Preimplant Bone Augmentation Research Articles

Segmental sandwich osteotomy and tunnel technique for three-dimensional reconstruction of the jaw atrophy: a case report

BackgroundA three-dimensionally favourable mandibular bone crest is desirable to be able to successfully implant placement to meet the aesthetic and functional criteria in the implant-prosthetic rehabilitation. Several surgical procedures have been advocated for bone augmentation of the atrophic mandible, and the sandwich osteotomy is one of these techniques. The aim of the present case report was to assess the suitability of segmental mandibular sandwich osteotomy combined with a tunnel technique of soft tissue. Based on our knowledge, nobody described before the sandwich osteotomy with tunnel technique to improve the healing of the wound and meet the dimensional requirements of preimplant bone augmentation in cases of a severely atrophic mandible.Case presentationA 59-year-old woman with a severely atrophied right mandible was treated with the sandwich osteotomy technique filled with autologous bone graft harvested by a cortical bone collector from the ramus. Clinical examination revealed that the mandible was edentulous bilaterally from the first molar to the second molar region. Radiographically, atrophy of the mandibular alveolar ridge in the same teeth site was observed. We began to treat the right side. A horizontal osteotomy of the edentulous mandibular bone was then made with a piezoelectric device after tunnel technique of the soft tissue. The segmental mandibular sandwich osteotomy (SMSO) was finished by two (mesial and distal) slightly divergent vertical osteotomies. The entire bone fragment was displaced cranially, and the desirable position was obtained. The gap was filled completely with autologous bone chips harvested from the mandibular ramus through a cortical bone collector. No barrier membranes were used to protect the grafts. The vertical incisions were closing with interruptive suturing of the flaps with a resorbable material. In this way, the suture will not fall on the osteotomy line of the jaw; the result will be a better predictability of soft and hard tissue healing.ConclusionsSegmental mandibular sandwich osteotomy is an easy and safety technique that could be performed in an atrophic posterior mandible. Future studies involving long-term follow-up are needed to evaluate the permanence of these results.

Clinical Performance of Narrow-Diameter Titanium-Zirconium Implants: A Systematic Review.

Implant-supported prosthetic rehabilitations are in constant augmentation in everyday dental practice. This is largely due to increasing demand from patients for fixed or implant-stabilized prosthesis, although they are frequently reticent to complex preimplant bone augmentation surgeries, whenever bone volume is lacking. Narrow-diameter implants (NDI; ≤3.5 mm) have been developed to offer relatively simple implant solutions in challenging bone-deficient sites. However, concerns regarding their mechanical properties have been raised. Special titanium-zirconium material (Ti-Zr), with superior mechanical resistance, compared with pure titanium alloys has been introduced into the market. The purpose of this systematic review was to determine the available data on clinical performance of Ti-Zr NDI. A literature search of all available clinical articles dealing with Ti-Zr NDI has been carried out. After including only prospective clinical trials, 14 papers were retrieved for thorough reviewing. Short-term results from preliminary clinical reports are quite promising, although the number of published studies and the follow-up periods are still insufficient to determine the real benefit of this hybrid material compared with titanium, especially when using NDI.

Simple Bone Augmentation for Alveolar Ridge Defects

Dental implant procedures, both surgical placement and preimplant bone augmentation, have become an integral aspect of the oral and maxillofacial surgeon's practice. The number of dental implants placed each year continues to increase as a result of increasing patient exposure and awareness of dental implants, the increased functional and esthetic dental demands of general practitioners and patients, the overall increase in age of the US patient population, and expanded insurance coverage of dental implant-related procedures. This article outlines relevant surgical procedures aimed toward reconstructing alveolar ridge defects to restore intra-arch alveolar discrepancies before restoration-driven dental implant placement.

Significance of buccopalatal implant position, biotype, platform switching, and pre-implant bone augmentation on the level of the midbuccal mucosa.

This study assessed whether buccopalatal implant position, biotype, platform switching, and pre-implant bone augmentation affects the level of the midbuccal mucosa (MBM). Ninety patients with a single-tooth implant in the esthetic zone were included. The level of the MBM was measured on photographs taken 1 year after crown placement. The factors analyzed only explained 22% of the level of the MBM. The more an implant was placed to the buccal, the more the MBM was positioned apically. A comparable phenomenon was observed in cases with a thick biotype and cases that underwent pre-implant bone augmentation. Platform switching did not affect the level of the MBM.

Influence of pre-implant bone augmentation on diving fitness: An in vitro study

Purpose: Autogenous bone grafts are commonly used for pre-implant bone augmentation or defect coverage in the maxillofacial region. Particulate bone or bone blocks without a vascular pedicle are normally used for this purpose. The objective of this study was to investigate the effects of hyperbaric conditions on the cell activity of augmented bone under pressure changes such as those to which combat divers and mine clearance divers are exposed. Materials and Methods: Systematic studies were performed using an animal model (isogeneic Lewis rats). We collected bone chips (n = 4) from rat femurs with a Safescraper; and obtained isogeneic bone blocks (n = 4) with a bone rongeur. Bone samples were exposed to three simulated 45-min dives to 5.0 bar using oxygen or compressed air. Bone chips and blocks that were not exposed to pressure served as controls. After 9 and 15 days of in vitro cultivation, osteoblast proliferation rates were assessed in a Neubauer counting chamber and the results were statistically analyzed. Results: Irrespective of the atmospheric conditions, bone blocks showed significantly higher proliferation rates (P = 0.05) than bone chips. When exposed to compressed air during simulated dives, both groups showed considerably lower proliferation rates than the control groups. When exposed to oxygen, both groups showed significantly higher proliferation rates than the control groups. Conclusion: Depending on the breathing gas used, changes in atmospheric conditions during simulated dives can lead to a decrease in osteoblast activity. Patients who underwent bone augmentation should therefore be advised not to dive using compressed air until osseointegration is complete.

Sandwich osteotomy for vertical and transversal augmentation of the posteriormandible: a review Sandwich osteotomy untuk augmentasi vertikal dan transversal pada posterior mandibula: sebuah tinjauan

The use of endosseous implants is directly related to the topography and quality of the patient’s residual bone. Severaltechniques have been tried to expand its application through implant design alterations and surgical techniques for boneaugmentation. This article reviews the sandwich osteotomy combined with an interpositional autograft for vertical andtransversal augmentation in the atrophic mandible prior to endosseous implant placement. In conclusion, segmentalmandibular sandwich osteotomy can be recommended to fulfill the dimensional requirements of preimplant boneaugmentation in atrophic posterior mandible.

Forty Sandwich Osteotomies in Atrophic Mandibles: A Retrospective Study

The aim of the present retrospective study was to assess the suitability of segmental mandibular sandwich osteotomy combined with an interpositional autograft to meet the dimensional requirements of preimplant bone augmentation in cases of a severely atrophic mandible. A total of 27 consecutive patients (6 men and 21 women) were included in the present study. The amount of bone gain was calculated using digital volume tomography before surgery and 3 months after bone augmentation. The postoperative course was uneventful for 18 patients. Temporary sensory disturbances were observed in 6 patients, with complete recovery after 3 to 12 weeks. Dehiscence of soft tissue closure occurred in 3 patients. The mean vertical gain was 3.41 mm (range 0.3 to 12). The mean horizontal gain was 3.08 mm (range 0.2 to 8.5). A total of 88 implants were placed in 40 surgical sites at 12 weeks after bone reconstruction. Segmental mandibular sandwich osteotomy is a suitable augmentation procedure in the mandible for the atrophic alveolar ridge and provides adequate height and transversal bone augmentation.

Bone augmentation after soft‐tissue expansion using hydrogel expanders: effects on microcirculation and osseointegration

The success of bone augmentation, for example of the alveolar ridge, might be endangered by dehiscence of the soft tissue that covers the augmented bone. Soft-tissue coverage can be achieved without tension through pre-augmentation tissue expansion with hydrogel expanders. We used a periosteal chamber to study the influence of tissue expansion on microcirculation and osseointegration in an in vivo animal model. Sixteen isogeneic Lewis rats were randomised into two groups. Additional eight animals served as donors of isogeneic bone grafts (Group 3, n=8). The bone grafts were harvested and implanted into Group 1 animals (n=8) (without tissue expansion) and Group 2 animals (after tissue expansion). In Group 2 (n=8), hydrogel expanders were inserted subperiosteally at the site to be augmented for 21 days. We used intravital microscopy to monitor microcirculation in vivo for 19 days after implantation. Specimens from both groups were evaluated histologically. During the entire study period, functional microvessel density in the region above the augmentation material was significantly higher after previous tissue expansion (P>0.05). Both groups showed physiological microcirculation around the augmentation material. Histology revealed bone osseointegration of the bone graft in the group with tissue expansion and the presence of connective and granulation tissue in the group without tissue expansion. Pre-augmentation soft-tissue expansion with hydrogel expanders leads to higher functional microvessel density in the tissue above the augmentation material and thus, to more rapid osseointegration. The use of hydrogel expanders appears to increase the probability of success, especially of pre-implant bone augmentation.

Sandwich osteotomy for vertical and transversal augmentation of the posterior mandible

The aim of this study is to describe the treatment outcome after alveolar ridge augmentation in the atrophic posterior mandible by segmental sandwich osteotomy combined with an interpositional autograft prior to placement of endosseous implants. Thirteen consecutive patients (five males, mean age 48 years, and eight females, mean age 61 years) were included in this study. The postoperative course was uneventful in six patients. Sensory disturbances in the mental nerve were found in five patients, all of them with hypoaesthesia. None of these patients complained of permanent sensory disturbances. Vertical gain ranged from 2.0 to 7.8mm (mean value 4.61mm). Horizontal gain ranged from 2.0 to 6.3 (mean value 3.42mm). A total of 41 implants were placed in 22 surgical sites, 12 weeks after bone reconstruction. In conclusion, segmental mandibular sandwich osteotomy is recommended to meet the dimensional requirements of preimplant bone augmentation in atrophic posterior mandible.

Maxillary Tuberosity Block Bone Graft: Innovative Technique and Case Report

Hard tissue defects resulting from trauma, infection, or tooth loss often lead to an unfavorable anatomy of maxillary and mandibular alveolar processes that become not suitable for implant therapy without bone grafting. The goal of pre-implant bone augmentation of the deficient alveolar ridge is reconstruction of the proper alveolar anatomy through the techniques of socket preservation, horizontal and vertical ridge augmentation, sinus bone grafting, and others. A variety of bone grafts and bone grafting materials have been used in the last 30 years for augmentation of deficient alveolar ridge for the purpose of implant treatment of partially and completely edentulous patients. Bone grafting options include autogenous, allogeneic, xenogeneic, synthetic bone, and combination of above. Autogenous bone grafts are considered "the gold standard" due to their compatibility and osteogenic potentials to form the new bone by processes of osteogenesis, osteoinduction, and osteoconduction. A particulate and block autogenous bone has been used for correction of alveolar ridge deficiency. Extraoral sites of autogenous block grafts include: ilium, calvarium, tibia, rib, and others. Intraoral sites of autogenous block grafts include symphysis and retromolar-ramus areas. In the clinical practice, a maxillary tuberosity bone graft has often been used as a particulate graft for augmentation of deficient alveolar ridge or maxillary sinus prior to or simultaneously with implant insertion. This article presents an innovative technique and reports a case of the maxillary tuberosity block bone graft that can be used to correct moderate to severe localized defects of the alveolar process prior to implant placement.

Bone Reformation: Contemporary Bone Augmentation Procedures in Oral and Maxillofacial Implant Surgery

Bone Reformation: Contemporary Bone Augmentation Procedures in Oral and Maxillofacial Implant Surgery