EAO‐503/PO‐SU‐011 | Bone gain, density and quality after vertical ridge augmentation: Preliminary results of RCT

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.

Download Full-text

Comparison of Calcium Sulfate and Bovine Collagen Barriers for Alveolar Ridge Augmentation

Journal of Contemporary Dentistry ◽

10.5005/jp-journals-10031-1083 ◽

2014 ◽

Vol 4 (3) ◽

pp. 129-138

Author(s):

Robert Spears ◽

Ibtisam Al-Hashimi ◽

Eric S Solomon ◽

David G Kerns ◽

William W Hallmon ◽

...

Keyword(s):

Bone Graft ◽

Calcium Sulfate ◽

Autogenous Bone ◽

Collagen Membrane ◽

Alveolar Ridge ◽

Bone Augmentation ◽

Alveolar Ridge Augmentation ◽

Ridge Augmentation ◽

Bovine Collagen ◽

Bone Gain

ABSTRACT Calcium sulfate is a biologically compatible osteoconductive graft material that binds underlying bone graft and provide space maintenance. The purpose of this study was to evaluate calcium sulfate as a barrier compared to a collagen membrane for augmentation of a standardized surgically created ridge defect. For this purpose, bilateral extraction of mandibular premolars was performed on six foxhounds (Canis familiaris). Eight weeks later, a standardized osseous ridge defects (24 total) were created using a 6 mm trephine. The study was approved by the Institutional Animal Care and Use Committee (IACUC) at Baylor College of Dentistry. The osseous defects were allocated into three groups (8 defects each): group 1 received autogenous bone graft covered with collagen membrane (CM); group 2 received autogenous bone graft covered with calcium sulfate barrier (CS), and group 3 was used as control and did not receive bone augmentation and was used as control. The animals were sacrificed after 12 weeks following bone augmentation and sites were evaluated histologically for total ridge width, percentage of bone gain and cortical bone thickness. Results All sites exhibited bony fill within the defect. Analysis of variance did not reveal statistically significant difference in the mean total bone gain among CM, CS, and control groups (12.2,11.6, and 11.9) mm2, respectively, p = 0.875. Conclusion Calcium sulfate does not appear to improve bone regeneration in an osseous defect. How to cite this article Heaton ML, Kerns DG, Hallmon WW, Kessler HP, Spears R, Solomon ES, Al-Hashimi I. Comparison of Calcium Sulfate and Bovine Collagen Barriers for Alveolar Ridge Augmentation. J Contemp Dent 2014;4(3):129-138.

Download Full-text

Clinical and Radiographic Evaluation of Simultaneous Alveolar Ridge Augmentation by Means of Preformed Titanium Meshes at Dehiscence-Type Peri-Implant Defects: A Prospective Pilot Study

Materials ◽

10.3390/ma13102389 ◽

2020 ◽

Vol 13 (10) ◽

pp. 2389 ◽

Cited By ~ 1

Author(s):

Carlo Maiorana ◽

Mattia Manfredini ◽

Mario Beretta ◽

Fabrizio Signorino ◽

Andrea Bovio ◽

...

Keyword(s):

Bone Regeneration ◽

Radiographic Evaluation ◽

Mesh Exposure ◽

Titanium Mesh ◽

Patient Centered ◽

Intimate Contact ◽

Ridge Augmentation ◽

Implant Placement ◽

Clinical Measurements ◽

Bone Gain

Background: bone augmentation by means of manually shaped titanium mesh is an established procedure to regenerate atrophic alveolar ridges and recreate a proper contour of the peri-implant bone anatomy. Conversely, current literature on the use of preformed titanium meshes instead of traditional grids remains lacking. Therefore, the aim of the present prospective study was to evaluate the use of preformed titanium mesh to support bone regeneration simultaneously to implant placement at dehiscence-type defects from clinical, radiological, and patient-related outcomes. Methods: 8 implants showing buccal dehiscence defects were treated with preformed titanium mesh directly fixed to flat abutments screwed to the implant. Intrasurgical clinical measurements and radiographic evaluations by means of cone-beam computed tomography scans were performed to assess the horizontal bone gain after 8 months from the augmentation surgery. Biological and patient-centered outcomes were also evaluated.; Results: clinically, a mean horizontal bone gain of 4.95 ± 0.96 mm, and a mean horizontal thickness of the buccal plate of 3.25 ± 0.46 mm were found. A mean horizontal bone gain of 5.06 ± 0.88 mm associated with a mean horizontal thickness of the buccal plate of 3.45 ± 0.68 mm were observed radiographically. From a macroscopic aspect, the remodeled graft appeared well integrated with the host bone. Well vascularized newly formed bone-like tissue was observed in intimate contact with the implants. Conclusions: preformed titanium mesh may be effective in supporting simultaneous horizontal bone regeneration at dehiscence-type peri-implant defects. Titanium mesh exposure still remain an issue in this type of surgery.

Download Full-text

Highly Predictable Augmentation of the Alveolar Ridge: Using a Titanium Mesh in Two-Stage Implant Surgery at the Mandible. Report of Clinical Cases and Surgical Technique

Journal of Diagnostics and Treatment of Oral and Maxillofacial Pathology ◽

10.23999/j.dtomp.2018.1.3 ◽

2018 ◽

Vol 2 (1) ◽

pp. 43-50

Keyword(s):

Mesh Exposure ◽

Alveolar Ridge ◽

Titanium Mesh ◽

Alveolar Ridge Augmentation ◽

Two Stage ◽

Implant Surgery ◽

Ridge Augmentation ◽

Mesh Material ◽

Bone Gain ◽

Prosthetic Complications

Purpose. The aim of this prospective surgical note was to evaluate the highly predictable horizontal bone gain of the alveolar ridge augmentation in two-stage implant surgery at the mandible with titanium mesh. Material and Methods. Five patients treated with 10 implants and simultaneous guided bone regeneration with titanium meshes (i–Gen®, MegaGen, Seoul, Republic of Korea) were selected for inclusion in the present surgical note. Primary outcomes were highly predictable horizontal bone gain of the alveolar ridge augmentation, secondary outcomes were biological and prosthetic complications. Results. After the removal of titanium meshes, the cone beam computed tomography (CBCT) showed a mean horizontal bone gain of 2 mm. The most frequent complications were mild postoperative edema (40% of patients) and discomfort after surgery (60% of patients); these complications were resolved within one week. Titanium mesh exposure occurred in 0 patients. And implant survival rate of 100% (implant-based). Conclusions. The horizontal ridge reconstruction with titanium meshes placed simultaneously with dental implants achieved predictable satisfactory results.

Download Full-text

Horizontal Ridge Augmentation: A Comparison between Khoury and Urban Technique

Biology ◽

10.3390/biology10080749 ◽

2021 ◽

Vol 10 (8) ◽

pp. 749

Author(s):

Javier Sánchez-Sánchez ◽

Finn Niclas Pickert ◽

Luis Sánchez-Labrador ◽

Francisco GF Tresguerres ◽

José María Martínez-González ◽

...

Keyword(s):

Meta Analysis ◽

Descriptive Analysis ◽

Cochrane Central Register ◽

Complication Rates ◽

Alveolar Ridge ◽

Ridge Augmentation ◽

Manual Search ◽

Central Register ◽

Augmentation Techniques ◽

Bone Gain

Purpose. The objective of this systematic review was to evaluate and compare the clinical efficacy of horizontal alveolar ridge augmentation techniques described by Khoury and Urban. Methods. A systematic electronic search in the MEDLINE databases, SCOPUS, WOS, and the Cochrane Central Register of Controlled Trials (CENTRAL) as well as a manual search, were conducted independently by two reviewers up to July 2021. Results. Six studies met the pre-established inclusion criteria and were included in the descriptive analysis. Due to the heterogeneity found across the included studies, meta-analysis could not be performed. Horizontal bone gain was between 3.93 ± 0.9 mm and 5.02 ± 0.8 mm with the Khoury technique and between 3.9 ± 0.9 mm and 5.68 ± 1.42 mm with the Urban technique. Similar complication rates were reported in both groups: infection (7%), in the Khoury technique, and membrane exposure (3.2–13.6%), in the Urban technique, being the most frequent events. Conclusions. Both techniques were found to be effective, in terms of clinical bone gain, for horizontal alveolar ridge gain. Nevertheless, available literature is limited, and there is a lack of comparative studies to better evaluate the results.

Download Full-text