Volumetric changes in edentulous alveolar ridge sites utilizing guided bone regeneration and a custom titanium ridge augmentation matrix (CTRAM): a case series study

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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Horizontal Ridge Augmentation Utilizing a Composite Graft of Demineralized Freeze-Dried Allograft, Mineralized Cortical Cancellous Chips, and a Biologically Degradable Thermoplastic Carrier Combined With a Resorbable Membrane: A Retrospective Evaluation of 73 Consecutively Treated Cases From Private Practices

Journal of Oral Implantology ◽

10.1563/aaid-joi-d-09-00100 ◽

2010 ◽

Vol 36 (6) ◽

pp. 467-474 ◽

Cited By ~ 17

Author(s):

Nicholas Toscano ◽

Danny Holtzclaw ◽

Ziv Mazor ◽

Paul Rosen ◽

Robert Horowitz ◽

...

Keyword(s):

Composite Material ◽

Measurement Data ◽

Case Series ◽

Collagen Membrane ◽

Ridge Augmentation ◽

Private Practices ◽

Implant Placement ◽

Freeze Dried ◽

Lateral Ridge ◽

Ridge Width

Abstract Ridge deficiency is an unfortunate obstacle in the field of implant dentistry. Many techniques are available to rebuild the deficient ridge. Some of these techniques are associated with significant morbidity and often require a second surgical site. With the advent of guided bone regeneration (GBR), one may now graft the deficient ridge with decreased morbidity and without a second surgical site. The purpose of this retrospective consecutive case series from 5 private practices is to report on the outcomes of a composite material of demineralized freeze-dried allograft, mineralized cortical cancellous chips, and a biologically degradable thermoplastic carrier (Regenaform RT) when combined with a resorbable membrane for GBR of lateral ridge defects in human patients. The specific aim was to quantify clinical results through direct measurement. Data were obtained from 73 consecutively treated lateral ridge augmentations performed on 67 partial and/or completely edentate patients. Clinical data (presurgical ridge width, ridge width at implant placement, and bone density at implant placement) were obtained retrospectively from 5 private practices via an exhaustive retrospective chart review, which was pooled and averaged for analysis. The average gain in horizontal ridge width was 3.5 mm (range, 3–6 mm). The density of the bone was noted to be type 2 to 3, with type 3 being the predominant finding. This retrospective case series from 5 clinical private practices suggests that the use of a composite material of demineralized freeze-dried allograft, mineralized cortical cancellous chips, and a biologically degradable thermoplastic carrier, when covered by a resorbable collagen membrane for GBR, is an effective means of horizontal ridge augmentation.

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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.

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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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Ridge Preservation Utilizing an Acellular Dermal Allograft and Demineralized Freeze-Dried Bone Allograft: Part II. Immediate Endosseous Implant Placement

Journal of Periodontology ◽

10.1902/jop.2000.71.8.1360 ◽

2000 ◽

Vol 71 (8) ◽

pp. 1360-1364 ◽

Cited By ~ 26

Author(s):

Edward B. Fowler ◽

Lawrence G. Breault ◽

George Rebitski

Keyword(s):

Bone Allograft ◽

Ridge Preservation ◽

Implant Placement ◽

Freeze Dried ◽

Endosseous Implant ◽

Acellular Dermal

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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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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.

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