Bone Ring Technique Research Articles

The role of bone ring technique for bone augmentation in implant surgery: A Narrative Review.

Bone grafting with simultaneous implant placement using the novel bone ring technique was a procedure introduced with the intention of three-dimensional bone augmentation with simultaneous implant placement in both maxilla and mandible. A ring-shaped bone is placed in the socket, which is secured by an implant placed through the ring. The current narrative review was planned to provide a concise summary of the core concepts surrounding bone augmentation, to provide context for understanding the bone ring technique, and to highlight the basics of bone grafting and the origin of the technique to its advancement and its importance in the light of current literature.

Autogenous bone ring augmentation around single tooth implantation in the esthetic zone: A retrospective case series study with 2–3 years of follow-up

Background/purpose: Bone ring technique (BRT) is an effective method to reconstruct alveolar bone defects with simultaneous implant placement. This study aimed to evaluate the efficacy of the BRT in single maxillary anterior tooth implantation and its esthetic outcomes over 2–3 years of follow-up. Materials and methodsFifteen patients with single maxillary incisor loss received autogenous BRT with simultaneous implant placement. The vertical/horizontal bone gain, remaining vertical bone height (RVBH), remaining buccal bone width (RBBW), and vertical/horizontal bone resorption around implant over 2–3 years of follow-up were measured by using cone-beam computed tomography. Esthetic results including white esthetic score (WES), pink esthetic score (PES), and papilla index (PI) were evaluated by clinical recorded photographs. ResultsAll implants showed evidence of osseointegration, and the mean vertical and horizontal bone gain of 14 sites was 5.55 ± 0.87 mm and 4.73 ± 0.70 mm, respectively. During 2–3 years of follow-up, all mean values of RBBW were more than 2 mm. Main vertical bone loss appeared within 4 months after surgery and the RVBH value decreased as the follow-up duration continued. Maximum buccal bone thickness resorption mostly appeared in the middle level of the implant during the primary two follow-up periods (P < 0.05). Esthetic results showed that the mean WES/PES was higher than 17, and more than half cases demonstrated relatively high PI (3 points) throughout the follow-up. ConclusionBRT could achieve excellent bone augmentation effect and can offer predictable esthetic outcomes for single tooth implant restoration in the esthetic zone.

Implant Placement Using the Bone Ring Technique With and Without Membrane Placement: A Preclinical 12-Month Study in Dogs.

The bone ring technique is applied for vertical augmentation, in which the dental implant and autogenous block bone graft are simultaneously inserted. We investigated the healing of bone around implants placed simultaneously using the bone ring technique with and without membrane placement after a 12-month healing period. Vertical bone defects were created on both sides of the mandible of Beagle dogs. Implants were inserted into the defects through bone rings and fixed with membrane screws as healing caps. The augmented sites on one side of the mandible were covered with a collagen membrane. Samples were harvested 12 months after implantation and assessed histologically and by microcomputed tomography analysis. All implants remained throughout the healing period; however, except for 1 implant, they showed lost caps and/or exposure to the oral cavity. The implants had contact with newly formed bone despite frequent bone resorption. The surrounding bone appeared mature. The medians of bone volume and percentages of total bone area and bone-to-implant contact within the bone ring were slightly higher in the group with membrane placement than in that without membrane placement. Nevertheless, none of the evaluated parameters were significantly affected by the membrane placement. In the present model, soft tissue complication was frequent, and the membrane application did not reveal the effect at 12 months after implant placement using the bone ring technique. Sustained osseointegration and maturation of surrounding bone were observed in both groups after a 12-month healing period.

Autogenous Bony Halo for Ridge Augmentation and Simultaneous Implant Placement

Tooth extraction often leads to alterations in the dimensions of the ridges. Hence it may be necessary to perform augmentation procedures before dental implants are placed. Various surgical procedures and materials have been introduced that enhance the soft tissue support and structural base of bone required by implants. Alveolar bone augmentation methods include guided bone regeneration onlay grafting interposition grafting distraction osteogenesis ridge splitting and socket preservation. The bone ring technique is another onestage procedure that is carried out to treat vertical alveolar ridge abnormalities. In this technique the dental implant and a block graft which can either be an autogenous graft or an allogenic cortico-cancellous graft are placed simultaneously. This case report describes the application of the bone ring approach for augmentation of the implant site along with the simultaneous placement of the dental implant. This is an easy procedure for obtaining ring-shaped donor bone for the three-dimensional 3D reconstruction of bone deformities.

Radiographic Assessment of Buccolingual Dimension of Allogenic Bone Ring When Used Simultaneously with Dental Implant Placement

Purpose: This study aimed to evaluate the use of allogenic bone ring technique to restore the bucco-lingual dimension of the alveolar bone defects combined with simultaneous dental implant placement. Subjects and methods: Ten patients requiring bone augmentation horizontally or both horizontally and vertically at the time of implant placement were included in this retrospective study. All patients received simultaneous bone augmentation surgery and implant placement with allogenic bone ring grafts. Postoperative efficacy of the technique was evaluated using CBCT as a radiographical parameter. Results: Survival rates of implants were 100%. Cone-beam computed tomography revealed that the allogenic bone ring graft had significantly sufficient horizontal bone augmentation below the implant neck platform to 0 mm, 1 mm, 2 mm, and 3 mm. It could also provide an excellent peri-implant tissue condition during the 6 months’ follow-up after loading. Conclusion: The bone ring technique with allogenic bone ring graft could increase and maintain horizontal bone mass in the region of the implant neck platforms in serious horizontal bone defects.

Bone allograft block using demineralized freeze-dried bone ring technique in Indian patients.

Our study aimed to evaluate the effectiveness of the bone ring technique for ridge augmentation using Demineralized Freeze - Dried Bone Allograft block in Siebert's class II/class III defects along with simultaneous implant placement. A total of 15 partially edentulous patients (16 surgical sites) with Siebert's class II and/or class III defects in the anterior region of both jaws requiring ridge augmentation along with implant placement were selected. Starting from the first stage, surgery (Ridge augmentation+ implant placement) was done in the first month. Then, with continuous follow-ups and radiographic assessment, after 6 months of 2nd stage surgery was done, the implant was loaded with the final restoration. Significant results were revealed with all the parameters other than keratinized gingival and peri-implant mucosa thickness. With the mean bone resorption of 1.22 mm and 1.17 mm at the mesial and distal site at a 6-month interval, the success rate of the bone ring technique was 93.75%. The allograft bone ring technique showed a favorable outcome for the reconstruction of large vertical defects.

Prerequisite for Successful Implant Placement with a Comparative Study on Novel Bone Ring Technique: A Review

Implant placement is getting space day by day. However, in every case, we never get the ideal condition of alveolar bone for implant placement. Alveolar bone loss is seen due to periodontitis, tooth loss, tooth extraction, and periapical infection, etc.&#x0D; Resorption of alveolar bone varies from person to person and side to side. It has been noted that the size of the residual ridge shrinks more quickly within the first six months.&#x0D; There is new demand for reconstruction of the alveolar ridge for implant placement. Various techniques are available for increasing the ridge height and width by using bone graft, membrane, etc., one of these is the vertical ring procedure.&#x0D; Bone ring technique (BRT) has been described as a one-stage approach to restore vertical ridge height defects, in which an autogenous or allogeneic bone block graft is used and the implant is placed simultaneously.&#x0D; This review aims to focus on the importance of the implant placement, consequences of complete edentulism, the problem with removable partial denture (RPD) placement, as a result of bone loss in fully edentulism patients, and the use of vertical ring technique for the implant placement.

Horizontal bone augmentation and simultaneous implant placement using xenogeneic bone rings technique: a retrospective clinical study

This study evaluated the use of bone ring technique with xenogeneic bone grafts in treating horizontal alveolar bone defects. In total, 11 patients in need of horizontal bone augmentation treatment before implant placement were included in this retrospective study. All patients received simultaneous bone augmentation surgery and implant placement with xenogeneic bone ring grafts. We evaluated the postoperative efficacy of the bone ring technique with xenogeneic bone grafts using radiographical and clinical parameters. Survival rates of implants were 100%. Cone-beam computed tomography revealed that the xenogeneic bone ring graft had significantly sufficient horizontal bone augmentation below the implant neck platform to 0 mm, 1 mm, 2 mm, and 3 mm. It could also provide an excellent peri-implant tissue condition during the 1-year follow-up after loading. The bone ring technique with xenogeneic bone ring graft could increase and maintain horizontal bone mass in the region of the implant neck platforms in serious horizontal bone defects.

Comparison of in-situ bone ring technique and tent-pole technique for horizontally deficient alveolar ridge in the anterior maxilla.

Limited studies focused on the bone profile maintenance at the alveolar ridge crest applying horizontal bone augmentation. A novel approach named as "in-situ bone ring technique" was introduced to be compared with tent-pole technique to evaluate their horizontal bone gain, resorption, and postoperative perception. A total of 30 patients were included in this retrospective cohort study. All patients required horizontal bone augmentation at anterior site. Accordingly, quantitative and qualitative analyses were conduct radiographically and histologically between in-situ bone ring (ring group) and tent-pole technique (tent group). Moreover, the visual analog scale (VAS) was introduced to assess the patients' perception toward both treatments. Cone-beam computed tomography results showed great significant difference regarding horizontal bone width at 0 mm and 3 mm from alveolar ridge crest between two groups (P < .05). On the basis of histological outcomes, delightful bony fusion was shown 6-month postoperatively in ring group. The VAS ratings for pain and swelling reflected similar results between two groups. In-situ bone ring technique evidently increased and maintained horizontal bone mass at the alveolar ridge crest compared to tent-pole technique, which might be favorable for implant rehabilitation in anterior area. Meanwhile, no further discomfort was caused according to VAS scoring between two groups.

Single-staged implant placement using the bone ring technique with and without membrane placement: Micro-CT analysis in a preclinical in vivo study.

To assess the impact of collagen membrane application on bone formation surrounding implants placed simultaneously with the bone ring technique. Dental implants were inserted simultaneously with the bone ring technique in standardized, vertical alveolar bony defects in the mandible of dogs. On one side of the mandible, the augmented sites were covered with a collagen membrane (M-Group). On the contralateral side, no membranes were used (NM-Group). Implants were left to heal with osseointegration for three and six months. The harvested samples were analyzed by means of micro-CT. A nonparametric analysis of data revealed that the membranes were not a significant negative factor for bone volume (BV), but for bone-to-implant contact (BIC, p=.04). Absence of healing caps impaired BV (p=.04) and BIC (p=.02) as well. Furthermore, loss of healing caps and exposure to the oral environment significantly and negatively affected BV (p<.001) and bone mineral density (p<.05) within 2mm below the implant shoulder. Implant exposure and healing time had a negative interaction effect on both BV (p=.01) and BIC (p=.01). Within its limitations, the present study revealed no benefit of membrane application to implant placement simultaneous with the bone ring technique. Disruption of soft tissue healing was identified as a risk factor for decrease in BV and BIC.

One-Stage Vertical Ridge Augmentation and Dental Implantation With Allograft Bonerings: Results 1 Year After Surgery.

The aim of this study was to analyze the success rate of dental implants and the graft shrinkage rate after vertical ridge augmentation and simultaneous implantation with an allograft bonering. Fifty-one patients (81 augmentations and simultaneous implantations) were included. The bonering technique followed a standardized protocol. The alveolar ridge was prepared using a congruent trephine, and depending on the defect size, an allograft bonering with an outer diameter of 6-7 mm was placed. The height of the bonering was trimmed with a diamond disc to the required length. The average height of vertical augmentation was 5.5 mm. Implants were inserted through the bonering into the native bone of alveolar ridge. After 6 months, dental implants were exposed, and dental prosthetics were placed. Of 81 implants placed with the bonering technique, two failed during a 12-month follow-up, corresponding to a success rate of 97.5%. One year after surgery, the allograft bonering exhibited an average vertical graft shrinkage rate of 8.6%. In conclusion, the allograft bonering technique was associated with a favorable outcome, and in cases with large vertical defects, both treatment time and donor site morbidity could be reduced.

Single-staged implant placement using bone ring technique with and without membrane placement: An experimental study in the Beagle dog.

To evaluate the impact of a collagen membrane on bone remodeling and osseointegration of implants placed simultaneously with a bone ring technique. Standardized, vertical alveolar bone defects in the mandibles of six dogs were created. Tapered dental implants designed for two-stage subcrestal placement were inserted simultaneously with a bone ring technique. On one side of the mandible, the augmented sites were covered with a collagenous membrane. Implants with (M Group) and without membranes (NM Group) were left for an osseointegration period of 3 and 6months, respectively. Block biopsies of the implants with surrounding bone were harvested and analyzed histologically. Implant exposure was a common finding (2/3) concomitantly with loss of healing caps. It appeared to be related to advanced bone loss around the implants. Exposure of implants was more frequent in M Group, however, without significant differences when compared to NM Group. The total bone area within the region of the bone ring was greater in the NM Group compared to the M Group. Moreover, in the region of the pristine bone of the M Group, the total bone was greater than at the corresponding NM Group sites at both observation periods. A nonparametric analysis of variance (ANOVA) revealed no significant effects of membrane placement or healing period on the total area of the bone. The total bone-to-implant contact (BIC) for the two groups was similar at each observation time point. However, BIC increased significantly at 6-month compared with 3-month observation period (p=.0088) in both groups. In vertical bone augmentation applying the bone ring technique, the disruption of soft tissue was a frequent complication. Membrane placement yielded no significant advantage on the osseointegration (BIC) of implants or bone characteristics.

Single-staged vs. two-staged implant placement in vertically deficient alveolar ridges using bone ring technique - Part 2: implant osseointegration.

The aim of this study was to evaluate the osseointegration of implants placed in a single-staged compared to two-staged procedure using bone ring technique. In this study were used standardized, vertical alveolar bone defects in dogs. In the test group, dental implants (Straumann BL® , Basel, Switzerland) were inserted simultaneously with bone ring technique. As control group served implants inserted 6months following grafting. Implants of both groups were left for an osseointegration period of 3 and 6months. The peri-implant bone loss and bone-to-implant contact within the bone ring and native bone were analyzed morphometrically. An explorative statistical analysis was performed. The peri-implant bone level remained relatively stable within groups and between groups per given time period. Most of bone apposite on the implant surface in two groups was composed of newly formed bone. A nonparametric analysis of variance (ANOVA) revealed no significant advantage for two-staged implant placement for new and total bone, except for residual bone (P=.0084). Furthermore, two groups of implants performed similarly in bone ring and in native bone throughout the observation period. In terms of osseointegration, both techniques are likely equally efficient in the present defect model. The single-staged implant placement with cortical bone grafts warrants further documentation in clinical studies.

Single-staged vs. two-staged implant placement using bone ring technique in vertically deficient alveolar ridges - Part 1: histomorphometric and micro-CT analysis.

Simultaneous implant placement with bone grafting shortens the overall treatment period, but might lead to the peri-implant bone loss or even implant failure. The aim of this study was to compare the single-staged to two-staged implant placement using the bone ring technique. Four standardized alveolar bone defects were made in the mandibles of nine dogs. Dental implants (Straumann BL® , Basel, Switzerland) were inserted simultaneously with bone ring technique in test group and after 6months of healing period in control group. Animals of both groups were euthanized at 3 and 6months of osseointegration period. The harvested samples were analyzed by means of histology and micro-CT. The amount of residual bone decreased while the amount of new bone increased up to 9months of healing period. All morphometric parameters remained stable between 3 and 6months of osseointegration period within groups. Per a given time point, median area of residual bone graft was higher in test group and area of new bone in control group. The volume of bone ring was greater in test than in control group, reaching the significance at 6months of osseointegration period (P=0.002). In the present type of bone defect, single-staged implant placement may be potentially useful to shorten an overall treatment period.