Vertical ridge augmentation with guided bone regeneration in association with dental implants: an experimental study in dogs

Purpose – The purpose of this paper is to describe two different approaches for manufacturing pre-formed titanium meshes to assist prosthetically guided bone regeneration of atrophic maxillary arches. Both methods are based on the use of additive manufacturing (AM) technologies and aim to limit at the minimal intervention the bone reconstructive surgery by virtual planning the surgical intervention for dental implants placement. Design/methodology/approach – Two patients with atrophic maxillary arches were scheduled for bone augmentation using pre-formed titanium mesh with particulate autogenous bone graft and alloplastic material. The complete workflow consists of four steps: three-dimensional (3D) acquisition of medical images and virtual planning, 3D modelling and design of the bone augmentation volume, manufacturing of biomodels and pre-formed meshes, clinical procedure and follow up. For what concerns the AM, fused deposition modelling (FDM) and direct metal laser sintering (DMLS) were used. Findings – For both patients, a post-operative control CT examination was scheduled to evaluate the progression of the regenerative process and verify the availability of an adequate amount of bone before the surgical intervention for dental implants placement. In both cases, the regenerated bone was sufficient to fix the implants in the planned position, improving the intervention quality and reducing the intervention time during surgery. Originality/value – A comparison between two novel methods, involving AM technologies are presented as viable and reproducible methods to assist the correct bone augmentation of atrophic patients, prior to implant placement for the final implant supported prosthetic rehabilitation.

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Buccal bone thickness adjacent to virtual dental implants following guided bone regeneration

Journal of Periodontology ◽

10.1002/jper.18-0304 ◽

2019 ◽

Vol 90 (6) ◽

pp. 595-607 ◽

Cited By ~ 5

Author(s):

Daniel J. Phillips ◽

Dane T. Swenson ◽

Thomas M. Johnson

Keyword(s):

Bone Regeneration ◽

Dental Implants ◽

Guided Bone Regeneration ◽

Bone Thickness

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Horizontal-guided Bone Regeneration using a Titanium Mesh and an Equine Bone Graft

The Journal of Contemporary Dental Practice ◽

10.5005/jp-journals-10024-1653 ◽

2015 ◽

Vol 16 (2) ◽

pp. 154-162 ◽

Cited By ~ 12

Author(s):

Danilo Alessio Di Stefano ◽

Gian Battista Greco ◽

Lorenzo Cinci ◽

Laura Pieri

Keyword(s):

Bone Graft ◽

Bone Regeneration ◽

Guided Bone Regeneration ◽

Bone Sample ◽

Successful Outcome ◽

Autogenous Bone ◽

Titanium Mesh ◽

Ridge Augmentation ◽

Stereolithographic Model ◽

Equine Bone

ABSTRACT Aim The present work describes a horizontal ridge augmentation in which a titanium mesh was preshaped by adapting it to a stereolithographic model of the patient's jaw that was fabricated from CT scans. Background Guided bone regeneration (GBR) involves covering the augmentation site with a long-lasting barrier to protect it from the invasion of surrounding soft tissues. Among barriers, titanium meshes may provide a successful outcome, but the intraoperatory time needed to shape them is a disadvantage. Case description The 54-year-old patient, missing the right mandibular second bicuspid, first molar, and second molar, had her atrophic ridge augmented with a 30:70 mixture of autogenous bone and equine, enzyme-deantigenic collagenpreserved bone substitute. Two conical implants were inserted concomitantly in the second bicuspid and first molar positions, and the site was protected with the preshaped mesh. Four months later, the titanium mesh was retrieved, a bone sample was collected, and histological and histomorphometric analyses were performed. Provisional and definitive prostheses were then delivered, and follow-up controls were performed for up to 24 months. Conclusion Preshaping the mesh on a model of the patient's mandible shortened the surgical time and enabled faster mesh placement. Two years after surgery, the implants were perfectly functional, and the bone width was stable over time as shown by radiographic controls. Histological analysis of the bone sample showed the heterologous biomaterial to be biocompatible and undergoing advanced remodeling and replacement with newly formed bone. Clinical significance Preshaping a titanium mesh over a stereolithographic model of the patient's jaw allowed for a significant reduction of the intraoperative time and may be therefore, advisable in routine practice. How to cite this article Di Stefano DA, Greco GB, Cinci L, Pieri L. Horizontal-guided Bone Regeneration using a Titanium Mesh and an Equine Bone Graft. J Contemp Dent Pract 2015;16(2):154-162.

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Surgical procedure for guided bone regeneration using resorbable membrane barrier for ridge augmentation in successful implant placement

Journal of Indian Academy of Dental Specialist Researchers ◽

10.4103/2229-3019.177931 ◽

2015 ◽

Vol 2 (2) ◽

pp. 70

Author(s):

Raghavendra Nagappa ◽

AshrafSM Elzer ◽

SalemFaraj Ben Younis ◽

Megharaj Doddagoudar

Keyword(s):

Bone Regeneration ◽

Surgical Procedure ◽

Guided Bone Regeneration ◽

Ridge Augmentation ◽

Implant Placement ◽

Membrane Barrier

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Localized Ridge Augmentation Using Guided Bone Regeneration

Craniomaxillofacial Reconstructive and Corrective Bone Surgery ◽

10.1007/978-1-4939-1529-3_16 ◽

2019 ◽

pp. 177-196

Author(s):

Alex M. Greenberg

Keyword(s):

Bone Regeneration ◽

Guided Bone Regeneration ◽

Ridge Augmentation

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Can the Macrogeometry of Dental Implants Influence Guided Bone Regeneration in Buccal Bone Defects? Histomorphometric and Biomechanical Analysis in Beagle Dogs

Journal of Clinical Medicine ◽

10.3390/jcm8050618 ◽

2019 ◽

Vol 8 (5) ◽

pp. 618 ◽

Cited By ~ 1

Author(s):

Manuel Fernández-Domínguez ◽

Victor Ortega-Asensio ◽

Elena Fuentes Numancia ◽

Juan Aragoneses ◽

Horia Barbu ◽

...

Keyword(s):

Bone Regeneration ◽

Dental Implants ◽

Animal Study ◽

Statistical Significance ◽

Guided Bone Regeneration ◽

Biomechanical Analysis ◽

Implant Stability ◽

Beagle Dogs ◽

Implant Placement ◽

Cervical Portion

The aim of this experimental animal study was to assess guided bone regeneration (GBR) and implant stability (ISQ) around two dental implants with different macrogeometries. Forty eight dental implants were placed within six Beagle dogs. The implants were divided into two groups (n = 24 per group): G1 group implants presented semi-conical macrogeometry, a low apical self-tapping portion, and an external hexagonal connection (whereby the cervical portion was bigger than the implant body). G2 group implants presented parallel walls macrogeometry, a strong apical self-tapping portion, and an external hexagonal connection (with the cervical portion parallel to the implant body). Buccal (mouth-related) defects of 2 mm (c2 condition) and 5 mm (c3 condition) were created. For the control condition with no defect (c1), implants were installed at crestal bone level. Eight implants in each group were installed under each condition. The implant stability quotient (ISQ) was measured immediately after implant placement, and on the day of sacrifice (3 months after the implant placement). Histological and histomorphometric procedures and analysis were performed to assess all samples, measuring crestal bone loss (CBL) and bone-to-implant contact (BIC). The data obtained were compared with statistical significance set at p < 0.05. The ISQ results showed a similar evolution between the groups at the two evaluation times, although higher values were found in the G1 group under all conditions. Within the limitations of this animal study, it may be concluded that implant macrogeometry is an important factor influencing guided bone regeneration in buccal defects. Group G1 showed better buccal bone regeneration (CBL) and BIC % at 3 months follow up, also parallel collar design can stimulate bone regeneration more than divergent collar design implants. The apical portion of the implant, with a stronger self-tapping feature, may provide better initial stability, even in the presence of a bone defect in the buccal area.

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