Ridge Augmentation Procedures Research Articles

An enchiridion on the socket shield technique

Abstract Socket shield technique is one of the recent innovative techniques of immediate implant placement. The importance of this technique is maintenance of both hard and soft tissues, especially in esthetically critical areas like maxillary anterior region. It involves preservation of a portion of root followed by immediate placement of implant. It has various advantages over other ridge preservation procedures like conventional immediate implant placement, socket preservation methods, and ridge augmentation procedures. This review briefly summarizes the classification, surgical technique, variations, and potential complications of this technique.

Bilayer Technique for Alveolar Ridge Augmentation in Pre-Prosthetic Implant Surgery: Indications and Problems

Abstract Background: Prosthetic rehabilitation of missing teeth with dental implant-supported restorations has recently become a predictable treatment option in contemporary dentistry with a highly successful rate. Due to different factors, vertical and horizontal bone loss could present, and the available alveolar bone may not be sufficient for optimum implant position. Ridge augmentation procedures could be applied to increase the volume of the deficient sites for accurate prosthetic implant placement, which assures functional and esthetic stability of tissues around the implants, essential for long-term success. Our study aims to evaluate the efficiency of the bilayer technique of guided bone regeneration for alveolar ridge augmentation procedure in cases of bone deficiency for optimum implant placement and long-term success. Materials and methods: We present several cases of alveolar bone deficiency treated with the bilayer technique – the combination of allo- and xenograft, covered by collagen membrane, with long-term follow-up. The defects were filled with allograft, and a layer of xenograft and barrier membrane was placed above it. This technique combines the benefits of all xenografts and barrier membranes. Results: The bilayer technique with allo- and xenograft and collagen membranes is predictable, with a high success rate and lower morbidity. We have a 100% survival rate of the implants placed in a grafted area with long-term follow-up with excellent aesthetic and functional results. Conclusions: The bilayer technique uses the benefits of two bone graft materials, is associated with less morbidity for the patients, and has excellent long-term results if performed accurately according to indications and technique.

A Review on Intraoral Soft Tissue Expanders: A Novel Technique for Tissue Augmentation Prior to Treating Ridge Defects

Periodontitis, is a complex infectious disease resulting in destruction of tooth supporting structures, which gradually may result in bone loss. Common complications of ridge augmentation procedures are soft tissue dehiscence and attaining a tension free primary closure after grafting. Soft tissue expanders provide a novel alternative to invasive, tedious methods of soft tissue augmentation by gradually increasing the volume and thickness of soft tissues, before ridge augmentation. This is a short review article on the available soft tissue expanders and their benefits on achieving a proper ridge morphology.

Updating on autogenous bone graft material in dentistry

Background: Prosthodontic therapy, such as dentures and implants, can be options for rehabilitating the oral cavity for patients who have lost teeth. However, defects in the alveolar bone pose a challenge in prosthodontic treatment. Among the various bone grafting materials available, only autogenous bone offers osteogenic, osteoinductive, and osteoconductive characteristics compared to other bone substitute and composite materials. Due to its properties and lack of immunological reaction, autogenous bone grafts are widely regarded as the gold standard and the most efficient material for bone regeneration procedures. Objectives: To review and assess the efficacy, advantages, disadvantages, and clinical outcomes of autogenous bone graft materials in dentistry. Conclusion: Autogenous bone graft material remains a gold standard in dentistry for its excellent biological properties and high success rates. Autogenous bone grafts involve using a patient's own bone, typically harvested from intraoral or extraoral sites, to regenerate bone in dental implant placement, ridge augmentation, and other reconstructive procedures. Moreover, autogenous bone grafts demonstrate excellent biocompatibility, as they come from the patient's own body. The use of autogenous bone grafts also eliminates concerns regarding disease transmission, making it a safe and reliable option..

Complications following alveolar ridge augmentation procedures.

Oral rehabilitation through implant supported dental restorations often requires a ridge augmentation procedure (RAP) prior to implant fixture placement since tooth extraction/loss results in alveolar ridge deficiencies. Although RAP-related surgical techniques and biomaterials have been in practice for several decades, outcomes are not always predictable. Post-surgical complications experienced during the early or late wound healing phases may jeopardize the targeted ideal ridge dimensions, required for implant fixture placement, and may have other consequences, such as negatively impacting the patient's quality of life. This review describes reported post-surgical complications following RAP under the following subtitles: complications by tissue type, complications in function and aesthetics, complications by healing time, complications by biomaterial type, and complications by surgical protocol modalities. Specifically, RAP performed by using particulate bone graft substitutes and related complications are explored. Modalities developed to prevent/manage these complications are also discussed.

The Effectiveness of the Addition of Platelet-Rich Fibrin to Bovine Xenografts in Sinus and Bone Ridge Augmentation: A Systematic Review.

Dental implants sometimes need bone augmentation to recreate an adequate bone height and volume. Numerous bone augmentation techniques have been described, and, currently, the most commonly used bone graft procedure is xenografts with deproteinized bovine bone mineral (DBBM). The addition of platelet-rich fibrin (PRF) to DBBM has already shown better performance than DBBM alone in restoring intrabony periodontal defects, but the role of PRF in preimplantation bone grafts is still not clear. The objective of this systematic review was to evaluate the efficacy of the adjunction of PRF or L-PRF to DBBM in bone ridge augmentation procedures. Clinical randomized controlled studies using PRF associated with DBBM were included. In April 2023, three electronic databases (PubMed, Cochrane, and Web of Science) were searched. The search strategy was performed according to PRISMA guidelines. The risk of bias assessments were performed using the Cochrane Collaboration tool. A total of seven articles were included and analyzed. The results show no statistically significant effect of PRF added to DBBM compared to DBBM alone in the sinus lift procedure but do show an effect in the reduction in bone graft resorption in one study of mandibular guided bone regeneration.

Efficacy of Labial Split-Thickness Eversion Periosteoplasty for Soft Tissue Management in Posterior Mandibular Horizontal Ridge Augmentation Procedures: A Prospective Clinical Study

Efficacy of Labial Split-Thickness Eversion Periosteoplasty for Soft Tissue Management in Posterior Mandibular Horizontal Ridge Augmentation Procedures: A Prospective Clinical Study

Ridge Augmentation Procedure: Review and Case Report

Ridge Augmentation procedures involve techniques utilized to increase the dimensions of the alveolar ridge, correcting deficiency in width, height or combination of both beyond the confines of the skeletal envelope of the ridge. The goal of this article is to review classification systems for alveolar ridge deficiencies as well as present on a Case report of effective clinical management for patient with combined horizontal and vertical alveolar ridge deficiency using a titanium mesh membrane.

Vertical ridge augmentation of atrophic posterior mandible with corticocancellous onlay symphysis graft versus sandwich technique: clinical and radiographic analysis.

Alveolar ridge augmentation of atrophic posterior mandibular ridge represents a challenge in oral and maxillofacial surgery to restore aesthetic and function. The aim of the study was to compare the clinical and radiographic outcomes of bone formation in atrophic posterior mandibles augmented using onlay symphysis cortico-cancellous bone block with that augmented using sandwich bone augmentation technique (Inlay). Twelve patients were selected with missing mandibular posterior teeth. CBCT were done for all patients preoperatively to assess the residual bone height, ranged between 5 and 7mm from the inferior alveolar nerve with adequate sufficient alveolar ridge width more than 4mm. Patients required bone augmentation procedure with autologous onlay chin graft (group I) versus those used as inlay sandwich technique (group II). Clinical and radiographic analysis were done to analyses the newly formed bone and bone height. Percent of change in bone height was also calculated and revealed that group I was higher than group II, however, statistically insignificant differences between the two groups were found regarding the percentage of newly formed bone. Vertical ridge augmentation procedures using onlay chin graft took lesser time than the interpositional grafting with fixation technique, however, both techniques are promising for vertical ridge augmentation.

Vertical and horizontal ridge augmentation using customized three-dimensionally printed polycaprolactone mesh in atrophic posterior maxillae: a case report.

Polycaprolactone has exhibited expediency as a biomaterial for bone regenerative procedures preclinically. The present report of the two clinical cases in the posterior maxilla is the first to describe clinical application of a customized 3D printed polycaprolactone mesh for alveolar ridge augmentation. Two patients needing extensive ridge augmentation procedures for dental implant therapy were selected. Polycaprolactone meshes were virtually designed, 3D printed and applied in combination with a xenogeneic bone substitute. Cone-beam computed tomography was taken pre-operatively, immediately after the surgery, and 1.5 to 2 years after the delivery of implant prostheses. The serial cone-beam computed tomography images were superimposed to measure the augmented height and width at 1 mm increments from the implant platform to 3 mm apically. After 2 years, the mean [maximum, minimum] bone gain was 6.05 [8.64, 2.85] mm vertically and 7.77 [10.03, 6.18] mm horizontally at 1 mm below the implant platform. From immediately postoperative to 2 years, there was 14 % reduction of augmented ridged height and 24 % reduction of augmented width at 1 mm below the platform. All implants placed in augmented sites were successfully maintained until 2 years. The customized Polycaprolactone mesh might be a viable material for ridge augmentation in the atrophic posterior maxilla. This needs to be confirmed through randomized controlled clinical trials in future studies.

Could Future Implant Failures be Predicted Based on Observed Bone Levels and Bone Loss After 5 Years? A Retrospective Investigation on Patients Presented in Previous Studies.

Purpose: To evaluate the diagnostic accuracy of bone loss/bone levels, as detected after 5 years of implant function, in identifying patients who suffered implant failures in the following 5 years. Materials and Methods: Data on radiographic measurements of marginal bone levels at prosthesis placement and after 5 years of function were retrospectively retrieved from 11 previous publications. Included patients were allocated into different subgroups with regard to bone loss/bone level during/after 5 years in function, respectively. A diagnostic test was used to estimate the accuracy of finding patients/jaws/implants at risk for a future implant failure by calculating sensitivity, specificity, positive predictive values (PPVs), and negative predictive values (NPVs) in different subgroups, respectively. Results: Altogether, 749 treated jaws (723 patients/3,363 implants) were included in the study group. Treated jaws in the high-level subgroups presented an overall higher risk of implant failures from 5 to 10 years in function (P < .05). Many treated jaws/implants were allocated into the high-level groups, but the proportions of implant failures were low in these groups. The diagnostic test comparing high- and low-level groups with and without implant failures showed low accuracy to predict implant failures; the PPV ranged from 4% to 33%. Lower PPVs were observed for diagnostic tests for individual implants (range: 4% to 6%). Conclusion: More severe bone loss was associated with higher risk of future implant failure. However, many patients/ implants with obvious bone loss in the study group and low prevalence of implant failures at the 10-year examination resulted in poor accuracy in identifying individual patients or implants at risk for failure. This suggests that it is difficult to predict future implant failures based only on radiographic measurements.

Supplementation of Platelet-Derived Products in Distraction Osteogenesis for Alveolar Ridge Augmentation: A Systematic Review

Background: Distraction osteogenesis (DO) is one of the recent tissue engineering techniques which have been utilized for alveolar ridge augmentation procedures. It makes use of tensional strains created within the fractured segments to initiate a cascade of responses ultimately resulting in the formation of new mature bone. Supplementation of platelet-derived products such as platelet-rich plasma and platelet-rich fibrin in DO could stimulate this cascade and accelerate the formation of new bone with improved quality. Materials and Methods: Literature search was performed on eminent databases for studies using platelet-derived products with DO in alveolar ridge augmentation. Data relating to bibliographic information, and study outcomes were extracted. A risk of bias assessment was performed for each study. Measures of outcome included increase in bone height, and any reported postoperative complications. Results: Planned alveolar height was reached in all the studies with an adequate amount of bone formation for the placement of dental implants. Studies reported long-term implant survival. Postoperative complications included displacement of fractured segments, temporary paresthesia, and scar formation. Conclusion: DO supplemented with platelet-derived products provides an ideal micro-environment for the recruitment of various signaling molecules and stem cell precursors inducing the formation of new bone. It circumvents the unpredictable outcomes and complications such as donor site morbidity, which is associated with conventional placement of bone grafts. However, the available literature is scarce in this area and further randomized studies are required to form a conclusive body of evidence to support the translatability of this innovative technique into clinical practice.

Immediate implant placement using autogenous bone graft with autologous platelet-rich fibrin (A-PRF) for severe vertical bone loss: A case report

Introduction: Dental implants have become the treatment of option for replacing missing teeth. But dental implant placement needs adequate available bone for primary stability to attain successful osseointegration. In patients with inadequate bone volume, various bone augmentation procedures are available for facilitating implant placement. The mandibular ramus acts as an admirable source of autogenous bone for alveolar ridge augmentation procedures. Case Report: In the present case report a female patient with Siebert class III defect with respective to 46 was managed by implant placement along with autogenous bone grafting keeping in mind about the crown root ratio which could be a post-complication in anticipation. Conclusion: Thus, this article describes a case report of reconstruction of extensive vertical bone defect, using intraoral ramus block bone graft and autogenous A-PRF for implant site augmentation presented admirable results.

Autogenous Dentin Particulate Graft for Alveolar Ridge Augmentation with and without Use of Collagen Membrane: Preliminary Histological Analysis on Humans.

(1) Background: The phenomenon of ankylosis of the dental elements has led clinicians to think that properly treated dentin and cement may be a potential graft for alveolar ridge augmentation. Currently, there are no studies in the literature able to histomorphometrically compare the healing patterns of an autogenous dentin particulate graft with the association, or not, of resorbable membranes. The aim of this pilot study is to histologically compare bone after an alveolar ridge augmentation using an autogenous dentin particulate graft with and without a resorbable collagen membrane. (2) Methods: this clinical trial enrolled six patients with defects requiring bone augmentation. Two procedures were performed in all six adult human patients in order to perform a study–control study: in Group 1, a ridge augmentation procedure with an autogenous dentin particulate graft and a resorbable collagen membrane was performed, and, in Group 2, an alveolar ridge preservation without a membrane was performed at the same time (T0). At 4 months, a biopsy of the bone tissues was performed using a 4 mm trephine bur in order to perform a histomorphometric analysis. (3) Results: The histomorphometric analysis demonstrated that Group 1 presented 45% of bone volume, 38% of vital bone, and 7% of residual graft. On the contrary, membrane-free regenerative procedures demonstrated 37% of bone volume, 9% of vital bone, and 27% of non-resorbed graft. In all cases, the regenerated bone allowed the insertion of implants with a standard platform, and no early failures were recorded. (4) Conclusions: Autogenous dentin particulate grafts seem to work best when paired with a membrane.

SHORT IMPLANTS IN POSTERIOR JAWS– A LITERATURE REVIEW

One of the greatest challenges that dentists face today is to rehabilitate severe atrophied alveolar ridges in partially and completely edentulous patients with implants. Loss of bone volume at the level of the posterior maxilla and mandible can complicate rehabilitation with implants, since it leads to a reduction in the distance to the maxillary sinus and the inferior alveolar nerve, respectively. Various techniques have been used for many years to avoid damaging these structures, such as alveolar ridge augmentation procedures, bone grafting, tooth nerve transposition, or even zygomatic implants. An alternative to these surgical treatments is the use of short implants in areas where bone availability is reduced.

Effect of Bioactive Agents on Alveolar Ridge Augmentation: A Systematic Review and Meta-Analysis

&lt;p&gt;Objectives: This review aimed at investigating the impact of bioactive agents on alveolar ridge augmentation at peri-implant sites and edentulous ridges. Material and Methods: Electronic and manual literature searches were conducted for articles up to April 2021. Human randomized clinical trials, clinical trials, or retrospective studies reporting outcomes of alveolar ridge augmentation procedures with or without bioactive agents were included. Sinus lifting or extraction socket preservation articles were excluded in this study. A random-effect meta-analysis was conducted to investigate ridge dimensional changes and complication rate. Results: Overall, ten articles were included in the quantitative analysis. In bone width and height augmentation, the weighted mean difference (WMD) of the horizontal bone gain at edentulous ridges was 0.38 mm (95% CI = 0.07 to 0.69 mm, p = 0.02) when comparing sites with and without PRP/PRF. The WMD of the vertical bone gain at edentulous ridges was 0.46 mm (95% CI = 0.06 to 0.86 mm, p = 0.02) when comparing sites with and without platelet- rich plasma (PRP) or platelet-rich fibrin (PRF). When evaluating the effect of adjunctive use of bone morphogenetic proteins (BMPs) at alveolar ridge augmentation sites compared to alveolar ridge augmentation sites without BMP application, the WMD of the horizontal bone gain at edentulous ridges was 0.90 mm (95% CI = 0.30 to 1.49 mm, p = 0.003). In addition, the odds ratio of the titanium mesh exposure was 0.13 (95% CI of 0.02 to 0.71, p = 0.02). All analyses showed favorable outcomes at the sites with bioactive agent. Conclusion: Within the limits of this review, application of bioactive agents during alveolar ridge augmentation procedures presents increased horizontal and vertical bone augmentative changes. The complication rate can also be reduced with usage of PRP/PRF in titanium mesh-guided alveolar ridge augmentation.&lt;/p&gt; &lt;p&gt;&amp;nbsp;&lt;/p&gt;

Extraction site reconstruction by alveolar ridge preservation and indirect sinus lifting procedure for dental implant placement

Dimensional changes to the alveolar ridge are inexorable following tooth extraction. To avoid this hard-tissue loss, alveolar ridge preservation (ARP) soon after extraction needs to be done. However, despite taking precautions to prevent the ridge loss, some cases might require ridge and sinus augmentation procedures for dental implant placement subsequent to tooth extraction. The present case report briefs on management of extraction site by ARP and indirect sinus lifting by osteotome sinus floor elevation approach, for dental implant placement.

Socket preservation using autogenous bone graft and dentin autograft after surgical removal of impacted mandibular third molar – A split-mouth study design

Introduction: In our study, we have compared the efficacy of dentin bone graft for purpose of ridge preservation and have compared it with autogenous bone graft (ABG). A total of 15 patients were included in this study requiring extraction of bilaterally impacted third molar. On the one side, the socket was filled with processed dentin graft prepared after extraction of the third molar, and on the other side, the socket was filled with ABG harvested from external oblique ridge. The two were compared on the basis of various soft tissue and hard tissue parameters. Aims: This study aimed to evaluate and compare the efficacy of the dentin autograft with ABG for preservation of socket defect after removal of mandibular third molars clinically and radiographically. Materials and Methods: A total of 15 patients were included undergoing extraction for bilaterally impacted third molar. The socket on one side after extraction was filled with processed dentin from the same extracted tooth, and the other side of the socket was filled with ABG harvested from the external oblique ridge. Results: It was seen that dentin graft had the regenerative properties and showed potential for ridge preservation. Conclusions: Ridge preservation is essential for placement of implant and other prostheses. Preservation of ridge immediately after extraction bypasses the need for extensive ridge augmentation procedure. Hence, dentin graft can be used for this purpose as it has potential for bone regeneration.

Edentulous ridge space closure after bone augmentation using different graft materials: A report of two cases

Abstract Post-extraction alveolar ridge resorption is a common sequela when missing mandibular molar spaces are not managed in a timely fashion. The situation becomes more complicated in patients who seek orthodontic treatment if closure of the edentulous space is the major objective in order to avoid prosthetic rehabilitation. In the present article, two cases are reported, in which different bone augmentation graft materials were used and treatment duration and post-orthodontic alveolar ridge characteristics were compared. A regional acceleratory phenomenon after the grafting procedure facilitated uneventful orthodontic space closure. The status of the investing alveolar bone was compared using post-treatment cone-beam computed tomography. Both autogenous bone graft and allograft ridge augmentation procedures aided in successful molar protraction through the resorbed mandibular alveolar ridge, as well as preventing periodontal attachment loss.

Prevalence of the Use of Particulate Graft versus Block Bone Graft in Ridge Augmentation: A Hospital Based Retrospective Study

Aim: To assess the prevalence of the use of particulate graft versus block bone graft in ridge augmentation.&#x0D; Introduction: Ridge augmentation is a process of replacing the lost bone of residual ridge by grafting natural or synthetic material. Dimensional changes in the alveolar ridge after extraction often compromises on achieving optimal implant stability and placement of implants in the right prosthodontic positions. These situations demand augmentation of the residual ridge to achieve successful implant placement and long-term survival.&#x0D; Materials and Methods: Case sheets of thirty-eight patients who had underwent ridge augmentation procedure were analysed for the study. The collected data was statistically analysed using chi square test and the results were obtained. SPSS software was used for obtaining the results.&#x0D; Results and Discussion: Majority of the participants in the study were around the age 15-30 years. Around 74% of the participants have undergone particulate bone graft rather than block bone graft. From the study it is proven that around 81% of the augmentation type are for the hard tissue.&#x0D; Conclusion: Hence from the study it is proven that particulate graft is more commonly opted than block bone graft.