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Ghambaryan N, Yessayan L, Hakobyan G. Long-term effectiveness of UV functionalised short (≤ 6 mm) dental implants placed in the posterior segments of the atrophied maxilla: controlled case series. Odontology 2024; 112:1316-1325. [PMID: 38526626 DOI: 10.1007/s10266-024-00926-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2023] [Accepted: 03/01/2024] [Indexed: 03/27/2024]
Abstract
This study evaluated long-term effectiveness UV functionalised short implants (≤ 6 mm) placed in the posterior segments of the atrophied maxilla. The study included 47 patients from 2018 to 2023 (aged 27 to 56 years, 24 women and 23 men) without any systemic diseases, with unilateral/bilateral missing teeth and vertical atrophy of the posterior maxillary area. Total installed were 64 short UV-functionalized implants and 62 standard implants over 10 mm in length in segments maxilla with sufficient bone parameters. Clinical, laboratory and cone beam computed tomography (CBCT) methods were used to plan implant therapy. The clinical indices included the following parameters: ISQ, MBL, OHIP-G scale. For short implants, the median ISQ at placement was 62.2 for primary stability and the median ISQ at 5 months was 69.6 ISQ. For standard implant, the mean ISQ at placement was 64.3 ISQ, and ISQ after 5 months was 71.6 ISQ. After 6 months mean MBL short implants 0.87 mm, after 1 year 1.13 mm, after 5 years was 1.48 mm. After 6 months mean MBL standard implants 0.84 mm, after 1 year 1.24 mm, after 5 years was 1.58 mm. Mean OHIP-G scores-patients satisfaction with the implant at 4.8 ± 0.3, satisfaction with the operation 4.6 ± 0.4; satisfaction with prosthetics 4.7 ± 0.5. Cumulative success rate 5 years short implants was 96.7%, standard implants was 97.4%, and prosthesis cumulative survival rate was 97.2%. Short ultraviolet functionalized implants used in the posterior resorbed segment of maxilla have been shown to be a reliable alternative to sinus lift, demonstrating fewer complications, reduction in the number of additional surgical interventions and showed satisfactory long-term survival.
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Affiliation(s)
- Naira Ghambaryan
- Department of Surgical Stomatology and Maxillofacial Surgery, Yerevan State Medical University After M. Heratsi, Yerevan, Armenia
| | - Lazar Yessayan
- Department of Therapeutic Stomatology, Yerevan State Medical University. M. Heratsi, Yerevan, Armenia
| | - Gagik Hakobyan
- Department of Surgical Stomatology and Maxillofacial Surgery, Yerevan State Medical University After M. Heratsi, Yerevan, Armenia.
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Moussa AK, Shawky M, Aly LAA, Mounir M, Esmael WF. Assessment of bone gain and neurosensory affection with the sandwich osteotomy technique for vertically deficient posterior mandible using a full digital workflow versus conventional protocol: A randomized split mouth study. Clin Implant Dent Relat Res 2024; 26:621-630. [PMID: 38556885 DOI: 10.1111/cid.13324] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2023] [Revised: 03/14/2024] [Accepted: 03/14/2024] [Indexed: 04/02/2024]
Abstract
BACKGROUND Using the sandwich osteotomy technique in the posterior mandible is delicate. This study aimed to assess the safety and the amount of bone gain using a full digital workflow versus the conventional procedure. PATIENTS AND METHODS This split mouth study included 10 patients with bilateral vertically deficient posterior mandible. One side received conventional sandwich interpositional bone grafting (control group), while the other side received the same protocol using two patient-specific guides. The first guide (cutting guide) was used to place the osteotomies safely and accurately according to the predetermined dimensions and locations, and the second guide was used to fix the mobilized bony segment, leaving the desired gap to be filled with a particulate xenogenic bone graft. RESULTS Full neurosensory recovery was documented at 2 months postoperative for all patients and bilaterally. After 4 months, there was a statistically significant difference in vertical bone gain between both groups (p = 0.001), measuring an average of 3.76 ± 0.72 mm in the study group and 2.69 ± 0.37 mm in the control group. No statistically significant difference was found between the planned vertical augmentation (3.85 ± 0.58 mm) and the obtained vertical bone gain (3.76 ± 0.72 mm) in the study group (p = 0.765) proving the accuracy of the guided procedure. CONCLUSION Computer-guided sandwich interpositional grafting is predictable regarding the execution of the osteotomies and the accuracy of fixation of the transport segment.
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Affiliation(s)
- Ahmed K Moussa
- Oral and Maxillofacial Surgery Division, School of Dentistry, New Giza University, Giza, Egypt
| | - Mohamed Shawky
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Cairo University, Cairo, Egypt
| | - Lobna Abdel Aziz Aly
- Department of Oral and Maxillofacial Surgery, Faculty of Oral and Dental Medicine, Future University in Egypt, Cairo, Egypt
| | - Mohamed Mounir
- Oral and Maxillofacial Surgery Division, School of Dentistry, New Giza University, Giza, Egypt
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Cairo University, Cairo, Egypt
| | - Waleed F Esmael
- Department of Oral and Maxillofacial Surgery, Faculty of Oral and Dental Medicine, Future University in Egypt, Cairo, Egypt
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Theologie-Lygidakis N, Kamperos G, Pavli M, Christopoulos P, Tzermpos F, Tsiklakis K, Iatrou I. Mandibular Distraction Osteogenesis in Children and Adolescents: A Clinical and Radiographic Research Using Cone-Beam Computed Tomography. J Craniofac Surg 2024; 35:1163-1169. [PMID: 38376164 DOI: 10.1097/scs.0000000000010044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2023] [Accepted: 01/08/2024] [Indexed: 02/21/2024] Open
Abstract
AIM The aim of this cross-sectional study was to evaluate, via cone-beam computed tomography, the long-term postoperative outcome in children treated with mandibular distraction osteogenesis. MATERIALS AND METHODS All young patients treated with mandibular distraction osteogenesis (MDO), during a 16-year period, at the University Department of Oral and Maxillofacial Surgery of a Pediatric Hospital, were recalled, and various clinical and radiographic parameters were recorded. RESULTS Eleven patients were included: 5 with hemifacial microsomia (HFM) and 6 with mandibular micrognathia. In all cases, MDO had been successful in regular follow-up and decannulation, soon after MDO, was achieved in all tracheostomy cases. The long-term result in cases of HFM was found stable, functionally and esthetically accepted, although less satisfactory than in regular follow-up; in micrognathia patients, relapse of different degrees was registered in 4 of 6 cases, without any need for tracheostomy though. Detailed and accurate information was obtained by cone-beam computed tomography (CBCT). The shape of the regenerated bone was irregular in HFM cases and relatively normal in the micrognathia cases. Quality of the regenerated bone was normal in all patients. The irregular shape registered in HFM cases did not compromise a safe orthognathic operation. CONCLUSIONS Distraction osteogenesis remains an early treatment choice in cases of mandibular deformities. Long-term findings showed that there is a degree of relapse with growth, which was more obvious in mandibular micrognathia cases. Computed tomography contributes to detailed evaluation of changes at the distraction site.
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Affiliation(s)
- Nadia Theologie-Lygidakis
- Department of Oral and Maxillofacial Surgery, School of Dentistry, National and Kapodistrian University of Athens, and "P. & A. Kyriakou" Children's Hospital
| | - Georgios Kamperos
- Department of Oral and Maxillofacial Surgery, School of Dentistry, National and Kapodistrian University of Athens
| | - Maria Pavli
- Department of Oral and Maxillofacial Surgery, School of Dentistry, National and Kapodistrian University of Athens
| | - Panos Christopoulos
- Department of Oral and Maxillofacial Surgery, School of Dentistry, National and Kapodistrian University of Athens
| | - Fotios Tzermpos
- Department of Oral and Maxillofacial Surgery, School of Dentistry, National and Kapodistrian University of Athens
| | - Kostas Tsiklakis
- Department of Oral Diagnosis and Radiology, School of Dentistry, National and Kapodistrian University of Athens, Athens, Greece
| | - Ioannis Iatrou
- Department of Oral and Maxillofacial Surgery, School of Dentistry, National and Kapodistrian University of Athens
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Cucchi A, Maiani F, Franceschi D, Sassano M, Fiorino A, Urban IA, Corinaldesi G. The influence of vertical ridge augmentation techniques on peri-implant bone loss: A systematic review and meta-analysis. Clin Implant Dent Relat Res 2024; 26:15-65. [PMID: 38114425 DOI: 10.1111/cid.13282] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Revised: 08/09/2023] [Accepted: 09/12/2023] [Indexed: 12/21/2023]
Abstract
INTRODUCTION The primary aim of this systematic review was to investigate and compare the outcomes of different vertical ridge augmentation (VRA) techniques in relation to peri-implant bone loss (PBL), after at least 12 months of functional loading. MATERIAL AND METHODS The search was conducted to find all the studies about VRA and measurements of PBL with at least 12 months follow-up. Three pairwise meta-analysis (MA) was performed to completely evaluate the outcomes. RESULTS A total of 42 studies were included, of which 11 were randomized clinical trials (RCTs). RCTs were available only for guided bone regeneration (GBR), onlay, and inlay techniques. The weighted mean estimate (WME) of PBL value was found to be 1.38 mm (95% confidence interval [95% CI]: 1.10-1.66) after a mean follow-up of 41.0 ± 27.8 months. GBR, Inlay, Onlay, osteodistraction, and SBB represented in weight 32.9%, 30.6%, 25.0%, 7.6%, and 3.9%, respectively; and their WME (95% CI) were 1.06 (0.87-1.26) mm, 1.72 (1.00-2.43) mm, 1.31 (0.87-1.75) mm, 1.81 (0.87-1.75) mm, and 0.66 (0.55-0.77) mm, respectively. Among the secondary outcomes, the analysis was conducted for vertical bone gain, healing complication rate, surgical complication rate, implant survival, and success rate. CONCLUSIONS The primary findings of the meta-analysis, based on the changes between final and baseline values, showed that the peri-implant bone loss could be influenced by the type of intervention but there is a need to evaluate in RCTs the behavior of the peri-implant bone levels after long-term follow-up for all techniques.
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Affiliation(s)
| | | | - Debora Franceschi
- Department of Experimental and Clinic Medicine, University of Florence, Firenze, Italy
| | - Michele Sassano
- Department of Life Sciences and Public Health, Catholic University of The Sacred Heart, Rome, Italy
| | - Antonino Fiorino
- Department of Neuroscience and Reproductive and Odontostomatological Sciences, "Federico II" University of Naples, Napoli, Italy
| | - Istvan A Urban
- Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, Michigan, USA
- Department of Periodontics, University of Szeged, Szeged, Hungary
- Urban Regeneration Institute, Budapest, Hungary
| | - Giuseppe Corinaldesi
- Department of Biomedical and Neuromotor Sciences (DIBINEM), University of Bologna, Bologna, Italy
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Wu J, Wang P, Yin Y, Liang J, Fan Y, Zhang X, Han X, Sun Y. Cationic Biopolymeric Scaffold of Chelating Nanohydroxyapatite Self-Regulates Intraoral Microenvironment for Periodontal Bone Regeneration. ACS APPLIED MATERIALS & INTERFACES 2023; 15:55409-55422. [PMID: 37942935 DOI: 10.1021/acsami.3c13047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/10/2023]
Abstract
Periodontal bone defect is a common but longstanding healthcare issue since traditional bone grafts have limited functionalities in regulating complex intraoral microenvironments. Here, a porous cationic biopolymeric scaffold (CSC-g-nHAp) with microenvironment self-regulating ability was synthesized by chitosan-catechol chelating the Ca2+ of nanohydroxyapatite and bonding type I collagen. Chitosan-catechol's inherent antibacterial and antioxidant abilities endowed this scaffold with desirable abilities to eliminate periodontal pathogen infection and maintain homeostatic balances between free radical generation and elimination. Meanwhile, this scaffold promoted rat bone marrow stromal cells' osteogenic differentiation and achieved significant ectopic mineralization after 4 weeks of subcutaneous implantation in nude mice. Moreover, after 8 weeks of implantation in the rat critical-sized periodontal bone defect model, CSC-g-nHAp conferred 5.5-fold greater alveolar bone regeneration than the untreated group. This cationic biopolymeric scaffold could regulate the local microenvironment through the synergistic effects of its antibacterial, antioxidant, and osteoconductive activities to promote solid periodontal bone regeneration.
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Affiliation(s)
- Jingwen Wu
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
| | - Peilei Wang
- National Engineering Research Center for Biomaterials, Sichuan University, Chengdu 610064, China
- College of Biomedical Engineering, Sichuan University, Chengdu 610064, China
| | - Yijia Yin
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
| | - Jie Liang
- National Engineering Research Center for Biomaterials, Sichuan University, Chengdu 610064, China
- College of Biomedical Engineering, Sichuan University, Chengdu 610064, China
- Sichuan Testing Center for Biomaterials and Medical Devices, Sichuan University, 29 Wangjiang Road, Chengdu 610064, P. R. China
| | - Yujiang Fan
- National Engineering Research Center for Biomaterials, Sichuan University, Chengdu 610064, China
- College of Biomedical Engineering, Sichuan University, Chengdu 610064, China
| | - Xingdong Zhang
- National Engineering Research Center for Biomaterials, Sichuan University, Chengdu 610064, China
- College of Biomedical Engineering, Sichuan University, Chengdu 610064, China
| | - Xianglong Han
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
| | - Yong Sun
- National Engineering Research Center for Biomaterials, Sichuan University, Chengdu 610064, China
- College of Biomedical Engineering, Sichuan University, Chengdu 610064, China
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Vardić A, Puljak L, Galić T, Viskić J, Kuliš E, Poklepović Peričić T. Heterogeneity of outcomes in randomized controlled trials on implant prosthodontic therapy is hindering comparative effectiveness research: meta-research study. BMC Oral Health 2023; 23:908. [PMID: 37993826 PMCID: PMC10666438 DOI: 10.1186/s12903-023-03658-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2023] [Accepted: 11/12/2023] [Indexed: 11/24/2023] Open
Abstract
BACKGROUND Consistency in outcomes across clinical trials allows for comparing and combining results from different studies. A core outcome set (COS), representing a minimally agreed standardized group of outcomes that should be monitored and measured through research in a specific field of medicine, is not yet available for trials in implant prosthodontic (dental implant) therapy. This meta-research study aimed to analyze outcomes used in clinical trials on implant prosthodontic therapy. METHODS We searched the Cochrane Oral Health Group (COHG) register to identify systematic reviews of interventions in implant prosthodontic therapy published by October 2023. From the randomized controlled trials (RCTs) included in the relevant reviews, we extracted data on the characteristics of the included trials and the outcomes used. We categorized outcomes into domains. RESULTS From 182 systematic reviews in the COHG register, we included 11 systematic reviews on dental implant therapy. The reviews included 117 unique RCTs with 4725 participants, published from 1995 to 2020, which analyzed 74 different outcomes. Using different definitions, implant failure was analyzed in 73 RCTs. Seventeen RCTs did not define implant failure. Failure was most often (30 RCTs) followed up for one year. Only one RCT assessed implant failure after five years. Trials used 17 definitions of implant failure, while 17 trials did not report on the criteria of implant failure. Complications were analyzed in 48 RCTs, although they were not clearly defined in 12 RCTs. Failure of prosthodontic supra-structure was analyzed in 74 RCTs, with definitions of failure and criteria not clearly defined in 44 RCTs. Trials considered adverse events, peri-implant tissue health, patient attitudes, and other outcomes, including cost, aesthetics, or procedure duration. These outcomes were often different between trials. Twenty-six outcomes were used only once per study. CONCLUSIONS Clinical trials in implant prosthodontics used different outcomes, different definitions of outcomes and used different times to monitor them. Standardization of outcomes is necessary to allow comparability and evidence synthesis about the effectiveness of implant prosthodontic therapy.
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Affiliation(s)
- Ante Vardić
- Study of Dental Medicine, University of Split School of Medicine, Split, Croatia
| | - Livia Puljak
- Center for Evidence-Based Medicine and Health Care, Catholic University of Croatia, Zagreb, Croatia.
| | - Tea Galić
- Department of Prosthodontics, Study of Dental Medicine, University of Split School of Medicine, Split, Croatia
| | - Joško Viskić
- Department of Fixed Prosthodontics, University of Zagreb School of Dental Medicine, Zagreb, Croatia
| | - Ena Kuliš
- Study of Dental Medicine, University of Split School of Medicine, Split, Croatia
| | - Tina Poklepović Peričić
- Department of Prosthodontics, Study of Dental Medicine, University of Split School of Medicine, Split, Croatia
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Alotaibi FF, Rocchietta I, Buti J, D'Aiuto F. Comparative evidence of different surgical techniques for the management of vertical alveolar ridge defects in terms of complications and efficacy: A systematic review and network meta-analysis. J Clin Periodontol 2023; 50:1487-1519. [PMID: 37495541 DOI: 10.1111/jcpe.13850] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2022] [Revised: 06/04/2023] [Accepted: 06/29/2023] [Indexed: 07/28/2023]
Abstract
AIM To systematically appraise the available evidence on vertical ridge augmentation (VRA) techniques and estimate a treatment-based ranking on the incidence of complications as well as their clinical effectiveness. MATERIALS AND METHODS Searches were conducted in six databases to identify randomized clinical trials comparing VRA techniques up to November 2022. The incidence of complications (primary) and of early, major, surgical and intra-operative complications, vertical bone gain (VBG), marginal bone loss, need for additional grafting, implant success/survival, and patient-reported outcome measures (secondary) were chosen as outcomes. Direct and indirect effects and treatment ranking were estimated using Bayesian pair-wise and network meta-analysis (NMA) models. RESULTS Thirty-two trials (761 participants and 943 defects) were included. Five NMA models involving nine treatment groups were created: onlay, inlay, dense-polytetrafluoroethylene, expanded-polytetrafluoroethylene, titanium, resorbable membranes, distraction osteogenesis, tissue expansion and short implants. Compared with short implants, statistically significant higher odds ratios of healing complications were confirmed for all groups except those with resorbable membranes (odds ratio 5.4, 95% credible interval 0.92-29.14). The latter group, however, ranked last in clinical VBG. CONCLUSIONS VRA techniques achieving greater VBG are also associated with higher incidence of healing complications. Guided bone regeneration techniques using non-resorbable membranes yield the most favourable results in relation to VBG and complications.
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Affiliation(s)
- Faisal F Alotaibi
- Unit of Periodontology, UCL Eastman Dental Institute, London, UK
- Department of Oral and Maxillofacial Surgery and Diagnostic Sciences, College of Dentistry, Prince Sattam bin Abdulaziz University, Alkharj, Saudi Arabia
| | | | - Jacopo Buti
- Unit of Periodontology, UCL Eastman Dental Institute, London, UK
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Guan D, Zhao R, Guo Y, Li J, Ma N, Gong J. Efficacy of autogenous tooth block for lateral ridge augmentation compared with autogenous bone block: A systematic review and meta-analysis. Medicine (Baltimore) 2023; 102:e35326. [PMID: 37773788 PMCID: PMC10545093 DOI: 10.1097/md.0000000000035326] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/05/2023] [Accepted: 08/31/2023] [Indexed: 10/01/2023] Open
Abstract
BACKGROUND Autogenous tooth block (ATB) has been used as an alternative material for bone regeneration, but its efficacy compared with autogenous bone block (ABB) remains uncertain. The aim of this systematic review was to investigate and compare the clinical and histological performance of ATB and ABB grafts in lateral alveolar ridge augmentation (LARA). METHODS Electronic retrieval of MEDLINE, Embase, Cochrane Library (CENTRAL), Scopus, Web of Science, China national knowledge infrastructure, Wanfang data, SinoMed, and manual searching until July 2023 were used to identify controlled clinical trials employing ATB grafts in LARA. The identified reports included at least one of the following outcome variables: ridge width gain, graft resorption, postoperative complications, histology, and histomorphometry. Weighted or mean differences (MD), relative risk, and corresponding 95% confidence intervals (CI) were calculated. Descriptive analysis was applied to the qualitative statistics. The protocol followed the preferred reporting items for systematic reviews and meta-analyses statement and was prospectively registered in PROSPERO (CRD42023399611). RESULTS Four controlled clinical trials with 77 participants each using ATB and ABB grafts were included. Meta-analysis indicated that ATB grafts resulted in greater bone width (MD = 1.31, 95% CI [0.92, 1.71], P < .00001) and less graft resorption (MD = -0.71, 95% CI [-1.22, -0.21], P = .005) than ABB grafts on LARA. There was no statistical difference in postoperative complications between ATB and ABB grafts (relative risk = 0.81, 95% CI [0.32, 2.04], P = .66). Furthermore, the ATB grafts exhibited positive replacement resorption with alveolar bone for favorable signs of new bone activity on histology and histomorphometry. CONCLUSION Within the limitations of this study, ATB grafts could serve as an alternative material for ABB to support LARA. Further research with a longer follow-up period is required to verify these findings.
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Affiliation(s)
- Delin Guan
- The 940th Hospital of Joint Logistic Support Force of Chinese People’s Liberation Army, Department of Stomatology, Lanzhou City, China
| | - Ruimin Zhao
- The 940th Hospital of Joint Logistic Support Force of Chinese People’s Liberation Army, Department of Stomatology, Lanzhou City, China
- Quzhou Hospital Affiliated to Wenzhou Medical University (Quzhou People’s Hospital), Department of Stomatology, Quzhou City, China
| | - Yan Guo
- The 940th Hospital of Joint Logistic Support Force of Chinese People’s Liberation Army, Department of Stomatology, Lanzhou City, China
| | - Jianxue Li
- The 940th Hospital of Joint Logistic Support Force of Chinese People’s Liberation Army, Department of Stomatology, Lanzhou City, China
| | - Na Ma
- The 940th Hospital of Joint Logistic Support Force of Chinese People’s Liberation Army, Out-patient department, Lanzhou City, China
| | - Jiaming Gong
- The 940th Hospital of Joint Logistic Support Force of Chinese People’s Liberation Army, Department of Stomatology, Lanzhou City, China
- Quzhou Hospital Affiliated to Wenzhou Medical University (Quzhou People’s Hospital), Department of Stomatology, Quzhou City, China
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Wadde K, Kri M, Venkatakrishnan L, Landge J, Nadkarni S. Vertical Ridge Augmentation Using Distraction Osteogenesis Versus Autogenous Bone Grafting: A Systematic Review and Meta-Analysis. J Maxillofac Oral Surg 2023; 22:672-679. [PMID: 37534356 PMCID: PMC10390398 DOI: 10.1007/s12663-023-01943-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2022] [Accepted: 05/20/2023] [Indexed: 08/04/2023] Open
Abstract
Aim The aim of this systematic review was to systematically assess the papers comparing the surgical techniques of Alveolar Distraction Osteogenesis(ADO) and Autogenous Bone grafting (ABG) for Vertical Ridge Augmentation in terms of bone gain, bone resorption and incidences of complications. Metholodology The review was registered on PROSPERO with the ID : CRD42021237671. A broad electronic survey was conducted in the PubMed, Scopus, Web of Science, Cochrane Library, and Virtual Health Library databases of all studies published till 08/03/2022. Four studies fulfilled the criteria to carry out a meta-analysis a in which a total of 58 patients underwent ADO and 43 patients for ABG. A total of 133 implants were placed in the ABG group and 124 in the ADO group. Statistical Analysis DerSimonian-Laird estimator of variance was used for Random effect meta-analysis. The estimates of an intervention were expressed as the odds ratio (OR) and standard mean difference (SMD) in millimeters. Results There was statistically significant difference in terms of bone height gain with SMD of - 0.78 (95% 0.04-1.55) in ABG. Bone resorption and complications were statistically insignificant with SMD of 0.52 (95% - 1.59 to 0.56) and OR 0.55 (95% 0.18-1.70), respectively.PROSPERO Registration ID: CRD42021237671.
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Affiliation(s)
- Kavita Wadde
- Department of Oral and Maxillofacial Surgery, Government Dental College and Hospital, 49 PD’Mello Road, Near CSMT, Fort, Mumbai, Maharashtra 400001 India
| | - Mrimingsi Kri
- Department of Oral and Maxillofacial Surgery, Government Dental College and Hospital, 49 PD’Mello Road, Near CSMT, Fort, Mumbai, Maharashtra 400001 India
| | - Lakshmi Venkatakrishnan
- Department of Oral and Maxillofacial Surgery, Government Dental College and Hospital, 49 PD’Mello Road, Near CSMT, Fort, Mumbai, Maharashtra 400001 India
| | - Jayant Landge
- Department of Oral and Maxillofacial Surgery, Government Dental College and Hospital, 49 PD’Mello Road, Near CSMT, Fort, Mumbai, Maharashtra 400001 India
| | - Shambhavi Nadkarni
- Department of Oral and Maxillofacial Surgery, Government Dental College and Hospital, 49 PD’Mello Road, Near CSMT, Fort, Mumbai, Maharashtra 400001 India
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Sanz-Sánchez I, Sanz-Martín I, Ortiz-Vigón A, Molina A, Sanz M. Complications in bone-grafting procedures: Classification and management. Periodontol 2000 2022; 88:86-102. [PMID: 35103322 DOI: 10.1111/prd.12413] [Citation(s) in RCA: 38] [Impact Index Per Article: 19.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Bone-regenerative interventions aiming to restore deficient alveolar ridges, such as the use of block grafts or through the application of guided bone-regeneration principles, have reported positive outcomes in the published scientific literature. These interventions, however, are invasive, and hence, intraoperative and/or postoperative complications may occur. The types of complications and their severity may vary from the exposure of the biomaterial (membrane or graft) to postsurgical infections, neurosensorial disturbances, occurrence of hemorrhage, and pain, etc. The aim of the present narrative review was to search the available scientific evidence concerning the incidence of these complications, their effect on treatment outcomes, their clinical management and, finally, strategies aimed at prevention. Exposure of the barrier membrane or the block graft is the most common complication associated with oral regenerative interventions. To manage these complications, depending on the extent of the exposure and the presence or absence of concomitant infections, therapeutic measures may vary, from the topical application of antiseptics to the removal of the barrier membrane or the block graft. Regardless of their treatment, the occurrence of these complications has been associated with patient selection, with compliant patients (eg, nonsmokers) having a lower reported incidence of complications. Similarly, surgical factors such as correct flap elevation and a tensionless closure are of obvious importance. Finally, to prevent the incidence of complications, it appears prudent to utilize whenever possible less invasive surgical interventions.
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Affiliation(s)
- Ignacio Sanz-Sánchez
- Section of Graduate Periodontology, University Complutense, Madrid, Spain.,Etiology and Therapy of Periodontal and Peri-Implant Diseases (ETEP) Research Group, University Complutense, Madrid, Spain
| | | | | | - Ana Molina
- Section of Graduate Periodontology, University Complutense, Madrid, Spain.,Etiology and Therapy of Periodontal and Peri-Implant Diseases (ETEP) Research Group, University Complutense, Madrid, Spain
| | - Mariano Sanz
- Section of Graduate Periodontology, University Complutense, Madrid, Spain.,Etiology and Therapy of Periodontal and Peri-Implant Diseases (ETEP) Research Group, University Complutense, Madrid, Spain
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Sandwich osteotomy of the atrophic posterior mandible with interpositional autogenous bone block graft compared with bone substitute material: a systematic review and meta-analysis. Br J Oral Maxillofac Surg 2020; 58:e237-e247. [PMID: 32811722 DOI: 10.1016/j.bjoms.2020.07.040] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2019] [Accepted: 07/29/2020] [Indexed: 11/23/2022]
Abstract
The objective of the present systematic review was to test the hypothesis that there were no differences in outcome of implant treatment after sandwich osteotomy in the atrophic posterior mandible with interpositional autogenous bone block graft, compared with bone substitute material. A MEDLINE/PubMed, Embase and Cochrane Library search in combination with hand-search of selected journals was conducted. Two short-term randomised controlled trials with a split-mouth study design and low risk of bias fulfilled the inclusion criteria. High survival rate of suprastructures and implants was disclosed with no significant difference between interpositional autogenous bone block graft compared with bone substitute material. Meta-analysis revealed patient-based implant survival risk ratio of 1.05 (95% CI: 0.88 to 1.25) and peri-implant marginal bone loss of 0.31mm (95% CI: -0.29 to 0.90) indicating no significant differences between the two treatments. High implant stability values, gain in vertical alveolar ridge height, bone formation, and few complications were reported with both treatments. Sandwich osteotomy with interpositional grafting material appears to be a predictable surgical technique for enhancement of the vertical alveolar ridge height in the atrophic posterior mandible prior to implant placement.
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Thirty Years Later: What Has Craniofacial Distraction Osteogenesis Surgery Replaced? Plast Reconstr Surg 2020; 145:1073e-1088e. [DOI: 10.1097/prs.0000000000006821] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
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The sandwich osteotomy technique to treat vertical alveolar bone defects prior to implant placement: a systematic review. Clin Oral Investig 2020; 24:1073-1089. [DOI: 10.1007/s00784-019-03183-6] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2018] [Accepted: 12/23/2019] [Indexed: 01/06/2023]
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Louis PJ, Sittitavornwong S. Managing Bone Grafts for the Mandible. Oral Maxillofac Surg Clin North Am 2019; 31:317-330. [DOI: 10.1016/j.coms.2018.12.008] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Hameed MH, Gul M, Ghafoor R, Khan FR. Vertical Ridge Gain with Various Bone Augmentation Techniques: A Systematic Review and Meta‐Analysis. J Prosthodont 2019; 28:421-427. [DOI: 10.1111/jopr.13028] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/27/2019] [Indexed: 01/23/2023] Open
Affiliation(s)
- Muhammad Hasan Hameed
- Department of Surgery, Section of DentistryAga Khan University Hospital Karachi Pakistan
| | - Meisha Gul
- Department of Surgery, Section of DentistryAga Khan University Hospital Karachi Pakistan
| | - Robia Ghafoor
- Department of Surgery, Section of DentistryAga Khan University Hospital Karachi Pakistan
| | - Farhan Raza Khan
- Department of Surgery, Section of DentistryAga Khan University Hospital Karachi Pakistan
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Toledano-Serrabona J, Sánchez-Garcés MÁ, Sánchez-Torres A, Gay-Escoda C. Alveolar distraction osteogenesis for dental implant treatments of the vertical bone atrophy: A systematic review. Med Oral Patol Oral Cir Bucal 2019; 24:e70-e75. [PMID: 30573711 PMCID: PMC6344013 DOI: 10.4317/medoral.22750] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2018] [Accepted: 10/06/2018] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND To determine if alveolar vertical distraction osteogenesis obtains better results compared to other bone regeneration treatments (guided bone regeneration with membranes and / or filling material, or autogenous bone graft) in terms of bone gain, complications, and implant survival and success rates. MATERIAL AND METHODS An electronic search was performed in Pubmed (MEDLINE), Cochrane Library and Scopus databases in March 2017. Besides, a manual search was carried out. Inclusion criteria were randomized controlled trials published within the last 10 years with at least 1 year of follow-up after implant placement. No language restriction was applied. Exclusion criteria were studies in patients with bone defects produced by trauma, congenital malformation or oncologic surgical treatment. The methodological quality of the selected studies was evaluated by means of the Cochrane Collaboration's Tool for assessing risk of bias. The reports were classified into different levels of recommendation according to the "Strength of Recommendation Taxonomy ". RESULTS Out of 221 articles, two randomized controlled trials were finally selected for the inclusion in the systematic review. Bone gain and complications were higher with the alveolar vertical distraction osteogenesis compared to the autologous bone graft. There was higher bone resorption with the autologous bone graft. Implant survival and success rates were similar between studies, despite of the used technique. CONCLUSIONS Both alveolar distraction osteogenesis and autogenous bone graft are effective bone regeneration techniques for the treatment of mandibular vertical bone atrophy. A level B recommendation can be established for the use of alveolar vertical distraction osteogenesis for the treatment of the mandibular vertical bone atrophy.
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de N. Dias F, Pecorari V, Martins C, Del Fabbro M, Casati M. Short implants versus bone augmentation in combination with standard-length implants in posterior atrophic partially edentulous mandibles: systematic review and meta-analysis with the Bayesian approach. Int J Oral Maxillofac Surg 2019; 48:90-96. [DOI: 10.1016/j.ijom.2018.05.009] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2017] [Revised: 04/04/2018] [Accepted: 05/03/2018] [Indexed: 10/16/2022]
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Abstract
This study presents a systematic review of randomized controlled trials (RCTs) in cleft and craniofacial surgery. All studies reporting on RCTs in cleft and craniofacial surgery were identified on PubMed using the search terms "cleft," "velopharyngeal insufficiency," "velopharyngeal dysfunction," "nasoalveolar molding," "gingivoperiosteoplasty," "Pierre Robin sequence," "craniofacial," "craniosynostosis," "craniofacial microsomia," "hemifacial microsomia," "hypertelorism," "Le Fort," "monobloc," "distraction osteogenesis," "Treacher Collins," and "Goldenhar." Studies were excluded if they were not randomized, did not focus primarily on topics related to cleft or craniofacial surgery, included repeat publications of data, or were unavailable in English. Studies were evaluated on demographic and bibliometric data, study size, specific area of focus, and findings reported. Four hundred forty-seven unique studies were identified. One hundred eighty-three papers met inclusion criteria (115 cleft lip and palate, 65 craniofacial, and 3 spanning both disciplines). Sixty-six (36%) were dedicated to topics related to surgical techniques. There were no studies comparing current cleft lip or soft palate repair techniques and no studies on cleft rhinoplasty. The most frequently reported surgical topic was cleft palate. There were several studies on orthognathic techniques which compared distraction osteogenesis to traditional advancement. Most craniofacial operations, such as cranial vault remodeling and frontofacial advancement/distraction, were not represented. Several standard operations in cleft and craniofacial surgery are not supported by Level I evidence from randomized controlled trials. Our community should consider methods by which more RCTs can be performed, or redefine the acceptable standards of evidence to guide our clinical decisions.
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Starch-Jensen T, Nielsen HB. Prosthetic Rehabilitation of the Partially Edentulous Atrophic Posterior Mandible with Short Implants (≤ 8 mm) Compared with the Sandwich Osteotomy and Delayed Placement of Standard Length Implants (> 8 mm): a Systematic Review. EJOURNAL OF ORAL MAXILLOFACIAL RESEARCH 2018; 9:e2. [PMID: 30116514 PMCID: PMC6090250 DOI: 10.5037/jomr.2018.9202] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/11/2018] [Accepted: 06/28/2018] [Indexed: 01/26/2023]
Abstract
Objectives Test the hypothesis of no difference in prosthetic rehabilitation of the partially edentulous atrophic posterior mandible with short implants (≤ 8 mm) compared with the sandwich osteotomy and delayed placement of standard lengths implants (> 8 mm). Material and Methods A MEDLINE (PubMed), Embase and Cochrane library search in combination with a hand-search was conducted by including studies published in English. No year of publication restriction was applied. Results Six randomized controlled trials characterized by low or moderate risk of bias fulfilled the inclusion criteria. There were no statistically significant differences (P > 0.05) in the survival rate of suprastructures and implants between the two treatment modalities after one year. Sandwich osteotomy and delayed implant placement demonstrated statistically significant higher long-term peri-implant marginal bone loss as well as biological and technical complications compared with short implants (P < 0.0001). Moreover, patients significantly favoured prosthetic rehabilitation with short implants (P < 0.0001). Conclusions Short implants and the sandwich osteotomy with delayed placement of standard length implants appear to result in predictable outcomes in terms of high survival rate of suprastructures and implants after prosthetic rehabilitation of the partially edentulous atrophic posterior mandible. However, further long-term randomized controlled trials assessing donor site morbidity, an economic perspective, professional and patient-related outcome measures with the two treatment modalities are needed before definite conclusions can be provided about the beneficial use of short implants for prosthetic rehabilitation of the partially edentulous atrophic posterior mandible compared with the sandwich osteotomy and delayed placement of standard length implants.
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Affiliation(s)
- Thomas Starch-Jensen
- Department of Oral and Maxillofacial Surgery, Aalborg University Hospital, AalborgDenmark
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Adánez MH, Brezavšček M, Vach K, Fonseca M, Att W. Clinical and Radiographic Evaluation of Short Implants Placed in the Posterior Mandible: A 1-Year Pilot Split-Mouth Study. J ORAL IMPLANTOL 2018; 44:250-259. [PMID: 29717922 DOI: 10.1563/aaid-joi-d-18-00037] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
In many cases, due to anatomical limitations, the placement of regular-length implants cannot be facilitated without the performance of advanced surgical procedures. However, these are associated with morbidity, prolonged treatment time, and costs. To overcome such disadvantages, short implants were introduced. The aim of this prospective pilot split-mouth study was to compare the clinical outcome between short implants (7 mm) and regular-length (≥10 mm) implants placed in the posterior mandible after 1 year of prosthetic delivery. Ten patients received 4 implants in the posterior mandible. Two short implants were placed in one side and 2 regular-length implants were placed contralaterally. These were restored by means of splinted screw-retained metal-ceramic crowns. Marginal bone loss (MBL) and soft-tissue parameters were compared. No implant failed. Both types of implants showed success rates of 90% and survival rates of 100%. From prosthetic delivery to 1 year post-loading a bone gain of +0.29 mm for short implants and +0.19 mm for regular-length implants was present without showing any statistically significant differences in MBL between the 2 implant types ( P > .05). Bleeding on probing, clinical attachment level, probing depth, and crown-to-implant ratio did not show any statistically significant differences between the 2 implant lengths ( P > .05). One case of chipping occurred in the regular-length implant group, leading to a prosthetic survival rate of 95%. Short implants showed a prosthetic survival rate of 100%. After 1 year, short implants showed comparable clinical outcomes to that of regular-length implants, making them a viable treatment option in the posterior mandible.
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Affiliation(s)
- Mireia Haro Adánez
- 1 Department of Prosthetic Dentistry, University Medical Center Freiburg, Faculty of Medicine, University of Freiburg, Germany
| | | | - Kirstin Vach
- 3 Institute for Medical Biometry and Statistics, Faculty of Medicine and Medical Center, University of Freiburg, Germany
| | - Manrique Fonseca
- 4 Department of Prosthetic Dentistry, School of Dentistry, University Hospital Bern, Switzerland
| | - Wael Att
- 5 Department of Prosthodontics, Tufts University School of Dental Medicine, Boston, Mass
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Toti P, Marchionni S, Menchini-Fabris GB, Marconcini S, Covani U, Barone A. Surgical techniques used in the rehabilitation of partially edentulous patients with atrophic posterior mandibles: A systematic review and meta-analysis of randomized controlled clinical trials. J Craniomaxillofac Surg 2017; 45:1236-1245. [DOI: 10.1016/j.jcms.2017.04.011] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2017] [Revised: 02/13/2017] [Accepted: 04/21/2017] [Indexed: 11/30/2022] Open
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Abstract
This study aims to evaluate the possible effect of more cortical bone decortication (CBD) on guided bone augmentation. A total of 16 New Zealand rabbits and 32 titanium domes were used. No cortical bone decortication was applied to the control group and in the study groups, the cortical bones were decorticated with a round burr (Group A: 1 hole with bleeding, Group B: 5 holes with bleeding, Group C: a thin layer of compact bone was completely removed with no bleeding). Then 2 titanium domes were placed on the calvarium of each rabbit with hydroxyapatite/beta-tricalcium phosphate. After 3 months, the animals were sacrificed and specimens were sent for histological and histomorphometric analysis. Histological and histomorphometric analysis showed that bone decortication with burr significantly increased new bone regeneration in all the experimental groups compared with the control group (P <0.05). No statistically significant difference was determined between the study groups. In conclusion, CBD, which has no negative impact on surgery, has a positive effect on guided bone augmentation. However, a greater amount of CBD does not have a greater effect.
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Rachmiel A, Shilo D, Aizenbud D, Emodi O. Vertical Alveolar Distraction Osteogenesis of the Atrophic Posterior Mandible Before Dental Implant Insertion. J Oral Maxillofac Surg 2017; 75:1164-1175. [PMID: 28208057 DOI: 10.1016/j.joms.2017.01.013] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2016] [Revised: 01/12/2017] [Accepted: 01/13/2017] [Indexed: 12/15/2022]
Abstract
PURPOSE Augmentation of deficient mandibular posterior alveolar ridges poses a great challenge because of extensive bone deficiency and the presence of the inferior alveolar nerve. This study sets its focus on vertical alveolar distraction osteogenesis (ADO) at the posterior mandible before dental implant placement. MATERIALS AND METHODS The study included 21 sites in 18 patients with severe mandibular posterior alveolar ridge deficiency. A trapezoidal osteotomy was performed, and an extraosseous alveolar distraction device was fixed and activated after a 4-day latency period at a rate of 0.5 mm/day. After a 4-month retention period, the distraction device was removed and titanium dental implants were placed. RESULTS A mean vertical augmentation of 14.47 mm was gained. The newly formed bone was shown using panoramic radiography and computed tomography. We placed 56 dental implants, and during a minimum follow-up period of 36 months, 2 implants were lost, resulting in a success rate of 96.42%. CONCLUSIONS ADO offers marked vertical ridge augmentation with simultaneous soft tissue expansion and stable results. ADO diminishes the need for autogenous bone graft, thus sparing donor-site morbidity. ADO of the deficient posterior mandibular alveolar ridge is useful in moderate to severe bony deficiencies and allows for adequate bone formation, which allows implant insertion.
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Affiliation(s)
- Adi Rachmiel
- Professor, Department of Oral and Maxillofacial Surgery, Rambam Medical Care Center, Haifa, Israel; and Ruth & Bruce Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel
| | - Dekel Shilo
- Resident, Department of Oral and Maxillofacial Surgery, Rambam Medical Care Center, Haifa, Israel.
| | - Dror Aizenbud
- Professor, Ruth & Bruce Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel; and Department of Orthodontics and Cleft Palate, School of Dental Surgery, Rambam Medical Care Center, Haifa, Israel
| | - Omri Emodi
- Attending Physician, Department of Oral and Maxillofacial Surgery, Rambam Medical Care Center, Haifa, Israel; and Ruth & Bruce Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel
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Kamperos G, Zografos I, Tzermpos F, Iatrou I. Segmental sandwich osteotomy of the posterior mandible in pre-implant surgery - A systematic review. Med Oral Patol Oral Cir Bucal 2017; 22:e132-e141. [PMID: 27918747 PMCID: PMC5217491 DOI: 10.4317/medoral.21633] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2016] [Accepted: 11/11/2016] [Indexed: 12/02/2022] Open
Abstract
Background The rehabilitation of the atrophic posterior mandible with dental implants often requires bone augmentation procedures. The aim of the present study is the systematic review of the literature concerning the success rate of Segmental Sandwich Osteotomy (SSO) of the posterior mandible in pre-implant surgery. Material and Methods Systematic review of all clinical cases and clinical studies of SSO of the posterior mandible in pre-implant surgery with a minimum follow-up of 6 months after implant loading was performed, based on specific inclusion and exclusion criteria. The search strategy involved searching the electronic databases of MEDLINE, EMBASE, COCHRANE LIBRARY, Clinical Trials (www.clinicaltrials.gov) and National Research Register (www.controlled-trials.com), supplemented by a manual search, in August 2015. In every study, the intervention characteristics and the outcome were recorded. Results Out of the 756 initial results, only 17 articles fulfilled the predetermined inclusion and exclusion criteria. They consisted of 9 retrospective case reports or series and 8 prospective randomized clinical trials. Overall, the studies included 174 patients. In these patients, 214 SSO augmentation procedures were performed in the posterior mandible and 444 implants were placed. The follow-up period after implant loading ranged between 8 months and 5.5 years. The success rate of SSO ranged between 90% and 100%. The implant survival during the follow-up period ranged between 90.9% and 100%. Conclusions Segmental Sandwich Osteotomy should be considered as a well documented technique for the rehabilitation of the atrophic posterior mandible, with long-term postsurgical follow-up. The success rates are very high, as well as the survival of the dental implants placed in the augmented area. Key words:Segmental osteotomy, dental implant, mandible, inlay graft.
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Keestra JAJ, Barry O, Jong LD, Wahl G. Long-term effects of vertical bone augmentation: a systematic review. J Appl Oral Sci 2016; 24:3-17. [PMID: 27008252 PMCID: PMC4775004 DOI: 10.1590/1678-775720150357] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2015] [Accepted: 10/22/2015] [Indexed: 11/21/2022] Open
Abstract
Extraction, periodontitis, or trauma can cause a reduction on the alveolar ridge. This could result in an insufficient alveolar bone width and height. Different techniques of vertical bone augmentation are described in literature. However, nowadays there is not enough evidence against lateral augmentation procedures to verify if these techniques are stable over a long period of time.
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Affiliation(s)
| | - Obada Barry
- Mund- und Kieferheilkunde, Poliklinik für Chirurgische Zahn-, Universität Bonn, Bonn, Germany
| | | | - Gerhard Wahl
- Mund- und Kieferheilkunde, Poliklinik für Chirurgische Zahn-, Universität Bonn, Bonn, Germany
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Khojasteh A, Motamedian SR, Sharifzadeh N, Zadeh HH. The influence of initial alveolar ridge defect morphology on the outcome of implants in augmented atrophic posterior mandible: an exploratory retrospective study. Clin Oral Implants Res 2016; 28:e208-e217. [PMID: 27804178 DOI: 10.1111/clr.12991] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/14/2016] [Indexed: 12/11/2022]
Abstract
OBJECTIVES Clinicians commonly consider atrophic site topography as an important determinant in deciding the augmentation technique to utilize, as well as forecasting the likelihood of success. The purpose of this retrospective study was to examine the influence of initial atrophic posterior mandible morphology on the outcome of implants placed following augmentation. MATERIALS AND METHODS A total of 52 patients contributed 71 edentulous sites, and 185 implants were placed with mean follow-up of 37.97 months. The initial defect morphology was classified according to ABC classification (Journal of Oral Implantology, 37, 2013a and 361). Ridge augmentation was performed by "cortical autogenous tenting" (CAT) followed by either simultaneous or delayed implant placement after 4-6 months of healing. The European Academy of Osseointegration success criteria were used to evaluate implant outcomes. RESULTS The overall survival and success rates of dental implants were 98.91% and 80%, respectively. Cumulative success and survival rates in CAT group were 95% and 100% after 2 years of follow-up. The highest marginal bone loss (MBL) was observed (1.26 mm ± 0.99) around implants placed in augmented edentulous sites with initially narrow and flat alveolar crest (defect class CII). Conversely, least MBL (0.48 mm ± 0.78) was detected around implants placed into edentulous sites with two sloped boney walls (defect class AII). Differences between MBL observed around implants placed into initial defect class C, initial defect type and class A (I, II), as well as class BII, were statistically significant (P < 0.05). Among all implants, 148 were considered as successful, 26 exhibited satisfactory survival, nine with compromised survival, and two implants failed. CONCLUSION The present data confirmed the effect of initial ridge morphology on the outcome of implants placed into augmented bone. Specifically, class A and class B atrophic ridge defects, with one and two vertical boney walls, respectively, may be considered as more favorable recipient sites than class C defects with flat morphology. This conclusion is based on least MBL around implants placed into initial defect class A and class B augmented sites, and higher MBL in implants placed into class C recipient sites. A randomized controlled trial is warranted to examine these exploratory observations.
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Affiliation(s)
- Arash Khojasteh
- Department of Tissue Engineering, School of Advanced Technologies in Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Saeed Reza Motamedian
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Navid Sharifzadeh
- Laboratory for Immunoregulation and Tissue Engineering, Ostrow School of Dentistry, University of Southern California, Los Angeles, CA, USA
| | - Homayoun H Zadeh
- Laboratory for Immunoregulation and Tissue Engineering, Ostrow School of Dentistry, University of Southern California, Los Angeles, CA, USA
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Guided "sandwich" technique: a novel surgical approach for safe osteotomies in the treatment of vertical bone defects in the posterior atrophic mandible: a case report. IMPLANT DENT 2016; 23:738-44. [PMID: 25290283 DOI: 10.1097/id.0000000000000168] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE A novel technique to perform safe osteotomies during inlay block regenerative procedures in the posterior atrophic mandible is described. MATERIAL AND METHODS A 52-year-old male patient with vertical atrophy of the left posterior mandible was treated adopting an inlay block "sandwich" technique using an allogenic cancelous block and a mixture of mineralized and demineralized human bone allograft in putty form as graft. The horizontal osteotomy for the lifting of the osteotomized bone segment was performed using a template prepared from a virtual anatomical replica of the patient's mandible obtained from cone beam computed tomography data. In the second surgical phase, 3 months after the augmentation, 2 implants were easily placed. RESULTS The horizontal osteotomy was carried out, with no risk, very close to the nerve structures after the precise osteotomy line established preoperatively on the three-dimensional computed tomography (3D-CT) virtual reconstruction. No neurological complications were observed in the first days after the procedure, and no subsequent problems were recorded during the 3-month healing period. CONCLUSION Radiographic evaluations and complication-free clinical healing demonstrate the effectiveness of this technique to obtain safe and precise osteotomies.
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Camps-Font O, Burgueño-Barris G, Figueiredo R, Jung RE, Gay-Escoda C, Valmaseda-Castellón E. Interventions for Dental Implant Placement in Atrophic Edentulous Mandibles: Vertical Bone Augmentation and Alternative Treatments. A Meta-Analysis of Randomized Clinical Trials. J Periodontol 2016; 87:1444-1457. [PMID: 27468794 DOI: 10.1902/jop.2016.160226] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
BACKGROUND The purpose of the current study is to assess which vertical bone augmentation techniques are most effective for restoring atrophic posterior areas of the mandible with dental implants and compare these procedures with alternative treatments. METHODS Electronic literature searches in PubMed (MEDLINE), Ovid, and the Cochrane Library were conducted to identify all relevant articles published up to July 1, 2015. Eligibility was based on inclusion criteria, and quality assessments were conducted. The primary outcome variables were implant and prosthetic failure. After data extraction, meta-analyses were performed. RESULTS Out of 527 potentially eligible papers, 14 randomized clinical trials were included. Out of these 14 studies, four trials assessed short implants (5 to 8 mm) as an alternative to vertical bone augmentation in sites with a residual ridge height of 5 to 8 mm. No statistically significant differences were found in implant (odds ratio [OR]: 1.02; 95% confidence interval [CI]: 0.31 to 3.31; P = 0.98; I2: 0%) or prosthetic failure (OR: 0.64; 95% CI: 0.21 to 1.96; P = 0.43; I2: 0%) after 12 months of loading. However, complications at treated sites increased with the augmentation procedures (OR: 8.33; 95% CI: 3.85 to 20.0; P <0.001; I2: 0%). There was no evidence of any vertical augmentation procedure being of greater benefit than any other for the primary outcomes (implant and prosthetic failure). CONCLUSIONS Short implants in the posterior area of the mandible seem to be preferable to vertical augmentation procedures, which present similar implant and prosthetic failure rates but greater morbidity. All the vertical augmentation technique comparisons showed similar intergroup results.
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Affiliation(s)
- Octavi Camps-Font
- Department of Oral Surgery and Implantology, Faculty of Dentistry, University of Barcelona, Barcelona, Spain
| | - Genís Burgueño-Barris
- Department of Oral Surgery and Implantology, Faculty of Dentistry, University of Barcelona, Barcelona, Spain
| | - Rui Figueiredo
- Department of Oral Surgery and Implantology, Faculty of Dentistry, University of Barcelona, Barcelona, Spain.,Bellvitge Biomedical Research Institute, Barcelona, Spain
| | - Ronald E Jung
- Division of Implantology, Center of Dental Medicine, University of Zürich, Zürich, Switzerland.,Clinic for Fixed and Removable Prosthodontics and Dental Material Science, Zürich, Switzerland
| | - Cosme Gay-Escoda
- Bellvitge Biomedical Research Institute, Barcelona, Spain.,Department of Oral and Maxillofacial Surgery, School of Dentistry, University of Barcelona.,Department of Oral Surgery and Implantology, European Foundation for Health Research and Education, Belize City, Belize.,Department of Oral Surgery and Implantology, Private Catalan Foundation for Oral Health, Barcelona, Spain.,Department of Oral Surgery, Implantology, and Maxillofacial Surgery, Teknon Medical Center, Barcelona, Spain
| | - Eduard Valmaseda-Castellón
- Department of Oral Surgery and Implantology, Faculty of Dentistry, University of Barcelona, Barcelona, Spain.,Bellvitge Biomedical Research Institute, Barcelona, Spain
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Cardinal L, Dominguez GC, Marodin AL, Rau LH. Unusual Spontaneous Mandibular Regeneration of a Large Defect Followed by Orthodontics, Alveolar Distraction, and Dental Implant Rehabilitation: A 10-Year Follow-Up. J Oral Maxillofac Surg 2015; 74:786-93. [PMID: 26706489 DOI: 10.1016/j.joms.2015.11.013] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2015] [Revised: 09/22/2015] [Accepted: 11/11/2015] [Indexed: 10/22/2022]
Abstract
This report describes an atypical case of spontaneous mandibular regeneration of a large size bony defect after resection of an aseptic osteonecrotic area near the symphysis and parasymphyseal area. The patient underwent orthodontic therapy, vertical osteogenic distraction of the alveolar bone, and oral rehabilitation with an implant borne prosthesis. This case study also describes the 10-year follow-up of comprehensive multidisciplinary treatment and successful recovery of a patient's esthetic and functional aspects.
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Affiliation(s)
- Lucas Cardinal
- PhD Student, Department of Orthodontics and Pediatric Dentistry, University of São Paulo, São Paulo, SP, Brazil.
| | - Gladys Cristina Dominguez
- Associate Professor, Department of Orthodontics and Pediatric Dentistry, University of São Paulo, São Paulo, SP, Brazil
| | - Aline Luiza Marodin
- Chief Resident, Department of Maxillofacial Surgery, Joana de Gusmao Children Hospital, Florianópolis, SC, Brazil
| | - Levy Hermes Rau
- Program Director, Department of Maxillofacial Surgery, Joana de Gusmao Children Hospital, Florianópolis, SC, Brazil
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Complications of mandibular distraction osteogenesis for acquired deformities: a systematic review of the literature. Int J Oral Maxillofac Surg 2015; 44:956-64. [DOI: 10.1016/j.ijom.2014.12.008] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2014] [Revised: 12/01/2014] [Accepted: 12/04/2014] [Indexed: 11/23/2022]
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Rodriguez-Grandjean A, Reininger D, López-Quiles J. Complications in the treatment with alveolar extraosseous distractors. Literature review. Med Oral Patol Oral Cir Bucal 2015; 20:e518-24. [PMID: 25858083 PMCID: PMC4523266 DOI: 10.4317/medoral.20512] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2014] [Accepted: 02/26/2015] [Indexed: 12/03/2022] Open
Abstract
Background To review the literature that analyses the types and frequency of complications associated with the use of extraosseous alveolar distraction from 2007 to 2013. Material and Methods Review of the literature in PubMed, using these keywords; alveolar ridge, alveolar distraction osteogenesis, complication, literature review. Inclusion criteria were: articles published between 2007 and 2013 that included the distraction protocol, the complications encountered and the time when they occurred. Results According to the above criteria, 12 articles were included in this review, where 334 extraosseous distractors were placed and 395 complications were encountered, of which 19 (4.81%) were intraoperative, 261 (66.07%) postoperative and 115 (29.11 %) were postdistraction. The most common complication was the incorrect distraction vector found in 105 cases (26.58%), in 23 cases (5.82%) there were severe complications, of which 14 (3.54%) were mandibular fracture and 9 (2.27%) were fractures of the distractor elements. Conclusions According to this review, although alveolar distraction is a safe and predictable technique, it can cause complications; however, they are usually minor and easily resolved without affecting the treatment outcome. Key words:
Alveolar ridge, alveolar distraction osteogenesis, complication, literature review.
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Affiliation(s)
- Alfredo Rodriguez-Grandjean
- Department of Oral Surgery and Maxillofacial Surgery, Complutense University of Madrid, Spain, Plaza de Ramón y Cajal, 3, 28040 Madrid, Spain,
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Nisand D, Picard N, Rocchietta I. Short implants compared to implants in vertically augmented bone: a systematic review. Clin Oral Implants Res 2015; 26 Suppl 11:170-9. [DOI: 10.1111/clr.12632] [Citation(s) in RCA: 65] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/12/2015] [Indexed: 11/30/2022]
Affiliation(s)
| | | | - I. Rocchietta
- Department of Biomaterials; Institute for Clinical Sciences; The Sahlgrenska Academy; University of Gothenburg; Gothenburg Sweden
- Private Practice; London UK
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Masaki C, Nakamoto T, Mukaibo T, Kondo Y, Hosokawa R. Strategies for alveolar ridge reconstruction and preservation for implant therapy. J Prosthodont Res 2015; 59:220-8. [PMID: 26022542 DOI: 10.1016/j.jpor.2015.04.005] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2015] [Revised: 04/21/2015] [Accepted: 04/23/2015] [Indexed: 10/23/2022]
Abstract
PURPOSE In dental implant treatment, ridge preservation and immediate or early implant placement are recommended to minimize bone resorption after tooth extraction and achieve esthetic outcomes. However, there is no consensus concerning the efficacy of this surgical method. There is also no consensus on the efficacy of bone and soft tissue grafts and surgical methods for alveolar ridge reconstruction. STUDY SELECTION This paper reports ridge alteration in the anterior maxilla after tooth extraction, and summarizes the efficacy of various ridge preservation methods and immediate or early implant placement as alveolar ridge preservation methods to minimize bone resorption after tooth extraction. The advantages and complications of alveolar ridge reconstruction methods, and the efficacy and surgical method of soft tissue graft are reviewed. RESULTS The anterior maxilla is in the esthetic zone, and the thickness of the bone on the labial side around the natural tooth is less than 1mm in many cases. Therefore, it is impossible to prevent bone resorption completely, even if ridge preservation and immediate or early implant placement are performed after tooth extraction. It is necessary to obtain stable and long-term esthetics by combining connective tissue and free gingival grafts, in addition to hard tissue augmentation. CONCLUSIONS It is important to consider the burden and level of satisfaction of patients, such as in terms of donor site morbidity in hard and soft tissue grafting, and to pay attention to appropriate indications to avoid overtreatment.
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Affiliation(s)
- Chihiro Masaki
- Department of Oral Reconstruction and Rehabilitation, Kyushu Dental University, Japan.
| | - Tetsuji Nakamoto
- Department of Prosthodontics, Graduate School of Oral & Maxillofacial Biology, School of Dentistry, Matsumoto Dental University, Japan
| | - Taro Mukaibo
- Department of Oral Reconstruction and Rehabilitation, Kyushu Dental University, Japan
| | - Yusuke Kondo
- Department of Oral Reconstruction and Rehabilitation, Kyushu Dental University, Japan
| | - Ryuji Hosokawa
- Department of Oral Reconstruction and Rehabilitation, Kyushu Dental University, Japan
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Terbish M, Yoo SH, Kim HJ, Yu HS, Hwang CJ, Baik HS, Cha JY. Accelerated Bone Formation in Distracted Alveolar Bone After Injection of Recombinant Human Bone Morphogenetic Protein-2. J Periodontol 2015; 86:1078-86. [PMID: 25957054 DOI: 10.1902/jop.2015.140697] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
BACKGROUND This study evaluates the effect of recombinant human bone morphogenetic protein-2 (rhBMP-2) on the quality and quantity of regenerated bone when injected into distracted alveolar bone. METHODS Sixteen adult beagle dogs were assigned to either the control or rhBMP-2 group. After distraction was completed, an rhBMP-2 dose of 330 μg in 0.33 mL was injected slowly into the distracted alveolar crest of the mesial, middle, and distal parts of the alveolar bone in the experimental group. Histologic and microcomputed tomography analyses of regenerated bone were done after 2 and 6 weeks of consolidation. RESULTS After 6 weeks of consolidation, the vertical defect height in the middle of the regenerated bone was significantly lower in the rhBMP-2 group (2.2 mm) than in the control group (3.4 mm) (P <0.05). Additionally, the width of the regenerated bone was significantly greater in the rhBMP-2 group (4.3 mm) than in the control group (2.8 mm) (P <0.05). The bone density and volume of regenerated bone in the rhBMP-2 group were greater than in the control group after 6 weeks of consolidation (P <0.001). CONCLUSION Injection of rhBMP-2 into regenerated bone after a distraction osteogenesis procedure significantly increased bone volume in the dentoalveolar distraction site and improved both the width and height of the alveolar ridge and increased the bone density.
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Affiliation(s)
- Munkhdulam Terbish
- Department of Orthodontics, Institute of Craniofacial Deformity, College of Dentistry, Yonsei University, Seoul, South Korea
| | - Seong-Hun Yoo
- Department of Orthodontics, Institute of Craniofacial Deformity, College of Dentistry, Yonsei University, Seoul, South Korea
| | - Hee-Jin Kim
- Division of Anatomy and Developmental Biology, Department of Oral Biology, Yonsei University
| | - Hyung-Seog Yu
- Department of Orthodontics, Institute of Craniofacial Deformity, College of Dentistry, Yonsei University, Seoul, South Korea
| | - Chung-Ju Hwang
- Department of Orthodontics, Institute of Craniofacial Deformity, College of Dentistry, Yonsei University, Seoul, South Korea
| | - Hyung-Seon Baik
- Department of Orthodontics, Institute of Craniofacial Deformity, College of Dentistry, Yonsei University, Seoul, South Korea
| | - Jung-Yul Cha
- Department of Orthodontics, Institute of Craniofacial Deformity, College of Dentistry, Yonsei University, Seoul, South Korea
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Lizio G, Mingione A, Marchetti C. The Pre-Implant "Window-Osteotomy" Technique for the Atrophic Posterior Mandible. J ORAL IMPLANTOL 2015; 42:195-200. [PMID: 25643264 DOI: 10.1563/aaid-joi-d-14-00144] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Affiliation(s)
- Giuseppe Lizio
- 1 Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy
| | - Antonio Mingione
- 1 Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy.,2 Private practice, Bologna, Italy
| | - Claudio Marchetti
- 1 Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy
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Checchi V, Felice P. The Inlay Technique With an Allograft Block Used for the Rehabilitation of an Atrophic Posterior Mandible: A Case Report. Clin Adv Periodontics 2015; 5:68-74. [DOI: 10.1902/cap.2013.130040] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2013] [Accepted: 06/04/2013] [Indexed: 11/13/2022]
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Clinical study comparing alveolar distraction using the lead system and MODUS MDO 1.5/2.0. J Craniofac Surg 2014; 25:e584-8. [PMID: 25376144 DOI: 10.1097/scs.0000000000001044] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
This article compares 2 different alveolar distractors: Lead System (LS) and MODUS MDO 1.5/2.0 (M-MDO). This is a clinical retrospective study; 32 distractions were performed. We used the LS distractor (intraosseous) on 24 patients and the M-MDO (extraosseous) on the other 8. The variables included bone alveolar ridge height, alterations of the oral mucosa, number of distractors, implant survival, and complications. We also developed descriptive and univariate statistical analysis. The mean increase of bone height after performing the alveolar distraction was 6.15 mm, 5.74 mm with LS, and 8.36 mm with M-MDO (P < 0.0001). The survival rates of the implants in the intraosseous and extraosseous groups reached 100%. However, the use of M-MDO resulted in a significant defect in the alveolar mucosa during implant insertion (100%), an event that did not occur when using LS (P < 0.001). The most common complication in the intraosseous group was the tilting of the segment (25%), whereas, in the extraosseous group, the main difficulty was the rod interference with the opposing arch (75%). Bone defects after alveolar distraction appeared both in the intraosseous group (66.7%) and in the extraosseous group (50%). Both the LS and the M-MDO distractors are effective for alveolar bone distraction. The choice of one distractor over another depends on the clinical characteristics of each case, such as the size and shape of the defect, the patient's tolerance, the distance to the opposing arch, and the surgeon's experience.
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Leong DJM, Oh TJ, Benavides E, Al-Hezaimi K, Misch CE, Wang HL. Comparison Between Sandwich Bone Augmentation and Allogenic Block Graft for Vertical Ridge Augmentation in the Posterior Mandible. IMPLANT DENT 2014; 24:4-12. [DOI: 10.1097/id.0000000000000180] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Kocyigit ID, Tuz HH, Ozgul O, Coskunses FM, Kisnisci RS. A simple solution for vector control in vertical alveolar distraction osteogenesis. J ORAL IMPLANTOL 2014; 40:557-60. [PMID: 25295887 DOI: 10.1563/aaid-joi-d-12-00018] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
One of the important and frequent complications in alveolar distraction osteogenesis is vectorial change of the transport segment. This report presents a simple solution for vector angulation control by placing intermaxillary fixation screws intraoperatively. Advantages of the technique are also discussed.
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Affiliation(s)
- Ismail Doruk Kocyigit
- 1 Department of Oral and Maxillofacial Surgery, Kirikkale University, Kirikkale, Turkey
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Soehardi A, Meijer GJ, Berge SJ, Stoelinga PJW. Lower border bone onlays to augment the severely atrophic (class VI) mandible in preparation for implants: a preliminary report. Int J Oral Maxillofac Surg 2014; 43:1493-9. [PMID: 25017193 DOI: 10.1016/j.ijom.2014.06.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2013] [Revised: 06/08/2014] [Accepted: 06/10/2014] [Indexed: 11/16/2022]
Abstract
We present the preliminary results of a study involving a group of consecutive patients who underwent lower border onlay grafting, limited to the symphyseal area, in preparation for implant insertion. This technique allows for maximum-sized implants, followed by prosthetic rehabilitation. The main advantage of this method is the minimal risk of damage to the mental nerve. Sixteen patients were followed for a period of 6 months to 4 years and all were free of neurosensory disturbances. Eight had a removable overdenture placed and were satisfied with the result. This surgical approach allows the patient to wear their dentures during the healing period. A further advantage of lower border grafting over intraoral upper border grafting is that mucosal dehiscences are not seen.
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Affiliation(s)
- A Soehardi
- Department of Oral and Maxillofacial Surgery, Radboud University, Nijmegen Medical Centre, Nijmegen, The Netherlands.
| | - G J Meijer
- Department of Oral and Maxillofacial Surgery, Radboud University, Nijmegen Medical Centre, Nijmegen, The Netherlands
| | - S J Berge
- Department of Oral and Maxillofacial Surgery, Radboud University, Nijmegen Medical Centre, Nijmegen, The Netherlands
| | - P J W Stoelinga
- Department of Oral and Maxillofacial Surgery, Radboud University, Nijmegen Medical Centre, Nijmegen, The Netherlands
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Li T, Zhang Y, Shao B, Gao Y, Zhang C, Cao Q, Kong L. Partially Biodegradable Distraction Implant to Replace Conventional Implants in Alveolar Bone of Insufficient Height: A Preliminary Study in Dogs. Clin Implant Dent Relat Res 2014; 17:1164-73. [PMID: 24888978 DOI: 10.1111/cid.12229] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
BACKGROUND Dental implants have been widely used in the last few decades. However, patients with insufficient bone height need reconstructive surgeries before implant insertion. The distraction implant (DI) has been invented to simplify the treatment procedure, but the shortcomings of DIs have limited their clinical use. We incorporated biodegradable polyester into a novel DI called the partially biodegradable distraction implant (PBDI). PURPOSE The purpose of this study was to assess the radiological, histological, and biomechanical properties of the PBDI in animal models. MATERIAL AND METHODS PBDIs were manufactured and inserted into the atrophied mandibles of nine dogs. Box-shaped alveolar bones were segmented and distracted. The dogs were randomly divided into three groups that were sacrificed 1, 2, and 3 months after the implant insertion. Actual augmentation height (AAH) of the bone segments was measured to evaluate the effect of distraction. X-ray examination and micro-CT reconstruction and analysis were used to evaluate the regenerated bone in the distraction gap and bone around the functional element. Histological sections were used to evaluate the osseointegration and absorption of the PBDI. Fatigue tests were used to evaluate the biomechanical properties of the PBDI. RESULTS Little change was found in AAH among the three groups. X-ray examination and micro-CT reconstruction showed good growth of regenerated bone in the distraction gap. Alveolar bone volume around the functional element increased steadily. No obvious bone absorption occurred in the alveolar crest around PBDI. Three months after distraction, the functional element achieved osseointegration, and the support element began to be absorbed. All PBDIs survived the fatigue test. CONCLUSIONS The PBDI is a novel and reliable dental implant. It becomes a conventional implant after the absorption of the support element and the removal of the distraction screw. It is a promising replacement for conventional implants in patients with insufficient alveolar bone height.
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Affiliation(s)
- Tao Li
- State Key Laboratory of Military Stomatology, Department of Orthodontics, School of Stomatology, Fourth Military Medical University, Xi'an, China.,Department of Stomatology, PLA Second Artillery General Hospital, Beijing, China
| | - Yongqiang Zhang
- State Key Laboratory of Military Stomatology, Department of Oral and Maxillofacial Surgery, School of Stomatology, Fourth Military Medical University, Xi'an, China
| | - Bo Shao
- State Key Laboratory of Military Stomatology, Department of Oral and Maxillofacial Surgery, School of Stomatology, Fourth Military Medical University, Xi'an, China
| | - Yuan Gao
- Department of Stomatology, No. 263 Clinical Section of the General Hospital of Beijing Military Region, Beijing, China
| | - Chen Zhang
- Department of Neurology, PLA Second Artillery General Hospital, Beijing, China
| | - Qiang Cao
- State Key Laboratory of Military Stomatology, Department of Oral and Maxillofacial Surgery, School of Stomatology, Fourth Military Medical University, Xi'an, China
| | - Liang Kong
- State Key Laboratory of Military Stomatology, Department of Oral and Maxillofacial Surgery, School of Stomatology, Fourth Military Medical University, Xi'an, China
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Long term follow-up in inferior alveolar nerve transposition: our experience. BIOMED RESEARCH INTERNATIONAL 2014; 2014:170602. [PMID: 24949422 PMCID: PMC4052621 DOI: 10.1155/2014/170602] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/19/2014] [Revised: 04/07/2014] [Accepted: 04/10/2014] [Indexed: 11/18/2022]
Abstract
Introduction. Inferior alveolar nerve transposition (IANT) is a surgical technique used in implantoprosthetic rehabilitation of the atrophic lower jaw which has not been well embraced because of the high risk of damage to the inferior alveolar nerve (IAN). There are cases in which this method is essential to obtain good morphologic and functional rebalancing of the jaw. In this paper, the authors present their experience with IANT, analyzing the various situations in which IANT is the only surgical preprosthetic option. Methods. Between 2003 and 2011, 35 patients underwent surgical IANT at our center. Thermal and physical sensitivity were evaluated in each patient during follow-up. The follow-up ranged from 14 to 101 months.
Results and Conclusion. Based on our experience, absolute indications of IANT are as follows: (1) class IV, V, or VI of Cawood and Howell with extrusion of the antagonist tooth and reduced prosthetic free space; (2) class V or VI of Cawood and Howell with presence of interforaminal teeth; (3) class V or VI of Cawood and Howell if patient desires fast implantoprosthetic rehabilitation with predictable outcomes; (4) class VI of Cawood and Howell when mandibular height increase with inlay grafts is advisable.
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Vertical ridge augmentation of the atrophic posterior mandible with sandwich technique: bone block from the chin area versus corticocancellous bone block allograft--clinical and histological prospective randomized controlled study. BIOMED RESEARCH INTERNATIONAL 2014; 2014:982104. [PMID: 24877155 PMCID: PMC4020564 DOI: 10.1155/2014/982104] [Citation(s) in RCA: 79] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/29/2014] [Accepted: 04/15/2014] [Indexed: 11/18/2022]
Abstract
UNLABELLED The aim of the present study is to compare the histological aspects of bone formation in atrophic posterior mandibles augmented by autologous bone block from chin area with corticocancellous bone block allograft used as inlays with the sandwich technique. MATERIALS AND METHODS Sixteen patients with bilateral partial edentulism in the posterior mandible were selected. The residual bone height, preliminarily measured by computed tomography scans, ranged between 5 and 7 mm from the inferior alveolar nerve. All patients required regeneration procedure with autologous bone block from chin area (control group) versus bone block allograft Puros (Zimmer Dental, 1900 Aston Avenue, Carlsbad, CA, USA) (test group). Histological and histomorphometric samples were collected at the time of implant positioning in order to analyze the percentage of newly formed bone, the residual graft material, and marrow spaces/soft tissue. RESULTS No statistically significant differences between the two groups were found regarding the percentage of newly formed bone. The percentage of residual grafted material was significantly higher in the test group, whilst the percentage of marrow spaces was higher in control group. CONCLUSIONS In conclusion, both procedures supported good results, although the use of bone blocks allograft was less invasive and preferable than harvesting bone from the mental symphysis.
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Evaluation of bone width lateral to the mandibular canal as an alternative approach for implant installation. IMPLANT DENT 2014; 22:97-101. [PMID: 23303270 DOI: 10.1097/id.0b013e31827e8640] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE The objective of the present study was to realize an indirect morphometric evaluation of bone thickness lateral to the mandibular canal. MATERIAL AND METHODS In 30 partially or totally edentulous dry jaws, the first and second molar areas were analyzed using computed tomography. RESULTS The findings indicated that 28.33% of the sites could be considered for the installation of a standard 3.75-mm-diameter implant laterally between the mandibular canal and its bony counterpart. CONCLUSION Implant installation in the posterior mandible region, lateral to the mandibular canal, is an alternative to more complex techniques, such as vertical ridge augmentation.
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Prosthodontic rehabilitation in patient with ectodermal dysplasia combining preprosthetic techniques: a case report. IMPLANT DENT 2013; 22:460-4. [PMID: 24013396 DOI: 10.1097/id.0b013e3182a2b8d2] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Oral manifestations in ectodermal dysplasia include oligodontia, alveolar ridges hypoplasia, and others. Due to the special conditions in terms of unhealthy teeth and lack of bone, implant-supported rehabilitation seems to offer the most satisfactory outcome. A 27-year-old male diagnosed with ectodermal dysplasia was referred to our department for oral rehabilitation. Oral manifestations included oligodontia, maxillary and mandibular atrophy, mandibular alveolar ridge with knife-edge morphology, and conical teeth. Treatment planning consisted of a Le Fort I osteotomy with interpositional grafts, bilateral sinus lift, and placement of maxillary and mandibular inlay and onlay corticocancellous grafts, using autologous iliac crest bone. In the second surgery, all remaining teeth were removed and 11 endosteal implants were placed. Six months after implant placement, a bimaxillary fixed implant-supported prosthesis was delivered, maintaining a satisfactory esthetic and functional result after a 2-year follow-up. The use of combined preprosthetic techniques allows the placement of endosteal implants and a fixed implant-supported prosthesis in patients with oligodontia and ectodermal dysplasia, providing an esthetic and functional oral rehabilitation.
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Distraction osteogenesis for the cranio-maxillofacial region (III): A compendium of devices for the dentoalveolus. JOURNAL OF ORAL AND MAXILLOFACIAL SURGERY, MEDICINE, AND PATHOLOGY 2013. [DOI: 10.1016/j.ajoms.2012.08.017] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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Cheung LK, Chua HDP, Hariri F, Pow EH, Zheng L. Alveolar Distraction Osteogenesis for Dental Implant Rehabilitation Following Fibular Reconstruction: A Case Series. J Oral Maxillofac Surg 2013; 71:255-71. [DOI: 10.1016/j.joms.2012.09.028] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2012] [Revised: 09/26/2012] [Accepted: 09/29/2012] [Indexed: 10/27/2022]
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Case of Severe Bone Atrophy of the Posterior Maxilla Rehabilitated With Blocks of Equine Origin Bone. IMPLANT DENT 2013; 22:8-15. [DOI: 10.1097/id.0b013e3182777239] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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