Introduction: Iliac particulate cancellous bone and marrow (PCBM) is commonly used as a high-quality reconstruction material;however, PCBM cannot be extracted in sufficient amounts to meet demand. To determine the app...Introduction: Iliac particulate cancellous bone and marrow (PCBM) is commonly used as a high-quality reconstruction material;however, PCBM cannot be extracted in sufficient amounts to meet demand. To determine the appropriate amount of iliac PCBM to be collected, we used digital technology to measure the volume required for jaw reconstruction before surgery. Clinical Case: The patient, a 23-year-old man, underwent surgery for a calcifying odontogenic cyst. A maxillary cyst occupied the left anterior-premolar region (tooth 21 - 25) and the deciduous canine remained;a permanent canine was included in the cyst. We planned to preserve the teeth except for the impacted canine, completely excise the maxillary cyst, and preserve the alveolar ridge morphology. Preoperative digital imaging was used to determine the amount of alveolar ridge reconstruction required and accordingly determine the amount of iliac cancellous bone to be harvested. We used a titanium mesh tray and grafts of iliac particulate cancellous bone and marrow to reconstruct the alveolar ridge. The amount of iliac cancellous bone that needed to be collected was clarified and the supply amount could be collected in just the right amount;thus, the cortical bone of the iliac inner plate could be preserved. The alveolar bone morphology was reconstructed to allow the placement of dental implants as per the preoperative digital surgery. Three years after the operation, no sign of recurrence has been observed. Conclusion: Minimally invasive surgery was performed by clarifying the amount of iliac cancellous bone graft that needs to be harvested, which improved the accuracy of surgery.展开更多
The loss of the post-extraction alveolar ridge vertical and horizontal volume constitutes an irreversible process and presents a considerable impact on the prosthetic rehabilitation, particularly when implantsupported...The loss of the post-extraction alveolar ridge vertical and horizontal volume constitutes an irreversible process and presents a considerable impact on the prosthetic rehabilitation, particularly when implantsupported. Therefore, alveolar ridge resorption has become a challenge in contemporary clinical dentistry and alveolar ridge preservation and augmentation are an interesting therapeutic approach. The employment of biomaterials, as a therapeutic alternative to preserve bone in height and volume, has been frequently studied over the years, due to its conceptual attractiveness and its simple technique. The purpose of this paper is to review and discuss current methods to optimize the alveolar bone repair while maintaining its horizontal and vertical dimensions. This paper is based on scientific studies published in English including systematic reviews and also animal and human studies that were searched using the keywords "alveolar ridge preservation," "bone substitute", "biomaterials", "bone graft" and "grafting". Either autogenous bone as xenogenic and alloplastic materials, platelet rich plasma and use of membrane are alternatives. It becomes fundamental to understand that alveolar bone loss is still a clinical challenge and alveolar ridge preservation techniques can minimize, but not completely, eliminate the resorption process. The goal of alveolar ridge preservation and augmentation is to use a combination of bone or biomaterials to create bone which is sufficient for dental implant placement. Freeze-dried bone is generally recognized as giving more predictable treatment outcomes than synthetic materials or platelet rich plasma, and membranes must always be used to separate hard and soft tissues to promote optimal tissue healing.展开更多
Aim: Ridge augmentation for the atrophied mandible or for supporting dental implants is, an effective treatment in patients with alveolar defects that preserve bone height for the placement of implants or desirable ap...Aim: Ridge augmentation for the atrophied mandible or for supporting dental implants is, an effective treatment in patients with alveolar defects that preserve bone height for the placement of implants or desirable appearance. Two common substans for bone augmentation are autografts and allografts. However, it is difficult to demonstrate that one surgical procedure offers better outcomes than another. Our study aimed to address and compare changes in ridge augmentation following autograft and allograft bone grafting within a 6-month follow up period. Materials and Methods: In a randomized blinded clinical trial, 18 patients who were candidates for mandible bone grafts were randomly divided into two autograft (tibia graft) (n = 9) and allograft (n = 9) groups. In the autograft group demineralized frozen dried bone was used. Height of three local points on graft replacement (Right, Middle and Left points) were measured based on the OPG preoperatively and also 3 and 6 months after the grafting. Results: In all patient, the trend of ridge augmentation change was significant within 6 months following grafting;however no difference was observed in height changes between the autograft and allograft procedures. Conclusion: From the clinical point of view, these two procedures appear to have similar efficacies for treating localized mandibular ridge defects. Clinical Significances: Comparison the success rate and increase the anterior of mandibular height between autogenous bone graft and allogeneic bone graft.展开更多
Residual ridge shape is important for the seating of a prosthesis. The objective of this case report was to illustrate the importance of reduction maneuvers with regard to alveolar bone plates after multiple tooth ext...Residual ridge shape is important for the seating of a prosthesis. The objective of this case report was to illustrate the importance of reduction maneuvers with regard to alveolar bone plates after multiple tooth extractions in patients with prostheses and special needs. In the current patient, there were difficulties during the adaptation and fitting of the upper denture. Bilateral bone resection was indicated in the molar buccal region. Late regularization of the alveolar ridge, which was accomplished in hospital, was necessary for the preparation, adaptation, and use of the denture. The general and systemic health care of the patient should be monitored throughout surgical intervention. Though tooth extractions are common procedures, particular attention is required to ensure adequate alveolar ridge remodeling that is conducive to oral rehabilitation.展开更多
Background: The vast percentage of the alveolar bone resorption process happens within the first 12 to 24 weeks post extraction;however, this phenomenon is chronic, and the alveolar ridge continues to resorb. In order...Background: The vast percentage of the alveolar bone resorption process happens within the first 12 to 24 weeks post extraction;however, this phenomenon is chronic, and the alveolar ridge continues to resorb. In order to prevent this reduction or at least recompense the loss of bone dimensions, the alveolar ridge preservation (ARP) technique was developed. Objectives: This research studied the vertical and horizontal bone dimensional changes as a result of non-molar teeth extraction alone against extraction with alveolar ridge preservation utilizing composite (bioceramics/collagen) graft by cone-beam computed tomography radiographies analyses. Material and Methods: This research was a randomized split-mouth controlled trial. 12 patients need extraction of the maxillary non-molar teeth were enrolled and allocated into 2 groups. 12 sockets after atraumatic extraction were filled with a composite graft in the role of the test group, 12 sockets left to unassisted healing after atraumatic extraction without any graft materials in the role of the control group. Two CBCT radiographs were taken at baseline and at 4 months after extraction for comparison. Both vertical and horizontal resorptions of the alveolar ridge were analyzed between test and control group by CBCT radiographs. Results: 4 months after extraction, there was a mean of vertical alveolar bone resorption compared with the baseline (0.56 ± 0.15 mm) in the test group and (1.47 ± 0.30 mm) in the control group. Whereas it was a mean of horizontal alveolar bone resorption compared with the baseline (0.90 ± 0.16 mm) in the test group and (2.26 ± 0.30 mm) in the control group. Therefore, there was a significant difference between the two groups. Conclusions: Within the limitations of this research, we demonstrated that the osteogen-plug technique significantly decreased the reduction of the bone dimensional in comparison to the tooth extraction alone, and showed that the dimensional change of the alveolar ridge after tooth extraction was minimized by using an osteogen-plug.展开更多
目的:评价重组人骨形态发生蛋白-2(recombinant bone morphogenetic proteinrh-2,rhBMP-2)用于骨壁缺损拔牙位点保存的临床效果。方法:2019年2月~2023年1月将符合条件的142例患者随机分组,A组使用rhBMP-2+胶原蛋白海绵填充拔牙窝,B组使...目的:评价重组人骨形态发生蛋白-2(recombinant bone morphogenetic proteinrh-2,rhBMP-2)用于骨壁缺损拔牙位点保存的临床效果。方法:2019年2月~2023年1月将符合条件的142例患者随机分组,A组使用rhBMP-2+胶原蛋白海绵填充拔牙窝,B组使用胶原蛋白海绵,C组不使用移植物。于拔牙后18周、24周开展种植手术,并编为A1、A2;B1、B2;C1、C2组,种植术中发现有牙槽嵴顶骨缺损的病例测量牙槽嵴缺损的最大近远中径(L)、颊舌径(W)及深度(H),计算体积(V)值(V=L×W×H);无牙槽骨顶骨缺损的病例取种植窝骨块进行组织学分析。结果:A1、A2组牙槽嵴顶骨缺损的发生频率分别为:0.32、0.14;B1、B2组分别为:0.75、0.43;C1、C2组分别为:0.72、0.37。A1B1组间、A2B2组间、A1C1组间及A2C2组间V值差异有统计学意义(P<0.05)。A1B1组间及A1C1组间新生骨占比差异有统计学意义(P<0.05)。结论:rhBMP-2用于骨壁缺损的拔牙位点保存可缩短成骨时间(18周),减少不良愈合的发生,为后期种植手术的开展创造更有利的骨条件。展开更多
Implant placement in severely atrophic jaws is especially challenging because of the poor quality and quantity of the future implant bed. Although various bone augmentation procedure like ridge augmentation, sinus lif...Implant placement in severely atrophic jaws is especially challenging because of the poor quality and quantity of the future implant bed. Although various bone augmentation procedure like ridge augmentation, sinus lift these procedures are possible today but it may lead to surgical morbidity they increase the risks and costs of dental implant treatment as well as the number of necessary operations. Also sometimes the patient is not agreeing for such extensive surgical procedures, according to the well-known implantological rules for dental restorations, crestal implants are indicated in situations when an adequate vertical bone supply is given but single piece dental implant (basal implants) is a viable treatment option derives support from the basal bone area which usually remains free from the infection and less prone to resorption.展开更多
The alveolar antral artery resides lateral to the maxillary sinus and can lead to complications in sinus lift surgery. Traditional approaches that decrease intraoperative bleeding into the surgical field include vesse...The alveolar antral artery resides lateral to the maxillary sinus and can lead to complications in sinus lift surgery. Traditional approaches that decrease intraoperative bleeding into the surgical field include vessel preservation using multiple bony windows or neutralizing the vessel at the surgical site. Unfortunately, these methods are technique sensitive, time intensive, and may lead to hemosinus and graft loss. The variable distance from the crest of the alveolar ridge and vessel diameter further complicates pre-operative planning. This paper discusses the anatomical features of the alveolar antral artery, techniques for clinical assessment, and current management strategies. We then describe a novel protocol to manage the alveolar antral artery in sinus lift procedures via tamponade of the vessel at a proximal site. This method is faster than those described in the literature, does not require any additional equipment or expertise, and aims to improve long-term graft predictability by decreasing the risk of sinus membrane perforation. The alveolar antral artery is an under-reported source of surgical complications and warrants further research.展开更多
文摘Introduction: Iliac particulate cancellous bone and marrow (PCBM) is commonly used as a high-quality reconstruction material;however, PCBM cannot be extracted in sufficient amounts to meet demand. To determine the appropriate amount of iliac PCBM to be collected, we used digital technology to measure the volume required for jaw reconstruction before surgery. Clinical Case: The patient, a 23-year-old man, underwent surgery for a calcifying odontogenic cyst. A maxillary cyst occupied the left anterior-premolar region (tooth 21 - 25) and the deciduous canine remained;a permanent canine was included in the cyst. We planned to preserve the teeth except for the impacted canine, completely excise the maxillary cyst, and preserve the alveolar ridge morphology. Preoperative digital imaging was used to determine the amount of alveolar ridge reconstruction required and accordingly determine the amount of iliac cancellous bone to be harvested. We used a titanium mesh tray and grafts of iliac particulate cancellous bone and marrow to reconstruct the alveolar ridge. The amount of iliac cancellous bone that needed to be collected was clarified and the supply amount could be collected in just the right amount;thus, the cortical bone of the iliac inner plate could be preserved. The alveolar bone morphology was reconstructed to allow the placement of dental implants as per the preoperative digital surgery. Three years after the operation, no sign of recurrence has been observed. Conclusion: Minimally invasive surgery was performed by clarifying the amount of iliac cancellous bone graft that needs to be harvested, which improved the accuracy of surgery.
文摘The loss of the post-extraction alveolar ridge vertical and horizontal volume constitutes an irreversible process and presents a considerable impact on the prosthetic rehabilitation, particularly when implantsupported. Therefore, alveolar ridge resorption has become a challenge in contemporary clinical dentistry and alveolar ridge preservation and augmentation are an interesting therapeutic approach. The employment of biomaterials, as a therapeutic alternative to preserve bone in height and volume, has been frequently studied over the years, due to its conceptual attractiveness and its simple technique. The purpose of this paper is to review and discuss current methods to optimize the alveolar bone repair while maintaining its horizontal and vertical dimensions. This paper is based on scientific studies published in English including systematic reviews and also animal and human studies that were searched using the keywords "alveolar ridge preservation," "bone substitute", "biomaterials", "bone graft" and "grafting". Either autogenous bone as xenogenic and alloplastic materials, platelet rich plasma and use of membrane are alternatives. It becomes fundamental to understand that alveolar bone loss is still a clinical challenge and alveolar ridge preservation techniques can minimize, but not completely, eliminate the resorption process. The goal of alveolar ridge preservation and augmentation is to use a combination of bone or biomaterials to create bone which is sufficient for dental implant placement. Freeze-dried bone is generally recognized as giving more predictable treatment outcomes than synthetic materials or platelet rich plasma, and membranes must always be used to separate hard and soft tissues to promote optimal tissue healing.
文摘Aim: Ridge augmentation for the atrophied mandible or for supporting dental implants is, an effective treatment in patients with alveolar defects that preserve bone height for the placement of implants or desirable appearance. Two common substans for bone augmentation are autografts and allografts. However, it is difficult to demonstrate that one surgical procedure offers better outcomes than another. Our study aimed to address and compare changes in ridge augmentation following autograft and allograft bone grafting within a 6-month follow up period. Materials and Methods: In a randomized blinded clinical trial, 18 patients who were candidates for mandible bone grafts were randomly divided into two autograft (tibia graft) (n = 9) and allograft (n = 9) groups. In the autograft group demineralized frozen dried bone was used. Height of three local points on graft replacement (Right, Middle and Left points) were measured based on the OPG preoperatively and also 3 and 6 months after the grafting. Results: In all patient, the trend of ridge augmentation change was significant within 6 months following grafting;however no difference was observed in height changes between the autograft and allograft procedures. Conclusion: From the clinical point of view, these two procedures appear to have similar efficacies for treating localized mandibular ridge defects. Clinical Significances: Comparison the success rate and increase the anterior of mandibular height between autogenous bone graft and allogeneic bone graft.
文摘Residual ridge shape is important for the seating of a prosthesis. The objective of this case report was to illustrate the importance of reduction maneuvers with regard to alveolar bone plates after multiple tooth extractions in patients with prostheses and special needs. In the current patient, there were difficulties during the adaptation and fitting of the upper denture. Bilateral bone resection was indicated in the molar buccal region. Late regularization of the alveolar ridge, which was accomplished in hospital, was necessary for the preparation, adaptation, and use of the denture. The general and systemic health care of the patient should be monitored throughout surgical intervention. Though tooth extractions are common procedures, particular attention is required to ensure adequate alveolar ridge remodeling that is conducive to oral rehabilitation.
文摘Background: The vast percentage of the alveolar bone resorption process happens within the first 12 to 24 weeks post extraction;however, this phenomenon is chronic, and the alveolar ridge continues to resorb. In order to prevent this reduction or at least recompense the loss of bone dimensions, the alveolar ridge preservation (ARP) technique was developed. Objectives: This research studied the vertical and horizontal bone dimensional changes as a result of non-molar teeth extraction alone against extraction with alveolar ridge preservation utilizing composite (bioceramics/collagen) graft by cone-beam computed tomography radiographies analyses. Material and Methods: This research was a randomized split-mouth controlled trial. 12 patients need extraction of the maxillary non-molar teeth were enrolled and allocated into 2 groups. 12 sockets after atraumatic extraction were filled with a composite graft in the role of the test group, 12 sockets left to unassisted healing after atraumatic extraction without any graft materials in the role of the control group. Two CBCT radiographs were taken at baseline and at 4 months after extraction for comparison. Both vertical and horizontal resorptions of the alveolar ridge were analyzed between test and control group by CBCT radiographs. Results: 4 months after extraction, there was a mean of vertical alveolar bone resorption compared with the baseline (0.56 ± 0.15 mm) in the test group and (1.47 ± 0.30 mm) in the control group. Whereas it was a mean of horizontal alveolar bone resorption compared with the baseline (0.90 ± 0.16 mm) in the test group and (2.26 ± 0.30 mm) in the control group. Therefore, there was a significant difference between the two groups. Conclusions: Within the limitations of this research, we demonstrated that the osteogen-plug technique significantly decreased the reduction of the bone dimensional in comparison to the tooth extraction alone, and showed that the dimensional change of the alveolar ridge after tooth extraction was minimized by using an osteogen-plug.
文摘目的:评价重组人骨形态发生蛋白-2(recombinant bone morphogenetic proteinrh-2,rhBMP-2)用于骨壁缺损拔牙位点保存的临床效果。方法:2019年2月~2023年1月将符合条件的142例患者随机分组,A组使用rhBMP-2+胶原蛋白海绵填充拔牙窝,B组使用胶原蛋白海绵,C组不使用移植物。于拔牙后18周、24周开展种植手术,并编为A1、A2;B1、B2;C1、C2组,种植术中发现有牙槽嵴顶骨缺损的病例测量牙槽嵴缺损的最大近远中径(L)、颊舌径(W)及深度(H),计算体积(V)值(V=L×W×H);无牙槽骨顶骨缺损的病例取种植窝骨块进行组织学分析。结果:A1、A2组牙槽嵴顶骨缺损的发生频率分别为:0.32、0.14;B1、B2组分别为:0.75、0.43;C1、C2组分别为:0.72、0.37。A1B1组间、A2B2组间、A1C1组间及A2C2组间V值差异有统计学意义(P<0.05)。A1B1组间及A1C1组间新生骨占比差异有统计学意义(P<0.05)。结论:rhBMP-2用于骨壁缺损的拔牙位点保存可缩短成骨时间(18周),减少不良愈合的发生,为后期种植手术的开展创造更有利的骨条件。
文摘Implant placement in severely atrophic jaws is especially challenging because of the poor quality and quantity of the future implant bed. Although various bone augmentation procedure like ridge augmentation, sinus lift these procedures are possible today but it may lead to surgical morbidity they increase the risks and costs of dental implant treatment as well as the number of necessary operations. Also sometimes the patient is not agreeing for such extensive surgical procedures, according to the well-known implantological rules for dental restorations, crestal implants are indicated in situations when an adequate vertical bone supply is given but single piece dental implant (basal implants) is a viable treatment option derives support from the basal bone area which usually remains free from the infection and less prone to resorption.
文摘The alveolar antral artery resides lateral to the maxillary sinus and can lead to complications in sinus lift surgery. Traditional approaches that decrease intraoperative bleeding into the surgical field include vessel preservation using multiple bony windows or neutralizing the vessel at the surgical site. Unfortunately, these methods are technique sensitive, time intensive, and may lead to hemosinus and graft loss. The variable distance from the crest of the alveolar ridge and vessel diameter further complicates pre-operative planning. This paper discusses the anatomical features of the alveolar antral artery, techniques for clinical assessment, and current management strategies. We then describe a novel protocol to manage the alveolar antral artery in sinus lift procedures via tamponade of the vessel at a proximal site. This method is faster than those described in the literature, does not require any additional equipment or expertise, and aims to improve long-term graft predictability by decreasing the risk of sinus membrane perforation. The alveolar antral artery is an under-reported source of surgical complications and warrants further research.
