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Saulacic N, Lang NP, Corluka S, Mendaña MP, Muñoz Guzón FM. Vertical Alveolar Ridge Regeneration by Means of Periosteal Activation-A Proof-of-Principle Study. J Clin Periodontol 2024. [PMID: 39148400 DOI: 10.1111/jcpe.14057] [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: 03/05/2024] [Revised: 07/22/2024] [Accepted: 07/30/2024] [Indexed: 08/17/2024]
Abstract
AIM To assess the possibility of vertical alveolar ridge augmentation by means of activation of the periosteum. MATERIALS AND METHODS Six adult male Beagle dogs were used for the study. All premolars and first molars were extracted, and one vertical saucer-shaped bony defect was created on each side of the mandible. After 3 months of healing, full-thickness muco-periosteal flaps were elevated, and one distraction device was placed on each side of the mandible. The distraction plate was left submerged, and the activation mechanism connected to the distraction rod was exposed intra-orally. The protocol of periosteal activation (PP: periosteal 'pumping') was initiated after a latency of 7 days. The alternation of activation and relaxation at the rate of 0.35 mm/12 h during 5 days was followed by the sole activation of 0.35 mm/12 h for 5 days (PP group). Devices were left inactivated on the contralateral control side of the mandible (C group). All animals were euthanized after 8 weeks of consolidation. Samples were analysed histologically and by means of micro-CT. RESULTS New mature lamellar bone was formed over the pristine bone in all groups. More intensive signs of bone modelling and remodelling were observed in the PP group compared to the C group. Mean new bone, bone marrow, connective tissue and total volumetric densities were greater in the PP group (p < 0.001, p = 0.001, p = 0.003 and p < 0.001, respectively). No differences were observed in the relative area parameters. Total tissue volume and bone volume were higher in the PP group (p = 0.031 and p = 0.076, respectively), while the bone mineral densities were higher in the C group (p = 0.041 and p = 0.003, respectively). Trabecular number, trabecular thickness and trabecular separation values were similar between the two groups. CONCLUSIONS Regeneration of vertical alveolar bone ridge defects may be enhanced by activation of the periosteum, without the application of bone grafting materials.
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Affiliation(s)
- Nikola Saulacic
- Department of Cranio-Maxillofacial Surgery, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Niklaus P Lang
- Department of Cranio-Maxillofacial Surgery, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Slavko Corluka
- Tissue Engineering for Orthopaedics and Mechanobiology, Bone and Joint Program, Department for BioMedical Research (DBMR), Faculty of Medicine, University of Bern, Bern, Switzerland
| | - Maria Permuy Mendaña
- Department of Veterinary Clinical Sciences, Faculty of Veterinary, University of Santiago de Compostela, Lugo, Spain
- Ibonelab SL, Lugo, Spain
| | - Fernando M Muñoz Guzón
- Department of Veterinary Clinical Sciences, Faculty of Veterinary, University of Santiago de Compostela, Lugo, Spain
- Ibonelab SL, Lugo, Spain
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Zhang H, Xu T, Wei Y, Wei N, Han Z, Hu W. Assessment of soft and hard tissue changes following micro crestal flap-Alveolar ridge preservation and augmentation at molar extraction sites in patients with stage III/IV periodontitis: A randomized controlled trial. J Clin Periodontol 2024. [PMID: 39043452 DOI: 10.1111/jcpe.14045] [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: 12/01/2023] [Revised: 06/25/2024] [Accepted: 07/02/2024] [Indexed: 07/25/2024]
Abstract
AIM This study aimed to assess hard and soft tissue contour changes following micro crestal flap-alveolar ridge preservation (MCF-ARP) and natural healing (NH) in periodontally compromised molar extraction sites and to analyse the feasibility and need for bone augmentation during implant therapy. MATERIALS AND METHODS Fifty-six patients with 70 sites were randomized into two groups at the site level (35 sites from 31 patients in the test group and 35 sites from 29 patients in the control group). Among whom, four patients contributed one tooth to the control group and one tooth to the test group. Hard tissue indicators were measured using cone beam computed tomography performed before tooth extraction and 6 months after surgery. Soft tissue contour changes were assessed using intraoral scanning performed before and immediately after surgery and also 2 weeks and 1, 3 and 6 months after surgery. RESULTS Six months after surgery, the MCF-ARP group showed less resorption in buccal bone height (p = .032) and greater augmentation in central bone height (p = .001) and ridge width (p = .009). The mean, vertical and horizontal collapse of buccal soft tissue contour in the MCF-ARP group were 0.95 mm (p = .010), 0.61 mm (p = .019) and 0.56 mm (p = .013) less than that in the NH group, respectively. There were significantly (p = .007) fewer sites in the MCF-ARP group than in the NH group (0% vs. 26.7%) for staged bone augmentation and more sites that could be treated with simple implant procedure in the MCF-ARP group than in the NH group (71.9% vs. 56.6%). CONCLUSIONS Compared with NH, MCF-ARP reduced bone resorption in periodontally compromised molar extraction sites and maintained the buccal soft tissue contour. MCF-ARP reduces the need for complex bone augmentation procedures in implant therapy. TRIAL REGISTRATION Chinese Clinical Trial Register (ChiCTR) ChiCTR2200056335. Registered on 4 February 2022, Version 1.0.
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Affiliation(s)
- Haoyun Zhang
- Department of Periodontology, Peking University School and Hospital of Stomatology, National Center for Stomatology, National Clinical Research Center for Oral Diseases, National Engineering Research Center of Oral Biomaterials and Digital Medical Devices, NHC Research Center of Engineering and Technology for Computerized Dentistry, Beijing, China
| | - Tao Xu
- Department of Emergency, Peking University School and Hospital of Stomatology, National Center for Stomatology, National Clinical Research Center for Oral Diseases, National Engineering Research Center of Oral Biomaterials and Digital Medical Devices, NHC Research Center of Engineering and Technology for Computerized Dentistry, Beijing, China
| | - Yiping Wei
- Department of Periodontology, Peking University School and Hospital of Stomatology, National Center for Stomatology, National Clinical Research Center for Oral Diseases, National Engineering Research Center of Oral Biomaterials and Digital Medical Devices, NHC Research Center of Engineering and Technology for Computerized Dentistry, Beijing, China
| | - Ning Wei
- Department of Periodontology, Peking University School and Hospital of Stomatology, National Center for Stomatology, National Clinical Research Center for Oral Diseases, National Engineering Research Center of Oral Biomaterials and Digital Medical Devices, NHC Research Center of Engineering and Technology for Computerized Dentistry, Beijing, China
| | - Ziyao Han
- Department of Periodontology, Peking University School and Hospital of Stomatology, National Center for Stomatology, National Clinical Research Center for Oral Diseases, National Engineering Research Center of Oral Biomaterials and Digital Medical Devices, NHC Research Center of Engineering and Technology for Computerized Dentistry, Beijing, China
| | - Wenjie Hu
- Department of Periodontology, Peking University School and Hospital of Stomatology, National Center for Stomatology, National Clinical Research Center for Oral Diseases, National Engineering Research Center of Oral Biomaterials and Digital Medical Devices, NHC Research Center of Engineering and Technology for Computerized Dentistry, Beijing, China
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An YZ, Song YW, Thoma DS, Strauss FJ, Lee JS. Enhancing guided bone regeneration with cross-linked collagen-conjugated xenogeneic bone blocks and membrane fixation: A preclinical in vivo study. Clin Oral Implants Res 2024. [PMID: 38838049 DOI: 10.1111/clr.14309] [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: 09/06/2023] [Revised: 05/11/2024] [Accepted: 05/18/2024] [Indexed: 06/07/2024]
Abstract
OBJECTIVE To determine whether combining cross-linked (CL) collagen-integrated xenogeneic bone blocks stabilized with the fixation of resorbable collagen membranes (CM) can enhance guided bone regeneration (GBR) in the overaugmented calvarial defect model. MATERIALS AND METHODS Four circular defects with a diameter of 8 mm were prepared in the calvarium of 13 rabbits. Defects were randomly assigned to receive one of the following treatments: (i) non-cross-linked (NCL) porcine-derived collagen-embedded bone block covered by a CM without fixation (NCL + unfix group); (ii) NCL bone block covered by CM with fixation using bone-tack (NCL + fix group); (iii) cross-linked (CL) porcine-derived collagen-embedded bone block covered by CM without fixation (CL + unfix group); and (iv) CL bone block covered by CM with fixation using bone-tack fixation (CL + fix group). The efficacy of GBR was assessed through histological and molecular analyses after 2 and 8 weeks. RESULTS At 2 weeks, there were no significant differences in histologically measured areas of newly formed bone among the groups. At 8 weeks, however, the CL + fix group exhibited a larger area of new bone (5.08 ± 1.09 mm2, mean ± standard deviation) compared to the NCL + unfix (1.62 ± 0.42 mm2; p < .0083), NCL + fix (3.97 ± 1.39 mm2) and CL + unfix (2.55 ± 1.04 mm2) groups. Additionally, the expression levels of tumour necrosis factor-alpha, fibroblast growth factor-2, vascular endothelial growth factor, osteocalcin and calcitonin receptor were significantly higher in the CL + fix group compared to the other three groups (p < .0083). CONCLUSION Cross-linked bone blocks stabilized with collagen membrane fixation can significantly enhance GBR.
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Affiliation(s)
- Yin-Zhe An
- Department of Periodontology, Affiliated Stomatology Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China
- Guangzhou Key Laboratory of Basic and Applied Research of Oral Regenerative Medicine, Guangdong Engineering Research Center of Oral Restoration and Reconstruction, Guangzhou, Guangdong, China
| | - Young Woo Song
- Department of Periodontology, Dental Hospital, Veterans Health Service Medical Center, Seoul, Korea
| | - Daniel S Thoma
- Department of Periodontology, Research Institute for Periodontal Regeneration, Yonsei University College of Dentistry, Seoul, Korea
- Clinic of Reconstructive Dentistry, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
| | - Franz J Strauss
- Clinic of Reconstructive Dentistry, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
- Faculty of Dentistry, Universidad Finis Terrae, Santiago, Chile
| | - Jung-Seok Lee
- Department of Periodontology, Research Institute for Periodontal Regeneration, Yonsei University College of Dentistry, Seoul, Korea
- Innovation Research and Support Center for Dental Science, Yonsei University Dental Hospital, Seoul, Korea
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Won C. Restoring Severely Atrophic Edentulous Ridge of Mandible Using Self-Expanding Tissue Expander-A Case Report. MEDICINA (KAUNAS, LITHUANIA) 2024; 60:759. [PMID: 38792943 PMCID: PMC11123316 DOI: 10.3390/medicina60050759] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/06/2024] [Revised: 04/20/2024] [Accepted: 04/30/2024] [Indexed: 05/26/2024]
Abstract
This report describes the use of Self Inflating Tissue Expanders (SITEs) to rehabilitate severely atrophic edentulous mandibular ridges, enabling successful bone grafting and implant placement. The treatment resulted in stable and complication-free implants over a seven-year follow-up, demonstrating SITEs' effectiveness in providing sufficient bone volume and soft tissue coverage for dental implants.
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Affiliation(s)
- Chiyun Won
- Purpose Driven Dental Clinic, Seoul 04099, Republic of Korea
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Johansson L, Latorre JL, Liversain M, Thorel E, Raymond Y, Ginebra MP. Three-Dimensional Printed Patient-Specific Vestibular Augmentation: A Case Report. J Clin Med 2024; 13:2408. [PMID: 38673680 PMCID: PMC11051386 DOI: 10.3390/jcm13082408] [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: 03/17/2024] [Revised: 04/10/2024] [Accepted: 04/16/2024] [Indexed: 04/28/2024] Open
Abstract
Background: The anterior maxilla is challenging regarding aesthetic rehabilitation. Current bone augmentation techniques are complex and 3D-printed bioceramic bone grafts can simplify the intervention. Aim: A four-teeth defect in the anterior maxilla was reconstructed with a 3D-printed synthetic patient-specific bone graft in a staged approach for dental implant delivery. Methods: The bone graft was designed using Cone-Beam Computed Tomography (CBCT) images. The bone graft was immobilized with fixation screws. Bone augmentation was measured on CBCT images at 11 days and 8 and 13 months post-surgery. A biopsy sample was retrieved at reentry (10 months post-augmentation) and evaluated by histological and micro-computed tomography assessments. The definitive prosthesis was delivered 5 months post-reentry and the patient attended a visit 1-year post-loading. Results: A total bone width of 8 mm was achieved (3.7 mm horizontal bone gain). The reconstructed bone remained stable during the healing period and was sufficient for placing two dental implants (with an insertion torque > 35 N·cm). The fractions of new bone, bone graft, and soft tissue in the biopsy were 40.77%, 41.51%, and 17.72%, respectively. The histological assessment showed no signs of encapsulation, and mature bone was found in close contact with the graft, indicating adequate biocompatibility and suggesting osteoconductive properties of the graft. At 1-year post-loading, the soft tissues were healthy, and the dental implants were stable. Conclusions: The anterior maxilla's horizontal ridge can be reconstructed using a synthetic patient-specific 3D-printed bone graft in a staged approach for implant placement. The dental implants were stable and successful 1-year post-loading.
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Affiliation(s)
- Linh Johansson
- Biomaterials, Biomechanics and Tissue Engineering Group (BBT), Department of Materials Science and Engineering, Universitat Politècnica de Catalunya BarcelonaTech (UPC), Av. Eduard Maristany, 16, 08019 Barcelona, Spain;
- Barcelona Research Centre in Multiscale Science and Engineering, Escola d’Enginyeria de Barcelona Est (EEBE), Universitat Politècnica de Catalunya (UPC), Av. Eduard Maristany, 10-14, 08019 Barcelona, Spain
- Biomedical Engineering Research Center (CREB), Universitat Politècnica de Catalunya (UPC), Av. Diagonal, 647, 08028 Barcelona, Spain
- Institut de Recerca Sant Joan de Déu (IRSJD), 39-57, 08950 Esplugues del Llobregat, Spain
- Mimetis Biomaterials S.L., Carrer de Cartagena, 245, 3E, 08025 Barcelona, Spain (Y.R.)
| | - Jose Luis Latorre
- Freelance Implantologist: Oris Dental Center, C. de Joan Güell, 108, 08028 Barcelona, Spain
| | - Margaux Liversain
- Mimetis Biomaterials S.L., Carrer de Cartagena, 245, 3E, 08025 Barcelona, Spain (Y.R.)
| | - Emilie Thorel
- Mimetis Biomaterials S.L., Carrer de Cartagena, 245, 3E, 08025 Barcelona, Spain (Y.R.)
| | - Yago Raymond
- Mimetis Biomaterials S.L., Carrer de Cartagena, 245, 3E, 08025 Barcelona, Spain (Y.R.)
| | - Maria-Pau Ginebra
- Biomaterials, Biomechanics and Tissue Engineering Group (BBT), Department of Materials Science and Engineering, Universitat Politècnica de Catalunya BarcelonaTech (UPC), Av. Eduard Maristany, 16, 08019 Barcelona, Spain;
- Barcelona Research Centre in Multiscale Science and Engineering, Escola d’Enginyeria de Barcelona Est (EEBE), Universitat Politècnica de Catalunya (UPC), Av. Eduard Maristany, 10-14, 08019 Barcelona, Spain
- Biomedical Engineering Research Center (CREB), Universitat Politècnica de Catalunya (UPC), Av. Diagonal, 647, 08028 Barcelona, Spain
- Institute for Bioengineering of Catalonia (IBEC), BIST, Carrer Baldiri Reixac 10-12, 08028 Barcelona, Spain
- CIBER de Bioingeniería, Biomateriales y Nanomedicina, Instituto de Salud Carlos III, 28029 Madrid, Spain
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Valamvanos TF, Dereka X, Katifelis H, Gazouli M, Lagopati N. Recent Advances in Scaffolds for Guided Bone Regeneration. Biomimetics (Basel) 2024; 9:153. [PMID: 38534838 DOI: 10.3390/biomimetics9030153] [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: 02/04/2024] [Revised: 02/26/2024] [Accepted: 02/28/2024] [Indexed: 03/28/2024] Open
Abstract
The rehabilitation of alveolar bone defects of moderate to severe size is often challenging. Currently, the therapeutic approaches used include, among others, the guided bone regeneration technique combined with various bone grafts. Although these techniques are widely applied, several limitations and complications have been reported such as morbidity, suboptimal graft/membrane resorption rate, low structural integrity, and dimensional stability. Thus, the development of biomimetic scaffolds with tailor-made characteristics that can modulate cell and tissue interaction may be a promising tool. This article presents a critical consideration in scaffold's design and development while also providing information on various fabrication methods of these nanosystems. Their utilization as delivery systems will also be mentioned.
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Affiliation(s)
- Theodoros-Filippos Valamvanos
- Laboratory of Biology, Department of Basic Medical Sciences, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece
| | - Xanthippi Dereka
- Department of Periodontology, School of Dentistry, National and Kapodistrian University of Athens, 11527 Athens, Greece
| | - Hector Katifelis
- Laboratory of Biology, Department of Basic Medical Sciences, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece
| | - Maria Gazouli
- Laboratory of Biology, Department of Basic Medical Sciences, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece
- School of Science and Technology, Hellenic Open University, 26335 Patra, Greece
| | - Nefeli Lagopati
- Laboratory of Biology, Department of Basic Medical Sciences, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece
- Greece Biomedical Research Foundation, Academy of Athens, 11527 Athens, Greece
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Fok MR, Pelekos G, Jin L. Efficacy of Alveolar Ridge Preservation in Periodontally Compromised Molar Extraction Sites: A Systematic Review and Meta-Analysis. J Clin Med 2024; 13:1198. [PMID: 38592010 PMCID: PMC10931845 DOI: 10.3390/jcm13051198] [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: 01/11/2024] [Revised: 02/08/2024] [Accepted: 02/13/2024] [Indexed: 04/10/2024] Open
Abstract
AIM To investigate the efficacy of alveolar ridge preservation (ARP) in periodontally compromised molar extraction sites. METHODS An electronic search was performed on 10th November 2023 across five databases, seeking randomised/non-randomised controlled trials (RCTs/NCTs) that included a minimum follow-up duration of four months. The RoB2 and Robins-I tools assessed the risk of bias for the included studies. Data on alveolar ridge dimensional and volumetric changes, keratinized mucosal width, and need for additional bone augmentation for implant placement were collected. Subsequently, a meta-analysis was carried out to derive the pooled estimates. RESULTS Six studies were incorporated in the present review, and a total of 135 molar extraction sockets in 130 subjects were included in the meta-analysis. ARP was undertaken in 68 sites, and 67 sites healed spontaneously. The follow-up time ranged from 4 to 6 months. The meta-analysis of both RCTs and NCTs showed significant differences in mid-buccal ridge width changes at 1 mm level below ridge crest with a mean difference (MD) of 3.80 (95% CI: 1.67-5.94), mid-buccal ridge height changes (MD: 2.18; 95% CI: 1.25-3.12) and volumetric changes (MD: 263.59; 95% CI: 138.44-388.74) in favour of ARP, while the certainty of evidence is graded low to very low. Moreover, ARP appeared to reduce the need for additional sinus and bone augmentation procedures at implant placement with low certainty of evidence. CONCLUSIONS Within the limitations of this study, alveolar ridge preservation in periodontally compromised extraction sites may, to some extent, preserve the ridge vertically and horizontally with reference to spontaneous healing. However, it could not eliminate the need for additional augmentation for implant placement. Further, longitudinal studies with large sample sizes and refined protocols are needed.
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Affiliation(s)
- Melissa Rachel Fok
- Division of Periodontology and Implant Dentistry, Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR, China
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Alarcón-Sánchez MA, Romero-Servin S, Yessayan L, Mosaddad SA, Heboyan A. Oral findings and comprehensive dental management of Moebius syndrome: a systematic review. BMC Oral Health 2024; 24:192. [PMID: 38321523 PMCID: PMC10845393 DOI: 10.1186/s12903-024-03968-6] [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: 11/17/2023] [Accepted: 02/01/2024] [Indexed: 02/08/2024] Open
Abstract
BACKGROUND Moebius syndrome (MS) is a rare, non-progressive, neuromuscular, congenic disease involving the oral maxillofacial region. The present study aimed to describe the oral and extraoral findings in MS patients and their comprehensive dental management. METHODS A digital search was carried out in PubMed/MEDLINE, Scopus, Web of Science, and Google Scholar, restricted to articles in English from Jan 01, 2000, to Apr 02, 2023, following PRISMA guidelines. The methodological quality of the studies was evaluated following the JBI guidelines. Qualitative analysis was carried out on the overall result, extraoral and intraoral manifestations, considering dental management as appropriate. RESULTS Twenty-three studies were included, and a total of 124 cases of patients with MS were analyzed. The 82% of patients with MS were younger than 15 years of age. The most frequent extraoral manifestations were blinking and visual problems (78,22%), malformations of the upper and lower limbs (58,22%), bilateral facial paralysis (12,90%), lack of facial expression (12.09%), and unilateral facial paralysis (6,45%). On the other hand, the most frequent oral manifestations were tongue deformities (78,22%), micrognathia (37,90%), labial incompetence (36,29%), cleft palate (22,87%), gothic palate (16,12%), microstomia (15,32%), anterior open bite (15,32%), dental caries (8,87%), and periodontal disease (8,06%). The majority of MS patients were treated by pediatric dentistry (60,86%), using a surgical approach (56,52%), and orthodontic and orthopedic maxillary (43,47%) followed by restorative (39,13%), and periodontal treatments (21,73%). CONCLUSIONS This systematic review demonstrates that patients with MS present a wide variety of oral and extraoral manifestations, for which dental treatments are planned and tailored to each patient in accordance with oral manifestations. These treatments encompass problem resolution and oral health maintenance, incorporating recent techniques in managing and treating patients with MS.
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Affiliation(s)
- Mario Alberto Alarcón-Sánchez
- Biomedical Science, Faculty of Chemical-Biological Science, Autonomous University of Guerrero, Chilpancingo 39090, Guerrero, Mexico
| | - Selenne Romero-Servin
- Resident Student, Oral and Maxillofacial Pathology, National School of Higher Studies, Leon Unit of the National Autonomous University of Mexico, Leon 37684, Guanajuato, Mexico
| | - Lazar Yessayan
- Department of Therapeutic Stomatology, Faculty of Stomatology, Yerevan State Medical University after Mkhitar Heratsi, Yerevan, Armenia
| | - Seyed Ali Mosaddad
- Student Research Committee, School of Dentistry, Shiraz University of Medical Sciences, Qasr-e-Dasht Street, Shiraz, Iran.
- Department of Research Analytics, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, India.
| | - Artak Heboyan
- Department of Prosthodontics, Faculty of Stomatology, Yerevan State Medical University after Mkhitar Heratsi, Str. Koryun 2, Yerevan, 0025, Armenia.
- Department of Research Analytics, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, India.
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La Monaca G, Di Giorgio G, Pranno N, Serafini G, De Biase A, Cristalli MP. Implant-Prosthetic Rehabilitation of Mandibular Posttraumatic Severe Dentoalveolar Loss With a Reconstructive Staged Approach: A Clinical Report With 3-Year Follow-Up. J ORAL IMPLANTOL 2023; 49:567-572. [PMID: 38279654 DOI: 10.1563/aaid-joi-d-23-00143] [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] [Indexed: 01/28/2024]
Abstract
This clinical report describes the oral rehabilitation of a 25-year-old male patient who lost the lower incisors, right canine, and a significant amount of anterior mandibular bony and soft tissue following severe dentoalveolar trauma due to a car accident. The patient's young age, anterior esthetic zone in the lower jaw, previous mandibular fracture, and extended bony and soft-tissue defect hindering ideal 3-dimensional implant placement oriented the therapeutic plan toward a staged approach, with several reconstructive surgical procedures before implant rehabilitation. The treatment involved deepening the labiobuccal vestibule and lingual sulcus to correct cicatricial shrinkage due to previous surgical fixation of the mandibular fracture, vertical guided bony augmentation to regenerate adequate volumes of bone, free gingival graft to achieve sufficient height and thickness of peri-implant soft tissues, and a prosthetic-driven surgical procedure to place the implants in a good functional and esthetic position. This therapeutic approach restored function and esthetics and achieved outcome stability at 3-year follow-up.
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Affiliation(s)
- Gerardo La Monaca
- Department of Oral and Maxillo-Facial Sciences, Sapienza, University of Rome, Rome, Italy
| | - Gianni Di Giorgio
- Department of Oral and Maxillo-Facial Sciences, Sapienza, University of Rome, Rome, Italy
| | - Nicola Pranno
- Department of Oral and Maxillo-Facial Sciences, Sapienza, University of Rome, Rome, Italy
| | - Giorgio Serafini
- Department of Oral and Maxillo-Facial Sciences, Sapienza, University of Rome, Rome, Italy
| | - Alberto De Biase
- Department of Oral and Maxillo-Facial Sciences, Sapienza, University of Rome, Rome, Italy
| | - Maria Paola Cristalli
- Department of Oral and Maxillo-Facial Sciences, Sapienza, University of Rome, Rome, Italy
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Nickenig HJ, Zöller JE, Kreppel M. Indications and surgical technique for distraction osteogenesis of the alveolar bone for augmentation prior to insertion of dental implants. Periodontol 2000 2023; 93:327-339. [PMID: 37940190 DOI: 10.1111/prd.12524] [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: 05/30/2022] [Revised: 06/30/2023] [Accepted: 08/01/2023] [Indexed: 11/10/2023]
Abstract
When bone is limited, short, ultra-short, or narrow implants help to restore oral rehabilitation with an acceptable long-term outcome. This becomes more difficult with severe vertical bone loss. Guided bone regeneration, onlay block transplantation, or sandwich osteotomy have been established to build up these defects. The alternative to the alveolar distraction osteogenesis (ADO) has only been established in some centers, with a standardized protocol. On the one hand, ADO is a biological procedure that allows almost a "restitutio ad integrum" when building up hard and soft tissue. On the other hand, there are clear indications, limitations, and complications of the procedure in the literature. In addition to the literature, concept of Tissue Regeneration by Alveolar Callusdistraction Cologne (TRACC), which has been practiced successfully for over two decades, will be presented for different indications.
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Affiliation(s)
- Hans-Joachim Nickenig
- Department of Oral and Maxillofacial Plastic Surgery, University of Cologne, Cologne, Germany
- Interdisciplinary Department of Oral Surgery and Implantology, University of Cologne, Cologne, Germany
| | - Joachim E Zöller
- Department of Oral and Maxillofacial Plastic Surgery, University of Cologne, Cologne, Germany
- Interdisciplinary Department of Oral Surgery and Implantology, University of Cologne, Cologne, Germany
| | - Matthias Kreppel
- Department of Oral and Maxillofacial Plastic Surgery, University of Cologne, Cologne, Germany
- Interdisciplinary Department of Oral Surgery and Implantology, University of Cologne, Cologne, Germany
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