RESUMEN

PURPOSE: To review and compare the available literature on bone regeneration using titanium mesh and map the current evidence on bone gain outcomes and complications while comparing this scaffold with collagen membranes. MATERIALS AND METHODS: A comprehensive electronic and manual search was performed to identify randomised and non-randomised prospective controlled clinical trials that involved the use of titanium mesh in at least one arm, with outcomes including complications and vertical and/or horizontal bone gain. The focused questions were defined as follows: What are the outcomes of using titanium mesh in ridge augmentation compared to other types of barrier membrane, and what is the complication rate (membrane exposure and infection) when titanium mesh is used in these procedures? RESULTS: A total of 22 articles were included in the qualitative analysis. Overall, the studies that measured bone gain resulted in 3.36 mm vertical (196 subjects; 95% confidence interval 2.44 to 4.64 mm, range 1.4 to 5.7 mm) and 3.26 mm horizontal augmentation (81 subjects; 95% confidence interval 2.93 to 3.63 mm, range 2.6 to 3.7 mm), with variability among studies. The most commonly noted complication was mesh exposure, regardless of the type of mesh used, and the second most common was graft failure. The overall pooled complications rate reported in clinical trials was 10.8%. The meta-analysis comparing titanium mesh and collagen membranes, controlling for the type of bone regeneration (staged or simultaneous with implant placement), failed to show a significant difference in horizontal bone gain between the two techniques. CONCLUSIONS: Within the limitations of the present study and acknowledging the heterogeneity among the articles included, titanium mesh can serve as a feasible protective scaffold for bone regeneration with a relatively acceptable complication rate and in defects requiring around 4 mm 3D reconstruction. Data on patient-reported outcomes were scarce. CONFLICT-OF-INTEREST STATEMENT: None of the authors have any financial interests, either directly or indirectly, in the products or information mentioned in the present article.

Asunto(s)

Aumento de la Cresta Alveolar , Regeneración Ósea , Mallas Quirúrgicas , Titanio , Humanos , Mallas Quirúrgicas/efectos adversos , Aumento de la Cresta Alveolar/métodos , Colágeno/uso terapéutico , Membranas Artificiales

RESUMEN

Dental implants are a reliable treatment option for restoring missing teeth, but adequate bone quantity and quality are crucial for success. This case series presents four cases treated by different clinicians, all following very similar concepts for combined periodontal and vertical ridge augmentation using recombinant human platelet-derived growth factor-BB. All cases involved a severe periodontal defect requiring either extraction of the adjacent tooth or periodontal regeneration. Different bone grafts and membrane types were utilised. Although true periodontal regeneration cannot be said categorically to have occurred due to a lack of histological evidence, the clinical and radiographic findings suggest almost complete bone fill in all cases. This case series demonstrates that combined periodontal and vertical ridge augmentation using recombinant human platelet-derived growth factor-BB could be successful, but proper case selection and patient preparation for the possibility of multiple surgical procedures are recommended. Conflict-of-interest statement: At the time of preparing this manuscript, Dr Saleh was a clinical advisor for Lynch Biologics, Franklin, TN, USA. The other authors declare that they have no conflicts of interest relating to this study.

Asunto(s)

Aumento de la Cresta Alveolar , Becaplermina , Humanos , Femenino , Masculino , Aumento de la Cresta Alveolar/métodos , Persona de Mediana Edad , Becaplermina/uso terapéutico , Adulto , Proteínas Recombinantes/uso terapéutico , Regeneración Ósea/efectos de los fármacos , Pérdida de Hueso Alveolar/cirugía , Pérdida de Hueso Alveolar/tratamiento farmacológico , Trasplante Óseo/métodos , Proteínas Proto-Oncogénicas c-sis/uso terapéutico , Regeneración Tisular Guiada Periodontal/métodos

RESUMEN

AIM: The aim of this randomized clinical trial was to compare the qualitative (linear alveolar ridge changes) and quantitative (healing complications) outcomes after guided bone regeneration (GBR) using a custom-made 3D printed titanium mesh versus titanium reinforced dense PTFE membrane for vertical and horizontal augmentation of deficient alveolar ridges.

Asunto(s)

Aumento de la Cresta Alveolar , Politetrafluoroetileno , Impresión Tridimensional , Mallas Quirúrgicas , Titanio , Humanos , Aumento de la Cresta Alveolar/métodos , Mallas Quirúrgicas/efectos adversos , Masculino , Femenino , Persona de Mediana Edad , Adulto , Regeneración Ósea , Cicatrización de Heridas , Regeneración Tisular Guiada Periodontal/métodos , Resultado del Tratamiento

RESUMEN

BACKGROUND: Alveolar Bone loss occurs frequently during the first six months after tooth extraction. Various studies have proposed different methods to reduce as much as possible the atrophy of the alveolar ridge after tooth extraction. Filling the socket with biomaterials after extraction can reduce the resorption of the alveolar ridge. We compared the height of the alveolar process at the mesial and distal aspects of the extraction site and the resorption rate was calculated after the application of HA/ß-TCP or synthetic co-polymer polyglycolic - polylactic acid PLGA mixed with blood to prevent socket resorption immediately and after tooth extraction. METHODS: The study was conducted on 24 extraction sockets of impacted mandibular third molars bilaterally, vertically, and completely covered, with a thin bony layer. HA/ß-TCP was inserted into 12 of the dental sockets immediately after extraction, and the synthetic polymer PLGA was inserted into 12 of the dental sockets. All sockets were covered completely with a full-thickness envelope flap. Follow-up was performed for one year after extraction, using radiographs and stents for the vertical alveolar ridge measurements. RESULTS: The mean resorption rate in the HA/ß-TCP and PLGA groups was ± 1.23 mm and ± 0.1 mm, respectively. A minimal alveolar bone height reduction of HA/ß-TCP was observed after 9 months, the reduction showed a slight decrease to 0.93 mm, while this rate was 0.04 mm after 9 months in the PLGA group. Moreover, the bone height was maintained after three months, indicating a good HA/ß-TCP graft performance in preserving alveolar bone (1.04 mm) while this rate was (0.04 mm) for PLGA. CONCLUSION: The PLGA graft demonstrated adequate safety and efficacy in dental socket preservation following tooth extraction. However, HA/ß-TCP causes greater resorption at augmented sites than PLGA, which clinicians should consider during treatment planning.

Asunto(s)

Pérdida de Hueso Alveolar , Sustitutos de Huesos , Ácido Láctico , Copolímero de Ácido Poliláctico-Ácido Poliglicólico , Extracción Dental , Alveolo Dental , Humanos , Alveolo Dental/cirugía , Pérdida de Hueso Alveolar/prevención & control , Sustitutos de Huesos/uso terapéutico , Copolímero de Ácido Poliláctico-Ácido Poliglicólico/uso terapéutico , Masculino , Femenino , Ácido Láctico/uso terapéutico , Adulto , Ácido Poliglicólico/uso terapéutico , Proceso Alveolar/patología , Tercer Molar/cirugía , Diente Impactado/cirugía , Estudios de Seguimiento , Adulto Joven , Colgajos Quirúrgicos , Materiales Biocompatibles/uso terapéutico , Aumento de la Cresta Alveolar/métodos , Hidroxiapatitas/uso terapéutico , Mandíbula/cirugía , Fosfatos de Calcio/uso terapéutico , Resultado del Tratamiento

RESUMEN

OBJECTIVES: Adequate bone thickness around dental implants is vital for their stability and to reduce resorption. This study evaluated the ability of implant fixtures to serve as ridge expanders by measuring width changes pre- and post-implantation. MATERIALS AND METHODS: Measurements including initial alveolar bone width, post-osteotomy width, post-expansion width, and buccal bone thickness were recorded for patients undergoing implant placement. Bone quality was assessed using established criteria. RESULTS: Of the 102 subjects (52% male, 48% female), significant ridge width increases at 0 mm and 2 mm levels were noted (p < 0.05). Larger implant diameters resulted in greater ridge expansion. Absence of prior augmentation was linked to higher bone quality (B = -1.684, p = 0.001), explaining 15% of bone quality variance. Ridge expansion effects also correlated with the site, implant diameter, and design. CONCLUSIONS: Dental implant fixtures can effectively expand the ridge, with expansion influenced by implant diameter, anatomical location, prior augmentation, and implant design. These factors must be considered for tailored treatment planning in implant dentistry. CLINICAL RELEVANCE: This study's clinical relevance lies in its exploration of the potential benefits of dental implant fixtures can effectively to expand the ridge taking into consideration implant diameter, anatomical location, prior augmentation, and implant design.

Asunto(s)

Aumento de la Cresta Alveolar , Implantación Dental Endoósea , Implantes Dentales , Humanos , Masculino , Femenino , Persona de Mediana Edad , Aumento de la Cresta Alveolar/métodos , Implantación Dental Endoósea/métodos , Adulto , Diseño de Prótesis Dental , Anciano , Resultado del Tratamiento , Osteotomía/métodos

RESUMEN

OBJECTIVES: To assess and compare the clinical, radiological, and histological outcomes of socket seal surgery between two protocols: deproteinized demineralized tooth matrix (dpDTM) and freeze-dried bone allograft (FDBA) each covered with a free gingival graft. MATERIALS AND METHODS: Twenty extraction sockets in the anterior or premolar region were randomly allocated to either the dpDTM or FDBA protocol (n = 10 per group). Measurements of the alveolar ridge changes were obtained using an intraoral scanner and cone-beam computed tomography at 3 months post-operation. Three-month post surgery, the dental implant was installed (n = 5 per group), bone biopsies were obtained for histomorphometrical and micro-computed tomography analyses. Implant stability quotients (ISQs) were determined and compared at 3 months post-implant. RESULTS: Lower significant reductions in buccal alveolar ridge height and hard tissue volume were observed in dpDTM group compared to FDBA group at 3 months (0.25 ± 0.35 mm vs. 1.60 ± 0.66 mm [p = .000] and 9.64 ± 15.39% mm3 vs. 31.45 ± 18.11% mm3 [p = .010], respectively). At the same time, lower soft tissue volume reduction was detected in the dpDTM group compared to FDBA group (4.21 ± 5.25% mm3 vs. 5.25 ± 5.79% mm3). No statistically significant difference in the percentage of mineralized tissue formation was found between dpDTM group (53.39 ± 11.16%) and FDBA group (49.90 ± 3.27%). Even though the ISQ in the dpDTM group showed a higher value than the FDBA group at 3 months post-implant, the results were without statistical significance. CONCLUSIONS: Alveolar ridge preservation using dpDTM is an efficacious procedure for providing the conditions for the development of functional and esthetic implants.

Asunto(s)

Tomografía Computarizada de Haz Cónico , Alveolo Dental , Humanos , Alveolo Dental/cirugía , Masculino , Femenino , Persona de Mediana Edad , Adulto , Resultado del Tratamiento , Trasplante Óseo/métodos , Microtomografía por Rayos X , Implantación Dental Endoósea/métodos , Aumento de la Cresta Alveolar/métodos , Extracción Dental , Biopsia , Encía , Pérdida de Hueso Alveolar/prevención & control , Pérdida de Hueso Alveolar/diagnóstico por imagen , Proceso Alveolar/diagnóstico por imagen , Proceso Alveolar/patología , Proceso Alveolar/cirugía , Dentina

RESUMEN

OBJECTIVES: To compare effectiveness of Autologous Particulate Dentin (APD) with Demineralized Freeze-Dried Bone Allograft (DFDBA) in ridge preservation, using radiographic and clinical parameters. MATERIALS AND METHODS: Thirty subjects with indication of mandibular posterior teeth extraction were randomly assigned to either test or control group. After atraumatic extraction, ridge preservation was performed using APD or DFDBA mixed with i-PRF in test and control groups respectively. Both groups had sockets sealed with A-PRF membrane. Clinical parameters (plaque, gingival and healing indices) and radiographic parameters (vertical ridge height, horizontal ridge width) were assessed at baseline and 6 months using CBCT. Statistical analysis was performed using an independent t-test to compare clinical and radiographic parameters between the groups. RESULTS: Both groups had significant decreases in ridge dimensions over 6 months (p < 0.001). The test group showed less reduction in ridge dimensions than control group at 6 months (p < 0.001). Mean change in vertical height was not significant (1.37 ± 1.32, 1.7311 ± 0.563), but in horizontal ridge width (1.3120 ± 1.13, 1.8093 ± 1.16) was significantly different between test and control groups respectively. There was no statistical difference in clinical parameters between the groups at 6 months (p > 0.001). CONCLUSIONS: APD grafts resulted in significant improvements in radiographic parameters, specifically in vertical ridge height and horizontal ridge width, compared to DFDBA group. CLINICAL RELEVANCE: Autologous particulate dentin is a promising, versatile substitute for regenerative procedures. While more research on its long-term efficacy and application is needed, current evidence suggests it could significantly improve patient care and outcomes.

Asunto(s)

Trasplante Óseo , Dentina , Liofilización , Extracción Dental , Humanos , Femenino , Masculino , Estudios Prospectivos , Dentina/diagnóstico por imagen , Trasplante Óseo/métodos , Extracción Dental/métodos , Adulto , Resultado del Tratamiento , Mandíbula/cirugía , Mandíbula/diagnóstico por imagen , Aumento de la Cresta Alveolar/métodos , Tomografía Computarizada de Haz Cónico , Persona de Mediana Edad , Alveolo Dental/cirugía , Alveolo Dental/diagnóstico por imagen , Aloinjertos , Trasplante Autólogo

RESUMEN

An urgent issue is the preservation or reconstruction of the volume of bone tissue in planning and surgical treatment in the fields of medicine, such as traumatology, orthopedics, maxillofacial surgery and dentistry. After tooth extraction, resorption of the bone tissue of the alveolar crest of the jaws occurs, which must either be further eliminated by performing additional operations or using osteoplastic material for socket preservation at the extraction stage. Background and Objectives: The aim of the study was a comparative analysis of various osteoplastic materials used to preserve the volume of bone tissue in the preimplantation period. Materials and Methods: As part of the study, 80 patients were treated, who underwent socket preservation using xenografts, plasma enriched with growth factors, an autologous dentin matrix (ADM) and hydroxyapatite. Results: The results of the treatment 16 weeks after removal were comprehensively analyzed using a morphometric analysis of the bone's volume, cone beam tomography and morphological examination of burr biopsy specimens, as well as by determining the stability of the installed implant at different stages of treatment. Conclusions: The lowest level of bone tissue resorption according to the CBCT data was noted in the ADM and xenograft groups. It should be noted that the use of osteoplastic material in jaw surgery when reconstructing alveolar defects is an essential procedure for preventing the atrophy of bone tissue.

Asunto(s)

Proceso Alveolar , Dentina , Humanos , Femenino , Masculino , Persona de Mediana Edad , Proceso Alveolar/cirugía , Proceso Alveolar/diagnóstico por imagen , Adulto , Extracción Dental/métodos , Extracción Dental/efectos adversos , Aumento de la Cresta Alveolar/métodos , Tomografía Computarizada de Haz Cónico/métodos , Anciano , Pérdida de Hueso Alveolar/prevención & control , Pérdida de Hueso Alveolar/cirugía

RESUMEN

The purpose of this report is to describe an original technique for bone grafting using an inverted autogenous bone block taken from the same edentulous site that was to be implanted. A 54-year-old female presented for replacement of a missing lower premolar. Clinical and radiographical assessments revealed a deficiency in the width of the alveolar ridge. It was decided to expand the edentate area using an inverted bone block. The graft was harvested from the same edentate site that was to be implanted. The crestal bone width after nine months of healing was increased, and an implant was placed. An autogenous inverted bone block can be used as a bone grafting procedure to augment some bone-deficient sites prior to dental implantations. This novel technique provides an autogenous bone without the complexity of having a second surgical site. This technique can be used in specific situations when there is proper bone anatomy.

Asunto(s)

Aumento de la Cresta Alveolar , Trasplante Óseo , Mandíbula , Humanos , Femenino , Persona de Mediana Edad , Aumento de la Cresta Alveolar/métodos , Trasplante Óseo/métodos , Mandíbula/cirugía , Mandíbula/diagnóstico por imagen , Implantación Dental Endoósea/métodos

RESUMEN

BACKGROUND: It is common to see patients who need orthodontic treatment but with insufficient alveolar bone volume. However, safe and effective tooth movement requires sufficient alveolar bone width and height. The aim of this study is to compare the bone augmentation efficacy of Autologous Partially Demineralized Dentin Matrix (APDDM) and Deproteinized Bovine Bone Mineral (DBBM) in orthodontic patients with insufficient bone by using a randomized controlled clinical trial approach. MATERIALS AND METHODS: Twenty-seven orthodontic patients involving 40 posterior teeth alveolar sites (n = 40) with insufficient alveolar bone volume were randomly divided into a control group (n = 20) and an experimental group (n = 20). The patients in the experimental group were treated with APDDM, and those in the control group were treated with DBBM. After surgery, the adjacent teeth are moved toward the bone grafting sites according to the orthodontic treatment plan. Patients completed a postoperative response questionnaire by the Visual Analogue Scale (VAS) score to indicate pain and swelling in the bone grafted area at the time of suture removal; and CBCT scans were conducted before surgery, 6 months and 2 years after surgery to assess changes in buccal and central alveolar heights, as well as widths at the alveolar ridge apex and 3 mm, 5 mm below the apex, respectively. The CBCT image sequences were imported into Mimics 21.0 software in DICOM format. The data of the patients in both groups were collected and analyzed by SPSS 25.0. RESULTS: The VAS scores were significantly lower in the APDDM group than in the DBBM group (p < 0.05). Significant increases were observed in alveolar bone height and width at 6 months and 2 years postoperative (p < 0.05); At 2 years, the APDDM group exhibited a reduction in buccal crest height and in 3 mm, 5 mm width below alveolar ridge apex, relative to 6 months (p < 0.05), while the DBBM group showed a decrease only in the central height of the alveolar bone (p < 0.05). There was a significant bone augmentation increase found only 3 mm below the alveolar ridge apex in the APDDM group compared with the DBBM group among all 6 months group comparison (p < 0.05). At 2 years, the augmentation effects were similar across both groups (p > 0.05). CONCLUSION: Radiomics analysis indicates that APDDM serves as a viable bone augmentation material for orthodontic patients with insufficient alveolar bone volume, achieving comparable clinical efficacy to DBBM. Additionally, APDDM is associated with a milder postoperative response than DBBM. THE REGISTRATION NUMBER (TRN): ChiCTR2400084607.

Asunto(s)

Dentina , Humanos , Femenino , Masculino , Bovinos , Animales , Dentina/trasplante , Dentina/diagnóstico por imagen , Resultado del Tratamiento , Adolescente , Tomografía Computarizada de Haz Cónico/métodos , Adulto Joven , Aumento de la Cresta Alveolar/métodos , Pérdida de Hueso Alveolar/diagnóstico por imagen , Pérdida de Hueso Alveolar/cirugía , Técnicas de Movimiento Dental/métodos , Sustitutos de Huesos/uso terapéutico , Proceso Alveolar/diagnóstico por imagen , Proceso Alveolar/patología , Minerales/uso terapéutico , Dimensión del Dolor , Adulto , Estudios de Seguimiento

RESUMEN

Cases of relatively safe dental implant treatment in patients with low-volume bisphosphonate (BP) have been gradually reported. Although bone augmentation is commonly used when the bone volume is insufficient for implant placement, the studies and case reports regarding the safety of bone augmentation in patients treated with BP remain insufficient. Herein, we report a case wherein bone augmentation was performed after BP treatment with bone healing realized according to imaging, and we review the literature regarding BP and bone augmentation. A 67-year-old Japanese woman requested implant treatment for a hopeless lower right second molar. She had been taking minodronic acid hydrate (50 mg/4 wk) for 18 months to treat steroid-induced osteoporosis. After obtaining informed consent, tooth extraction and bone augmentation within the extraction socket were performed. The tooth was extracted atraumatically to preserve the surrounding alveolar bone, and the extraction socket was intensely curetted. Subsequently, the socket was filled with carbonate apatite granules and covered with a biodegradable membrane, and the wound was sutured without tension. Although protracted wound healing without any symptoms of infection was observed, the wound healed completely. No clinical symptoms were observed, the color of the mucosa at the site was healthy, and imaging findings at 6 months postoperation indicated that osteogenesis had progressed uneventfully.

Asunto(s)

Aumento de la Cresta Alveolar , Conservadores de la Densidad Ósea , Difosfonatos , Humanos , Femenino , Anciano , Aumento de la Cresta Alveolar/métodos , Conservadores de la Densidad Ósea/efectos adversos , Conservadores de la Densidad Ósea/uso terapéutico , Difosfonatos/efectos adversos , Difosfonatos/uso terapéutico , Alveolo Dental/cirugía , Extracción Dental , Imidazoles/uso terapéutico , Imidazoles/efectos adversos , Sustitutos de Huesos/uso terapéutico , Mandíbula/cirugía , Osteoporosis/tratamiento farmacológico , Implantación Dental Endoósea , Diente Molar/cirugía

RESUMEN

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.

Asunto(s)

Aumento de la Cresta Alveolar , Trasplante Óseo , Humanos , Trasplante Óseo/métodos , Aumento de la Cresta Alveolar/métodos , Implantación Dental Endoósea/métodos , Implantes Dentales , Mandíbula/cirugía , Maxilar/cirugía

RESUMEN

OBJECTIVE: The aim of this study was to evaluate the effectiveness of a novel biomaterial (FG) for alveolar ridge preservation compared to CTG in terms of soft tissue thickness and bone dimensional changes. MATERIALS AND METHODS: A randomized clinical trial was conducted on 30 patients who required extraction of 30 hopeless mandibular posterior teeth. All patients went through atraumatic tooth extraction, and then, they were randomly allocated to either a CTG, an FG, or a spontaneous healing (SH) group (1:1:1). All patients received a dental implant placed 6 months postoperatively. The soft tissue thickness and bone dimensional changes were measured before and 6 months after the procedure. RESULTS: The study's analysis revealed statistically significant differences in buccal gingival thickness and dimensional bone changes across the three examined groups after 6 months (p < 0.05). The SH group had lower gingival thickness (1.31 ± 0.65 mm) and higher vertical resorption (-1.46 ± 1.67 mm at the buccal aspect) compared with the CTG and FG groups. The CTG and FG groups had similar gingival thickness (2.42 ± 0.70 and 3.00 ± 0.71 mm, respectively) and bone width reduction (+0.86 ± 2.31 and +0.93 ± 2.38 mm, respectively), whereas the CTG group had lower vertical bone loss (-0.30 ± 1.09 mm at the buccal aspect) than the FG group (-0.47 ± 2.30 mm at the buccal aspect). CONCLUSION: FG and CTG demonstrate equivalent soft tissue thickness and comparable horizontal bone dimension outcomes in ARP.

Asunto(s)

Pérdida de Hueso Alveolar , Aumento de la Cresta Alveolar , Tejido Conectivo , Encía , Extracción Dental , Humanos , Masculino , Femenino , Adulto , Extracción Dental/efectos adversos , Extracción Dental/métodos , Pérdida de Hueso Alveolar/prevención & control , Encía/cirugía , Encía/patología , Persona de Mediana Edad , Aumento de la Cresta Alveolar/métodos , Proceso Alveolar/cirugía , Proceso Alveolar/patología , Mandíbula/cirugía , Resultado del Tratamiento , Implantación Dental Endoósea/métodos , Materiales Biocompatibles

RESUMEN

Immediate implant placement in the anterior maxilla remains complex, particularly when the labial cortical plate of the socket is deficient and there is an associated class IV ridge defect with both hard- and soft-tissue deficiencies. This case report describes a novel combination of polydioxanone (PDS) suture tenting to support a synthetic bone graft with simultaneous implant placement with implants featuring a body-shift design and subcrestal internal angle correction. In addition, the implants were immediately loaded with a four-unit provisional bridge at the time of surgery, thus reducing morbidity, costs, and total treatment time.

Asunto(s)

Carga Inmediata del Implante Dental , Maxilar , Alveolo Dental , Humanos , Maxilar/cirugía , Carga Inmediata del Implante Dental/métodos , Alveolo Dental/cirugía , Trasplante Óseo/métodos , Aumento de la Cresta Alveolar/métodos , Femenino , Polidioxanona , Masculino , Persona de Mediana Edad , Técnicas de Sutura

RESUMEN

Patients with severe alveolar ridge defects cannot be directly implanted and repaired, which seriously affects their quality of life. Onlay bone grafting is the main solution for severe alveolar ridge bone defect reconstruction, among which autogenous block bone grafting is the most widely used and is also the focus of clinical research on bone tissue reconstruction. This article expounds the characteristics and basic principles of autogenous bone block grafting, and comprehensively analyzes the selection of autogenous bone donor site, the principles of surgical operation, and the progress of bone graft techniques. In order to help surgeons make correct clinical decisions, increase the predictability of surgical effects, and improve the level of clinical diagnosis and treatment.

Asunto(s)

Proceso Alveolar , Aumento de la Cresta Alveolar , Trasplante Óseo , Humanos , Trasplante Óseo/métodos , Aumento de la Cresta Alveolar/métodos , Proceso Alveolar/anomalías , Proceso Alveolar/cirugía , Trasplante Autólogo , Procedimientos de Cirugía Plástica/métodos , Pérdida de Hueso Alveolar/cirugía , Sitio Donante de Trasplante

RESUMEN

A 61-year-old edentulous patient presented with dental problems. Examination revealed a very narrow alveolar process in the symphysis area of the chin, with moderate vertical resorption. The decision was made for bone augmentation by means of harvesting an autologous bone graft from the alveolar process. This method can be carried out in an outpatient or day surgery unit and is much more cost effective and less invasive than harvesting an autologous bone graft from the hip area.

Asunto(s)

Trasplante Óseo , Mandíbula , Humanos , Persona de Mediana Edad , Trasplante Óseo/métodos , Mandíbula/cirugía , Trasplante Autólogo , Aumento de la Cresta Alveolar/métodos , Masculino

RESUMEN

OBJECTIVES: This study aims to evaluate the efficacy of concentrated growth factor (CGF) membrane and collagen as barrier materials in sealing the alveolar socket in alveolar ridge preservation (ARP) in the posterior region during a one-year follow-up. METHODS: A total of 24 patients who underwent ARP in the posterior region were selected for inclusion and randomly assigned to the CGF group (12 cases) and Collagen group (12 cases). The patients in both groups underwent extraction of posterior teeth. The extraction sockets were filled with a bone substitute to the level of the pre-extraction buccal and lingual or palatal alveolar bone plates. The wounds in the CGF group were closed with a fabricated CGF overlaying the upper edge of the bone substitute material, whereas those in the Collagen group were closed with Bio-Oss Collagen. The implants were placed after 6 months. The evaluation was based on implant retention, re-grafting rate, and vertical and horizontal alveolar ridge bone volume changes measured by cone beam computed tomography (CBCT). Data were statistically analyzed using SPSS 28.0 software. RESULTS: No patient withdrew throughout the follow-up period. No implant failure and no severe peri-implant or mucosal soft tissue complications were observed. Six months after the operation, the degree of vertical alveolar ridge height resorption in the CGF group was lower than that in the Collagen group (P<0.05). There were no statistically difference between the groups at 1 year after the operation (P>0.05). The amount of bone reduction in horizontal alveolar ridge width showed no difference between the groups at 6 months and 1 year after surgery (P>0.05). CONCLUSIONS: CGF membrane and Bio-Oss Collagen as barrier materials for posterior ARP inhibited reduction in alveolar ridge bone mass.

Asunto(s)

Aumento de la Cresta Alveolar , Sustitutos de Huesos , Colágeno , Extracción Dental , Alveolo Dental , Humanos , Estudios Prospectivos , Aumento de la Cresta Alveolar/métodos , Alveolo Dental/cirugía , Sustitutos de Huesos/uso terapéutico , Estudios de Seguimiento , Péptidos y Proteínas de Señalización Intercelular/uso terapéutico , Proceso Alveolar/cirugía , Tomografía Computarizada de Haz Cónico , Minerales , Pérdida de Hueso Alveolar/prevención & control

RESUMEN

Three-dimensional (3D) alveolar ridge deficiencies necessitate horizontal and vertical bone reconstruction for optimal implant positioning. Despite several available techniques, achieving desired augmentation outcomes remains challenging. This case study aims to present a modified ridge split technique for bone reconstruction in horizontal and vertical dimensions. The proposed technique was used to reconstruct the horizontal and vertical ridge defect from removing a previously failed implant. This technique includes placing a cortical allograft plate as an internal tent in the split ridge. A portion of the plate was inserted into the ridge, while the other part was placed in the coronal of the vertical defect. Additional guided bone regeneration was performed around the tented plate on both the buccal and lingual sides. After 5 months, cone beam computerized tomography revealed sufficient bone formation in horizontal and vertical dimensions. Within the limitations of the present case study, internal cortical tenting would be a reliable method for 3D bone reconstruction in cases where the ridge split is feasible.

Asunto(s)

Aumento de la Cresta Alveolar , Tomografía Computarizada de Haz Cónico , Humanos , Aumento de la Cresta Alveolar/métodos , Trasplante Óseo/métodos , Placas Óseas , Femenino , Masculino , Persona de Mediana Edad

RESUMEN

After vertical bone augmentation (VBA) surgery, loss of both keratinized tissue (KT) and vestibule depth (VD) take place. This article evaluated KT gain, patient satisfaction, and aesthetic outcomes after a modified apically repositioned flap (ARF) in combination with a strip-free gingival graft (FGG) harvested from the palate and a xenogeneic collagen matrix (XCM) to correct mucogingival distortion (MGD) after VBA. This technique minimizes patient morbidity by reducing the need for extensive masticatory mucosa grafts. The study included 12 patients with ≤3 mm KT after vertical augmentation procedures. Keratinized tissue gain and tissue thickness were measured. Patient morbidity and aesthetic outcomes were also evaluated. Twenty-four months after surgery, significant VD gain was observed, obtaining a vertical KT augmentation of 5.38 ± 2.06 mm, although tissue thickness increase was only 0.42 ± 0.42mm. Regarding patient satisfaction, aesthetic results evaluating tissue color and texture were satisfactory; the pain was slight, obtaining a score of 2.10 ± 1.13 out of 10, measured using a Visual Analogue Scale (VAS). The present retrospective case series study shows that using an apically repositioned flap combined with a strip FGG and an XCM might offer a valid means of achieving KT gain.

Asunto(s)

Aumento de la Cresta Alveolar , Colágeno , Encía , Satisfacción del Paciente , Humanos , Colágeno/uso terapéutico , Aumento de la Cresta Alveolar/métodos , Femenino , Estudios Retrospectivos , Persona de Mediana Edad , Encía/trasplante , Masculino , Estética Dental , Adulto , Queratinas , Colgajos Quirúrgicos

RESUMEN

INTRODUCTION: Horizontal ridge augmentation of a deficient alveolar bone site is performed either simultaneously with implant placement or in a staged approach prior to implant insertion. There are several available strategies for the augmentation of alveolar ridge deficiencies, including guided bone regeneration (GBR) through the use of barrier membranes. The success of the GBR approach mainly depends on the exclusion of soft tissue cells during bone remodeling. CASE PRESENTATION: A healthy 25-year-old male patient presented with a missing upper left central incisor after clinical and radiographic examination, the site showed a class III defect horizontal atrophy. The procedure performed was the horizontal alveolar ridge augmentation using resorbable pericardium membrane with double layer graft technique (DLT) where autogenous bone placed as a first layer of the graft followed by xenograft as a second layer, the membrane was fixed with titanium pins. A cone beam computed tomography (CBCT) was performed before, immediately and 6 month following the surgery. After 6 months during implant placement, a core biopsy specimen was retrieved, stored and prepared for histological evaluation, with assessment of primary implant stability. The radiographic analysis showed a horizontal width gain of about 4 mm, at 6 month following implant placement, the implant was successfully osteointegrated with stability assessment also done after 6 months from placement. CONCLUSION: DLT was successfully used for horizontal alveolar ridge augmentation, thus allowing a prosthetically driven implant placement. More cases assessing implant survival and success are needed to confirm the results of this case report.

Asunto(s)

Aumento de la Cresta Alveolar , Tomografía Computarizada de Haz Cónico , Implantación Dental Endoósea , Humanos , Masculino , Aumento de la Cresta Alveolar/métodos , Adulto , Tomografía Computarizada de Haz Cónico/métodos , Implantación Dental Endoósea/métodos , Trasplante Óseo/métodos , Incisivo/diagnóstico por imagen