scholarly journals A Modified Ridge Splitting Technique Using Autogenous Bone Blocks—A Case Series

Materials ◽  
2020 ◽  
Vol 13 (18) ◽  
pp. 4036
Author(s):  
Dorottya Pénzes ◽  
Fanni Simon ◽  
Eitan Mijiritsky ◽  
Orsolya Németh ◽  
Márton Kivovics
Keyword(s):  
Case Series ◽  
Clinical Results ◽  
Autogenous Bone ◽  
Bone Block ◽  
Alveolar Ridge ◽  
Splitting Technique ◽  
Implant Placement ◽  
Bone Width ◽  
Novel Approach ◽  
Piezoelectric Surgery

Background: Alveolar atrophy following tooth loss is a common limitation of rehabilitation with dental implant born prostheses. Ridge splitting is a well-documented surgical method to restore the width of the alveolar ridge prior to implant placement. The aim of this case series is to present a novel approach to ridge expansion using only autogenous bone blocks. Methods: Patients with Kennedy Class I. and II. mandibles with insufficient bone width were included in this study. Ridge splitting was carried out with the use of a piezoelectric surgery device by preparing osteotomies and after mobilization of the buccal cortical by placing an autologous bone block harvested from the retromolar region as a spacer between the buccal and lingual cortical plates. Block-grafts were stabilized by osteosynthesis screws. Implant placement was carried out after a 3-month healing period. A total of 13 implants were placed in seven augmented sites of six patients. Results: Upon re-entry, all sites healed uneventfully. Mean ridge width gain was 2.86 mm, range: 2.0–5.0 mm. Conclusions: Clinical results of our study show that the modified ridge splitting technique is a safe and predictable method to restore width of the alveolar ridge prior to implant placement.

scholarly journals Unprotected autogenous bone block grafts in anterior maxilla: Resorption rates and clinical outcomes

2017 ◽  
Vol 74 (4) ◽  
pp. 305-310
Author(s):  
Ivan Kosanic ◽  
Miroslav Andric ◽  
Bozidar Brkovic ◽  
Vladimir Kokovic ◽  
Milan Jurisic
Keyword(s):  
Bone Grafts ◽  
Autogenous Bone ◽  
Bone Block ◽  
Alveolar Ridge ◽  
Implant Stability ◽  
Anterior Maxilla ◽  
Ridge Augmentation ◽  
Implant Placement ◽  
Mean Width ◽  
The Mean

Background/Aim. The use of autogenous bone grafts for augmentation of the resorbed alveolar ridge is still considered the gold standard in implant dentistry. The aim of this study was to analyze the resorption rate of autogenous bone block grafts from the retromolar region placed in the frontal segment of the upper jaw unprotected by barrier membranes, to assess the stability of implants placed into the grafted bone, as well as to monitor its changes during the healing period. Methods. The study included 18 patients with a total of 20 grafted sites. The residual alveolar ridge was measured before and after the augmentation and prior to implant placement. All implants were restored with provisional crowns within 48 hours after the placement. Implant stability was assessed using resonance frequency analysis. Results. The average period from ridge augmentation to reentry was 5.4 months (range 4?6 months). At reentry the healed alveolar ridge had a mean width of 6.1 ? 1.27 mm. The mean calculated width gain was 3.04 ? 1.22 mm. The overall surface resorption of block grafts was 0.68 ? 0.69 mm (18.85%). At the time of implant placement the mean value of implant stability quotient (ISQ) was 71.25 ? 5.77. The lowest ISQ values were noted after three weeks of healing, followed by a gradual increase until week 12. After 12 weeks implants showed significantly higher ISQ values compared to primary stability (p < 0.05 Wilcoxon signed ranks test). During the 3-years followup period no cases of implant loss were recorded. Conclusion. Despite a significant resorption of bone grafts, it was possible to place implants in all the cases and to use the immediate loading protocol without affecting implant survival rate.

scholarly journals Histologic and Tomographic Findings of Bone Block Allografts in a 4 Years Follow-up: A Case Series

2016 ◽  
Vol 27 (6) ◽  
pp. 775-780 ◽  
Author(s):  
Daniel Deluiz ◽  
Luciano Santos Oliveira ◽  
Paul Fletcher ◽  
Fábio Ramôa Pires ◽  
Justine Monnerat Tinoco ◽  
...  
Keyword(s):  
Small Sample Size ◽  
Case Series ◽  
Small Sample ◽  
Histological Evaluation ◽  
Bone Block ◽  
Mucogingival Surgery ◽  
Native Bone ◽  
Implant Placement

Abstract The aim of this paper is to report histologic and tomographic findings of fresh frozen bone block allografts bearing dental implants in functional occlusion in a long-term follow-up. Four patients with implants functionally loaded for 4 years on augmented ridges requiring additional mucogingival surgery or implant placement were included in this case series. Cone-beam tomography scans were compared volumetrically between the baseline (first implant placement) and current images. Biopsies of the grafts were retrieved and sent to histological analysis. Volumetric reduction of the grafts varied from 2.1 to 7.7%. Histological evaluation demonstrated well-incorporated grafts with different degrees of remodeling. While data presented in this report are from a small sample size and do not allow definitive conclusions, the biopsies of the grafted sites were very similar to the host's native bone. Remodeling of the cortical portion of the allografts seems to take longer than the cancellous portion. The presence of unincorporated graft remains did not impair the implant success or the health of the surrounding tissues. This is the first time histologic and tomographic long term data of bone allograft have been made available in dentistry.

Bilateral Vertical Ridge Augmentation With Block Grafts and Guided Bone Regeneration in the Posterior Mandible: A Case Report

2012 ◽  
Vol 38 (S1) ◽  
pp. 533-537 ◽  
Author(s):  
Maria A. Peñarrocha ◽  
Jose A. Vina ◽  
Laura Maestre ◽  
David Peñarrocha-Oltra
Keyword(s):  
Case Report ◽  
Bone Regeneration ◽  
Mandibular Canal ◽  
Guided Bone Regeneration ◽  
Autogenous Bone ◽  
Collagen Membrane ◽  
Bone Block ◽  
Alveolar Ridge ◽  
Ridge Augmentation ◽  
Implant Loading

The aim is to describe bilateral vertical ridge augmentation with intraoral block grafts and guided bone regeneration in the posterior mandible in preparation for implant placement. A 61-year-old woman, edentulous in the posterior mandible, presented for implant rehabilitation. The radiographic study showed 3 to 6 mm of bone height from the ridge to the mandibular canal. Autogenous bone block grafts from the chin and the mandibular ramus, harvested with ultrasonics, were used to augment the alveolar ridge. To reduce resorption, the grafts were covered with particulate alloplastic material and a collagen membrane. Delayed implants were placed 6 months after vertical augmentation, and 3 months later implants were loaded with a fixed prosthesis. A temporary sensory complication occurred, but 12 months after implant loading, there were no failures. In this case report block bone grafting was a feasible option to vertically augment the alveolar ridge in the posterior mandible.

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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