematic Review

Background: Regenerative medicine in dentistry involves tissue engineering applications suitable for the unique oral environment. In this regard, advances in computer-aided technology have facilitated the creation of 3D scaffolds using cone beam computed tomography (CBCT). This review aimed to investigate whether 3D-printed scaffolds can be effectively used to achieve ridge preservation and/or predictable vertical and horizontal bone augmentation, ensuring successful outcomes for dental implant placement. Methods: A comprehensive search was conducted across six electronic databases (PubMed, Scopus, ScienceDirect, Google Scholar, Web of Science, Ovid) to identify relevant studies according to specific eligibility criteria, following the PRISMA guidelines. Two independent reviewers screened and selected studies, performed data extraction, and assessed the risk of bias using the Cochrane tool for randomized clinical trials and the Newcastle–Ottawa Scale for non-randomized clinical trials. Results: The initial search yielded 419 articles, which were subsequently screened to remove duplicates. After evaluating 293 articles based on title and abstract, 10 studies remained for full-text assessment. Ultimately, only three studies met all the pre-established eligibility criteria. Conclusions: The studies included in this systematic review showed that the use of multidimensional customized scaffolds appears to promote dental implant placement. Nevertheless, despite the positive reported effects, further well-designed randomized clinical trials are necessary to determine the special characteristics of the optimal 3D-customized scaffold.