Saat melakukan segala jenis prosedur bedah, ahli bedah perlu mengetahui kemungkinan variasi dalam konfigurasi anatomi kanalis mandibula dan nervus alveolaris inferior (IAN) [1,2,3] Hal ini terutama terjadi saat melakukan reseksi akar, pencabutan gigi bungsu atau pengambilan cangkok tulang autologus. .
Teknik yang berbeda dijelaskan untuk rekonstruksi area tulang yang hilang sebelum atau selama pe...
Fig. 6. Position of the right mental foramen
Fig. 5. Position of the left mental foramen
Fig. 4. Left (l) and right (r) mandibular bone thickness (bt) in the four age groups (group 1, 0–20 years old; group 2, 21–40 years old; group 3, 41–60 years old; group 4, 61 and older) in men (0) and women [1]
Fig. 3. Left (l) and right (r) mandibular bone thickness in all patients
Fig. 2. Definition of the position of the mental foramen
Fig. 1. Measurement of mandibular bone thickness, defined as the distance between the lateral wall of the mandibular canal and the lateral mandibular compact bone (solid turquoise line)
Age groupTotal1234SexMale41363930146Female44513538168Total 85877468314Table 1 Number of men and women in each age group (group 1, 0–20 years old; group 2, 21–40 years old; group 3, 41–60 years old; group 4, 61 and older)
Valdec, S., Borm, J.M., Casparis, S. et al. Vestibular bone thickness of the mandible in relation to the mandibular canal—a retrospective CBCT-based study.
Int J Implant Dent 5, 37 (2019). https://doi.org/10.1186/s40729-019-0189-z
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Received: 04 June 2019
Accepted: 30 September 2019
Published: 15 November 2019
DOI: https://doi.org/10.1186/s40729-019-0189...
Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were m...
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Silvio Valdec and Jan Borm are equally contributing first authors.
The study was approved by the cantonal ethics committee of the canton of Zurich (KEK 2018-01691).
Not applicable.
Silvio Valdec, Jan Borm, Stephanie Casparis, Georg Damerau, Michael Locher and Bernd Stadlinger declare that they have no competing interests.
Silvio Valdec and Jan M. Borm contributed equally to this work.
Clinic of Cranio-Maxillofacial and Oral Surgery, Centre for Dental Medicine, University of Zurich, Plattenstrasse 11, 8032, Zurich, Switzerland
Silvio Valdec, Jan M. Borm, Stephanie Casparis, Georg Damerau, Michael Locher & Bernd Stadlinger
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This study was conducted without external funding.
The authors thank Jacquie Klesing, Board-Certified Editor in the Life Sciences (ELS), for editing assistance with the manuscript. Further, we thank Malgorzata Roos for supporting the statistical analysis.
Namano S, Behrend DA, Harcourt JK, Wilson PR. Angular asymmetries of the human face. Int J Prosthodont. 2000;13(1):41–6.
Phillips JL, Weller RN, Kulild JC. The mental foramen: 2. Radiographic position in relation to the mandibular second premolar. J Endod. 1992;18(6):271–4.
Pyun JH, Lim YJ, Kim MJ, Ahn SJ, Kim J. Position of the mental foramen on panoramic radiographs and its relation to the...
Nucera R, Lo Giudice A, Bellocchio AM, Spinuzza P, Caprioglio A, Perillo L, et al. Bone and cortical bone thickness of mandibular buccal shelf for mini-screw insertion in adults. Angle Orthod. 2017;87(5):745–51.
Scomparin L, Soares MQ, Rubira CM, Yaedu RY, Imada TS, Centurion BS, et al. CBCT location of the fusion between the buccal and lingual cortical in the mandibular ramus: importance to sa...
Benninger B, Miller D, Maharathi A, Carter W. Dental implant placement investigation: is the anterior loop of the mental nerve clinically relevant? J Craniomaxillofac Surg. 2011;69(1):182–5.
Greenstein G, Tarnow D. The mental foramen and nerve: clinical and anatomical factors related to dental implant placement: a literature review. J Periodontol. 2006;77(12):1933–43.
Kuribayashi A, Watanabe...
Ozturk A, Potluri A, Vieira AR. Position and course of the mandibular canal in skulls. Oral Surg Oral Med Oral Pathol Oral Radiol. 2012;113(4):453–8.
Agbaje JO, de Casteele EV, Salem AS, Anumendem D, Lambrichts I, Politis C. Tracking of the inferior alveolar nerve: its implication in surgical planning. Clin Oral Investig. 2017;21(7):2213–20.
Zahedi S, Mostafavi M, Lotfirikan N. Anatomic stud...
Bone thickness
Cone-beam computed tomography
Digital Imaging and Communications in Medicine
Inferior alveolar nerve
The original datasets supporting the findings are available.
The results of this study support the relevance of a preoperative CBCT to allow detailed planning of a surgical intervention that may potentially touch the area of the mandibular canal. This applies to surgical procedures like wisdom tooth removal, root resection, implant placement and bone block harvesting. A CBCT allows the exact determination of the horizontal bone thickness vestibular to the I...
In a study comparing measurements between cadavers and CT images, the distance between the upper edge of the mandibular canal and the alveolar ridge showed possible over- and underestimations. The quantification showed a possible overestimation of up to 1.05 mm and a possible underestimation of up to 1.36 mm [34]. This discrepancy is of relevance in preoperative planning. Intraoperatively, a r...
The IAN is an important anatomical structure whose course affects the preoperative planning of a bone graft or implant insertion in the mandible. Knowledge on the bone thickness between the lateral wall of the mandibular canal and the lateral mandibular compact bone as well as of the position of the mental foramen facilitates decision-making [24]. Furthermore, for many other surgical procedures, t...
The median age of the patients was 40.2 years (range 12.6–84.4 years). Patients were distributed almost evenly across the age groups (see Table 1).
Figure 3 clearly shows the median vestibular bone thicknesses (bt) at 2-mm intervals throughout the anterior to posterior course of the canal on both the right (bt2 r to bt66 r) and left (bt2 l to bt66 l) side of the mandible. The maximum di...
In addition, the position of the mental foramen was determined relative to the roots of the neighbouring teeth. This was assessed by defining regions of interest in the area of the first premolar, second premolar and first molar by extending the respective mesial and distal points of the cement-enamel junction caudally along the tooth axis. The position of the midpoint of the mental foramen was th...
Three hundred fourteen cone-beam computed tomograms (CBCTs) from 168 (53.5%) females and 146 (46.5%) males from the database of the Department of Cranio-Maxillofacial and Oral Surgery, Center of Dental Medicine, University of Zurich, Switzerland, from the years 2008 to 2013 were analysed. Patients were divided into 4 age groups: group 1 = 0–20 years, group 2 = 21–40 years, group 3...
The mandibular canal is a bilateral, intraosseous opening through which the IAN runs from the mandibular foramen to the mental foramen. The nerve innervates the teeth, the mucous membranes in the area of the mental foramen and the skin around the chin [14, 15]. Anatomical variations of the mandibular canal, such as bifid canals and an anterior loop of the mental nerve, are common [16, 17] and have...
When performing any kind of surgical procedure, a surgeon needs to be familiar with the possible variations in the anatomical configurations of both the mandibular canal and inferior alveolar nerve (IAN) [1,2,3]. This is particularly the case when performing root resections, removing wisdom teeth or harvesting autologous bone grafts.
Different techniques are described for reconstruction of missin...
Fig. 3. Site of evaluation. (1) Corner of the mouth: 5 mm below the corner of the mouth. (2) Lower lip: 5 mm laterally from the midline. (3) Mental region: at the midpoint of the perpendicular from the lower edge to the lower lip to the chin and 5 mm laterally from the midline
Fig. 3. Site of evaluation. (1) Corner of the mouth: 5 mm below the corner of the mouth. (2) Lower lip: 5 mm lat...
Fig. 2. started from a filament of 0.165 mm in diameter of the most weak force, and performed three times at one site
Fig. 2. a SW perception tester is composed of different diameters (a: 0.165 mm, b: 0.215 mm, c: 0.315 mm). b The use of SW perception tester started from a filament of 0.165 mm in diameter of the most weak force, and performed three times at one site
Fig. 1. Alveolar nerve repositioning in a partially edentulous mandible. a Preoperative radiograph. b The inferior alveolar nerve was transposed from the mental foramen. c Postoperative radiograph after implant insertion
Fig. 1. Alveolar nerve repositioning in a partially edentulous mandible. a Preoperative radiograph. b The inferior alveolar nerve was transposed from the mental foramen. c Po...
No.
Sex
Age (years)
Range of IAN lateralization (width)
Implant site
Follow-up period (months)
...
Stage 0
Complete sensory loss
Stage 1
Advent of deep pain
Stage 2
Some degree of tactile recovery and pain ...
Nishimaki, F., Kurita, H., Tozawa, S. et al. Subjective and qualitative assessment of neural disturbance after inferior alveolar nerve transposition for dental implant placement.
Int J Implant Dent 2, 14 (2016). https://doi.org/10.1186/s40729-016-0047-1
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Received: 25 July 2015
Accepted: 26 April 2016
Published: 14 May 2016
DOI: https://doi.org/10.1186/s40...
Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were...
Fumihiro Nishimaki, Hiroshi Kurita, Shinya Tozawa, Yuji Teramoto, Rishiho Nishizawa, and Shin-ichi Yamada declare that they have no competing interests.
FN and HK conceived and designed the study, performed the experiments, and wrote the manuscript. ST and YT performed data analysis. RN and SY participated in manuscript preparation. All authors read and approved the final version of the manuscrip...
Department of Dentistry and Oral Surgery, Shinshu University School of Medicine, 3-3-1, Asahi, Matsumoto-shi, Nagano, 390-0804, Japan
Fumihiro Nishimaki, Hiroshi Kurita, Shinya Tozawa, Yuji Teramoto, Rishiho Nishizawa & Shin-ichi Yamada
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Morrison A, Chiaro M, Kirby S. Mental nerve function after inferior alveolar nerve transposition for placement of dental implants. J Can Dent Assoc. 2002;62:46–50.
Vetromilla BM, Moura LB, Sonegi CL, et al. Complications associated with inferior alveolar nerve repositioning for dental implant placement: a systematic review. Int J Oral Maxillofac Surg. 2014;43(11):1360–6.
Eggers G, Klein J, e...
Levin L, Sadet P, Grossmann Y. A retrospective evaluation of 1387 single-tooth implants: a six-year follow-up. J Periodontol. 2006;77:2080–3.
Levin L. Dealing with dental implant failures. J Appl Oral Sci. 2008;16:171–5.
Lorean A, Kablan F, Mazor Z, et al. Inferior alveolar nerve transposition and reposition for dental implant placement in edentulous or partially edentulous mandibles: a mult...
In conclusion, we investigated the quality of postoperative neurosensory function after IAN transposition for dental implant placement. IAN transposition is a useful method for placing implants in the atrophic posterior mandible. However, the procedure is complicated, with the possibility of some degree of neurosensory disturbance, although in most of our cases, it resolved within a clinically acc...
Dental restoration by means of dental implants can provide good functional rehabilitation, particularly in patients with atrophic mandibles. IAN lateralization is a useful method for placing implants in the atrophic posterior mandible. However, there is a possibility of the neurosensory function of the IAN being disturbed, although in most cases, it resolves within a clinically acceptable period.
...
Although the previous studies reported good results concerning ND in IAN transposition surgery, the methods for evaluating ND differed, and most of the studies did not fully describe the evaluation procedure. The evaluation of ND of the IAN can be performed by purely subjective (questionnaire), relatively objective (static light touch, 2-point discrimination, etc.), and purely objective methods (t...
IAN reposition may serve as a viable treatment option in the severely resorbed mandibles. Repositioning is performed via one of the two surgical techniques, lateralization, or transposition, with lateralization yielding lower degrees of nerve deficiency. In lateralization, the IAN is exposed and retracted laterally, held in this position during implant placement, then released to rest against the ...
In total, eight IAN transposition procedures were performed in seven patients. One patient underwent bilateral surgery. Surgery was performed under general anesthesia in four patients and under local anesthesia in three patients. The IAN was lateralized for a four-tooth breadth on one side, three-tooth breadth on three sides, and two-tooth breadth on three sides. In total, 22 dental implants were ...
This study was conducted in compliance with the principles of the Declaration of Helsinki, and was approved by the Committee for Ethics at Shinshu University School of Medicine. Patients who underwent dental rehabilitation by insertion of dental implants between 2000 and 2012 in our hospital were reviewed. Of these, seven patients underwent transposition of the IAN for dental implant placement and...
Tooth loss is one of the common causes of reduced quality of life in adults. Dental implants have become a widely accepted treatment option for both partially and completely edentulous patients [1–3]. However, in cases of posterior mandibular atrophy, suitably sized implants cannot be placed without encroaching on the inferior alveolar nerve (IAN). In such cases, restorative options include the ...
The purpose of this retrospective study was to accumulate data regarding the quality of postoperative neurosensory function after inferior alveolar nerve (IAN) transposition for dental implant placement.
The study included seven consecutive patients who underwent IAN transposition surgery for the insertion of a dental implant into the atrophic posterior mandible. Of these, six patients (seven sid...
Patients
Intervention
Follow-up
Outcome
Study
Reference
No.
Agea
No. of implants
Position
Supra-structure
Change
Declarations
(DAVIS et al. 1999) [17]
44
61.2
NG
Symphyseal
Fixed
6.6 Ya
VBH (−.8 to +3.3 mm)
–
R
(Powers et al. 1994) [32]
146
52
NG
TMI
Fixed
18–51 M
BF (+2 to 9 mm)
–
R
(Adell et al. 1981) [58]
410
53
276...
Focus question
In patient with implant restoration, what is the chance of residual alveolar ridge preserving and bone formation in the adaptive remodeling and what are the features of this preservation?
Search strategy
Population
#1—edentulous patient
Intervention
#2—implant OR overdenture OR fixed bridge OR transmandibular implant OR full rehabilitation
O...
Khalifa, A.K., Wada, M., Ikebe, K. et al. To what extent residual alveolar ridge can be preserved by implant? A systematic review. Int J Implant Dent 2, 22 (2016). https://doi.org/10.1186/s40729-016-0057-z
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Received: 21 May 2016
Accepted: 16 November 2016
Published: 23 November 2016
DOI: https://doi.org/10.1186/s40729-016-0057-z
Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were m...
Department of Prosthodontics, Faculty of Dentistry, Mansoura University, 68 ElGomhoria Street, ElMansoura, 35516, Egypt
Ahmed Khalifa Khalifa
Department of Prosthodontics, Gerodontology and Oral Rehabilitation, Osaka University Graduate School of Dentistry, 1-8 Yamadaoka, Suita, Osaka, 565-0871, Japan
Ahmed Khalifa Khalifa, Masahiro Wada, Kazunori Ikebe & Yoshinobu Maeda
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Murphy WM, Williams KR, Gregory MC. Stress in bone adjacent to dental implants. J Oral Rehabil. 1995;22(12):897–903.
Chou HY, Jagodnik JJ, Müftü S. Predictions of bone remodeling around dental implant systems. J Biomech. 2008;41(6):1365–73.
Chang S-H, Huang S-R, Huang S-F, Lin C-L. Mechanical response comparison in an implant overdenture retained by ball attachments on conventional regular...
Kremer U, Schindler S, Enkling N, Worni A, Katsoulis J, Mericske-Stern R. Bone resorption in different parts of the mandible in patients restored with an implant overdenture. A retrospective radiographic analysis. Clin Oral Implants Res. 2016;27(3):267-72.
von Wowern N, Gotfredsen K. Implant-supported overdentures, a prevention of bone loss in edentulous mandibles? A 5-year follow-up study. Clin ...
de Jong MHM, Wright PS, Meijer HJA, Tymstra N. Posterior mandibular residual ridge resorption in patients with overdentures supported by two or four endosseous implants in a 10-year prospective comparative study. Int J Oral Maxillofac Implants. 2010;25(6):1168–74.
Jacobs R, Schotte A, van Steenberghe D, Quirynen M, Naert I. Posterior jaw bone resorption in osseointegrated implant-supported over...
Block MS, Kent JN, Finger IM. Use of the integral implant for overdenture stabilization. Int J Oral Maxillofac Implants. 1990;5(2):140–7.
Norton MR, Gamble C. Bone classification: an objective scale of bone density using the computerized tomography scan. Clin Oral Implants Res. 2001;12(1):79–84.
de Oliveira RCG, Leles CR, Normanha LM, Lindh C, Ribeiro-Rotta RF. Assessments of trabecular bone...
Cowin SC. Bone stress adaptation models. J Biomech Eng. 1993;115(4B):528.
Byrne G. Fundamentals of implant dentistry. New Jersey: Wiley; 2014. 264 p.
Traini T, Degidi M, Iezzi G, Artese L, Piattelli A. Comparative evaluation of the peri-implant bone tissue mineral density around unloaded titanium dental implants. J Dent. 2007;35(1):84–92.
Hoshaw SJ, Brunski JB, Cochran GVB. Mechanical loading...
Roberts WE, Helm FR, Marshall KJ, Gongloff RK. Rigid endosseous implants for orthodontic and orthopedic anchorage. Angle Orthod. 1989;59(4):247–56.
Roberts WE, Smith RK, Zilberman Y, Mozsary PG, Smith RS. Osseous adaptation to continuous loading of rigid endosseous implants. Am J Orthod. 1984;86(2):95–111.
Wyatt CCLL. The effect of prosthodontic treatment on alveolar bone loss: a review of t...
Klemetti E, Kolmakow S. Morphology of the mandibular cortex on panoramic radiographs as an indicator of bone quality. Dentomaxillofacial Radiol. 1997;26(1):22–5.
Ortman LF, McHenry K, Hausmann E. Relationship between alveolar bone measured by 125I absorptiometry with analysis of standardized radiographs: 2. Bjorn technique. J Periodontol. 1982;53(5):311–4.
Davis WH, Lam PS, Marshall MW, Dorc...
Petersen PE, Bourgeois D, Ogawa H, Estupinan-Day S, Ndiaye C. The global burden of oral diseases and risks to oral health. Bull World Health Organ. 2005;83(9):661–9.
Nowjack-Raymer RE, Sheiham A. Association of edentulism and diet and Nutrition in US adults. J Dent Res. 2003;82(2):123–6.
Araújo MG, Lindhe J. Dimensional ridge alterations following tooth extraction. An experimental study in ...
Within the limitation of this review and based on previous studies, implant restoration has a noticeable residual alveolar ridge preservation which varies from reducing rate of physiologic resorption to bone apposition. However, the extension of this preservation from the implant to surrounding bony area, horizontally and vertically, is unknown. So, further studies are needed to elaborate the exte...
As most of the previous studies declared the favorable bone preservation of the residual alveolar ridge anteriorly around implants, biomechanically, and according to finite element analysis, bone modifying shows variations depending on the cancellous or cortical nature. Bone density is enhanced gradually from the third month to the end of the first year of loading coming stable after 30 months. W...
Despite age-related [71], local and/or systemic factors causing prolonged ridge resorption [9], authors reported the probability of preservative effect and overhaul to maintain the residual alveolar ridge with different restoration [70, 71]. In the previous study, bone formation was noticed with the distal implant in severely resorbed atrophied mandibular ridge [20]. Sennerby et al. [72] concluded...
Many procedures are used to recover denture foundation, but the majority is considered sophisticated techniques [51–53]. Observations tried to notify bone modifications with different types of implant-assisted restoration [23, 40, 54]. The clinical and radiographic investigations, detection of the altered mineral levels, or bone density within the bone may give a valuable data for the bony state...
Bone changes were reported after implant placement in three phases: healing, remodeling, and equilibrium. The remodeling phase is launched confronting the altered pattern of force transmission to the bone tissue. To withstand the applied functional load, continuous remodeling is conducted to reach a “steady state.” Mechanical stimulus is the primary bone modifier influenced by other in situ va...
Apparently, there is an enduring adaptive process surrounding the implant which sustains the rigid interface between alveolar bone and implant after non-destructive surgical and loading procedures. Like other body bones, and according to Wolff’s law, bone has the ability to differentiate with different stresses applied [22]. This reform is started from the time of surgical conduction of implant ...
The required documents were collected from PubMed, Web of Science, and Ovid databases. For expanding the traces of researching, further readings for the bibliography of the relevant publications and hand searching for some denoted articles were done. The keywords, for intervention and outcome, used in research engines in databases as “implant overdenture,” “implant bone resorption,” “alv...
Edentulism is rated between 7 and 69% internationally [1]. Many biological and non-bilogical predisposing factors lead to the main result of edentulism [2]. Regardless the debate to understand the way of resorption [3], the loss of periodontal ligament by tooth extraction leaves alveolar bone without a chance of reformation which leads to bone resorption only. The resorption shows variation in rat...
It has been reported that the load for (or to) implant-supported restoration may lead to bone remodeling as bone resorption and/or formation. While many authors supported the process of bone resorption, others elaborated bone apposition and increasing bone density close and remote to implant body (or fixture). This may suggest the role of the implant to reserve alveolar ridge from physiologic/path...
Fig. 7. Orthopantomograph 2 years after implant placement
Fig. 6. Clinical picture 2 years after implant placement
Fig. 6. Clinical picture 2 years after implant placement
Fig. 5. Occlusal view of implants after vertical repositioning of the dental alveolus segment showing proper mesiodistal space and buccolingual spacing
Fig. 5. Occlusal view of implants after vertical repositioning of the dental alveolus segment showing proper mesiodistal space and buccolingual spacing
Fig. 4. Vertical repositioning of dental alveolus segment with placement of dental implants
Fig. 4. Vertical repositioning of dental alveolus segment with placement of dental implants
Fig. 3. Direct sinus lift with implant osteotomy preparation
Fig. 3. Direct sinus lift with implant osteotomy preparation
Fig. 2. Marked incision site for surgical access
Fig. 2. Marked incision site for surgical access
Fig. 1. Edentulous site with supra-eruption of opposing dentition
Fig. 1. Edentulous site with supra-eruption of opposing dentition
Tsegga, T., Wright, T. Maxillary segmental osteoperiosteal flap with simultaneous placement of dental implants: case report of a novel technique. Int J Implant Dent 3, 2 (2017). https://doi.org/10.1186/s40729-017-0067-5
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Received: 06 December 2016
Accepted: 13 January 2017
Published: 19 January 2017
DOI: https://doi.org/10.1186/s40729-017-0067-5
Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were m...
Department of Oral & Maxillofacial Surgery, San Antonio Military Medical Center, 3551 Roger Brooke Dr., Ft. Sam Houston, 78234, TX, USA
Tibebu Tsegga & Thomas Wright
Department of Oral & Maxilofacial Surgery, Wilford Hall Ambulatory Surgical Center, 2200 Bergquist Dr, Suite 1, Lackland AFB, TX, 78236, USA
Tibebu Tsegga & Thomas Wright
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Irinakis T. Efficacy of injectable demineralized bone matrix as graft material during sinus elevation surgery with simultaneous implant placement in the posterior maxilla: clinical evaluation of 49 sinuses. J Oral and Maxillofac Surg. 2011;69:134–41.
Chiapasoo M, Casentini P, Zaniboni M. Bone augmentation procedures in implant dentistry. Int J Oral Maxillofac Implants. 2009;24:237–69.
Jenson...
This case highlights the evolving variations in dentoalveolar augmentation with an emphasis on concomitant implant placement. In the most traditional sense, a vertical osteoperiosteal flap technique would be bound with a stable basal bone that can be used to anchor simultaneous dental implant placement. Further refinement should consider minimizing crestal reflection and overall labial bone resorp...
A critical appraisal of the gingival architecture in the final end point of this case demonstrates some radiolucency through the soft tissue outlining the platform of the Nobel Biocare TiUnite implant. This would lead us to believe that either the transmucosal bone level placement attempt was inaccurate or excessive reflection of the labial tissue has caused some degree of resorption. This is anot...
A suitable alternative surgical management of this particular case might have been to simply perform an alveoloplasty to produce the desired inter-occlusal clearance and proceed with placement of implant and simultaneous direct sinus lift. That would have left more of the apical portion of the implant within the grafted sinus and possibly modified the location of keratinized band of tissue. The lo...
A 35-year-old female with a 10-year history of partial acquired edentulism at site numbers 3 and 4 presented to our clinic for dental implant evaluation. Preoperative clinical examination revealed a reproducible intercuspation, well-delineated band of keratinized tissue, and decreased inter-occlusal clearance to allow for optimal dimension of prosthetic crowns (Fig. 1). Radiographs demonstrated e...
Obtaining proper occlusal clearance to allow for a single unit crown restoration is a fundamental prerequisite for dental implant restoration. Long-standing edentulous sites are often fraught with disuse atrophy and unopposed supra-eruption of the opposing dentition. In the posterior maxillae/mandible, there are vital structures that have to be mobilized in order to allow space for either bone tra...
Dental restorative space from the opposing dentition requires adequate distance for restorative material for an acceptable restoration. Typically, long-standing edentulous alveolar ridges will have vertical and or horizontal defects that require alveolar ridge augmentation for ideal dental implant restorations. Along with these defects, one will see the opposing dentition supra erupt which can obl...
Fig. 20. Colour-coded superimposition of intraoral scans before extraction and after definitive prosthetic restoration
Fig. 20. Colour-coded superimposition of intraoral scans before extraction and after definitive prosthetic restoration
Fig. 19. Colour-coded superimposition of intraoral scans before extraction and after definitive prosthetic restoration
Fig. 19. Colour-coded superimposition of intraoral scans before extraction and after definitive prosthetic restoration
Fig. 18. Finalized prosthetic restoration after 1 year
Fig. 18. Finalized prosthetic restoration after 1 year
Fig. 17. Histology of dentin augmentation. aactive process in the bone marrow lacunae with osteoblast rimming. No signs of necrosis or infection (H&E stain, ×100 magnification). b Larger magnification at ×200. c EvG (Elastica van Gieson) stain, ×200
Fig. 17. Histology of dentin augmentation. a Asterisk denotes incorporated dentin particle, surrounded by vital woven bone. Triangle shows rea...
Fig. 16. Single tooth X-ray, 1 year post-implantation, showing the finalized crown
Fig. 16. Single tooth X-ray, 1 year post-implantation, showing the finalized crown
Fig. 15. Single tooth X-ray, showing a constant bone level 7 months after implant placement
Fig. 15. Single tooth X-ray, showing a constant bone level 7 months after implant placement
Fig. 14. Single tooth X-ray immediately after the augmentation using autogenous dentin
Fig. 14. Single tooth X-ray immediately after the augmentation using autogenous dentin
Fig. 13.
Fig. 13. a, b Clinical situation prior to implant placement
Fig. 12. Axial view
Fig. 12. Axial view
Fig. 11. Sagittal view
Fig. 11. Sagittal view
Fig. 10. Soft tissue graft placed on the recipient site
Fig. 10. Soft tissue graft placed on the recipient site
Fig. 9. Soft tissue punch
Fig. 9. Soft tissue punch
Fig. 8. Autologous, particulated dentin in the alveolar socket
Fig. 8. Autologous, particulated dentin in the alveolar socket
Fig. 7. Autologous, particulated dentin mixed with blood from the operating site
Fig. 7. Autologous, particulated dentin mixed with blood from the operating site
Fig. 6. Autologous dentin with the desired particle size
Fig. 6. Autologous dentin with the desired particle size
Fig. 5. Autologous dentin in a bone mill
Fig. 5. Autologous dentin in a bone mill
Fig. 4. Removal of enamel and the cementum
Fig. 4. Removal of enamel and the cementum
Fig. 3. Removal of the pulp
Fig. 3. Removal of the pulp
Fig. 2. The remaining root of tooth 11
Fig. 2. The remaining root of tooth 11
Fig. 1. Extraction with the benex system
Fig. 1. Extraction with the benex system
Valdec, S., Pasic, P., Soltermann, A. et al. Alveolar ridge preservation with autologous particulated dentin—a case series. Int J Implant Dent 3, 12 (2017). https://doi.org/10.1186/s40729-017-0071-9
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Received: 07 December 2016
Accepted: 15 March 2017
Published: 30 March 2017
DOI: https://doi.org/10.1186/s40729-017-0071-9
Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were m...
Clinic of Cranio-Maxillofacial and Oral Surgery, Center of Dental Medicine, University of Zurich, University Hospital Zurich, Plattenstrasse 11, 8032, Zürich, Switzerland
Silvio Valdec, Pavla Pasic, Bernd Stadlinger & Martin Rücker
Institute of Surgical Pathology, University Hospital Zurich, Zurich, Switzerland
Alex Soltermann
Clinic of Fixed and Removable Prosthodontics and Dental Mater...
We would like to express our thanks to Dr. Gabriel Bosch for the superimposition, calculation and illustration of the intraoral scans.
SV, BS and MR created the conception and study design. MR performed the surgical and DT the prosthodontic treatment. SV, PP and DT performed the data collection and AS the histological examination. SV, BS and AS analysed and interpreted the data. SV drafted the ma...
Sculean A, Berakdar M, Chiantella GC, Donos N, Arweiler NB, Brecx M. Healing of intrabony defects following treatment with a bovine-derived xenograft and collagen membrane. A controlled clinical study. J Clin Periodontol. 2003;30(1):73–80.
Sutton DN, Lewis BR, Patel M, Cawood JI. Changes in facial form relative to progressive atrophy of the edentulous jaws. Int J Oral Maxillofac Surg. 2004;33(7...
Liu X, Li Q, Wang F, Wang Z. Maxillary sinus floor augmentation and dental implant placement using dentin matrix protein-1 gene-modified bone marrow stromal cells mixed with deproteinized boving bone: a comparative study in beagles. Arch Oral Biol. 2016;64:102–8. doi:10.1016/j.archoralbio.2016.01.004.
Pang KM, Um IW, Kim YK, Woo JM, Kim SM, Lee JH. Autogenous demineralized dentin matrix from ex...
Furhauser R, Florescu D, Benesch T, Haas R, Mailath G, Watzek G. Evaluation of soft tissue around single-tooth implant crowns: the pink esthetic score. Clin Oral Implants Res. 2005;16(6):639–44. doi:10.1111/j.1600-0501.2005.01193.x.
Guirado JL, Troiano M, Lopez-Lopez PJ, Ramirez-Fernandez MP, de Val JE, Marin JM, Gehrke SA. Different configuration of socket shield technique in peri-implant bone...
Al-Asfour A, Andersson L, Kamal M, Joseph B. New bone formation around xenogenic dentin grafts to rabbit tibia marrow. Dent Traumatol. 2013;29(6):455–60. doi:10.1111/edt.12045.
Albrektsson T, Zarb G, Worthington P, Eriksson AR. The long-term efficacy of currently used dental implants: a review and proposed criteria of success. Int J Oral Maxillofac Implants. 1986;1(1):11–25.
Andersson L. Den...
Within the limits of this case series, it has been shown that particulated dentin of autologous teeth may serve as an alternative to autologous bone for alveolar ridge preservation prior to implant therapy. However, randomized studies on this treatment option are necessary.
In humans, particulated tooth material has been used for sinus augmentation in order to enhance implant therapy. Preliminary results from five patients histologically showed an osteoconductive osteogenesis with partial resorption of tooth components [25].
In the present case series, all patients underwent socket preservation with AutoPD. In all cases, one or two upper frontal central incisors wer...
The aim of this case series is to demonstrate the efficacy and safety of this novel augmentative procedure for ridge preservation prior to implant therapy. This shall serve as a basis for a prospective study.
In all four cases, patients showed a stable volume of soft and hard tissues after the augmentation with AutoPD and good osseointegration of titanium implants, having been placed in this augm...
Four months post-extraction and augmentation with autologous, particulated dentin, all four patients received an implant placement in the augmented area. In all cases, a CBCT was taken in between the dentin augmentation and the implant placement.
During implant placement, a biopsy of the bone from the augmented area was taken for histological examination (Fig. 17).
The final prosthetic solution...
The 1-year follow-up examination of the presented case showed an implant success, according to the appropriate clinical criteria [2] (Figs. 14, 15 and 16).
The pink esthetic score (PES) was used for the evaluation of reproducible soft tissue around the final implant crown as a parameter for the aesthetic outcome [12]. Seven variables were evaluated comparing the soft tissue around the implant wi...
An autologous soft tissue graft was harvested from the patient’s palate using a soft tissue punch (Biopsy Punch, kai Europe GmbH, Solingen, Germany) (Fig. 9). The graft had a comparable dimension as the recipient site. The gingival graft was placed on top of the augmentation material, adapted and carefully sutured to the marginal gingiva after the sulcus epithelium was removed with a rotating d...
Four patients between 36 and 65 years of age are presented in this case series. There was no financial compensation. All four patients suffered from a trauma, causing damage to one or two teeth of the anterior maxilla. The frontal tooth/teeth has/had to be extracted. The pulp of the extracted teeth of three patients and the root canal filling of one patient had to be removed. All patients were in...
Subsequent to tooth extraction, a resorption of the host bone as defined by atrophy of the alveolar ridge can be observed. Sutton et al. classified the different degrees of alveolar ridge atrophy [32]. Bone resorption especially occurs in the frontal and premolar area of the jaw in the region of the thin buccal lamella. This may lead to a change in contour [11, 28]. Physiological reason for this a...
Ridge preservation can be performed with autologous bone, alloplastic bone substitute material or a combination of both. Dentin is similar to bone in its chemical composition. In its use as bone substitute material, it undergoes a remodelling process and transforms to bone. The presented case report introduces a technique in which the extraction socket is augmented with autologous, particulated de...
Fig. 7 Second stage surgery of patient in Fig. 1. a Vestibular depth reduction after augmentation and implant placement. b Partial thickness and apical repositioned flap. c CMX healing and soft tissue dehiscence with CCXBB exposure. d Dehiscence healing after re-contouring and buccal emergency profile. e Buccal aspect of the final restoration. f Buccal ridge contour
Fig. 6 Immunohistochemical analysis of slices from the same sample with four different markers. a TRAP. b OPN. c ALP. d OSC
ple. a Ground section stained with Levai-Laczkó. b Tissue identification of the ROI. c Closer view a bone and CCXBB. d Closer view of b
Fig. 5. Histomorphometric analysis of the same sample. a Ground section stained with Levai-Laczkó. b Tissue identification of the ROI. c Closer view a arrow pointing a cement line between new mineralized bone and CCXBB. d Closer view of b
Fig. 4. Histological samples. a CCXBB control without implantation. b Histologic samples with acute inflammatory infiltration. c Histologic sample with limited remaining CCXBB and large bone ingrowth
Fig. 4. Histological samples. a CCXBB control without implantation. b Histologic samples with acute inflammatory infiltration. c Histologic sample with limited remaining CCXBB and large bone ingr...
Fig. 3. Re-entry procedure of patient in Fig. 1. a Buccal aspect of the augmented region. b Horizontal bone augmentation. c Screws and pins removal and bone trephine sampling. d Implants placement and buccal bone width from the implant shoulder. e Primary flap closure. f Implants submerged healing
Fig. 3. Re-entry procedure of patient in Fig. 1. a Buccal aspect of the augmented region. b Ho...
Fig. 2. Lateral bone augmentation of the alveolar crest (a) atrophic ridge. b Perforations and adaptation of the cortical layer. c Shaping, pre-wetting and fixation of CCXBB with titanium screws. d Horizontal contour and peripheral gap between CCXBB and bone layer. e Outlying DBBM filling. f CM stabilized with pins
Fig. 2. Lateral bone augmentation of the alveolar crest (a) atrophic ridge. b ...
Fig. 1. Study chart and follow-up visits
Fig. 1. Study chart and follow-up visits
Differentiated tissues
Implant lost (Yes/no)
Mean
SD
Percentage
SD (%)
...
Patient
TRAP (%)
OPN (%)
ALP (%)
OSC (%)
1
...
Tissue type
Mean
Standard deviation
Median
CI 95%
Mineralized bone
...
Patient
Soft tissue dehiscence
Mineralized bone (%)
CCXBB (%)
Bone marrow (%)
Connect...
Ortiz-Vigón, A., Martinez-Villa, S., Suarez, I. et al. Histomorphometric and immunohistochemical evaluation of collagen containing xenogeneic bone blocks used for lateral bone augmentation in staged implant placement.
Int J Implant Dent 3, 24 (2017). https://doi.org/10.1186/s40729-017-0087-1
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Received: 21 March 2017
Accepted: 12 June 2017
Published: 21 Ju...
Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were...
ETEP Research Group, Facultad de Odontología, Universidad Complutense de Madrid, Plaza Ramón y Cajal, 28040, Madrid, Spain
Alberto Ortiz-Vigón, Sergio Martinez-Villa, Iñaki Suarez, Fabio Vignoletti & Mariano Sanz
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Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
We wish to acknowledge the dedication and scientific advise of Prof. Dr. Tord Berglundh on the histological analysis as well as the diligent work in processing the histological samples to Estela Maldonado for the immunohistochemistry and Asal Shikhan and Fernando Muñoz for the histomorphometry. The work of Esperanza Gross on the statistical analysis is highly acknowledged.
This study was partial...
Patti A, Gennari L, Merlotti D, Dotta F, Nuti R. Endocrine actions of osteocalcin. Int J Endocrinol. 2013;2013:846480.
Schwarz F, Herten M, Sager M, Wieland M, Dard M, Becker J. Histological and immunohistochemical analysis of initial and early osseous integration at chemically modified and conventional SLA titanium implants: preliminary results of a pilot study in dogs. Clin Oral Implants Res. 2...
Araujo MG, Linder E, Lindhe J. Bio-Oss collagen in the buccal gap at immediate implants: a 6-month study in the dog. Clin Oral Implants Res. 2011;22:1–8.
Chiapasco M, Colletti G, Coggiola A, Di Martino G, Anello T, Romeo E. Clinical outcome of the use of fresh frozen allogeneic bone grafts for the reconstruction of severely resorbed alveolar ridges: preliminary results of a prospective study. I...
Jeno L, Geza L. A simple differential staining method for semi-thin sections of ossifying cartilage and bone tissues embedded in epoxy resin. Mikroskopie. 1975;31:1–4.
Dias RR, Sehn FP, de Santana Santos T, Silva ER, Chaushu G, Xavier SP. Corticocancellous fresh-frozen allograft bone blocks for augmenting atrophied posterior mandibles in humans. Clin Oral Implants Res. 2016;27:39–46.
Nissan ...
Cremonini CC, Dumas M, Pannuti C, Lima LA, Cavalcanti MG. Assessment of the availability of bone volume for grafting in the donor retromolar region using computed tomography: a pilot study. Int J Oral Maxillofac Implants. 2010;25:374–8.
Nkenke E, Weisbach V, Winckler E, Kessler P, Schultze-Mosgau S, Wiltfang J, et al. Morbidity of harvesting of bone grafts from the iliac crest for preprosthetic...
Sanz M, Vignoletti F. Key aspects on the use of bone substitutes for bone regeneration of edentulous ridges. Dent Mater. 2015;31:640–7.
Benic GI, Hammerle CH. Horizontal bone augmentation by means of guided bone regeneration. Periodontology. 2014;66:13–40.
Beretta M, Cicciu M, Poli PP, Rancitelli D, Bassi G, Grossi GB, et al. A Retrospective Evaluation of 192 Implants Placed in Augmented Bon...
Alkaline phosphatase
Cone beam computed tomography
Collagen containing xenogeneic bone block
Native collagen membrane
Deproteinized bovine bone mineral
Etiology and Therapy of Periodontal Diseases
Osteopontin
Osteocalcine
Tartrate-resistant acid phosphatase
Within the limitations of this clinical study, we may conclude that the use of CCXBB in combination with DBBM particles and a native bilayer collagen membrane for staged lateral bone augmentation in severe atrophic alveolar crests achieved significant horizontal crestal width allowing for staged implant placement in most of the patients. Histological analysis and implant survival records indicate ...
The immune-histochemical results reported expression of osteopontin mainly at the border between mineralized vital bone (MVB) with CCXBB, what coincides with findings from previous reports [38,39,40]. Alkaline phosphatase (ALP) is considered as an early osteoblast differentiation marker [41]. ALP-positive cells were detectable, in all specimens on the periphery of MVB, associated to areas of new b...
When correlating the clinical results and the histological outcomes, there was a positive association between the presence of soft tissue dehiscence with CCXBB exposure and a diminished amount of new mineralized bone (p = 0.06). This lower amount of new bone within the xenogeneic graft suggests a lack of full graft integration and diminished vascular supply, what may have caused the soft tissu...
The purpose of this investigation was to evaluate histologically and immunohistochemically the behavior of CCXBB blocks when used for staged lateral bone augmentation in severe human horizontal residual bone defects. Six months after the regenerative intervention using the CCXBB blocks, the mean increase in bone width was 4.12 mm and hence, this outcome allowed for the placement of dental implant...
The results from the histomorphometric measurements are depicted in Table 2. Bone biopsies were composed by 21.37% (SD 7.36) of residual CCXBB, 26.90% (SD 12.21) of mineralized vital bone (MVB), 47.13% (SD 19.15) of non-mineralized tissue and 0.92% of DBBM (Fig. 5b). Biopsies from patients who lost their implants had a statistical significant lower amount of MVB (p = 0.01u) and a statistical...
Twenty-eight CCXBB blocks were placed in 15 patients that fulfilled the selection criteria (12 women and 3 men) with a mean age of 54.5 (SD 8.34).
The detailed clinical and radiographical outcomes have been reported previously [21]. In brief, one patient experienced pain and soft tissue dehiscence leading to removal of the graft material 3 days after the regenerative procedure. Another patient r...
For the immunohistochemical analysis, the semi-thin sections were incubated over night with primary antibodies at 4 °C (Santa Cruz Biotechnology Inc., Santa Cruz, Calif., USA). The antibody dilutions used were alkaline phosphatase (ALP) 1:100, osteopontin (OPN) 1:100, osteocalcin (OSC) 1:100, and tatrate resistant acid phosphatase (TRAP) 1:100.
The obtained semi-thin sections were evaluated wit...
Twenty-six weeks after the regenerative procedure the patient returned for the re-entry intervention for placement of dental implants. After raising full-thickness flaps, the augmented area was exposed and horizontal crestal width measurements were performed. Then, the surgeon evaluated the bone availability and if implant placement was considered possible, a core bone biopsy was harvested with th...
CCXBB (Bio-Graft® Geistlich Pharma) is a bone substitute material in a natural block form. The dimensions of the Bio-Graft block are 10 mm in height, 10 mm in length and 5 mm in width. It consists of a natural cancellous bone structure of hydroxyapatite and endogenous collagen type I and III, equine origin and is a class III medical device according to the Medical Device Directive 93/42 EECs...
The present manuscript reports the histological outcomes of a prospective single arm study evaluating the safety and clinical performance of CCXBB blocks when used as replacement bone grafts for lateral bone augmentation prior to staged implant placement. The results of the clinical and radiographic outcomes have been reported in a previous publication [21]. For correlation of the histological wit...
Different techniques and grafting materials have been used for the horizontal reconstruction of deficient alveolar processes before implant placement, resulting in different degrees of predictability and clinical outcomes [1]. Among the grafting materials, particulated xenogeneic materials have been extensively studied in both experimental and clinical studies and when combined with porcine-derive...
The osteoconductive properties of collagen containing xenogeneic bone blocks (CCXBB) remain unclear. The aim of this prospective single-arm clinical study was to assess the histological outcomes of CCXBB blocks used as bone replacement grafts for lateral bone augmentation procedures.
In 15 patients with severe horizontal alveolar ridge resorption, lateral augmentation procedures were performed us...
Tsegga, T., Wright, T. Maxillary segmental osteoperiosteal flap with simultaneous placement of dental implants: case report of a novel technique.
Int J Implant Dent 3, 2 (2017). https://doi.org/10.1186/s40729-017-0067-5
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Received: 06 December 2016
Accepted: 13 January 2017
Published: 19 January 2017
DOI: https://doi.org/10.1186/s40729-017-0067-5
Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were...
Department of Oral & Maxillofacial Surgery, San Antonio Military Medical Center, 3551 Roger Brooke Dr., Ft. Sam Houston, 78234, TX, USA
Tibebu Tsegga & Thomas Wright
Department of Oral & Maxilofacial Surgery, Wilford Hall Ambulatory Surgical Center, 2200 Bergquist Dr, Suite 1, Lackland AFB, TX, 78236, USA
Tibebu Tsegga & Thomas Wright
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Irinakis T. Efficacy of injectable demineralized bone matrix as graft material during sinus elevation surgery with simultaneous implant placement in the posterior maxilla: clinical evaluation of 49 sinuses. J Oral and Maxillofac Surg. 2011;69:134–41.
Chiapasoo M, Casentini P, Zaniboni M. Bone augmentation procedures in implant dentistry. Int J Oral Maxillofac Implants. 2009;24:237–69.
Jenson...
This case highlights the evolving variations in dentoalveolar augmentation with an emphasis on concomitant implant placement. In the most traditional sense, a vertical osteoperiosteal flap technique would be bound with a stable basal bone that can be used to anchor simultaneous dental implant placement. Further refinement should consider minimizing crestal reflection and overall labial bone resorp...
A critical appraisal of the gingival architecture in the final end point of this case demonstrates some radiolucency through the soft tissue outlining the platform of the Nobel Biocare TiUnite implant. This would lead us to believe that either the transmucosal bone level placement attempt was inaccurate or excessive reflection of the labial tissue has caused some degree of resorption. This is anot...
A suitable alternative surgical management of this particular case might have been to simply perform an alveoloplasty to produce the desired inter-occlusal clearance and proceed with placement of implant and simultaneous direct sinus lift. That would have left more of the apical portion of the implant within the grafted sinus and possibly modified the location of keratinized band of tissue. The lo...
A 35-year-old female with a 10-year history of partial acquired edentulism at site numbers 3 and 4 presented to our clinic for dental implant evaluation. Preoperative clinical examination revealed a reproducible intercuspation, well-delineated band of keratinized tissue, and decreased inter-occlusal clearance to allow for optimal dimension of prosthetic crowns (Fig. 1). Radiographs demonstrated e...
Obtaining proper occlusal clearance to allow for a single unit crown restoration is a fundamental prerequisite for dental implant restoration. Long-standing edentulous sites are often fraught with disuse atrophy and unopposed supra-eruption of the opposing dentition. In the posterior maxillae/mandible, there are vital structures that have to be mobilized in order to allow space for either bone tra...
Dental restorative space from the opposing dentition requires adequate distance for restorative material for an acceptable restoration. Typically, long-standing edentulous alveolar ridges will have vertical and or horizontal defects that require alveolar ridge augmentation for ideal dental implant restorations. Along with these defects, one will see the opposing dentition supra erupt which can obl...
Valdec, S., Pasic, P., Soltermann, A. et al. Alveolar ridge preservation with autologous particulated dentin—a case series.
Int J Implant Dent 3, 12 (2017). https://doi.org/10.1186/s40729-017-0071-9
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Received: 07 December 2016
Accepted: 15 March 2017
Published: 30 March 2017
DOI: https://doi.org/10.1186/s40729-017-0071-9
Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were...
Clinic of Cranio-Maxillofacial and Oral Surgery, Center of Dental Medicine, University of Zurich, University Hospital Zurich, Plattenstrasse 11, 8032, Zürich, Switzerland
Silvio Valdec, Pavla Pasic, Bernd Stadlinger & Martin Rücker
Institute of Surgical Pathology, University Hospital Zurich, Zurich, Switzerland
Alex Soltermann
Clinic of Fixed and Removable Prosthodontics and Dental Mater...
We would like to express our thanks to Dr. Gabriel Bosch for the superimposition, calculation and illustration of the intraoral scans.
SV, BS and MR created the conception and study design. MR performed the surgical and DT the prosthodontic treatment. SV, PP and DT performed the data collection and AS the histological examination. SV, BS and AS analysed and interpreted the data. SV drafted the ma...
Sculean A, Berakdar M, Chiantella GC, Donos N, Arweiler NB, Brecx M. Healing of intrabony defects following treatment with a bovine-derived xenograft and collagen membrane. A controlled clinical study. J Clin Periodontol. 2003;30(1):73–80.
Sutton DN, Lewis BR, Patel M, Cawood JI. Changes in facial form relative to progressive atrophy of the edentulous jaws. Int J Oral Maxillofac Surg. 2004;33(7...
Liu X, Li Q, Wang F, Wang Z. Maxillary sinus floor augmentation and dental implant placement using dentin matrix protein-1 gene-modified bone marrow stromal cells mixed with deproteinized boving bone: a comparative study in beagles. Arch Oral Biol. 2016;64:102–8. doi:10.1016/j.archoralbio.2016.01.004.
Pang KM, Um IW, Kim YK, Woo JM, Kim SM, Lee JH. Autogenous demineralized dentin matrix from ex...
Furhauser R, Florescu D, Benesch T, Haas R, Mailath G, Watzek G. Evaluation of soft tissue around single-tooth implant crowns: the pink esthetic score. Clin Oral Implants Res. 2005;16(6):639–44. doi:10.1111/j.1600-0501.2005.01193.x.
Guirado JL, Troiano M, Lopez-Lopez PJ, Ramirez-Fernandez MP, de Val JE, Marin JM, Gehrke SA. Different configuration of socket shield technique in peri-implant bone...
Al-Asfour A, Andersson L, Kamal M, Joseph B. New bone formation around xenogenic dentin grafts to rabbit tibia marrow. Dent Traumatol. 2013;29(6):455–60. doi:10.1111/edt.12045.
Albrektsson T, Zarb G, Worthington P, Eriksson AR. The long-term efficacy of currently used dental implants: a review and proposed criteria of success. Int J Oral Maxillofac Implants. 1986;1(1):11–25.
Andersson L. Den...
Within the limits of this case series, it has been shown that particulated dentin of autologous teeth may serve as an alternative to autologous bone for alveolar ridge preservation prior to implant therapy. However, randomized studies on this treatment option are necessary.
In humans, particulated tooth material has been used for sinus augmentation in order to enhance implant therapy. Preliminary results from five patients histologically showed an osteoconductive osteogenesis with partial resorption of tooth components [25].
In the present case series, all patients underwent socket preservation with AutoPD. In all cases, one or two upper frontal central incisors wer...
The aim of this case series is to demonstrate the efficacy and safety of this novel augmentative procedure for ridge preservation prior to implant therapy. This shall serve as a basis for a prospective study.
In all four cases, patients showed a stable volume of soft and hard tissues after the augmentation with AutoPD and good osseointegration of titanium implants, having been placed in this augm...
Four months post-extraction and augmentation with autologous, particulated dentin, all four patients received an implant placement in the augmented area. In all cases, a CBCT was taken in between the dentin augmentation and the implant placement.
During implant placement, a biopsy of the bone from the augmented area was taken for histological examination (Fig. 17).
The final prosthetic solution...
The 1-year follow-up examination of the presented case showed an implant success, according to the appropriate clinical criteria [2] (Figs. 14, 15 and 16).
The pink esthetic score (PES) was used for the evaluation of reproducible soft tissue around the final implant crown as a parameter for the aesthetic outcome [12]. Seven variables were evaluated comparing the soft tissue around the implant wi...
An autologous soft tissue graft was harvested from the patient’s palate using a soft tissue punch (Biopsy Punch, kai Europe GmbH, Solingen, Germany) (Fig. 9). The graft had a comparable dimension as the recipient site. The gingival graft was placed on top of the augmentation material, adapted and carefully sutured to the marginal gingiva after the sulcus epithelium was removed with a rotating d...
Four patients between 36 and 65 years of age are presented in this case series. There was no financial compensation. All four patients suffered from a trauma, causing damage to one or two teeth of the anterior maxilla. The frontal tooth/teeth has/had to be extracted. The pulp of the extracted teeth of three patients and the root canal filling of one patient had to be removed. All patients were in...
Subsequent to tooth extraction, a resorption of the host bone as defined by atrophy of the alveolar ridge can be observed. Sutton et al. classified the different degrees of alveolar ridge atrophy [32]. Bone resorption especially occurs in the frontal and premolar area of the jaw in the region of the thin buccal lamella. This may lead to a change in contour [11, 28]. Physiological reason for this a...
Ridge preservation can be performed with autologous bone, alloplastic bone substitute material or a combination of both. Dentin is similar to bone in its chemical composition. In its use as bone substitute material, it undergoes a remodelling process and transforms to bone. The presented case report introduces a technique in which the extraction socket is augmented with autologous, particulated de...
Fig. 8. Soft tissue dehiscence (a) CCXBB exposure 15 weeks after bone augmentation, the dehiscence healed 2 weeks later after reducing the graft exposure (b) after soft tissue augmentation and abutment connection leading to the loss of the mesial implant. After partial removal of the bone graft and place a connective tissue graft the area healed properly and a month later it was possible to re...
Fig. 7. Second stage surgery of patient in Fig. 1. a Vestibular depth reduction after augmentation and implant placement. b Partial thickness and apical repositioned flap. c CMX healing and soft tissue dehiscence with CCXBB exposure. d Dehiscence healing after re-contouring and buccal emergency profile. e Buccal aspect of the final restoration. f Buccal ridge contour
Fig. 7. Second stage sur...
Fig. 6. Immunohistochemical analysis of slices from the same sample with four different markers. a TRAP. b OPN. c ALP. d OSC
Fig. 6. Immunohistochemical analysis of slices from the same sample with four different markers. a TRAP. b OPN. c ALP. d OSC
section stained with Levai-Laczkó. b Tissue identification of the ROI. c Closer view aized bone and CCXBB. d Closer view of b
Fig. 5. Histomorphometric analysis of the same sample. a Ground section stained with Levai-Laczkó. b Tissue identification of the ROI. c Closer view a arrow pointing a cement line between new mineralized bone and CCXBB. d Closer view of b
Fig. 4. Histological samples. a CCXBB control without implantation. b Histologic samples with acute inflammatory infiltration. c Histologic sample with limited remaining CCXBB and large bone ingrowth
Fig. 4. Histological samples. a CCXBB control without implantation. b Histologic samples with acute inflammatory infiltration. c Histologic sample with limited remaining CCXBB and large bone ingr...
Fig. 3. Re-entry procedure of patient in Fig. 1. a Buccal aspect of the augmented region. b Horizontal bone augmentation. c Screws and pins removal and bone trephine sampling. d Implants placement and buccal bone width from the implant shoulder. e Primary flap closure. f Implants submerged healing
Fig. 3. Re-entry procedure of patient in Fig. 1. a Buccal aspect of the augmented region. b Ho...
Fig. 2. Lateral bone augmentation of the alveolar crest (a) atrophic ridge. b Perforations and adaptation of the cortical layer. c Shaping, pre-wetting and fixation of CCXBB with titanium screws. d Horizontal contour and peripheral gap between CCXBB and bone layer. e Outlying DBBM filling. f CM stabilized with pins
Fig. 2. Lateral bone augmentation of the alveolar crest (a) atrophic ridge. b ...
Fig. 1. Study chart and follow-up visits
Fig. 1. Study chart and follow-up visits
Differentiated tissues
Implant lost (Yes/no)
Mean
SD
Percentage
SD (%)
...
Patient
TRAP (%)
OPN (%)
ALP (%)
OSC (%)
1
...
Tissue type
Mean
Standard deviation
Median
CI 95%
Mineralized bone
...
Patient
Soft tissue dehiscence
Mineralized bone (%)
CCXBB (%)
Bone marrow (%)
Connect...
Ortiz-Vigón, A., Martinez-Villa, S., Suarez, I. et al. Histomorphometric and immunohistochemical evaluation of collagen containing xenogeneic bone blocks used for lateral bone augmentation in staged implant placement.
Int J Implant Dent 3, 24 (2017). https://doi.org/10.1186/s40729-017-0087-1
Download citation
Received: 21 March 2017
Accepted: 12 June 2017
Published: 21 Ju...
Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were...
ETEP Research Group, Facultad de Odontología, Universidad Complutense de Madrid, Plaza Ramón y Cajal, 28040, Madrid, Spain
Alberto Ortiz-Vigón, Sergio Martinez-Villa, Iñaki Suarez, Fabio Vignoletti & Mariano Sanz
You can also search for this author in
PubMed Google Scholar
You can also search for this author in
PubMed Google Scholar
...
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
We wish to acknowledge the dedication and scientific advise of Prof. Dr. Tord Berglundh on the histological analysis as well as the diligent work in processing the histological samples to Estela Maldonado for the immunohistochemistry and Asal Shikhan and Fernando Muñoz for the histomorphometry. The work of Esperanza Gross on the statistical analysis is highly acknowledged.
This study was partial...
Patti A, Gennari L, Merlotti D, Dotta F, Nuti R. Endocrine actions of osteocalcin. Int J Endocrinol. 2013;2013:846480.
Schwarz F, Herten M, Sager M, Wieland M, Dard M, Becker J. Histological and immunohistochemical analysis of initial and early osseous integration at chemically modified and conventional SLA titanium implants: preliminary results of a pilot study in dogs. Clin Oral Implants Res. 2...
Araujo MG, Linder E, Lindhe J. Bio-Oss collagen in the buccal gap at immediate implants: a 6-month study in the dog. Clin Oral Implants Res. 2011;22:1–8.
Chiapasco M, Colletti G, Coggiola A, Di Martino G, Anello T, Romeo E. Clinical outcome of the use of fresh frozen allogeneic bone grafts for the reconstruction of severely resorbed alveolar ridges: preliminary results of a prospective study. I...
Jeno L, Geza L. A simple differential staining method for semi-thin sections of ossifying cartilage and bone tissues embedded in epoxy resin. Mikroskopie. 1975;31:1–4.
Dias RR, Sehn FP, de Santana Santos T, Silva ER, Chaushu G, Xavier SP. Corticocancellous fresh-frozen allograft bone blocks for augmenting atrophied posterior mandibles in humans. Clin Oral Implants Res. 2016;27:39–46.
Nissan ...
Cremonini CC, Dumas M, Pannuti C, Lima LA, Cavalcanti MG. Assessment of the availability of bone volume for grafting in the donor retromolar region using computed tomography: a pilot study. Int J Oral Maxillofac Implants. 2010;25:374–8.
Nkenke E, Weisbach V, Winckler E, Kessler P, Schultze-Mosgau S, Wiltfang J, et al. Morbidity of harvesting of bone grafts from the iliac crest for preprosthetic...
Sanz M, Vignoletti F. Key aspects on the use of bone substitutes for bone regeneration of edentulous ridges. Dent Mater. 2015;31:640–7.
Benic GI, Hammerle CH. Horizontal bone augmentation by means of guided bone regeneration. Periodontology. 2014;66:13–40.
Beretta M, Cicciu M, Poli PP, Rancitelli D, Bassi G, Grossi GB, et al. A Retrospective Evaluation of 192 Implants Placed in Augmented Bon...
Alkaline phosphatase
Cone beam computed tomography
Collagen containing xenogeneic bone block
Native collagen membrane
Deproteinized bovine bone mineral
Etiology and Therapy of Periodontal Diseases
Osteopontin
Osteocalcine
Tartrate-resistant acid phosphatase
Within the limitations of this clinical study, we may conclude that the use of CCXBB in combination with DBBM particles and a native bilayer collagen membrane for staged lateral bone augmentation in severe atrophic alveolar crests achieved significant horizontal crestal width allowing for staged implant placement in most of the patients. Histological analysis and implant survival records indicate ...
The immune-histochemical results reported expression of osteopontin mainly at the border between mineralized vital bone (MVB) with CCXBB, what coincides with findings from previous reports [38,39,40]. Alkaline phosphatase (ALP) is considered as an early osteoblast differentiation marker [41]. ALP-positive cells were detectable, in all specimens on the periphery of MVB, associated to areas of new b...
When correlating the clinical results and the histological outcomes, there was a positive association between the presence of soft tissue dehiscence with CCXBB exposure and a diminished amount of new mineralized bone (p = 0.06). This lower amount of new bone within the xenogeneic graft suggests a lack of full graft integration and diminished vascular supply, what may have caused the soft tissu...
The purpose of this investigation was to evaluate histologically and immunohistochemically the behavior of CCXBB blocks when used for staged lateral bone augmentation in severe human horizontal residual bone defects. Six months after the regenerative intervention using the CCXBB blocks, the mean increase in bone width was 4.12 mm and hence, this outcome allowed for the placement of dental implant...
The results from the histomorphometric measurements are depicted in Table 2. Bone biopsies were composed by 21.37% (SD 7.36) of residual CCXBB, 26.90% (SD 12.21) of mineralized vital bone (MVB), 47.13% (SD 19.15) of non-mineralized tissue and 0.92% of DBBM (Fig. 5b). Biopsies from patients who lost their implants had a statistical significant lower amount of MVB (p = 0.01u) and a statistical...
Twenty-eight CCXBB blocks were placed in 15 patients that fulfilled the selection criteria (12 women and 3 men) with a mean age of 54.5 (SD 8.34).
The detailed clinical and radiographical outcomes have been reported previously [21]. In brief, one patient experienced pain and soft tissue dehiscence leading to removal of the graft material 3 days after the regenerative procedure. Another patient r...
For the immunohistochemical analysis, the semi-thin sections were incubated over night with primary antibodies at 4 °C (Santa Cruz Biotechnology Inc., Santa Cruz, Calif., USA). The antibody dilutions used were alkaline phosphatase (ALP) 1:100, osteopontin (OPN) 1:100, osteocalcin (OSC) 1:100, and tatrate resistant acid phosphatase (TRAP) 1:100.
The obtained semi-thin sections were evaluated wit...
Twenty-six weeks after the regenerative procedure the patient returned for the re-entry intervention for placement of dental implants. After raising full-thickness flaps, the augmented area was exposed and horizontal crestal width measurements were performed. Then, the surgeon evaluated the bone availability and if implant placement was considered possible, a core bone biopsy was harvested with th...
CCXBB (Bio-Graft® Geistlich Pharma) is a bone substitute material in a natural block form. The dimensions of the Bio-Graft block are 10 mm in height, 10 mm in length and 5 mm in width. It consists of a natural cancellous bone structure of hydroxyapatite and endogenous collagen type I and III, equine origin and is a class III medical device according to the Medical Device Directive 93/42 EECs...
The present manuscript reports the histological outcomes of a prospective single arm study evaluating the safety and clinical performance of CCXBB blocks when used as replacement bone grafts for lateral bone augmentation prior to staged implant placement. The results of the clinical and radiographic outcomes have been reported in a previous publication [21]. For correlation of the histological wit...
Different techniques and grafting materials have been used for the horizontal reconstruction of deficient alveolar processes before implant placement, resulting in different degrees of predictability and clinical outcomes [1]. Among the grafting materials, particulated xenogeneic materials have been extensively studied in both experimental and clinical studies and when combined with porcine-derive...
The osteoconductive properties of collagen containing xenogeneic bone blocks (CCXBB) remain unclear. The aim of this prospective single-arm clinical study was to assess the histological outcomes of CCXBB blocks used as bone replacement grafts for lateral bone augmentation procedures.
In 15 patients with severe horizontal alveolar ridge resorption, lateral augmentation procedures were performed us...
Fig. 4. Linear regression plots to depict the relationship between BI26 and CWb/SA26 values. a CWb (TR group). b CWb (AB group). c SA26 (TR group). d SA26 (AB group)
Fig. 4. Linear regression plots to depict the relationship between BI26 and CWb/SA26 values. a CWb (TR group). b CWb (AB group). c SA26 (TR group). d SA26 (AB group)
Fig. 3. Representative CBCT outcomes at 26 weeks. a, b TR graft. c, d AB graft
Fig. 3. Representative CBCT outcomes at 26 weeks. a, b TR graft. c, d AB graft
Fig. 2. Radiographic assessments. Images of the coronal planes representing the most central aspect of the respective defect sites were analyzed for the basal graft integration (i.e., contact between the graft and the host bone in %) (BI26) and the cross-sectional grafted area (mm2) (SA26)
Fig. 2. Radiographic assessments. Images of the coronal planes representing the most central aspect of t...
Fig. 1. Lateral ridge augmentation—a surgical procedure in the AB and TR groups. a The retromolar area served as a donor site for the harvesting of monocortical bone blocks in the AB group. b AB blocks were shaped to match the size and configuration of the defect site and fixed using one central osteosynthesis screw. c TR grafts were separated from either partially/fully retain...
CWb
GT
SA26
BI26
a) TR group (n = 15 patients)
Mean
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Visit 1
Visit 2
Visit 3
Visit 4
Visit 5
Visit 6
...
Parvini, P., Sader, R., Sahin, D. et al. Radiographic outcomes following lateral alveolar ridge augmentation using autogenous tooth roots.
Int J Implant Dent 4, 31 (2018). https://doi.org/10.1186/s40729-018-0142-6
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Received: 11 July 2018
Accepted: 17 August 2018
Published: 28 September 2018
DOI: https://doi.org/10.1186/s40729-018-0142-6
Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were m...
The study protocol was approved by the ethics committee (4837R) of the Heinrich Heine University, Düsseldorf, Germany, and registered via the Internet Portal of the German Clinical Trials Register (DRKS00009586). Each patient was given a detailed description of the study procedures and signed a consent to participate.
Consent for publication was obtained from all participants.
Puria Parvini, Ro...
Department of Oral Surgery and Implantology, Carolinum, Johann Wolfgang Goethe-University, Frankfurt, Germany
Puria Parvini & Frank Schwarz
Department for Oral, Cranio-Maxillofacial and Facial Plastic Surgery, Medical Center of the Goethe University Frankfurt, Frankfurt, Germany
Robert Sader
Department of Oral Surgery, Universitätsklinikum Düsseldorf, Düsseldorf, Germany
Didem Sahin, J...
Sanz-Sanchez I, Ortiz-Vigon A, Sanz-Martin I, Figuero E, Sanz M. Effectiveness of lateral bone augmentation on the alveolar crest dimension: a systematic review and meta-analysis. J Dent Res. 2015;94(9 Suppl):128–42.
Burchardt H. The biology of bone graft repair. Clin Orthop Relat Res. 1983;174:28–42.
Burchardt H, Enneking WF. Transplantation of bone. Surg Clin North Am. 1978;58(2):403–27....
In conclusion and within its limitations, the present clinical study revealed that TR grafts may be associated with improved SA26 values following lateral alveolar ridge augmentation.
When further analyzing the present data, it was also noted that both TR and AB grafts were associated with comparable BI26 values, thus corroborating the clinical observation of a firm graft connection to the host bone at 26 weeks, which allowed for a proper placement of adequately dimensioned titanium implants at all sites investigated [9]. The regression analysis also revealed that BI26 values ...
The present analysis aimed at assessing and comparing CBCT outcomes following lateral alveolar ridge augmentation using TR and AB grafts. After a healing period of 26 weeks, it was observed that TR grafts were associated with significantly higher mean SA26 values when compared with the AB group. A similar tendency was also noted for mean BI26 values; however, this difference did not reach statist...
Mean CWb and GT values were comparable in both groups and amounted to 4.53 ± 1.54 mm (median 4.50; 95% CI 3.68, 5.38) and 5.66 ± 1.75 mm (median 5.0; 95% CI 4.69, 6.64) in the TR group and 5.26 ± 1.25 mm (median 5.00; 95% CI 4.57, 5.95) and 4.96 ± 1.75 mm (median 5.0; 95% CI 4.24, 5.68) in the AB group, respectively. Between-group differences did not reach statistical signi...
All measurements were performed by one previously calibrated investigator.
The sample size calculation considered a standard normal distribution (type I error set at .05; type II error set at .20) and a sigma which was estimated based on the standard deviations observed in a recent preclinical animal study [4]. The clinical width of the alveolar ridge was defined as the primary outcome variable, ...
Each patient was given a detailed description of the study procedures and signed a consent to participate. The study protocol was approved by the ethics committee (4837R) of the Heinrich Heine University, Düsseldorf, Germany, and registered via the Internet Portal of the German Clinical Trials Register (DRKS00009586).
The present reporting considered the checklist items as proposed in the STROBE...
This analysis was based on the radiographic (i.e., cone-beam computed tomographic—CBCT) data derived from a prospective controlled clinical monocenter study including a total of 30 patients [9]. Each participant exhibited either a tooth gap or a free-end situation with an inadequate horizontal ridge width and was in need of an implant-supported fixed restoration.
In brief, lateral ridge augment...
Autogenous bone (AB) blocks harvested from intraoral donor sites (i.e., retromandibular, chin) are the most commonly used procedure for lateral alveolar ridge augmentation [1]. However, despite significant horizontal bone gains, cortical bone blocks were noted to undergo an incomplete replacement resorption [2, 3], thus featuring a composition of non-vital residual and newly formed vital bone in t...
To assess and compare the radiographic outcomes following lateral alveolar ridge augmentation using autogenous tooth roots (TR) and autogenous bone (AB) blocks.
In a total of 30 patients, lateral ridge augmentation was conducted in parallel groups using either (1) healthy autogenous tooth roots (e.g., retained wisdom or impacted teeth) (n = 15) or (2) cortical autogenous bone blocks harvested...
5 CONCLUSION
This open cohort, retrospective study evaluated risk indicators associated with marginal bone loss (MBL) through the analysis of 4,591 dental implants, of various designs, placed in private practice and followed‐up for 5 to 10 years. Significant risk indicators for bone loss were found to include autoimmune disease, heavy smoking, bisphosphonate therapy, implant location, diamete...
In this study, prevalence of mucositis varied from nearly 50% of patients using a “strict” BOP threshold (IMI ≥1) (49.5%) compared with 18.2% if using the “relaxed” IMI threshold (IMI ≥2) (see supplementary Tables 3 and 4 in online Journal of Periodontology).
As the implants used in the current study were either platform shift or 1‐stage design 3 mm and BOP+ but no co...
This is in support of systematic reviews of ridge augmentation that often show some loss of grafted bone volume and furthermore, it has been speculated that although the bone graft at time of placement may provide stable hard tissue, the basal bone may be the actual bone that is integrated to the implant.
4.1 Effect of threshold selection on reported prevalence of peri‐implantitis
The choi...
However, the one‐stage tapered effect (TE) design was found to have increased initial MBL at base line (stage 2) (Figure 2C). For the TE design, the increased early MBL may be related to bone compression and a learning curve associated with placement of tapered implants. Two stage platform switch implants typically have bone loss of about 0.5 mm. For the bone level platform shift design, the...
The posterior mandible and posterior maxilla had equivalent crestal bone levels at the start but then the rate of MBL in the posterior maxilla was found to increase at a faster rate when compared with other locations (Figure 2A). This may be a result of crestal compression in lower density bone leading to MBL as described in finite element analysis. Indeed it was noted that about 6% of sites h...
This is a unique finding in the literature and may reflect altered remodeling potential of bone, or it may also be the effect of a few outlier cases where sudden MBL was noted in some but not all bisphosphonate cases. Conclusions drawn are limited however as the duration or dose of bisphosphonate therapy was not recorded in this study.
Interestingly, diabetes (pooled type 1 and type 2) was not ...
DISCUSSION
An analysis of risk indicators for changes in crestal bone level, as a measure of bone loss (MBL), surrounding dental implants has been reported in this study. Furthermore, the impact of the choice of thresholds in determining prevalence of mucositis and peri‐implantitis has been considered. Importantly, this private practice report includes conventional patients and sites as well ...
3.3.3 Implant design
Pairwise comparisons for CBL at the start between the four implant design groups revealed a similarity between standard and standard plus implants as well as between bone level and tapered effect implants (Figure 2C). However, a significant difference (P value
3.1 Risk indicators for bone loss (MBL)
All potential factors and related correlations were evaluated. Table 1 shows only variables that related significantly to changes in CBL over time in a multivariate model. Figures 1 through 3 illustrate the results of Table 1. The “start” refers to baseline at 3 months).
3.2 Patient‐related risk indicators
No significant effect on CBL was observ...
RESULTS
The study cohort of 2,060 patients and 4,591 implants was followed for up to 133 months, with a mean of 32.2 ± 26.8 months. The number of implants for each time period was; n = 2,372 at 2 to 3 years, n = 1,178 at 4 to 5 years, and n = 560 at 6 to 10 years. There were 32 implant failures resulting in cumulative survival rates of 99.3%, 99.0%, and 98.4% at 3, 5, and 7 years, respectively, ...
Mucositis was determined using either the “strict” criteria, IMI ≥1, as an indication for mucositis or the “relaxed” criteria, IMI ≥2, as an indication of mucositis. We defined peri‐implantitis as the combination of mucositis and MBL ≥1.0 mm, at least 1 year after installation.
2.1 Statistical analysis
CBL and MBL are scale variables and have been summarized by calculating the m...
Radiographs were taken and evaluated by the same examiner that placed the implants (DF). For each case the real implant length served as the calibration value to derive the Distance from Implant shoulder to the first Bone to implant contact (DIB). CBL was defined as DIB minus the neck length (NL) of an implant with the following standardization values to account for different implant neck designs...
MATERIALS AND METHODS
A description of the study cohort presenting explanatory variables and univariate and multivariate implant survival analysis has been previously published. Details on recall and follow up are further described in a companion paper. In brief, this was a retrospective study consisting of 2,060 patients with an initial total of 4,591 implants. All implants were placed between...
INTRODUCTION
Although dental implants have been reported to have fairly high survival rates of 95.7% at 5 years and 92.8% at 10‐years, it is also known that progressive marginal bone loss and peri‐implantitis remain a significant potential complication. The 2012 European academy of osseointegration (EAO) consensus report estimated the prevalence of peri‐implantitis to be at 10% of implants ...
Retrospective cohort study of 4,591 dental implants: Analysis of risk indicators for bone loss and prevalence of peri‐implant mucositis and peri‐implantitis
Abstract
Background
Due to the risk of peri‐implantitis, following dental implant placement, this study aimed to evaluate risk indicators associated with marginal bone loss from a retrospective open cohort study of 4,591 denta...
Figure 45. Radiographic height reduction
The mean crestal height change as assessed on the radiographs was 1.53 mm.
Figure 44. Mean height reduction
The mean reduction in height was approximately 1.7 mm.
Figure 43. Mean width reduction
The weighted means showed that the clinical loss in width is greater than the loss in height. The mean reduction in width of the alveolar ridge was calculated to be approximately 4 mm.
Figure 42. Dimensional change in alveolar bone
A recent systematic review evaluated the amount of change in height and width of the residual ridge after tooth extraction.
Figure 38. Reduction in dimension
This reduction occurs in both the horizontal and the vertical dimension, and as a result the arch is shortened. The amount of tissue atrophy following the loss of a single tooth can be substantial and is variable between different teeth and areas of the alveolar process.
Figure 37. Alveolar atrophy
Following multiple- or single-tooth extraction and the subsequent loss of masticatory function, the alveolar ridge will present a series of adaptive alterations known as alveolar atrophy. The alveolar atrophy is characterized by a reduction in the dimensions of the alveolar ridge that is a combination of hard and soft tissue changes.
Figure 20. Ridge of edentulous site
The outer walls of the alveolar ridge consist of cortical bone. The buccal bone plate is comparatively thinner than the lingual or palatal plate. The cortical plates enclose trabecular bone that consists of bony trabeculae and marrow. As a rule, the ridge of an edentulous site in the maxilla contains comparatively more trabecular bone than a site in the man...
Figure 19. Bone resorption forms alveolar ridge
The term alveolar ridge refers to the alveolar bone following loss of teeth. After a tooth is extracted, the alveolar process heals with formation of bone within the socket and external resorption or shrinkage of the bone, forming the alveolar ridge.
Figure 16. Macroanatomy of alveolar process
This image shows a cross section of the maxillary alveolar process at the mid-root level of the teeth. The bone between the roots of a tooth is called interradicular bone or interradicular septum. The bone between the roots of adjacent teeth is called interdental bone or interdental septum. Trabecular bone occupies most of the interdental bone. The ...
Figure 14. Cortical bone
The cortical bone is comprised of functional units called osteons that consist of concentric lamellae and canaliculi surrounding a central Haversian canal.
Figure 13. Cortical plate
The cortical plates of the supporting bone are continuous with the alveolar bone proper lining the tooth sockets. The cortical plates are thicker in the mandible than in the maxilla, and they are thickest in the molar and premolar regions of the mandible.
Figure 10. Alveolar bone proper
The gross anatomic term is alveolar bone proper, which is synonymous with the term cribriform plate, so-called because it is perforated by many minute openings for vascular and nervous components.
Figure 9. Alveolar bone proper
The histologic term for alveolar bone proper is bundle bone. In histologic sections, the alveolar bone proper appears as a thin lamella of cortical bone lined with bundle bone. Extrinsic collagen fiber bundles of the periodontal ligament known as Sharpey's fibers are embedded into the bundle bone. Their purpose is to connect the bundle bone with the root cementu...
Figure 11. Attachment apparatus
As shown in this histologic section, bundle bone, periodontal ligament, and cementum form an anatomic unit. When a tooth is extracted, the cementum and much of the periodontal ligament are removed. The bundle bone resorbs after tooth extraction.
Figure 9. Lamina dura
The radiographic term for alveolar bone proper is lamina dura. This structure appears more dense than adjacent bone on radiographs. Widening or disruption of the lamina dura may indicate periodontal pathology.
Figure 8. Different terms for the alveolar bone proper
There are several different terms used to describe the alveolar bone proper.
The gross anatomic term is alveolar bone proper, which is synonymous with the term cribriform plate, so-called because it is perforated by many minute openings for vascular and nervous components.
The histologic term is bundle bone. In histologic sections, the ...
Figure 7. Parts of lveolar process
The alveolar process, as previously mentioned, is composed of two parts, the alveolar bone proper and the supporting bone. The alveolar bone proper is the bone that lines the socket of a tooth. The function of the alveolar bone proper, together with the root cementum and the periodontal ligament, is to form the attachment apparatus of the tooth.
Figure 6. Tooth-dependent structure
The alveolar process contains the roots of the teeth and developing tooth buds of unerupted teeth. It is a tooth-dependent part of the jaws, since it forms in response to the development and eruption of the teeth. Its final volume and shape are determined by the form of the teeth, their axis of eruption, and their eventual inclination.
Figure 5. Forming alveolar ridge
After a tooth is extracted, the alveolar process heals with formation of bone within the socket and external resorption or shrinkage of the bone, forming the alveolar ridge.
Figure 4. Alveolar process
The bone that supports teeth in the maxilla and mandible may be divided into two parts. As can be seen in this diagram of the mandible, the part that contains the roots of the teeth and developing tooth buds of unerupted teeth is known as the alveolar process, or alveolar bone. The bone of the alveolar process is continuous with the second part, the basal bone of th...
Figure 3. Alveolar ridge
The outcome of this resorption is most often a significant modification of the pre-extraction outline of the alveolar ridge, which may present a problem for later prosthetic reconstruction. For this reason, a knowledge of the healing events following tooth extraction is essential for appropriate prosthodontically driven implant treatment planning. This...
BMP-2/ACS7
bone morphogenetic protein 2/ absorbable collagen sponge 7, protein morfogenetik tulang 2/ spons kolagen terabsorbsi 7
CAD/CAM
computer-aided design/computer-aided manufacturing, desain terbantu komputer/ manufaktur terbantu komputer
CBCT
cone beam computerized tomography, tomografi terkomputerisasi cahya kerucut
CBR
customized bone...
Simpulan
Laporan kasus ini menyajikan struktur kisi titanium tersesuai baru yang spesifik pasien, yang cocok untuk membentuk dan membangun kembali tulang cacat dalam situasi anatomi yang kompleks. Hasil klinis dan histologis menunjukkan protokol ini sebagai prosedur yang berhasil dan dapat diprediksi untuk membangun kembali tulang cacat yang menderita atrofi. Penelitian lebih lanjut diperlukan un...
Wedharan
Dalam laporan kasus ini, struktur kisi tersesuai spesifik pasien digunakan untuk augmentasi horizontal dan vertikal pada rahang bawah posterior. Struktur itu menawarkan kecocokan yang persis pas dan stabilitas yang tinggi setelah fiksasi sekrup seperti yang telah terbukti dalam penelitian terbaru untuk jala-jala yang telah dibentuk dulu sebelumnya. Jala yang tersesuai memperpendek durasi...
Weton
Sesuai permintaan pasien, penutupan celah interdental diperlukan untuk meningkatkan weton kosmetik dan fungsional. Oleh karena itu, penempatan implant diperlukan. Pilihan perawatan alternatif seperti prostetik konvensional (jembatan #27 sampai #30 dan #31) harus berurusan dengan berbagai macam stabilitas mekanik dan dapat membuat berkurangnya stabilitas mekanik. Dalam kasus ini, gigi poster...
Bahan dan Metode
Peserta
Seorang wanita saras berusia 61 tahun tanpa sejarah medis menunjukkan segmen yang sangat atrofi dari mandibula posterior kanan bawah (# 29 dan # 28). Defisit vertikal dan transversal yang signifikan, serta situasi jaringan lunak yang menantang, membuat penempatan implant yang fungsional dan estetis tidak bisa dilakukan (Gambar 1 dan 2).
Gambar 1. Tampilan klinis cacat...
Pendahuluan
Untuk beberapa pasien, implan gigi bukan pilihan jika tanpa augmentasi tulang horizontal atau tulang vertikal. Cacat tulang alveolar dapat dirawat dengan berbagai teknik regenerasi tulang termasuk cangkok tulang blok, regenerasi tulang terpandu (GBR), pemisahan punggungan gusi, dan osteogenesis gangguan, serta prosedur augmentasi dasar sinus di rahang atas.
Jala titanium sudah banyak...
Marcus Seiler, DDS1; Peer W. Kämmerer, MD, DDS, PhD, MA2; Michael Peetz, PhD3; Amely G. Hartmann, DDS1
1 Department of Oral and Maxillofacial Surgery, Private Practice, Filderstadt, Jerman.
2 Department of Oral and Maxillofacial Surgery, University Medical Center of the Johannes Gutenberg University, Mainz, Jerman.
3 Dental Campus, Zürich, Swiss.
Korespondensi:
* P...
References
Misch CM. Comparison of intraoral donor sites for onlay grafting prior to implant placement. Int J Oral Maxillofac Implants. 1997;12:767–776.
Hammerle CH, Karring T. Guided bone regeneration at oral implant sites. Periodontology 2000. 1998;17:151–175.
Simion M, Baldoni M, Zaffe D. Jawbone enlargement using immediate implant placement associated with a split-crest techniq...
Acknowledgments
The authors thank patients, nurses, and physicians for their support with patients' material and reports. Moreover, the authors thank all of our colleagues for helpful discussions. The authors thank Prof Dr Christoph Hämmerle, University of Zürich, for histologic examinations.
The authors declare that they have no competing interests. M.S. developed the methodology (owner of pa...
BMP-2/ACS7
bone morphogenetic protein 2/ absorbable collagen sponge 7
CAD/CAM
computer-aided design/computer-aided manufacturing
CBCT
cone beam computerized tomography
CBR
customized bone regeneration
DICOM
digital imaging and communication in medicine
GBR
guided bone regeneration
3DP
three-dimensional printing
Conclusion
This case report presents a novel patient-specific customized lattice structure made of titanium, which is suitable for shaping and rebuilding a bone defect in complex anatomic situations. Clinical and histologic results demonstrated this protocol as a successful and predictable procedure for rebuilding an atrophied bone defect. Further studies are needed to evaluate the effects and be...
Discussion
In this case report, a customized patient-specific lattice structure was used for horizontal and vertical augmentation in the posterior mandible. It offered a precise fit and high stability after screw fixation as already proven in recent studies for preformed meshes. A customized mesh shortens duration of surgery and offers all benefits of reduced time for intervention and improved su...
Results
According to the patient's request, a closure of the interdental gap was necessary to improve the cosmetic and functional outcome. Therefore, an implant placement was required. Alternative treatment options such as conventional prosthetics (bridge #27 to #30 and #31) would have to deal with a wide range and may result in reduced mechanical stability. In this case, the posterior teeth (#30...
Materials and Methods
Participant
A 61-year-old healthy woman without any medical history showed a highly atrophied segment of the right lower posterior mandible (#29 and #28). The significant vertical and transversal deficit, as well as the challenging soft tissue situation, made a functionally and esthetically satisfying implant placement impossible (Figures 1 and 2).
Figure 1. Clinical app...
Introduction
For some patients, dental implants would not be an option without horizontal or vertical bone augmentation. Alveolar bone defects may be treated with various bone regeneration techniques including block bone graft, guided bone regeneration (GBR), ridge splitting, and distraction osteogenesis, as well as sinus floor augmentation procedures in the upper jaw.
Titanium meshes have been...
Marcus Seiler, DDS1; Peer W. Kämmerer, MD, DDS, PhD, MA2; Michael Peetz, PhD3; Amely G. Hartmann, DDS1
1 Department of Oral and Maxillofacial Surgery, Private Practice, Filderstadt, Germany.
2 Department of Oral and Maxillofacial Surgery, University Medical Center of the Johannes Gutenberg University, Mainz, Germany.
3 Dental Campus, Zürich, Switzerland.
Correspondence:...
Lateralisasi saraf alveolar inferior adalah teknik baru. Dalam literatur implantologi, teknik tersebut adalah teknik lateralisasi total bisa dipakai dalam bidang prostesis gigi, misalnya untuk menangani perkara ompong rahang bawah posterior ketika tulang alveolar mengalami penyusutan dan prostesis menekan saraf di daerah foramen.
Teknik lateralisasi saraf alveolar inferior bisa pula dipakai dal...
Pemasangan implant gigi pada rahang bawah posterior dengan resorpsi yang parah bisa menimbulkan kerusakan pada saraf alveolar inferior. Teknik reposisi saraf telah dipakai untuk menciptakan peluang agar pemasangan implant gigi dengan panjang yang memadai bisa sukses dalam kasus semacam ini. Dalam kasus punggungan mandibula posterior atrofi, teknik reposisi saraf alveolar inferior jadi alternatif ...
Anatomi jalur saraf alveolar inferior sangat penting bagi dokter gigi, dokter saraf, radiolog, dan patolog guna membantu diagnosis, penanganan, perencanaan bedah, dan penerapan anestesia lokal. Demikian disampaikan oleh Polland et al. dalam penelitiannya pada tahun 2001.
Kerusakan saraf alveolar inferior menghasilkan dampak yang negatif pada kualitas sensibilitas fasial dan kemampuan pasien unt...
Tulang alveolar adalah bagian dari rayang yang membentuk dan melindungi soket gigi. Gigi bukanlah apa-apa bila tanpa keberadaan tulang alveolar, sebegitu pentingnya tulang alveolar itu. Bagian ini adalah bagian yang menebal dari ridge rahang. Tulang alveolar terdiri dari:Tulang alveolar rahang atas (maksila)Tulang alveolar rahang atas adalah ridge yang ada pada permukaan superior.Tulang alveola...