Custom Allogeneic Block Graft for Ridge Augmentation: Case Series

Abstract Background The purpose of this study was to evaluate the volumetric changes in partially edentulous alveolar ridges augmented with customized titanium ridge augmentation matrices (CTRAM), freeze-dried bone allograft, and a resorbable collagen membrane. Methods A pre-surgical cone beam computed tomography (CBCT) scan was obtained for CTRAM design/fabrication and to evaluate pre-surgical ridge dimensions. Ridge augmentation surgery using CTRAM, freeze-dried bone allograft, and a resorbable collagen membrane was performed at each deficient site. Clinical measurements of the area of augmentation were made at the time of CTRAM placement and re-entry, and a 2nd CBCT scan 7 months after graft placement was used for volumetric analysis. Locations of each CTRAM in situ were also compared to their planned positions. Re-entry surgery and implant placement was performed 8 months after CTRAM placement. Results Nine subjects were treated with CTRAM and freeze-dried bone allograft. Four out of the nine patients enrolled (44.4%) experienced premature CTRAM exposure during healing, and in two of these cases, CTRAM were removed early. Early exposure did not result in total graft failure in any case. Mean volumetric bone gain was 85.5 ± 30.9% of planned augmentation volume (61.3 ± 33.6% in subjects with premature CTRAM exposure vs. 104.9% for subjects without premature exposure, p = 0.03). Mean horizontal augmentation (measured clinically) was 3.02 mm, and vertical augmentation 2.86 mm. Mean surgical positional deviation of CTRAM from the planned location was 1.09 mm. Conclusion The use of CTRAM in conjunction with bone graft and a collagen membrane resulted in vertical and horizontal bone gain suitable for implant placement.

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Clinical, Radiographic, and Histomorphometric Evaluation of a Vertical Ridge Augmentation Procedure Using a Titanium-Reinforced Microporous Expanded Polytetrafluoroethylene Emrane: A Prospective Case Series with 1-Year Follow-Up

Materials ◽

10.3390/ma14143828 ◽

2021 ◽

Vol 14 (14) ◽

pp. 3828

Author(s):

Jung-Gu Ji ◽

Jung-A Yu ◽

Seong-Ho Choi ◽

Dong-Woon Lee

Keyword(s):

Case Series ◽

Graft Material ◽

Ridge Augmentation ◽

Expanded Polytetrafluoroethylene ◽

Implant Placement ◽

Significant Difference ◽

Staged Approach ◽

Height Change ◽

Prospective Case Series ◽

Augmentation Procedure

Vertical ridge augmentation for long-term implant stability is difficult in severely resorbed areas. We examined the clinical, radiological, and histological outcomes of guided-bone regeneration using novel titanium-reinforced microporous expanded polytetrafluoroethylene (MP-ePTFE) membranes. Eighteen patients who underwent implant placement using a staged approach were enrolled (period: 2018–2019). Vertical ridge augmentation was performed in areas with vertical bone defects ≥ 4 mm. Twenty-six implant fixtures were placed in 14 patients. At implant placement six fixtures had relatively low stability. On cone-beam computed tomography, the average vertical changes were 4.2 ± 1.9 (buccal), 5.9 ± 2.7 (central), and 4.4 ± 2.8 mm (lingual) at six months after vertical ridge augmentation. Histomorphometric analyses revealed that the average proportions of new bone, residual bone substitute material, and soft tissue were 34.91 ± 11.61%, 7.16 ± 2.74%, and 57.93 ± 11.09%, respectively. Stable marginal bone levels were observed at 1-year post-loading. The residual bone graft material area was significantly lower in the exposed group (p = 0.003). There was no significant difference in the vertical height change in the buccal side between immediately after the augmentation procedure and the implant placement reentry time (p = 0.371). However, all implants functioned well regardless of the exposure during the observation period. Thus, vertical ridge augmentation around implants using titanium-reinforced MP-ePTFE membranes can be successful.

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The Custom Alveolar Ridge-Splitting (CARS) Technique for Predictable Horizontal Ridge Augmentation in the Atrophic Anterior Maxilla: A Retrospective Case Series Study

The International Journal of Periodontics & Restorative Dentistry ◽

10.11607/prd.5411 ◽

2021 ◽

Vol 41 (3) ◽

pp. 397-403

Author(s):

Stuart Froum ◽

Raed Kadi ◽

Buddhapoom Wangsrimongkol ◽

Parnward Hengjeerajaras ◽

Natacha Reis ◽

...

Keyword(s):

Case Series ◽

Alveolar Ridge ◽

Retrospective Case ◽

Anterior Maxilla ◽

Ridge Augmentation ◽

Retrospective Case Series ◽

Case Series Study ◽

Series Study

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One-Time Cortical Lamina: A New Technique for Horizontal Ridge Augmentation. A Case Series

Journal of Biomedical Engineering and Medical Imaging ◽

10.14738/jbemi.86.11270 ◽

2021 ◽

Vol 8 (6) ◽

pp. 22-30

Author(s):

Vincenzo Foti ◽

Davide Savio ◽

Roberto Rossi

Keyword(s):

Fibrin Sealant ◽

Case Series ◽

X Rays ◽

Marginal Bone Loss ◽

Ridge Augmentation ◽

Keratinized Tissue ◽

A New Technique ◽

The One ◽

Hard Consistency

The aim of this case series is to introduce the One-Time Cortical Lamina Technique, a simplification of the F.I.R.S.T. (Fibrinogen-Induced Regeneration Sealing Technique) in cases where only horizontal augmentation is needed. The indications for this technique are ASA2 and ASA1 anxious patients. Pre-requisites for this surgical technique are: a good amount of keratinized tissue, sufficient alveolar ridge width for placement of implants, thickness of vestibular bone at CBCT planning less than 1 mm with risk of threads exposure. Five patients with horizontal deficiencies were selected to test the efficacy of this approach. The defects were augmented using a porcine cortical bone lamina in combination with collagenated porcine bone mixed with fibrin sealant. The cortical lamina was placed only buccal to the implants and stabilized with fibrin sealant, without pins or screws. Upon completion of the implant surgery, healing abutments were connected to the implants and the soft tissue sutured around them. The healing was uneventful in all cases. Six months after surgery impressions for final restorations were taken and screwed crowns delivered. The new volume had hard consistency and the follow-up CBCT measured an average of 4.17 mm of horizontal bone augmentation. One to three years of follow up demonstrated the maintenance of vestibular volume, hard consistency and clinical stability. Intraoral X-rays showed no marginal bone loss. An advantage of this technique could be the one stage surgery that creates a stable environment for regeneration from day one.

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