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

2010 ◽  
Vol 36 (6) ◽  
pp. 467-474 ◽  
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.

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

2020 ◽  
Vol 6 (1) ◽  
Author(s):  
Craig E. Hofferber ◽  
J. Cameron Beck ◽  
Peter C. Liacouras ◽  
Jeffrey R. Wessel ◽  
Thu P. Getka
Keyword(s):  
Case Series ◽  
Bone Allograft ◽  
Volumetric Analysis ◽  
Collagen Membrane ◽  
Ridge Augmentation ◽  
Implant Placement ◽  
Case Series Study ◽  
Freeze Dried ◽  
Clinical Measurements ◽  
Bone Gain

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.

scholarly journals Multi-Layer Technique (MLT) with Porcine Collagenated Cortical Bone Lamina for Bone Regeneration Procedures and Immediate Post-Extraction Implantation in the Esthetic Area: A Retrospective Case Series with a Mean Follow-Up of 5 Years

Materials ◽  
2021 ◽  
Vol 14 (18) ◽  
pp. 5180
Author(s):  
Paul Leonhard Schuh ◽  
Hannes Wachtel ◽  
Florian Beuer ◽  
Funda Goker ◽  
Massimo Del Fabbro ◽  
...  
Keyword(s):  
Cortical Bone ◽  
Case Series ◽  
Specific Factor ◽  
Alveolar Ridge ◽  
Implant Survival ◽  
Anterior Maxilla ◽  
Ridge Augmentation ◽  
Implant Placement ◽  
Ridge Width

Background: Augmentation of the edentulous atrophic anterior region is a challenging situation. The purpose of this article was to evaluate the effectiveness of a collagenated cortical bone lamina of porcine origin for horizontal ridge augmentation in patients with inadequate alveolar ridge width undergoing immediate post-extraction implantation in the anterior sites, and to report on implant survival rates/complications. Materials and methods: The cases were extracted electronically from a large database according to these specific inclusion criteria: patients with inadequate alveolar ridge width in the anterior maxilla or mandible, who underwent immediate post-extraction implant placement and simultaneous alveolar bone reconstruction using xenogeneic cortical bone lamina. An additional layer of palatal connective tissue graft was inserted between lamina and the vestibular mucosa, for improving soft tissue healing. A collagenated bone substitute was additionally placed in the gap between the lamina and implant surface in all patients. The main outcomes were implant survival and complications. Results: Forty-nine patients with 65 implants were included. Patients’ mean age at the time of implant surgery was 60.0 ± 13.6 years. The mean follow-up was 60.5 ± 26.6 months after implant placement. The implant survival was 100%. Four postoperative complications occurred in four patients. No specific factor was found to be associated with complication occurrence. Conclusion: The use of collagenated cortical bone lamina can be considered as a successful option for alveolar reconstruction in immediate post-extraction implant insertion procedures in anterior regions with inadequate alveolar ridge width.

Clinical and Histomorphometric Assessment of Lateral Alveolar Ridge Augmentation Using a Corticocancellous Freeze-Dried Allograft Bone Block

2017 ◽  
Vol 43 (3) ◽  
pp. 202-210 ◽  
Author(s):  
Roya Shariatmadar Ahmadi ◽  
Ferena Sayar ◽  
Vahid Rakhshan ◽  
Babak Iranpour ◽  
Jahanfar Jahanbani ◽  
...  
Keyword(s):  
Clinical Success ◽  
Bone Allograft ◽  
Bone Block ◽  
Graft Material ◽  
Alveolar Ridge Augmentation ◽  
Ridge Augmentation ◽  
Freeze Dried ◽  
Lateral Ridge ◽  
Ridge Width ◽  
Lateral Ridge Augmentation

Horizontal ridge augmentation with allografts has attracted notable attention because of its proper success rate and the lack of disadvantages of autografts. Corticocancellous block allografts have not been adequately studied in humans. Therefore, this study clinically and histomorphometrically evaluated the increase in ridge width after horizontal ridge augmentation using corticocancellous block allografts as well as implant success after 12 to 18 months after implantation. In 10 patients receiving implants (3 women, 7 men; mean age = 45 years), defective maxillary alveolar ridges were horizontally augmented using freeze-dried bone allograft blocks. Ridge widths were measured before augmentation, immediately after augmentation, and ∼6 months later in the reentry surgery for implantation. This was done at points 2 mm (A) and 5 mm (B) apically to the crest. Biopsy cores were acquired from the implantation site. Implant success was assessed 15.1 ± 2.7 months after implantation (range = 12–18 months). Data were analyzed using Friedman and Dunn tests (α = 0.05). At point A, ridge widths were 2.77 ± 0.37, 8.02 ± 0.87, and 6.40 ± 0.66 mm, respectively, before surgery, immediately after surgery, and before implantation. At point B, ridge widths were 3.40 ± 0.39, 9.35 ± 1.16, and 7.40 ± 1.10 mm, respectively, before surgery, immediately after surgery, and before implantation. The Friedman test showed significant increases in ridge widths, both at point A and point B (both P = .0000). Postaugmentation resorption was about 1.5–2 mm and was statistically significant at points A and B (P < .05, Dunn). The percentage of newly formed bone, residual graft material, and soft tissue were 33.0% ± 11.35% (95% confidence interval [CI] = 24.88%–41.12%), 37.50% ± 19.04% (95% CI = 23.88%–51.12%), and 29.5%, respectively. The inflammation was limited to grades 1 or zero. Twelve to 18 months after implantation, no implants caused pain or showed exudates or pockets. Radiographic bone loss was 2.0 ± 0.7 mm (range = 1–3). It can be concluded that lateral ridge augmentation with corticocancellous allograft blocks might be successful both clinically and histologically. Implants might have a proper clinical success after a minimum of 12 months.

Horizontal Bone Augmentation Using Autogenous Block Grafts and Particulate Xenograft in the Severe Atrophic Maxillary Anterior Ridges: A Cone-Beam Computerized Tomography Case Series

2015 ◽  
Vol 41 (S1) ◽  
pp. 366-371 ◽  
Author(s):  
Alberto Monje ◽  
Florencio Monje ◽  
Federico Hernández-Alfaro ◽  
Raúl Gonzalez-García ◽  
Fernando Suárez-López del Amo ◽  
...  
Keyword(s):  
Computerized Tomography ◽  
Case Series ◽  
Cone Beam ◽  
Collagen Membrane ◽  
Bone Augmentation ◽  
Class Iii ◽  
Anterior Maxilla ◽  
Implant Placement ◽  
Ridge Width ◽  
Cone Beam Computerized Tomography

The aim of the present study was to use cone-beam computerized tomography (CBCT) to assess horizontal bone augmentation using block grafts, harvested from either the iliac crest (IC) or mandibular ramus (MR) combined with particulate xenograft and a collagen membrane for in the severe maxillary anterior ridge defects (cases Class III-IV according to Cadwood and Howell's classification). Fourteen healthy partially edentulous patients requiring extensive horizontal bone reconstruction in the anterior maxilla were selected for the study. Nineteen onlay block grafts (from IC or MR) were placed. The amount of horizontal bone gain was recorded by CBCT at 3 levels (5, 7, and 11 mm from the residual ridge) and at the time of bone grafting as well as the time of implant placement (≈5 months). Both block donor sites provided enough ridge width for proper implant placement. Nonetheless, IC had significantly greater ridge width gain than MR (Student t test) (4.93 mm vs 3.23 mm). This was further confirmed by nonparametric Mann-Whitney test (P = .007). Moreover, mean pristine ridge and grafted ridge values showed a direct association (Spearman coefficient of correlation = .336). A combination of block graft, obtained from the IC or MR, combined with particulate xenograft then covered with an absorbable collagen membrane is a predictable technique for augmenting anterior maxillary horizontal ridge deficiency.

scholarly journals 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 ◽  
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.

The Bone Lamina Technique: A Novel Approach for Lateral Ridge Augmentation—A Case Series

2013 ◽  
Vol 33 (4) ◽  
pp. 491-497 ◽  
Author(s):  
Hannes Wachtel ◽  
Stefan Fickl ◽  
Marc Hinze ◽  
Wolfgang Bolz ◽  
Tobias Thalmair
Keyword(s):  
Case Series ◽  
Ridge Augmentation ◽  
Novel Approach ◽  
Lateral Ridge ◽  
Lateral Ridge Augmentation

scholarly journals Design Techniques to Optimize the Scaffold Performance: Freeze-dried Bone Custom-made Allografts for Maxillary Alveolar Horizontal Ridge Augmentation

2020 ◽  
Author(s):  
Felice Roberto Grassi ◽  
Roberta Grassi ◽  
Leonardo Vivarelli ◽  
Dante Dallari ◽  
Marco Govoni ◽  
...  
Keyword(s):  
Clinical Success ◽  
Secondary Site ◽  
Autogenous Bone ◽  
Ridge Augmentation ◽  
Implant Placement ◽  
Freeze Dried ◽  
Custom Made ◽  
Atrophic Maxilla ◽  
Bone Level ◽  
Density Analysis

Background: The aim of the present investigation was to evaluate the clinical success of horizontal ridge augmentation in the severely atrophic maxilla (Cawood and Howell class IV) using freeze-dried custom made bone harvested from cadaver donors tibial hemiplateau and to analyze the marginal bone level gain prior dental implants placement at 9 months after bone grafting and before prosthetic rehabilitation. Methods: A 52-year-old woman received custom made bone grafts. Patient underwent CT scans 2 weeks prior and 9 months after surgery for graft volume and density analysis. Results: The clinical and radiographic bone observations showed a very low rate of resorption after bone graft and implant placement. Conclusions: The custom-made allograft material was a highly effective modality for restoring the alveolar horizontal ridge, resulting in this way to reduce the need to obtain autogenous bone from a secondary site with predictable procedure. Further studies are needed to investigate its behavior at longer time points.

scholarly journals Vertical-guided bone regeneration with a titanium-reinforced d-PTFE membrane utilizing a novel split-thickness flap design: a prospective case series

2020 ◽  
Author(s):  
Peter Windisch ◽  
Kristof Orban ◽  
Giovanni E. Salvi ◽  
Anton Sculean ◽  
Balint Molnar
Keyword(s):  
Bone Regeneration ◽  
Case Series ◽  
Radiographic Examination ◽  
Radiographic Evaluation ◽  
Autogenous Bone ◽  
Hard Tissue ◽  
Ridge Augmentation ◽  
Implant Placement ◽  
Simultaneous Group ◽  
Flap Design

Abstract Objectives To evaluate the feasibility of a newly proposed minimally invasive split-thickness flap design without vertical-releasing incisions for vertical bone regeneration performed in either a simultaneous or staged approach and to analyze the prevalence of adverse events during postoperative healing. Materials and methods Following preparation of a split-thickness flap and bilaminar elevation of the mucosa and underlying periosteum, the alveolar bone was exposed over the defects, vertical GBR was performed by means of a titanium-reinforced high-density polytetrafluoroethylene membrane combined with particulated autogenous bone (AP) and bovine-derived xenograft (BDX) in 1:1 ratio. At 9 months after reconstructive surgery, vertical and horizontal hard tissue gain was evaluated based on clinical and radiographic examination. Results Twenty-four vertical alveolar ridge defects in 19 patients were treated with vertical GBR. In case of 6 surgical sites, implant placement was performed at the time of the GBR (simultaneous group); in the remaining 18 surgical, sites implant placement was performed 9 months after the ridge augmentation (staged group). After uneventful healing in 23 cases, hard tissue fill was detected in each site. Direct clinical measurements confirmed vertical and horizontal hard tissue gain averaging 3.2 ± 1.9 mm and 6.5 ± 0.5 mm respectively, in the simultaneous group and 4.5 ± 2.2 mm and 8.7 ± 2.3 mm respectively, in the staged group. Additional radiographic evaluation based on CBCT data sets in the staged group revealed mean vertical and horizontal hard tissue fill of 4.2 ± 2.0 mm and 8.5 ± 2.4 mm. Radiographic volume gain was 1.1 ± 0.4 cm3. Conclusion Vertical GBR consisting of a split-thickness flap and using titanium-reinforced non-resorbable membrane in conjunction with a 1:1 mixture of AP+BDX may lead to a predictable vertical and horizontal hard tissue reconstruction. Clinical relevance The used split-thickness flap design may represent a valuable approach to increase the success rate of vertical GBR, resulting in predicable hard tissue regeneration, and favorable wound healing with low rate of membrane exposure.

scholarly journals Conservative Technique Using Oral Dressing Material for Wound Dehiscence after Ridge Augmentation: A Technical Report with a Case Series

2021 ◽  
Vol 11 (13) ◽  
pp. 6115
Author(s):  
Jeong-Kui Ku ◽  
Yeong Kon Jeong ◽  
Yong-Suk Choi ◽  
Taeyeong Kim ◽  
In-Woo Cho ◽  
...  
Keyword(s):  
Conservative Treatment ◽  
Bone Graft ◽  
Case Series ◽  
Wound Dehiscence ◽  
Autogenous Bone ◽  
Collagen Membrane ◽  
Graft Material ◽  
Titanium Mesh ◽  
Ridge Augmentation ◽  
Secondary Healing

Wound dehiscence is the most frequent complication after ridge augmentation and causes postoperative infection, inadequate bone healing, or graft failure. In the oral cavity, conservative treatment for dehiscence is difficult to maintain until secondary healing occurs because of its normal flora, dynamic masticatory muscle movement, and humid environment. This paper reports an effective conservative method using an oral wound dressing material with an omnivec splint and presents three wound dehiscence cases: (1) autogenous tooth bone graft material with a collagen membrane, with dehiscence occurring at postoperative 5 days. (2) Autogenous bone graft covering titanium mesh, with dehiscence occurring at postoperative three weeks. The mesh was removed after 10 weeks with histologic analysis. (3) Autogenous bone and autogenous tooth bone graft covering a titanium mesh, with dehiscence occurring at postoperative 1 week. The exposed titanium mesh was maintained for 6 months after the graft. All cases achieved secondary healing and acceptable outcomes for a dental implant by conservative treatment without infection after the dehiscence after ridge augmentation.

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