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

Materials ◽  
2020 ◽  
Vol 13 (6) ◽  
pp. 1393 ◽  
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

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

scholarly journals Horizontal Ridge Augmentation Using a Xenograft Bone Substitute for Implant-Supported Fixed Rehabilitation: A Case Report with Four Years of Follow-Up

2020 ◽  
Vol 2020 ◽  
pp. 1-8
Author(s):  
Bruno Freitas Mello ◽  
Márcio de Carvalho Formiga ◽  
Luiz Fernando de Souza da Silva ◽  
Gustavo dos Santos Coura ◽  
Jamil Awad Shibli
Keyword(s):  
Case Report ◽  
Bone Tissue ◽  
Dental Implant ◽  
Bone Biopsy ◽  
Histological Evaluation ◽  
Autogenous Bone ◽  
High Survival ◽  
Ridge Augmentation ◽  
Implant Placement ◽  
Atrophic Maxilla

The guided bone regeneration (GBR) technique has been used to achieve optimal bone volume augmentation and allow dental implant placement in atrophic maxilla and mandible, with predictable results and high survival rates. The use of bone substitutes has reduced the necessity of autogenous bone grafts, reducing the morbidity at the donor areas and thus improving the patients’ satisfaction and comfort. This clinical case report shows a clinical and histological evaluation of the bone tissue behavior, in a case that required the horizontal augmentation of the alveolar ridge, with the use of xenograft biomaterial and further dental implant placement. After six months of healing time, six implants were placed, and a bone biopsy was done. The histological analysis depicted some fragments of the xenograft bone graft, integrated with the new-formed bone tissue.

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 The implant‐supported Cad Cam milled bar in the severely atrophic maxilla after horizontal ridge augmentation with autogenous bone blocks

2019 ◽  
Vol 30 (S19) ◽  
pp. 528-528
Author(s):  
Andreas Papandreou ◽  
Maria Sykara ◽  
Panagiotis Ntovas ◽  
Frank Zastrow
Keyword(s):  
Autogenous Bone ◽  
Ridge Augmentation ◽  
Atrophic Maxilla ◽  
Cad Cam

scholarly journals Xeno-Hybrid Composite Scaffold Manufactured with CAD/CAM Technology for Horizontal Bone-Augmentation in Edentulous Atrophic Maxilla: A Short Communication

2020 ◽  
Vol 10 (8) ◽  
pp. 2659 ◽  
Author(s):  
Maria Paola Cristalli ◽  
Gerardo La Monaca ◽  
Nicola Pranno ◽  
Susanna Annibali ◽  
Giovanna Iezzi ◽  
...  
Keyword(s):  
Short Communication ◽  
Bone Structure ◽  
Bovine Bone ◽  
Ridge Augmentation ◽  
Additional Surgery ◽  
Custom Made ◽  
Atrophic Maxilla ◽  
Computer Aided ◽  
Cad Cam ◽  
Deproteinized Bovine Bone

The present short communication described a new procedure for the reconstruction of the horizontal severely resorbed edentulous maxilla with custom-made deproteinized bovine bone block, fabricated using three-dimensional imaging of the patient and computer-aided design/computer-aided manufacturing (CAD/CAM) technology. The protocol consisted of three phases. In the diagnosis and treatment planning, cone-beam computed tomographic scans of the patient were saved in DICOM (digital imaging and communication in medicine) format, anatomic and prosthetic data were imported into a dedicated diagnostic and medical imaging software, the prosthetic-driven position of the implants, and the graft blocks perfectly adapted to the residual bone structure were virtually planned. In the manufacturing of customized graft blocks, the CAD-CAM technology and the bovine-derived xenohybrid composite bone (SmartBone® on Demand - IBI SA - Industrie Biomediche Insubri SA Switzerland) were used to fabricate the grafts in the exact shape of the 3D planning virtual model. In the surgical and prosthetic procedure, the maxillary ridge augmentation with custom-made blocks and implant-supported full-arch screw-retained rehabilitation were performed. The described protocol offered some advantages when compared to conventional augmentation techniques. The use of deproteinized bovine bone did not require additional surgery for bone harvesting, avoided the risk of donor site morbidity, and provided unlimited biomaterial availability. The customization of the graft blocks reduced the surgical invasiveness, shorting operating times because the manual shaping of the blocks and its adaptation at recipient sites are not necessary and less dependent on the clinician’s skill and experience.

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.

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