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Zhao R, Zhang Z, Yang P, Xu X, Yuan Z, Gong J. Efficacy of bone ring grafts for the reconstruction of alveolar ridge deficiencies: a systematic review. Part II: animal trials. Ann Med Surg (Lond) 2024; 86:2963-2975. [PMID: 38694314 PMCID: PMC11060297 DOI: 10.1097/ms9.0000000000001952] [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: 01/03/2024] [Accepted: 03/04/2024] [Indexed: 05/04/2024] Open
Abstract
Background Bone ring (BR) grafts have been introduced to reconstruct alveolar ridge defects with simultaneous implant placement, but their clinical effectiveness remains undetermined. The aim of the current systematic review was to critically appraise evidence from animal studies regarding the effectiveness of BR grafts in alveolar ridge reconstruction and their variations under different surgical protocols. Methods Electronic retrieval of six databases (MEDLINE, Embase, Cochrane Library, ScienceDirect, Web of Science, and Scopus) and citation search until 11 October 2023, for animal studies on bone augmentation employing BR grafts. The outcome variables were total bone area (BA), bone volume (BV), bone-implant contact (BIC), and histology. The protocol was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and prospectively registered with PROSPERO (CRD42023453949). Results Ten studies were included in the qualitative analysis according to the screening criteria. Two studies demonstrated favorable bone remodeling and osseointegration of the BR with both the implant and pristine bone. A comparative study between autogenous BRs and allogenic BRs reported a higher percentage of BA and BIC at 4 months of healing, but conflicting data were observed at 8 months. Another study indicated a significant advantage of autogenous BRs over bovine and biphasic ceramic BRs in terms of BA and BIC after 5 weeks. Three studies found that using collagen membranes did not significantly affect BA, BV, or BIC when used simultaneously with autogenous BRs during implant placement. Two studies evaluated one-stage and two-stage implant placement in conjunction with BR grafts, revealing similar levels of BA, BV, and BIC except for differences in total treatment time. Furthermore, one study found that the use of mucogingival junction incision and split-thickness flap significantly reduced the incidence of wound dehiscence compared with conventional incision and flap. Conclusions Vertical bone augmentation surgery utilizing BR grafts with one-stage implant placement yielded histological and histomorphometric outcomes comparable to those achieved with two-stage implant placement or the additional application of collagen membrane.
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Affiliation(s)
- Ruimin Zhao
- Department of Stomatology, The Quzhou Affiliated Hospital of Wenzhou Medical University, Quzhou People’s Hospital, Quzhou City
| | - Zhelun Zhang
- Department of Stomatology, Longyou Traditional Chinese Medicine Hospital, Zhejiang
| | - Peixuan Yang
- Department of Stomatology, The Quzhou Affiliated Hospital of Wenzhou Medical University, Quzhou People’s Hospital, Quzhou City
| | - Xu Xu
- Department of Stomatology, The Quzhou Affiliated Hospital of Wenzhou Medical University, Quzhou People’s Hospital, Quzhou City
- School of Stomatology, Zhejiang Chinese Medicine University, Zhejiang, People’s Republic of China
| | - Zhenfei Yuan
- Department of Stomatology, The Quzhou Affiliated Hospital of Wenzhou Medical University, Quzhou People’s Hospital, Quzhou City
| | - Jiaming Gong
- Department of Stomatology, The Quzhou Affiliated Hospital of Wenzhou Medical University, Quzhou People’s Hospital, Quzhou City
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Zhao R, Wang Y, Lin H, Cao M, Xu X, Yuan Z, Gong J. Efficacy of bone ring grafts for the reconstruction of alveolar ridge deficiencies: A systematic review. Part I: Clinical trials. Medicine (Baltimore) 2024; 103:e37471. [PMID: 38489729 PMCID: PMC10940972 DOI: 10.1097/md.0000000000037471] [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: 10/31/2023] [Revised: 01/12/2024] [Accepted: 02/12/2024] [Indexed: 03/17/2024] Open
Abstract
BACKGROUND Bone ring (BR) grafts have been introduced to reconstruct alveolar ridge defects with simultaneous implant placement, but its clinical effectiveness remains undetermined. This systematic review aimed to comprehensively investigate BR grafts in diverse scenarios of ridge defect with simultaneous or staged implant placement. METHODS Electronic retrieval of MEDLINE, Embase, Cochrane Library(CENTRAL), Web of Science, Scopus, and citation search until August 3, 2023, was used to identify relevant clinical articles that utilized BR grafts for ridge defect reconstruction. The quality of evidence in the studies reviewed was assessed with the Joanna Briggs Institute Critical Appraisal tool. The protocol was registered in Prospective Register of Systematic Reviews (CRD42023453943). RESULTS Fourteen studies with 251 BRs were identified, of which 8 studies were for alveolar ridge augmentation, 4 studies were for extraction socket augmentation, and 2 studies were for sinus floor elevation. Reported sources of BRs included autografts, allografts, and xenografts. The follow-up period ranged from 4 months to 4.7 years. Regarding the primary outcomes, the utilization of BR grafts demonstrated favorable bone gain along with acceptable graft absorption and marginal bone loss. Regarding the secondary outcomes, satisfactory bone mineral density and implant stability were confirmed, accompanied by a recorded incidence of postoperative complications (20 cases) and an implant failure rate of 5.58%. CONCLUSIONS BR grafting with simultaneous or staged implant insertion is an effective approach for reconstructing alveolar ridge deficiencies. The BR grafts demonstrate favorable bone remodeling and osteointegration with the alveolar bone and implant; however, its success may be compromised by complications. Future studies should further investigate the clinical efficacy of BR grafting comparing to other bone augmentation techniques in diverse scenarios.
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Affiliation(s)
- Ruimin Zhao
- Department of Stomatology, Quzhou Affiliated Hospital of Wenzhou Medical University, Quzhou People’s Hospital, Quzhou City, P. R. China
| | - Yi Wang
- Department of Emergency, Quzhou Affiliated Hospital of Wenzhou Medical University, Quzhou People’s Hospital, Quzhou City, P. R. China
| | - Huijing Lin
- Department of Stomatology, Quzhou Affiliated Hospital of Wenzhou Medical University, Quzhou People’s Hospital, Quzhou City, P. R. China
- School of Stomatology, Zhejiang Chinese Medicine University, Hangzhou City, P.R.China
| | - Min Cao
- Department of Stomatology, Quzhou Affiliated Hospital of Wenzhou Medical University, Quzhou People’s Hospital, Quzhou City, P. R. China
- School of Stomatology, Zhejiang Chinese Medicine University, Hangzhou City, P.R.China
| | - Xu Xu
- Department of Stomatology, Quzhou Affiliated Hospital of Wenzhou Medical University, Quzhou People’s Hospital, Quzhou City, P. R. China
- School of Stomatology, Zhejiang Chinese Medicine University, Hangzhou City, P.R.China
| | - Zhenfei Yuan
- Department of Stomatology, Quzhou Affiliated Hospital of Wenzhou Medical University, Quzhou People’s Hospital, Quzhou City, P. R. China
- School of Stomatology, Zhejiang Chinese Medicine University, Hangzhou City, P.R.China
| | - Jiaming Gong
- Department of Stomatology, Quzhou Affiliated Hospital of Wenzhou Medical University, Quzhou People’s Hospital, Quzhou City, P. R. China
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Chen X, Tang C, Zhang X, Chen Y, Huang P, Chen Z, Gao Y, Peng L. Autogenous bone ring augmentation around single tooth implantation in the esthetic zone: A retrospective case series study with 2-3 years of follow-up. J Dent Sci 2023; 18:1517-1526. [PMID: 37799880 PMCID: PMC10547987 DOI: 10.1016/j.jds.2023.03.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2023] [Revised: 03/06/2023] [Indexed: 03/28/2023] Open
Abstract
Background /purpose: Bone ring technique (BRT) is an effective method to reconstruct alveolar bone defects with simultaneous implant placement. This study aimed to evaluate the efficacy of the BRT in single maxillary anterior tooth implantation and its esthetic outcomes over 2-3 years of follow-up. Materials and methods Fifteen patients with single maxillary incisor loss received autogenous BRT with simultaneous implant placement. The vertical/horizontal bone gain, remaining vertical bone height (RVBH), remaining buccal bone width (RBBW), and vertical/horizontal bone resorption around implant over 2-3 years of follow-up were measured by using cone-beam computed tomography. Esthetic results including white esthetic score (WES), pink esthetic score (PES), and papilla index (PI) were evaluated by clinical recorded photographs. Results All implants showed evidence of osseointegration, and the mean vertical and horizontal bone gain of 14 sites was 5.55 ± 0.87 mm and 4.73 ± 0.70 mm, respectively. During 2-3 years of follow-up, all mean values of RBBW were more than 2 mm. Main vertical bone loss appeared within 4 months after surgery and the RVBH value decreased as the follow-up duration continued. Maximum buccal bone thickness resorption mostly appeared in the middle level of the implant during the primary two follow-up periods (P < 0.05). Esthetic results showed that the mean WES/PES was higher than 17, and more than half cases demonstrated relatively high PI (3 points) throughout the follow-up. Conclusion BRT could achieve excellent bone augmentation effect and can offer predictable esthetic outcomes for single tooth implant restoration in the esthetic zone.
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Affiliation(s)
- Xue Chen
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Implantology, West China Hospital of Stomatology, Sichuan University, Chengdu, China
- Stomatological Hospital of Chongqing Medical University, Chongqing Key Laboratory of Oral Diseases and Biomedical Science, Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing, China
| | - Chenxi Tang
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Implantology, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Xiaohan Zhang
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Implantology, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Yue Chen
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Implantology, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Peijun Huang
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Implantology, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Zhongren Chen
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Implantology, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Yuan Gao
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Endodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Lin Peng
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Implantology, West China Hospital of Stomatology, Sichuan University, Chengdu, China
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Osseointegration Levels of Implants Placed With Allogenic and Xenogenic Bone Ring: An Experimental Biomechanical Analysis. J Craniofac Surg 2022; 34:926-930. [PMID: 36730628 DOI: 10.1097/scs.0000000000009130] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2022] [Accepted: 09/14/2022] [Indexed: 02/04/2023] Open
Abstract
This in vivo study aimed to do a biomechanical analysis of the early period bone-implant connection of titanium implants simultaneously inserted with xsenogenic and allogenic bone ring. In this study, 28 Sprague Dawley female rats were used. Four rats were killed to obtain an allogenic bone ring, and after this, the remaining rats were divided into control (n=8), xsenogenic (n=8), and allogenic (n=8) bone ring groups. Titanium-machined surfaced implants were integrated right tibias of the rats. In controls, only implants were integrated into right tibias. In the greft groups, the implants were integrated simultaneously with bone rings. After 2 weeks of the experimental period, the rats were killed ,and titanium implants and surrounding bone tissues were removed for biomechanic analysis. After biomechanical reverse torque analysis bone-implant connection was determined as Newton/cm2; in controls 3.26 (1.2 to 4.5), in allogenic ring group 3.37 (2 to 4.4), in xsenogenic ring group 5.93 (2.8 to 10). Statistically significant differences were not detected between the groups (P>0.05). Within the limitation of this study, both allogenic and xsenogenic bone grafts could be successfully used in bone augmentation in implant surgery.
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Yu K, Liu W, Su N, Chen H, Wang H, Tan Z. Evaluation of Resorption and Osseointegration of Autogenous Bone Ring Grafting in Vertical Bone Defect With Simultaneous Implant Placement in Dogs. J ORAL IMPLANTOL 2021; 47:295-302. [PMID: 32870248 DOI: 10.1563/aaid-joi-d-19-00199] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
The aim of this research was to evaluate the resorption and osseointegration of an autogenous bone ring, which was grafted in a local vertical alveolar defect with simultaneous implant placement. Six Beagle dogs were enrolled in the study; their 4 nonadjacent mandibular premolars were extracted, and the buccal plate was removed to create bone defects in 2 of the 4 sites. Three months after extraction, Straumann implants (Ø 3.3 mm, length of 8 mm) were placed in the bone defect sites with simultaneous autogenous bone ring grafting and in the conventional extraction sites. After a 3-month healing period and a 3-month loading period, the animals were euthanized. The harvested samples were analyzed using micro-computed tomography (CT) scanning and histological analysis. From the micro-CT measurements, the average vertical bone resorption of the bone ring was 0.23 ± 0.03 mm, which was not significantly different from that around the conventional implant, 0.24 ± 0.12 mm (P > .05). The ratio of the bone volume to the total volume of the bone ring group was 91.11 ± 0.02, which was higher than that of the control group, 88.38 ± 2.34 (P < .05). From the hard tissue section, the bone rings developed fine osseointegration with the implants and the base alveolar bone. The results suggest autogenous bone ring grafting with simultaneous implant placement can survive in a local vertical bone defect with little bone resorption and good osseointegration in dogs with strict management. A bone ring graft must be compared with guided bone regeneration, and a larger and longer observation must be confirmed in clinical patients.
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Affiliation(s)
- Ke Yu
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases, Sichuan University, Chengdu, China; College of Stomatology, Hospital of Stomatology, Southwest Medical University, Luzhou, China
| | - Wenjia Liu
- Sichuan Hospital of Stomatology, Chengdu, China
| | - Naichuan Su
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases, West China School & Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Helin Chen
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases, West China School & Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Hang Wang
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases, West China School & Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Zhen Tan
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases, West China School & Hospital of Stomatology, Sichuan University, Chengdu, China
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Zhang Z, Gan Y, Guo Y, Lu X, Li X. Animal models of vertical bone augmentation (Review). Exp Ther Med 2021; 22:919. [PMID: 34335880 PMCID: PMC8290405 DOI: 10.3892/etm.2021.10351] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2021] [Accepted: 06/10/2021] [Indexed: 11/28/2022] Open
Abstract
Vertical bone augmentation is an important challenge in dental implantology. Existing vertical bone augmentation techniques, along with bone grafting materials, have achieved certain clinical progress but continue to have numerous limitations. In order to evaluate the possibility of using biomaterials to develop bone substitutes, medical devices and/or new bone grafting techniques for vertical bone augmentation, it is essential to establish clinically relevant animal models to investigate their biocompatibility, mechanical properties, applicability and safety. The present review discusses recent animal experiments related to vertical bone augmentation. In addition, surgical protocols for establishing relevant preclinical models with various animal species were reviewed. The present study aims to provide guidance for selecting experimental animal models of vertical bone augmentation.
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Affiliation(s)
- Zepeng Zhang
- Department of Oral and Maxillofacial Surgery, Shanxi Medical University School and Hospital of Stomatology, Taiyuan, Shanxi 030001, P.R. China
| | - Yaxin Gan
- Department of Oral and Maxillofacial Surgery, Shanxi Medical University School and Hospital of Stomatology, Taiyuan, Shanxi 030001, P.R. China
| | - Yarong Guo
- Department of Oral and Maxillofacial Surgery, Shanxi Medical University School and Hospital of Stomatology, Taiyuan, Shanxi 030001, P.R. China
| | - Xuguang Lu
- Department of Oral and Maxillofacial Surgery, Shanxi Medical University School and Hospital of Stomatology, Taiyuan, Shanxi 030001, P.R. China
| | - Xianqi Li
- Department of Oral and Maxillofacial Surgery, Shanxi Medical University School and Hospital of Stomatology, Taiyuan, Shanxi 030001, P.R. China.,Department of Oral and Maxillofacial Surgery, School of Dentistry, Matsumoto Dental University, Shiojiri, Nagano 399-0781, Japan
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Ding Y, Wang L, Su K, Gao J, Li X, Cheng G. Horizontal bone augmentation and simultaneous implant placement using xenogeneic bone rings technique: a retrospective clinical study. Sci Rep 2021; 11:4947. [PMID: 33654142 PMCID: PMC7925558 DOI: 10.1038/s41598-021-84401-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2020] [Accepted: 02/15/2021] [Indexed: 11/09/2022] Open
Abstract
This study evaluated the use of bone ring technique with xenogeneic bone grafts in treating horizontal alveolar bone defects. In total, 11 patients in need of horizontal bone augmentation treatment before implant placement were included in this retrospective study. All patients received simultaneous bone augmentation surgery and implant placement with xenogeneic bone ring grafts. We evaluated the postoperative efficacy of the bone ring technique with xenogeneic bone grafts using radiographical and clinical parameters. Survival rates of implants were 100%. Cone-beam computed tomography revealed that the xenogeneic bone ring graft had significantly sufficient horizontal bone augmentation below the implant neck platform to 0 mm, 1 mm, 2 mm, and 3 mm. It could also provide an excellent peri-implant tissue condition during the 1-year follow-up after loading. The bone ring technique with xenogeneic bone ring graft could increase and maintain horizontal bone mass in the region of the implant neck platforms in serious horizontal bone defects.
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Affiliation(s)
- Yude Ding
- Department of Stomatology, Zhejiang Provincial People's Hospital, People's Hospital of Hangzhou Medical College, Hangzhou, 310014, Zhejiang, People's Republic of China
| | - Lianfei Wang
- Department of Stomatology of Bengbu Medical College, Bengbu, Anhui, People's Republic of China
| | - Kuiwei Su
- Department of Stomatology of Bengbu Medical College, Bengbu, Anhui, People's Republic of China
| | - Jinxing Gao
- Department of Stomatology, Zhejiang Provincial People's Hospital, People's Hospital of Hangzhou Medical College, Hangzhou, 310014, Zhejiang, People's Republic of China
| | - Xiao Li
- Department of Stomatology of Bengbu Medical College, Bengbu, Anhui, People's Republic of China
| | - Gang Cheng
- Department of Stomatology, Zhejiang Provincial People's Hospital, People's Hospital of Hangzhou Medical College, Hangzhou, 310014, Zhejiang, People's Republic of China.
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Sáez-Alcaide LM, Brinkmann JCB, Sánchez-Labrador L, Pérez-González F, Molinero-Mourelle P, López-Quiles J. Effectiveness of the bone ring technique and simultaneous implant placement for vertical ridge augmentation: a systematic review. Int J Implant Dent 2020; 6:82. [PMID: 33313968 PMCID: PMC7732905 DOI: 10.1186/s40729-020-00280-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2020] [Accepted: 11/20/2020] [Indexed: 12/17/2022] Open
Abstract
Background Dimensional changes after dental extraction frequently lead to situations in which bone augmentation procedures are required prior to dental implant placement. Bone ring technique (BRT) has been described as a one-stage approach to restore vertical alveolar ridge defects, in which an autogenous or allogeneic cortico-cancellous bone block graft is stabilized with a dental implant inserted simultaneously. The objective of this systematic review was to evaluate the clinical performance of BRT. Materials and methods This review was conducted according to PRISMA guidelines. An electronic search was conducted in four databases: (1) The National Library of Medicine (MEDLINE/PubMed) via Ovid; (2) Web of Science (WOS); (3) SCOPUS; and (4) Cochrane Central Register of Controlled Trials (CENTRAL). The Newcastle-Ottawa Quality Assessment Scale and The Joanna Briggs Institute Critical Appraisal tool were used to assess the quality of evidence in the studies reviewed. Results Sixteen studies with a total of 186 patients treated with 219 bone rings bocks were included in the review. The studies showed a mean bone gain of 4.94 mm, mean bone resorption of 0.83 mm, and mean marginal bone loss of 0.57 mm after a mean follow-up period of 13.35 months. A mean bone ring survival rate of 97.26% and implant survival rate of 94.97% were recorded. Conclusions BRT would appear to be an adequate alternative technique for restoring single vertical alveolar ridge defects with simultaneous dental implant placement. However, further studies comparing this technique with other vertical ridge augmentation procedures in different clinical scenarios are needed to confirm the present results.
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Affiliation(s)
- Luis Miguel Sáez-Alcaide
- Department of Dental Clinical Specialties, Faculty of Dentistry, Complutense University of Madrid, Plaza Ramón y Cajal S/N, 28040, Madrid, Spain.
| | - Jorge Cortés-Bretón Brinkmann
- Department of Dental Clinical Specialties, Faculty of Dentistry, Complutense University of Madrid, Plaza Ramón y Cajal S/N, 28040, Madrid, Spain
| | - Luis Sánchez-Labrador
- Department of Dental Clinical Specialties, Faculty of Dentistry, Complutense University of Madrid, Plaza Ramón y Cajal S/N, 28040, Madrid, Spain
| | - Fabián Pérez-González
- Department of Dental Clinical Specialties, Faculty of Dentistry, Complutense University of Madrid, Plaza Ramón y Cajal S/N, 28040, Madrid, Spain
| | - Pedro Molinero-Mourelle
- Department of Conservative Dentistry and Orofacial Prosthodontics, Faculty of Dentistry, Complutense University of Madrid, Madrid, Spain.,Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern, Bern, Switzerland
| | - Juan López-Quiles
- Department of Dental Clinical Specialties, Faculty of Dentistry, Complutense University of Madrid, Plaza Ramón y Cajal S/N, 28040, Madrid, Spain
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Autogenous bone ring for vertical bone augmentation procedure with simultaneous implant placement: A systematic review of histologic and histomorphometric outcomes in animal studies. J Prosthet Dent 2020; 126:626-635. [PMID: 33039188 DOI: 10.1016/j.prosdent.2020.09.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2020] [Revised: 09/08/2020] [Accepted: 09/08/2020] [Indexed: 12/09/2022]
Abstract
STATEMENT OF PROBLEM The performance of the autogenous bone ring (ABR) technique used for the vertical bone augmentation procedure has not yet been determined. PURPOSE The purpose of this systematic review was to investigate whether the ABR technique for the vertical bone augmentation procedure with simultaneous implant placement enhances the histologic and histomorphometric outcomes in surgically created bone defects in animal models. MATERIAL AND METHODS An electronic search of 3 databases, Medline/PubMed, Science Direct, Lilacs, and a manual search of a reference list of relevant studies were performed. Only animal studies regarding vertical bone augmentation by using the ABR technique with simultaneous implant placement in surgically created bone defects were included in the review. The SYstematic Review Center for Laboratory Animal Experimentation tool was used to determine the risk of bias assessment, and the quality of included studies was assessed by using the Animal Research: Reporting in Vivo Experiments guidelines. RESULTS Five studies were included in the qualitative analysis based on the inclusion and exclusion criteria. One study comparing the ABR technique with the bovine and biphasic ring reported a high percentage of bone area and bone implant contact of the ABR at 5 weeks of osseointegration. Similar histologic findings were reported in another study at 4 months of healing, but contrasting data were reported at 8 months. Another study reported an increase in the percentage of bone area and bone implant contact of the ABR technique from 3 months to 6 months of osseointegration. Two studies reported an increase in the percentage of bone area, and 1 study reported a decrease in the mean of bone implant contact, both with simultaneous and staged implant procedures. CONCLUSION Based on the limited available studies, the use of the ABR technique for the vertical bone augmentation procedure with simultaneous implant placement presented optimal histologic and histomorphometric outcomes in surgically created bone defects in animal models. However, the results of the current review are not sufficiently robust to support the use of the ABR technique for vertical bone augmentation in humans.
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Yuan S, Mu Z, Huang Y, Bai S, Xu P, Chen T. Comparison of in-situ bone ring technique and tent-pole technique for horizontally deficient alveolar ridge in the anterior maxilla. Clin Implant Dent Relat Res 2020; 22:167-176. [PMID: 32022425 DOI: 10.1111/cid.12887] [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: 10/31/2019] [Revised: 12/05/2019] [Accepted: 01/21/2020] [Indexed: 12/14/2022]
Abstract
BACKGROUND Limited studies focused on the bone profile maintenance at the alveolar ridge crest applying horizontal bone augmentation. PURPOSE A novel approach named as "in-situ bone ring technique" was introduced to be compared with tent-pole technique to evaluate their horizontal bone gain, resorption, and postoperative perception. MATERIALS AND METHODS A total of 30 patients were included in this retrospective cohort study. All patients required horizontal bone augmentation at anterior site. Accordingly, quantitative and qualitative analyses were conduct radiographically and histologically between in-situ bone ring (ring group) and tent-pole technique (tent group). Moreover, the visual analog scale (VAS) was introduced to assess the patients' perception toward both treatments. RESULTS Cone-beam computed tomography results showed great significant difference regarding horizontal bone width at 0 mm and 3 mm from alveolar ridge crest between two groups (P < .05). On the basis of histological outcomes, delightful bony fusion was shown 6-month postoperatively in ring group. The VAS ratings for pain and swelling reflected similar results between two groups. CONCLUSIONS In-situ bone ring technique evidently increased and maintained horizontal bone mass at the alveolar ridge crest compared to tent-pole technique, which might be favorable for implant rehabilitation in anterior area. Meanwhile, no further discomfort was caused according to VAS scoring between two groups.
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Affiliation(s)
- Shuai Yuan
- Laboratory of Oral Diseases and Biomedical Sciences, Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing Medical University, Chongqing, People's Republic of China
| | - Zhixiang Mu
- Laboratory of Oral Diseases and Biomedical Sciences, Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing Medical University, Chongqing, People's Republic of China
| | - Yuanding Huang
- Laboratory of Oral Diseases and Biomedical Sciences, Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing Medical University, Chongqing, People's Republic of China
| | - Shi Bai
- Laboratory of Oral Diseases and Biomedical Sciences, Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing Medical University, Chongqing, People's Republic of China
| | - Peng Xu
- Laboratory of Oral Diseases and Biomedical Sciences, Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing Medical University, Chongqing, People's Republic of China
| | - Tao Chen
- Laboratory of Oral Diseases and Biomedical Sciences, Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing Medical University, Chongqing, People's Republic of China
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11
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Benlidayi ME, Tatli U, Salimov F, Tükel HC, Yüksel O. Comparison of autogenous and allograft bone rings in surgically created vertical bone defects around implants in a sheep model. Clin Oral Implants Res 2018; 29:1155-1162. [PMID: 30281857 DOI: 10.1111/clr.13379] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2017] [Revised: 08/06/2018] [Accepted: 08/28/2018] [Indexed: 11/28/2022]
Abstract
OBJECTIVES The aim of this study was to compare autogenous and allograft bone rings in surgically created vertical bone defects. MATERIAL AND METHODS Four male, 1-year-old sheep were used in this study. In each sheep, eight vertical bone defects 7 mm in diameter were created using trephine drill in the iliac wing. Autogenous and allograft bone rings 5 mm in height and 7 mm in diameter were used for vertical augmentation around implants. The study consisted of four groups according to the bone ring type and amount of vertical augmentation, autogenous 2 mm, allograft 2 mm, autogenous 4 mm, and allograft 4 mm. Two of the animals were sacrificed after 4 months, and the remaining two animals were sacrificed after 8 months. Undecalcified sections were prepared from harvested samples. Histological assessment and histomorphometric analysis were performed. RESULTS Autogenous 2 mm group showed higher values than allograft 2 mm group, and autogenous 4 mm group showed higher values than allograft 4 mm group in terms of bone area and bone-to-implant contact (BIC) after 4 months. However, allograft 2 mm group showed higher bone area and BIC values than autogenous 2 mm group after 8 months. Also, autogenous 4 mm and allograft 4 mm groups showed comparable results after 8 months. Allograft 2 mm and allograft 4 mm groups showed higher bone area and BIC values at 8 months compared with 4 months. CONCLUSIONS Allograft bone ring looks promising in augmentation of surgically created vertical bone defects around implants after 8 months of healing.
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Affiliation(s)
- Mehmet Emre Benlidayi
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Cukurova University, Adana, Turkey
| | - Ufuk Tatli
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Cukurova University, Adana, Turkey
| | - Fariz Salimov
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Cukurova University, Adana, Turkey
| | - Hüseyin Can Tükel
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Cukurova University, Adana, Turkey
| | - Orcan Yüksel
- Private Practice, Zahnarztpraxis Dr.Yüksel & Kollegen, Frankfurt, Germany.,Academic Teaching and Research Unit, Medical Faculty of Goethe-University Frankfurt, Frankfurt, Germany
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U-Shaped Bone Splitting and Osteotome Techniques for Narrow Alveolar Ridge in Implant Surgery. IMPLANT DENT 2018; 27:507-511. [PMID: 29958187 DOI: 10.1097/id.0000000000000795] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE Bone splitting and osteotome are common ridge expansion choices for patients with a narrow alveolar ridge requiring dental implant restoration. Despite the effectiveness of the 2 techniques in horizontal ridge augmentation, they could also result in severe complications, which is thus considered a contraindication. MATERIALS AND METHODS A modification of the bone splitting and the osteotome techniques is proposed hereby as an alternative. RESULTS The modified procedure reduces the tension of labial bone plate by creating a partial bone fracture at the most depressed area of labial defect where the thinner bone exists. CONCLUSIONS This technique is primarily useful for cases with a facial concavity. The modification could prevent iatrogenic labial bone defect during the surgery, and compared with onlay bone grafting, it may shorten the overall treatment time and avoid traumatizing the bone donor site.
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13
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Zimmermann T, Ferrandez-Montero A, Lieblich M, Ferrari B, González-Carrasco JL, Müller WD, Schwitalla AD. In vitro degradation of a biodegradable polylactic acid/magnesium composite as potential bone augmentation material in the presence of titanium and PEEK dental implants. Dent Mater 2018; 34:1492-1500. [PMID: 29941350 DOI: 10.1016/j.dental.2018.06.009] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2018] [Revised: 05/08/2018] [Accepted: 06/07/2018] [Indexed: 12/24/2022]
Abstract
OBJECTIVE The aim of this study was to assess the degradation behavior by measuring the H2 release of a biodegradable composite consisting of a polylactic acid matrix reinforced with 30% wt. spherical magnesium microparticles (PLA/Mg) as potential bone augmentation material in combination with dental implants of either titanium or polyetheretherketone (PEEK) in order to evaluate the potential influence of the titanium dental implants on the corrosion behavior of the Mg particles within the PLA matrix. METHODS Three PEEK dental implants and three titanium dental implants were put into a central perforation of six PLA/Mg-discs. These samples were incubated at 37°C for 30days in McCoy's 5A modified medium and the H2 release was evaluated. RESULTS Between day 7 and day 16 the average H2 release per cm2 of the surface of the PLA/Mg-samples in combination with the titanium implants was significantly higher than that of the sample group combined with the implants of PEEK (3.1±0.4ml vs. 2.8±0.4ml). This significant difference disappeared afterwards, whereas the H2 release was highest at day 30 and amounted 3.5±0.7ml/cm2 for the group with the titanium implants and 3.2±0.8ml/cm2 for the group with the PEEK implants. SIGNIFICANCE Regarding the similar values of the degradation depending H2 release of the two implant material groups, the co-implantation of a PLA/Mg composite is not only possible with new metal-free implant materials such as PEEK, but also with conventional implants of titanium.
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Affiliation(s)
- Tycho Zimmermann
- Charité -Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Dental Materials and Biomaterial Research, Department of Prosthodontics, Geriatric Dentistry and Craniomandibular Disorders, Aßmannshauser Str. 4-6, 14197 Berlin, Germany
| | - Ana Ferrandez-Montero
- Centro Nacional de Investigaciones Metalurgicas, CSIC, Avda. Gregorio del Amo 8, 28040, Madrid, Spain
| | - Marcela Lieblich
- Centro Nacional de Investigaciones Metalurgicas, CSIC, Avda. Gregorio del Amo 8, 28040, Madrid, Spain
| | - Begoña Ferrari
- Instituto de Cerámica y Vidrio, CSIC, Campus de Cantoblanco, c/ Kelsen 5, 28049, Madrid, Spain
| | | | - Wolf-Dieter Müller
- Charité -Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Dental Materials and Biomaterial Research, Department of Prosthodontics, Geriatric Dentistry and Craniomandibular Disorders, Aßmannshauser Str. 4-6, 14197 Berlin, Germany.
| | - Andreas Dominik Schwitalla
- Charité -Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Dental Materials and Biomaterial Research, Department of Prosthodontics, Geriatric Dentistry and Craniomandibular Disorders, Aßmannshauser Str. 4-6, 14197 Berlin, Germany
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14
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Haga-Tsujimura M, Nakahara K, Kobayashi E, Igarashi K, Schaller B, Saulacic N. Single-staged implant placement using bone ring technique with and without membrane placement: An experimental study in the Beagle dog. Clin Oral Implants Res 2017; 29:263-276. [PMID: 29235158 DOI: 10.1111/clr.13111] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/15/2017] [Indexed: 11/30/2022]
Abstract
AIM To evaluate the impact of a collagen membrane on bone remodeling and osseointegration of implants placed simultaneously with a bone ring technique. MATERIAL AND METHODS Standardized, vertical alveolar bone defects in the mandibles of six dogs were created. Tapered dental implants designed for two-stage subcrestal placement were inserted simultaneously with a bone ring technique. On one side of the mandible, the augmented sites were covered with a collagenous membrane. Implants with (M Group) and without membranes (NM Group) were left for an osseointegration period of 3 and 6 months, respectively. Block biopsies of the implants with surrounding bone were harvested and analyzed histologically. RESULTS Implant exposure was a common finding (2/3) concomitantly with loss of healing caps. It appeared to be related to advanced bone loss around the implants. Exposure of implants was more frequent in M Group, however, without significant differences when compared to NM Group. The total bone area within the region of the bone ring was greater in the NM Group compared to the M Group. Moreover, in the region of the pristine bone of the M Group, the total bone was greater than at the corresponding NM Group sites at both observation periods. A nonparametric analysis of variance (ANOVA) revealed no significant effects of membrane placement or healing period on the total area of the bone. The total bone-to-implant contact (BIC) for the two groups was similar at each observation time point. However, BIC increased significantly at 6-month compared with 3-month observation period (p = .0088) in both groups. CONCLUSIONS In vertical bone augmentation applying the bone ring technique, the disruption of soft tissue was a frequent complication. Membrane placement yielded no significant advantage on the osseointegration (BIC) of implants or bone characteristics.
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Affiliation(s)
- Maiko Haga-Tsujimura
- Department of Histology, The Nippon Dental University School of Life Dentistry at Niigata, Niigata, Japan
| | - Ken Nakahara
- Advanced Research Center, The Nippon Dental University School of Life Dentistry at Niigata, Niigata, Japan
| | - Eizaburo Kobayashi
- Department of Oral and Maxillofacial Surgery, The Nippon Dental University School of Life Dentistry at Niigata, Niigata, Japan
| | - Kensuke Igarashi
- Department of Life Science Dentistry, The Nippon Dental University, Niigata, Japan
| | - Benoit Schaller
- Department of Cranio-Maxillofacial Surgery, Inselspital, Bern University Hospital, University of Bern, Switzerland
| | - Nikola Saulacic
- Department of Cranio-Maxillofacial Surgery, Inselspital, Bern University Hospital, University of Bern, Switzerland
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15
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Intrasinusal locking technique: a novel use of the ring block technique at sinus perforations for simultaneous implant placement. Int J Oral Maxillofac Surg 2017; 47:499-504. [PMID: 29032854 DOI: 10.1016/j.ijom.2017.09.011] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2017] [Revised: 08/08/2017] [Accepted: 09/20/2017] [Indexed: 11/24/2022]
Abstract
Ten patients who underwent sinus lift surgery with simultaneous implant placement using the intrasinusal locking technique were evaluated retrospectively. All patients were scheduled for sinus floor elevation procedures with simultaneous implant placement. Schneiderian membrane perforation occurred during the lifting procedure, and conventional methods failed to repair the perforation. Therefore, an autogenous bone ring was placed at the base of the maxillary sinus and was locked to the alveolar crest with a dental implant. Marginal resorption around the dental implants was measured on panoramic radiographs. Prosthetic rehabilitation was performed at 6 months postoperative. The overall survival rate of the implants over a mean follow-up of 24.3 months was 90%. One case failed due to resorption of the alveolar crest around the implant as a result of infection; the implant and the adjacent ring were removed at 1 month postoperative. At the time of writing, the nine implants placed using the documented technique continue to function well, without any signs of peri-implant disease. The proposed approach allows for simultaneous dental implant placement in the extremely atrophic maxilla, even if there is extensive perforation of the Schneiderian membrane.
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16
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Al Amri MD, Abduljabbar TS, Al-Johany SS, Al Rifaiy MQ, Alfarraj Aldosari AM, Al-Kheraif AA. Comparison of clinical and radiographic parameters around short (6 to 8 mm in length) and long (11 mm in length) dental implants placed in patients with and without type 2 diabetes mellitus: 3-year follow-up results. Clin Oral Implants Res 2016; 28:1182-1187. [DOI: 10.1111/clr.12938] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/06/2016] [Indexed: 11/28/2022]
Affiliation(s)
- Mohammad D. Al Amri
- Department of Prosthetic Dental Sciences; College of Dentistry; King Saud University; Riyadh Saudi Arabia
| | - Tariq S. Abduljabbar
- Department of Prosthetic Dental Sciences; College of Dentistry; King Saud University; Riyadh Saudi Arabia
| | - Sulieman S. Al-Johany
- Department of Prosthetic Dental Sciences; College of Dentistry; King Saud University; Riyadh Saudi Arabia
| | - Mohammad Q. Al Rifaiy
- Department of Prosthetic Dental Sciences; College of Dentistry; King Saud University; Riyadh Saudi Arabia
| | | | - Abdulaziz A. Al-Kheraif
- Dental Biomaterials Research Chair; Dental Health Department, College of Applied Medical Sciences; King Saud University; Riyadh Saudi Arabia
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17
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Nakahara K, Haga-Tsujimura M, Sawada K, Kobayashi E, Schaller B, Saulacic N. Single-staged vs. two-staged implant placement in vertically deficient alveolar ridges using bone ring technique - Part 2: implant osseointegration. Clin Oral Implants Res 2016; 28:e31-e38. [PMID: 27090198 DOI: 10.1111/clr.12851] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/20/2016] [Indexed: 02/02/2023]
Abstract
OBJECTIVES The aim of this study was to evaluate the osseointegration of implants placed in a single-staged compared to two-staged procedure using bone ring technique. MATERIAL AND METHODS In this study were used standardized, vertical alveolar bone defects in dogs. In the test group, dental implants (Straumann BL® , Basel, Switzerland) were inserted simultaneously with bone ring technique. As control group served implants inserted 6 months following grafting. Implants of both groups were left for an osseointegration period of 3 and 6 months. The peri-implant bone loss and bone-to-implant contact within the bone ring and native bone were analyzed morphometrically. An explorative statistical analysis was performed. RESULTS The peri-implant bone level remained relatively stable within groups and between groups per given time period. Most of bone apposite on the implant surface in two groups was composed of newly formed bone. A nonparametric analysis of variance (ANOVA) revealed no significant advantage for two-staged implant placement for new and total bone, except for residual bone (P = .0084). Furthermore, two groups of implants performed similarly in bone ring and in native bone throughout the observation period. CONCLUSIONS In terms of osseointegration, both techniques are likely equally efficient in the present defect model. The single-staged implant placement with cortical bone grafts warrants further documentation in clinical studies.
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Affiliation(s)
- Ken Nakahara
- Advanced Research Center, The Nippon Dental University School of Life Dentistry at Niigata, Niigata, Japan
| | - Maiko Haga-Tsujimura
- Department of Histology, The Nippon Dental University School of Life Dentistry at Niigata, Niigata, Japan
| | - Kosaku Sawada
- Advanced Research Center, The Nippon Dental University School of Life Dentistry at Niigata, Niigata, Japan
| | - Eizaburo Kobayashi
- Department of Oral and Maxillofacial Surgery, The Nippon Dental University School of Life Dentistry at Niigata, Niigata, Japan
| | - Benoit Schaller
- Department of Cranio-Maxillofacial Surgery, Inselspital, Bern University Hospital and University of Bern, Bern, Switzerland
| | - Nikola Saulacic
- Department of Cranio-Maxillofacial Surgery, Inselspital, Bern University Hospital and University of Bern, Bern, Switzerland
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