Fig. 7. Orthopantomograph 2Â years after implant placement
Fig. 6. Clinical picture 2Â years after implant placement
Fig. 6. Clinical picture 2Â 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
Download citation
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
You can also search for this author in PubMed Google S...
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 1Â year
Fig. 18. Finalized prosthetic restoration after 1Â 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, 1Â year post-implantation, showing the finalized crown
Fig. 16. Single tooth X-ray, 1Â year post-implantation, showing the finalized crown
Fig. 15. Single tooth X-ray, showing a constant bone level 7Â months after implant placement
Fig. 15. Single tooth X-ray, showing a constant bone level 7Â 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
Download citation
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 65Â 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
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 OdontologÃa, 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 4.12Â 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 3Â 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 EECsâ€...
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
Download citation
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
You can also search for this author in
...
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
Download citation
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 65Â 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 15Â weeks after bone augmentation, the dehiscence healed 2Â 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 OdontologÃa, 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 4.12Â 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 3Â 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 EECsâ€...
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 26Â weeks. a, b TR graft. c, d AB graft
Fig. 3. Representative CBCT outcomes at 26Â 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...
Â
CWb
GT
SA26
BI26
a) TR group (n = 15 patients)
 Mean
...
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
Download citation
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, JÃ...
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 26Â 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 26Â 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...
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.Â
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 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...