1
|
Luo F, Mo Y, Jiang J, Wen J, Ji Y, Li L, Wan Q. Advancements in dental implantology: The alveolar ridge split technique for enhanced osseointegration. Clin Implant Dent Relat Res 2024. [PMID: 39075020 DOI: 10.1111/cid.13363] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2024] [Revised: 06/24/2024] [Accepted: 07/02/2024] [Indexed: 07/31/2024]
Abstract
The alveolar ridge split (ARS) technique is a pivotal advancement in dental implantology, addressing the limitation of insufficient bone width for implant placement. This review traces the historical development of ARS from its initial conceptualization to current practices and future directions. Emphasizing the technique's development, indications, procedural overview, and osteotomy variations, we highlight its minimally invasive nature, which reduces patient morbidity and treatment time. This article reviews various osteotomy methods within ARS, examining their applications, benefits, and limitations. Furthermore, it discusses the technique's role in expanding treatment options for patients with compromised alveolar structures, underpinned by a high implant survival rate and the potential for immediate implant placement. We also cover the necessity of meticulous surgical technique, the importance of patient-specific factors, and the promising future of ARS facilitated by advancements in biomaterials and regenerative medicine. In summary, this review provides a comprehensive overview of ARS, offering valuable insights for dental professionals and informing future clinical practices and research in implantology.
Collapse
Affiliation(s)
- Feng Luo
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China School of Stomatology, Sichuan University, Chengdu, China
| | - Yafei Mo
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China School of Stomatology, Sichuan University, Chengdu, China
| | - Jiapei Jiang
- Outpatient Department, Sichuan Electrical Power Hospital, Chengdu, China
| | - Jing Wen
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China School of Stomatology, Sichuan University, Chengdu, China
| | - Yixuan Ji
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China School of Stomatology, Sichuan University, Chengdu, China
| | - Lei Li
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China School of Stomatology, Sichuan University, Chengdu, China
| | - Qianbing Wan
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China School of Stomatology, Sichuan University, Chengdu, China
| |
Collapse
|
2
|
Lin Y, Li G, Xu T, Zhou X, Luo F. The efficacy of alveolar ridge split on implants: a systematic review and meta-analysis. BMC Oral Health 2023; 23:894. [PMID: 37986181 PMCID: PMC10662563 DOI: 10.1186/s12903-023-03643-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2023] [Accepted: 11/08/2023] [Indexed: 11/22/2023] Open
Abstract
OBJECTIVES To evaluate the effects of the alveolar ridge split (ARS) technique on gained horizontal width of the alveolar ridge and implant survival rate. MATERIALS AND METHODS Electronic searching was performed in six electronic databases (Pubmed, Embase, the Cochrane Central Register of Controlled Trials, Web of Science, China National Knowledge Infrastructure, and SIGLE) from January 1, 2010, to November 1, 2023. Two authors performed study selection, data extraction, and study qualities (ROBINS-I and RoB 2.0) independently. Meta-analysis was performed by Comprehensive meta-analysis 3.0. RESULTS 24 included studies were observational, and 1 study was a randomized controlled trial (RCT). 14 studies investigated the gained width of the horizontal alveolar ridge, and 17 examined the implants' survival rate. For assessment of risk of bias, nine studies were high risk of bias and 16 studies were moderate risk of bias. Meta-analysis demonstrated that the pooled gained alveolar ridge width was 3.348 mm (95%CI: 4.163 mm, 2.533 mm), and the implant survival rate was 98.1% (95%CI: 98.9%, 96.9%). Seven studies showed seven different complications including exposure, infection, bad split, dehiscence, fracture, paresthesia and soft tissue retraction. CONCLUSION Recent ARS technique seems to be an effective method of bone augmentation with enough gained width and a high implant survival rate. Further long-term and RCTs research remains needed to enhance the study quality. CLINICAL RELEVANCE The ARS technique could generate sufficient bone volume, and implants had a high-level survival rate. Therefore, ARS has been proposed to be a reliable horizontal bone augmentation technique that creates good conditions for the implantation of narrow alveolar crests.
Collapse
Affiliation(s)
- Yuanyou Lin
- State Key Laboratory of Oral Diseases, West China School of Stomatology, National Clinical Research Center for Oral Diseases, Sichuan University, Chengdu, 610041, China
| | - Guanlin Li
- State Key Laboratory of Oral Diseases, West China School of Stomatology, National Clinical Research Center for Oral Diseases, Sichuan University, Chengdu, 610041, China
| | - Tingxiang Xu
- State Key Laboratory of Oral Diseases, West China School of Stomatology, National Clinical Research Center for Oral Diseases, Sichuan University, Chengdu, 610041, China
| | - Xuexiao Zhou
- State Key Laboratory of Oral Diseases, West China School of Stomatology, National Clinical Research Center for Oral Diseases, Sichuan University, Chengdu, 610041, China
| | - Feng Luo
- State Key Laboratory of Oral Diseases, West China School of Stomatology, National Clinical Research Center for Oral Diseases, Sichuan University, Chengdu, 610041, China.
- Department of Prosthodontics, West China School of Stomatology, Sichuan University, No. 14, Section 3, Renmin Nanlu, Chengdu, 610041, China.
| |
Collapse
|
3
|
Artzi Z. Lateral augmentation of the jaw by the split expansion ridge technique. A critical review. Periodontol 2000 2023; 93:205-220. [PMID: 37736876 DOI: 10.1111/prd.12527] [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: 01/29/2023] [Revised: 06/24/2023] [Accepted: 08/15/2023] [Indexed: 09/23/2023]
Abstract
Bone augmentation has become a routine procedure to enhance and/or repair a deficient or resorbed alveolar ridge for predictable and successful implant placement. The split expansion ridge i.e., the alveolar ridge splitting (ARS) procedure, is one of the less invasive procedures, and is characterized by minor morbidity. This would allow to widen narrow ridges in order to allow implant reconstruction in a sufficient bone volume. Its efficacy and long-term stability rely upon clinical opinions and long-term retrospective studies, while prospective comparative studies and randomized controlled trials are rare. This critical review presents the development of this technique, describes the surgical procedure, and provides technical notes and modifications. The learning curve and in-depth knowledge of the oral anatomy, as well as the recognition of incidence and management of complications are of utmost importance in the clinical application of the ARS procedure.
Collapse
Affiliation(s)
- Zvi Artzi
- Department of Periodontology and Oral Implantology, School of Dental Medicine, Tel Aviv University, Tel Aviv, Israel
| |
Collapse
|
4
|
Comparison of two different augmentation techniques. ANADOLU KLINIĞI TIP BILIMLERI DERGISI 2022. [DOI: 10.21673/anadoluklin.1034650] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
|
5
|
Xu Z, Wang N, Ma Y, Dai H, Han B. Preparation and study of 3D printed dipyridamole/β-tricalcium phosphate/ polyvinyl alcohol composite scaffolds in bone tissue engineering. J Drug Deliv Sci Technol 2022. [DOI: 10.1016/j.jddst.2021.103053] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
|
6
|
SEVERITY OF ADENTIA AS A RISK FACTOR OF REPEATED DENTAL IMPLANT OPERATIONS. WORLD OF MEDICINE AND BIOLOGY 2022. [DOI: 10.26724/2079-8334-2022-2-80-33-37] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
|
7
|
Sharaf MY, Eskander AE, Elbakery AI. Short-Term Evaluation of Prosthetic Rehabilitation of Thin Wiry Ridge by Ridge Splitting and Simultaneous Implants Placement: Non-randomized Control Trial. Eur J Dent 2021; 16:414-423. [PMID: 34863083 PMCID: PMC9339942 DOI: 10.1055/s-0041-1736292] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Objective
This article evaluates the success of prosthetic rehabilitation of thin wiry ridge and implants placed simultaneously in splitted ridge both clinically and radiographically.
Materials and Methods
Twenty-one participants were enrolled of which 13 patients (8 females and 5 males) were suffering from maxillary ridge atrophy and 8 patients (5 females and 3 males) had mandibular ridge atrophy; a total of 42 implants were performed using the ridge expansion technique. The expansion was performed using the conventional disk technique, piezoelectric corticotomy, and self-threading expanders. Implants were placed and loaded with fixed partial denture after 4 months for the mandible and 6 months for the maxilla. Implant stability quotient (ISQ) was measured at T0 (implant placement) and TL (loading). Crestal bone levels were measured at different times: T0, TL, and T12 (12 months). Evaluation of prosthetic and surgical complications was carried out. Data were analyzed and compared using analysis of variance and paired
t
-tests at a significance level of 5%.
Results
All implants met the criteria for success. All implants showed a higher mean bone loss from T0 to TL (1.259 ± 0.3020) than from TL to T12 (0.505 ± 0.163) with a statistically significant difference (
p
< 0.0001). ISQ values sharply increased at the time of loading (72.52 ± 2.734) than at implant insertion (44.5 ± 4.062) with a significant difference (
p
< 0.0001). Minor prosthetic and surgical complications were reported.
Conclusion
The results from this study support the efficacy of prosthetic rehabilitation of thin wiry ridge using split ridge technique and the success of implants placed simultaneously in splitted ridge.
Collapse
Affiliation(s)
- Mohamed Y Sharaf
- Department of Prosthodontics, Faculty of Dentistry, University of Menoufia, Menoufia, Egypt
| | - Asharf Email Eskander
- Department of Prosthodontics, Faculty of Dentistry, University of Cairo, Cairo, Egypt
| | - Ahmed Ibrahim Elbakery
- Department of Prosthodontics, Faculty of Dentistry, University of Ahram Canadian, Cairo, Egypt
| |
Collapse
|
8
|
Alevizakos V, Mitov G, Schiller M, von See C. Ridge augmentation-The new field of computerized guided surgery: A technical note for minimal-invasive bone splitting. Clin Case Rep 2021; 9:2390-2396. [PMID: 33936701 PMCID: PMC8077347 DOI: 10.1002/ccr3.4046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2021] [Revised: 02/27/2021] [Accepted: 03/01/2021] [Indexed: 11/08/2022] Open
Abstract
Different instrumentation procedures of the alveolar ridge expansion technique (ARST) with or without Guided Bone Regeneration have proven to be effective for successful implant placement in cases of alveolar bone width between 3mm and 6mm. Conventional bone splitting techniques require flap arising. This technical note demonstrates a method for flapless guided bone splitting. For this purpose, a newly developed surgical guide with internal irrigation channels was used. Using CAD-CAM additive technology, a narrow slot along the field of interest and a pin of a cooling pipe was designed and implemented in a surgical guide template. The bone split was performed flapless through the surgical guide while the cooling pipe was connected to it. During surgery, the piezo-driven instrument was moved within that slot, and the irrigation solution was directly rinsing it at point of entry through the irrigation channel. This procedure was performed on a 3.3 mm wide alveolar ridge achieving over 3 mm of bone gain. The described method combines several positive aspects. The micro-invasive flapless surgical procedure might improve postoperative healing. Additionally, sufficient cooling of the bone might lead to less thermal affection of bone cells and less resorption of the cortical bone. However, systematic studies are needed to confirm the observations of the presented case report.
Collapse
Affiliation(s)
- Vasilios Alevizakos
- Department of Digital Technologies in Dentistry and CAD-CAM Danube Private University Krems an der Donau Austria
| | - Gergo Mitov
- Department of Prosthodontics and Biomaterials Danube Private University Krems an der Donau Austria
| | - Marcus Schiller
- Department of Oral and Maxillofacial Surgery Hannover Medical School Hanover Germany
| | - Constantin von See
- Department of Digital Technologies in Dentistry and CAD-CAM Danube Private University Krems an der Donau Austria
| |
Collapse
|
9
|
Tay JRH, Lu XJ, Lai WMC, Fu JH. Clinical and histological sequelae of surgical complications in horizontal guided bone regeneration: a systematic review and proposal for management. Int J Implant Dent 2020; 6:76. [PMID: 33241468 PMCID: PMC7688776 DOI: 10.1186/s40729-020-00274-y] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2020] [Accepted: 10/27/2020] [Indexed: 12/11/2022] Open
Abstract
It is not uncommon to encounter post-surgical complications after horizontal guided bone regeneration (GBR). The primary aim of this review was to evaluate the incidence and types of complications that occur after horizontal GBR and propose management strategies to deal with these clinical situations. A secondary aim was to conduct a histomorphometric review of the wound healing process at sites that experienced post-surgical complications after GBR. A keyword search of MEDLINE, EMBASE, and the Cochrane Central Register of Controlled Trials for studies published in English from January 2015 to January 2020 was conducted for the primary aim and 23 studies were selected. A second search addressing the secondary aim was conducted, and five studies were included. Site-level analysis showed that the weighted mean incidence proportion of minor wound dehiscence and minor infections occurring at the augmented site was 9.9% [95% CI 6.4, 13.9, P < 0.01] and 1.5% [95% CI 0.4, 3.1, P = 0.21) respectively. Patient-level analysis showed minor and major complications occurring at a weighted mean incidence proportion of 16.1% [95% CI 11.9, 20.8, P = 0.01] and 1.6% [95% CI 0.0, 4.7, P < 0.01] respectively, while neurosensory alterations at the donor site was 7.0% [95% CI 1.3, 15.5, P < 0.01]. Subgroup analysis also revealed that the use of block grafts increased the incidence proportion of minor post-surgical complications, whereas a staged GBR procedure increased the incidence proportion of both minor and major post-surgical complications. Although exposure of the barrier membrane is often associated with less bone regeneration and graft resorption, the type of membrane used (resorbable or non-resorbable) had no statistically significant influence on any post-surgical complication. Histologically, a layer of fibrous connective tissue instead of bone is commonly observed at the interface between the native bone at the recipient site and the regenerated bone in cases with membrane exposure after GBR procedure. Minor wound dehiscence was the highest incidence proportion of post-surgical complications. Methods ranging from daily application of antiseptics, use of systemic antimicrobials, regular reviews, and total removal of the non-integrated biomaterials are commonly prescribed to manage these post-surgical complications in attempt to minimise the loss of tissue at the surgical site.
Collapse
Affiliation(s)
- John Rong Hao Tay
- Discipline of Periodontics, National University Centre for Oral Health Singapore, 9 Lower Kent Ridge Road, Singapore, 119085, Singapore.,Department of Restorative Dentistry, National Dental Centre Singapore, 5 Second Hospital Ave, Singapore, 168938, Singapore
| | - Xiaotong Jacinta Lu
- Discipline of Periodontics, National University Centre for Oral Health Singapore, 9 Lower Kent Ridge Road, Singapore, 119085, Singapore
| | - Wei Ming Clement Lai
- Statistics Unit, National University Centre for Oral Health Singapore, 9 Lower Kent Ridge Road, Singapore, 119085, Singapore
| | - Jia-Hui Fu
- Discipline of Periodontics, National University Centre for Oral Health Singapore, 9 Lower Kent Ridge Road, Singapore, 119085, Singapore.
| |
Collapse
|
10
|
The Alveolar Ridge Splitting Technique on Maxillae: A Biomechanical Human Cadaveric Investigation. BIOMED RESEARCH INTERNATIONAL 2020; 2020:8894471. [PMID: 33860030 PMCID: PMC8025128 DOI: 10.1155/2020/8894471] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/11/2020] [Revised: 10/24/2020] [Accepted: 11/02/2020] [Indexed: 11/18/2022]
Abstract
The alveolar ridge splitting technique (ARST) offers an alternative to classic ridge augmentation techniques for successful insertion of dental implants. However, the buccal lamella is at risk of fracturing during ARST distraction. To better understand the fracture mechanisms and displacement limits of the split lamella, this study conducted biomechanical tests on human cadaveric maxilla specimens having extremely atrophied alveolar ridges treated with ARST. A total of 12 standardized alveolar splits were prepared on the maxillae of 3 elderly female donors using an oscillating piezoelectric saw. Mimicking the surgical distraction process of the lamella, each split was tested to failure using a dental osteotome attached to the crosshead of an electromechanical testing system. All specimens were scanned by means of high-resolution peripheral quantitative computed tomography prior to and post testing to evaluate split geometries and failure modes. Split stiffness, failure force, and displacement were 27.4 ± 18.7 N/mm, 12.0 ± 8.4 N, and 0.97 ± 0.31 mm, with no significant differences between anatomical sides and split locations (p ≥ 0.17). Stiffness correlated significantly with failure force (R2 = 0.71, p < 0.01). None of the alveolar split widths correlated significantly with the outcomes from biomechanical testing (p ≥ 0.10). The results suggest that simple geometrical measures do not predict the allowed extent of lamella distraction prior to failure. More sophisticated methods are required for surgical planning to optimize the ARST outcomes. Still, the present study may advocate a clinical protocol for the maxilla where the implant site is prepared directly after osteotomy setting and immediately before full lamella dislocation, when the lamella is still stable, resistant to mechanical stress, and bone loss caused by the abrasion of the burr is minimized.
Collapse
|
11
|
Çelebi Bektaş A, Yalçın M. Evaluation of deformation in the buccal lamellar bone with finite element analysis in alveolar ridge-splitting/expansion technique. JOURNAL OF STOMATOLOGY, ORAL AND MAXILLOFACIAL SURGERY 2020; 122:578-582. [PMID: 33011329 DOI: 10.1016/j.jormas.2020.09.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/18/2020] [Accepted: 09/22/2020] [Indexed: 11/24/2022]
Abstract
PURPOSE The aim of this study was to investigate deformation and stress distribution in the buccal lamellar bone via finite element analysis (FEA) in the application of alveolar ridge-splitting/expansion technique (ARST) in atrophic maxilla and mandible. MATERIAL AND METHOD Three-dimensional (3D) solid models of maxilla and mandible were formed using computer software, with an alveolar ridge thickness of 4 mm in the right first molar region. In both models, one horizontal and two releasing vertical osteotomies were made in the atrophic region. Vertical forces varying from 50 N to 1000 N were continuously applied on the midpoint of the horizontal osteotomy and then the axial and total deformation and von Mises stress distribution in the buccal lamellar bone was assessed by FEA. RESULTS The degrees of axial deformation and total deformation and the maximum von Mises stress value under a 50 N force were 0.22 mm, 0.23 mm, and 4.52 MPa in the maxillary buccal lamellar bone and were 0.04 mm, 0.06 mm, and 5.90 MPa in the mandibular buccal lamellar bone, respectively. Similarly, under a 1000 N force, the values were 4.44 mm, 4.75 mm, and 90.49 MPa in the maxillary buccal lamellar bone and were 0.96 mm, 1.1 mm, and 118.02 MPa in the mandibular buccal lamellar bone, respectively. CONCLUSION These findings implicate that the ARST used for implant placement or alveolar augmentation can be achieved with the application of lower amounts of force in the maxilla compared to the mandible. It was also revealed that in ARST, the maximum von Mises stress value was lower in the maxillary buccal lamellar bone than in the mandibular buccal lamellar bone. Based on these findings, we consider that the administration of ARST could be biomechanically more stable in the maxilla than in the mandible.
Collapse
Affiliation(s)
- Adalet Çelebi Bektaş
- Assistant Professor, Bingol University, Faculty of Dentistry, Department of Oral and Maxillofacial Surgery, Bingol, Turkey.
| | - Mustafa Yalçın
- Associate Professor, Istanbul Kent University, Faculty of Dentistry, Department of Oral and Maxillofacial Surgery, Istanbul, Turkey
| |
Collapse
|
12
|
Xia HB, Zhang YF, Shi B, Wang M. Two bone blocks sandwich technique for horizontal reconstruction of severely atrophic alveolar ridge in anterior maxilla: A case report. World J Clin Cases 2020; 8:971-979. [PMID: 32190635 PMCID: PMC7062619 DOI: 10.12998/wjcc.v8.i5.971] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/13/2019] [Revised: 02/06/2020] [Accepted: 02/11/2020] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Severe horizontal bone deficiency of the maxillary anterior region is considered a major challenge in reconstruction and successful implant placement. Various approaches have been developed to augment bone volume. Of these approaches, onlay bone graft, alveolar bone splitting, and guided bone regeneration have been suggested.
CASE SUMMARY A 22-year-old female patient, with no previous medical history, presented to the Department of Oral Implantology, Wuhan University due to a missing right maxillary incisor. The X-ray results showed severe horizontal bone deficiency, with an available bone width of 3.1-4.0 mm. The two bone blocks sandwich technique was performed to augment the bone volume. After 6 months healing, X-ray results showed that the newly formed alveolar ridge dimension increased to 4.7-9.5 mm horizontally. Implant insertion surgery was performed and all-ceramic restorations were fabricated. The implant was stable at the 1-year follow-up visit after restoration, and the X-ray showed a stable bone level around the dental implant. The scores for the pink esthetic score and white esthetic score were 12 and 8, respectively, and the patient was satisfied with the esthetic outcome.
CONCLUSION The two bone blocks sandwich technique may be an alternative treatment option in augmenting severe horizontal bone deficiency of the anterior maxilla.
Collapse
Affiliation(s)
- Hai-Bin Xia
- Department of Oral Implantology, School and Hospital of Stomatology, Wuhan University, Wuhan 430079, Hubei Province, China
| | - Yu-Feng Zhang
- Department of Oral Implantology, School and Hospital of Stomatology, Wuhan University, Wuhan 430079, Hubei Province, China
- The State Key Laboratory Breeding Base of Basic Science of Stomatology, Hubei Province and Key Laboratory of Oral Biomedicine (Wuhan University), Ministry of Education (Hubei-MOST and KLOBM), Wuhan 430079, Hubei Province, China
| | - Bin Shi
- Department of Oral Implantology, School and Hospital of Stomatology, Wuhan University, Wuhan 430079, Hubei Province, China
| | - Min Wang
- Department of Oral Implantology, School and Hospital of Stomatology, Wuhan University, Wuhan 430079, Hubei Province, China
- The State Key Laboratory Breeding Base of Basic Science of Stomatology, Hubei Province and Key Laboratory of Oral Biomedicine (Wuhan University), Ministry of Education (Hubei-MOST and KLOBM), Wuhan 430079, Hubei Province, China
| |
Collapse
|
13
|
Starch-Jensen T, Becktor JP. Maxillary Alveolar Ridge Expansion with Split-Crest Technique Compared with Lateral Ridge Augmentation with Autogenous Bone Block Graft: a Systematic Review. EJOURNAL OF ORAL MAXILLOFACIAL RESEARCH 2019; 10:e2. [PMID: 32158526 PMCID: PMC7012616 DOI: 10.5037/jomr.2019.10402] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/26/2019] [Accepted: 12/23/2019] [Indexed: 02/02/2023]
Abstract
Objectives The objective of the present systematic review was to test the hypothesis of no difference in implant treatment outcome after maxillary alveolar ridge expansion with split-crest technique compared with lateral ridge augmentation with autogenous bone block graft. Material and Methods A MEDLINE (PubMed), Embase and Cochrane Library search in combination with a hand-search of relevant journals was conducted. Human studies published in English until 8th of February, 2018 were included. Results One comparative and four noncomparative studies fulfilled the inclusion criteria. Both treatment modalities disclosed high survival rate of implants with few complications. High survival rate of prosthesis, implant stability values, limited peri-implant marginal bone loss and gain in maxillary alveolar ridge width were reported with the split-crest technique. Patient-reported outcome measure and length of patient treatment time was not assessed in any of the included studies. Conclusions The split-crest technique seems to be useful for horizontal augmentation of maxillary alveolar deficiencies with high survival rate of prosthesis and implants. However, further long-term randomized controlled trials with larger patient sample as well as assessment of patient-reported outcome measures and patient treatment time are needed before well-defined conclusions can be provided about the two treatment modalities.
Collapse
Affiliation(s)
- Thomas Starch-Jensen
- Department of Oral and Maxillofacial Surgery, Aalborg University Hospital, AalborgDenmark
| | - Jonas Peter Becktor
- Department of Oral and Maxillofacial Surgery and Oral Medicine, Malmö University, MalmöSweden
| |
Collapse
|
14
|
Alveolar Ridge Expansion: Comparison of Osseodensification and Conventional Osteotome Techniques. J Craniofac Surg 2019; 30:607-610. [PMID: 30507887 DOI: 10.1097/scs.0000000000004956] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
OBJECTIVE The aim of this in vivo study is to compare the osseointegration of endosteal implants placed in atrophic mandibular alveolar ridges with alveolar ridge expansion surgical protocol via an experimental osseodensification drilling versus conventional osteotome technique. METHODS Twelve endosteal implants, 4 mm × 13 mm, were placed in porcine models in horizontally atrophic mandibular ridges subsequent to prior extraction of premolars. Implants were placed with osseodensification drilling technique as the experimental group (n = 6) and osteotome site preparation as the control group (n = 6). After 4 weeks of healing, samples were retrieved and stained with Stevenel's Blue and Van Gieson's Picro Fuschin for histologic evaluation. Quantitative analysis via bone-to-implant contact (BIC%) and bone area fraction occupancy (BAFO%) were obtained as mean values with corresponding 95% confidence interval. A significant omnibus test, post-hoc comparison of the 2 drilling techniques' mean values was accomplished using a pooled estimate of the standard error with P-value set at 0.05. RESULTS The mean BIC% value was approximately 62.5% in the osseodensification group, and 31.4% in the regular instrumentation group. Statistical analysis showed a significant effect of the drilling technique (P = 0.018). There was no statistical difference in BAFO as a function of drilling technique (P = 0.198). CONCLUSION The combined osseodensification drilling-alveolar ridge expansion technique showed increased evidence of osseointegration and implant primary stability from a histologic and biomechanical standpoint, respectively. Future studies will focus on expanding the sample size as well as the timeline of the study to allow investigation of long-term prognosis of this novel technique.
Collapse
|
15
|
Gurler G, Delilbasi C, Garip H, Tufekcioglu S. Comparison of alveolar ridge splitting and autogenous onlay bone grafting to enable implant placement in patients with atrophic jaw bones. Saudi Med J 2018; 38:1207-1212. [PMID: 29209669 PMCID: PMC5787631 DOI: 10.15537/smj.2017.12.21462] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Objective: To compare alveolar ridge splitting (ARS) and autogenous onlay bone grafting (AOBG) in atrophic jaw bones. Methods: Forty patients were included in this retrospective, parallel-group study conducted at the Istanbul Medipol University School of Dentistry, Istanbul, Turkey, between 2012-2015. The initial bone thickness was measured by cone beam computed tomography (CBCT). Patients were allocated into ARS (n=17) and AOGB (n=23) groups on the basis of ridge thickness and shape. Follow-up CBCT measurements to assess horizontal bone were repeated 4 to 6 months post augmentation. The diameters of the implants were recorded. Implant bone resorption was measured at one year post implant placement on panoramic radiography. Surgical complications and implant survival were evaluated. Results: The final bone width in the AOBG group was significantly higher than that in the ARS group (p=0.029). Forty-four implants were inserted in the AOGB group, whereas 33 implants were inserted in the ARS group. There was no significant difference regarding implant diameter (p=0.920). Implant survival rate was 93.9% in the ARS group and 93.1% in the AOGB group. Peri-implant bone resorption at one year was higher in the AOBG group than in the ARS group (p=0.032). There were minor surgical complications, including bad split and wound dehiscence. Conclusion: The incidence of peri-implant bone resorption for the AOGB technique was higher than that for the ARS technique, but their implant survival rates were similar.
Collapse
Affiliation(s)
- Gokhan Gurler
- Department of Oral and Maxillofacial Surgery, Istanbul Medipol University School of Dentistry, Istanbul, Turkey. E-mail.
| | | | | | | |
Collapse
|