A Suggested Approach of Managing Excessive Maxillary Gingival Display in Terminal Dentition

The aim of this paper is to report a suggested approach for the management of excessive maxillary gingival display with terminal dentition. A segmental osteotomy of the maxillary process was performed, and the latter used as grafting material for lateral sinus augmentation that was performed simultaneously. Following the graft maturation period, implants were inserted and rehabilitated with a fixed dentogingival prosthesis. Consequently, the mandible was prosthetically restored following the new occlusal plane dictated by the rehabilitated maxilla. Clinically, the procedure showed a drastic improvement in the patient’s appearance, eliminating the excessive gingival display. Radiologically, it led to a vertical translation of the maxillary process level in an apical direction. Nevertheless, the resected process used as grafting material was noticed to have a suboptimal behavior as long as it showed increased intrasinusal resorption, barely sufficient for a regular implant accommodation. The described therapy concept seems to be a plausible approach when it comes to manage excessive maxillary gingival displays in edentulous patients or those presenting a terminal dentition. However, at the time of sinus augmentation, authors recommend to graft a mixture of resected maxillary process and a bone substitute material, in order to get more stable results.

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Maxillary sinus augmentation using xenogenic bone substitute material Bio-Oss® in combination with venous blood

Clinical Oral Implants Research ◽

10.1034/j.1600-0501.2000.011003217.x ◽

2000 ◽

Vol 11 (3) ◽

pp. 217-229 ◽

Cited By ~ 211

Author(s):

Murat Yildirim ◽

Hubertus Spiekermann ◽

Stefan Biesterfeld ◽

Daniel Edelhoff

Keyword(s):

Maxillary Sinus ◽

Bone Substitute ◽

Venous Blood ◽

Bone Substitute Material ◽

Sinus Augmentation ◽

Maxillary Sinus Augmentation ◽

Substitute Material ◽

Xenogenic Bone

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Clinical, Histological, and Histomorphometrical Analysis of Maxillary Sinus Augmentation Using Inorganic Bovine in Humans: Preliminary Results

Journal of Oral Implantology ◽

10.1563/aaid-joi-d-11-00012 ◽

2013 ◽

Vol 39 (1) ◽

pp. 73-80 ◽

Cited By ~ 19

Author(s):

Joseph Bassil ◽

Nada Naaman ◽

Raed Lattouf ◽

Cynthia Kassis ◽

Sylvie Changotade ◽

...

Keyword(s):

Maxillary Sinus ◽

Bone Substitute ◽

Bovine Bone ◽

Bone Substitute Material ◽

Sinus Augmentation ◽

Intimate Contact ◽

Average Percentage ◽

Maxillary Sinus Augmentation ◽

Bone Biopsies ◽

Substitute Material

The aim of the present study was to evaluate bone formation after maxillary sinus augmentation using bovine bone substitute material Bio-Oss alone by means of clinical, histological, and histomorphometrical examination of human biopsies. Deproteinized bovine bone (DPBB, Bio-Oss) was used to fill cavities after elevation of the sinus mucosa following major sinus pneumatization. Twenty patients with edentulous posterior maxillae were treated with 20 sinus augmentation procedures using a 2-stage technique. Residual lateral maxillary bone height was less than 3 mm. Forty-nine Straumann endosseous implants were used to complete the implant-prosthetic rehabilitation. Forty cylinder-shaped bone biopsies were taken from the augmented maxillary region 8 months after grafting during the second-stage surgery before implant placement. All implants were loaded 3 months after insertion, and no failures were recorded. Histomorphometrical analysis showed an average percentage of newly formed bone of 17.6% (±2.8%) and a proportion of residual bone substitute material of 29.9% (±4.9%) of the total biopsy area. Intimate contact between newly formed bone and Bio-Oss was detected along 28.2% (±6.8%) of the particle surfaces. The results also showed that in all cases, the DPBB granules had been interconnected by bridges of vital newly formed bone. Inorganic bovine bone appears to be biocompatible and osteoconductive, and it can be used with success as a bone substitute in maxillary sinus augmentation procedures.

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Determination of the Vertical Dimension and the Position of the Occlusal Plane in a Removable Prosthesis Using Cephalometric Analysis and Golden Proportion

Applied Sciences ◽

10.3390/app11156948 ◽

2021 ◽

Vol 11 (15) ◽

pp. 6948

Author(s):

Gabriele Cervino ◽

Sergio Sambataro ◽

Chiara Stumpo ◽

Salvatore Bocchieri ◽

Fausto Murabito ◽

...

Keyword(s):

Vertical Dimension ◽

Occlusal Plane ◽

X Rays ◽

Common Procedure ◽

Lower Incisor ◽

Golden Proportion ◽

The Face ◽

Removable Prosthesis ◽

Edentulous Patients

The aim of this study is to demonstrate the use and the effectiveness of cephalometry and golden proportions analysis of the face in planning prosthetic treatments in totally edentulous patients. In order to apply this method, latero-lateral and posterior-anterior X-rays must be performed in addition to the common procedure. Two main concerns for totally edentulous patients are the establishment of the vertical dimension and the new position of the occlusal plane. The divine proportion analysis was carried out by the use of a golden divider. The prosthetic protocol was divided into three steps and a case was selected for better understanding. Referring to the golden relations, if the distance from the chin to the wing of the nose is 1.0, the distance from the nose to eye is 0.618. This proportion is useful and effective in determining the correct prosthetic vertical dimension. The incisal margin of the lower incisor must be positioned between Point A (A) and protuberance menti (Pm) according to the gold ratio 0.618 of the total height A-Pm. Posteriorly the occlusal plane must be placed 2 mm below the divine occlusal plane (traced from the incisal margin of lower incisors to Xi point). A prosthesis made in accordance with cephalometric parameters and divine proportions of the face helps to improve the patient’s aesthetics, function and social personality.

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In Vivo Analysis of the Biocompatibility and Bone Healing Capacity of a Novel Bone Grafting Material Combined with Hyaluronic Acid

International Journal of Molecular Sciences ◽

10.3390/ijms22094818 ◽

2021 ◽

Vol 22 (9) ◽

pp. 4818

Author(s):

Annica Pröhl ◽

Milijana Batinic ◽

Said Alkildani ◽

Michael Hahn ◽

Milena Radenkovic ◽

...

Keyword(s):

Bone Substitute ◽

Sham Operation ◽

Bone Substitute Material ◽

Water Binding ◽

Sham Operation Group ◽

Operation Group ◽

Substitute Material ◽

Tissue Reactions ◽

Inflammatory Tissue

The present in vivo study analyses both the inflammatory tissue reactions and the bone healing capacity of a newly developed bone substitute material (BSM) based on xenogeneic bone substitute granules combined with hyaluronate (HY) as a water-binding molecule. The results of the hyaluronate containing bone substitute material (BSM) were compared to a control xenogeneic BSM of the same chemical composition and a sham operation group up to 16 weeks post implantationem. A major focus of the study was to analyze the residual hyaluronate and its effects on the material-dependent healing behavior and the inflammatory tissue responses. The study included 63 male Wistar rats using the calvaria implantation model for 2, 8, and 16 weeks post implantationem. Established and Good Laboratory Practice (GLP)-conforming histological, histopathological, and histomorphometrical analysis methods were conducted. The results showed that the new hyaluronate containing BSM was gradually integrated within newly formed bone up to the end of the study that ended in a condition of complete bone defect healing. Thereby, no differences to the healing capacity of the control BSM were found. However, the bone formation in both groups was continuously significantly higher compared to the sham operation group. Additionally, no differences in the (inflammatory) tissue response that was analyzed via qualitative and (semi-) quantitative methods were found. Interestingly, no differences were found between the numbers of pro- and anti-inflammatory macrophages between the three study groups over the entire course of the study. No signs of the HY as a water-binding part of the BSM were histologically detectable at any of the study time points, altogether the results of the present study show that HY allows for an optimal material-associated bone tissue healing comparable to the control xenogeneic BSM. The added HY seems to be degraded within a very short time period of less than 2 weeks so that the remaining BSM granules allow for a gradual osteoconductive bone regeneration. Additionally, no differences between the inflammatory tissue reactions in both material groups and the sham operation group were found. Thus, the new hyaluronate containing xenogeneic BSM and also the control BSM have been shown to be fully biocompatible without any differences regarding bone regeneration.

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Radiographic evaluation of a bone substitute material in alveolar ridge preservation for maxillary removable immediate dentures: A randomized controlled trial

Journal of Prosthetic Dentistry ◽

10.1016/j.prosdent.2021.02.013 ◽

2021 ◽

Author(s):

Christophe Rignon-Bret ◽

Claudine Wulfman ◽

Fabien Valet ◽

Alain Hadida ◽

Thien-Huong Nguyen ◽

...

Keyword(s):

Randomized Controlled Trial ◽

Bone Substitute ◽

Controlled Trial ◽

Radiographic Evaluation ◽

Ridge Preservation ◽

Alveolar Ridge ◽

Bone Substitute Material ◽

Randomized Controlled ◽

Alveolar Ridge Preservation ◽

Substitute Material

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The use of solvent-preserved human and bovine cancellous bone blocks for lateral defect augmentation - an experimental controlled study in vivo

Head & Face Medicine ◽

10.1186/s13005-021-00275-1 ◽

2021 ◽

Vol 17 (1) ◽

Author(s):

Lara Schorn ◽

Tim Fienitz ◽

Kathrin Berndsen ◽

Norbert R. Kübler ◽

Henrik Holtmann ◽

...

Keyword(s):

Bone Formation ◽

Cancellous Bone ◽

Bone Substitute ◽

Bone Matrix ◽

Human Bone ◽

Controlled Study ◽

Bovine Bone ◽

New Bone Formation ◽

Bone Substitute Material ◽

Substitute Material

Abstract Background The aim of this study was to compare new bone formation, resorbed bone matrix, and fibrous enclosed residual bone substitute material in laterally augmented alveolar bone defects using allogeneic, pre-treated and cleaned human bone blocks (tested in dogs, therefore considered to be xenogeneic), and pre-treated and cleaned bovine cancellous bone blocks, both with and without a collagen membrane in order to evaluate their augmentative potential. Methods Thirty-two critical size horizontal defects were prepared in the mandible of 4 adult foxhound dogs (8 per dog, 4 on each side). After 3 months of healing, the defects were laterally augmented in a split-mouth-design with either human (HXB) or bovine solvent-preserved bone blocks (BXB). Afterwards, defects were randomly covered with a bovine collagenous membrane (HXB + M, BXB + M). After a healing interval of 6 months, percentages of new bone formation, resorbed bone matrix, and fibrous enclosed residual bone substitute material were compared. Results Results showed little new bone formation of up to 3.7 % in human bone blocks (HXB 3.7 % ± 10.2, HXB + M 0.3 %± 0.4, BXB, 0.1 % ± 0.8, BXB + M 2.6 % ± 3.2, p = > 0.05). Percentages of fibrous encapsulation were higher in human bone blocks than in bovine bone blocks (HXB 71.2 % ± 8.6, HXB + M 73.71 % ± 10.6, BXB, 60.5 % ± 27.4, BXB + M 52.5 % ± 28.4, p = > 0.05). Resorption rates differed from 44.8 % in bovine bone blocks covered with a membrane to 17.4 % in human bone blocks (HXB 17.4 % ± 7.4, HXB + M 25.9 % ± 10.7, BXB, 38.4 % ± 27.2, BXB + M 44.8 % ± 29.6, p = > 0.05). The use of additional membranes did not significantly affect results. Conclusions Within its limitations, results of this study suggest that solvent-preserved xenogenic human and bovine bone blocks are not suitable for lateral bone augmentation in dogs. Furthermore, defect coverage with a membrane does not positively affect the outcome.

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