Horizontal maxillary ridge augmentation with ridge split procedure and simultaneous implant placement: A case report

Treatment of edentulous maxillary anterior region with horizontal ridge atrophy presents a clinical situation in which the placement of endosseous implants might be complex or sometimes impossible without a ridge augmentation procedure. This case report presents management of horizontally deficient maxillary anterior ridge with ridge split procedure using piezotome and simultaneous implant placement. In contrast to other ridge augmentation techniques, ridge splitting allows for immediate implant placement following surgery reducing the overall treatment time and eradicates the possible morbidity from a second surgical site.

A Split Mouth Study on Crestal Bone Architectural Changes by Flapped and Flapless Implant Surgical Procedures

Background: Rehabilitations by dental implants have often been utilized as an efficient procedure for restoring missing teeth. For implant placement two types of surgical methods are well documented. Conventional surgical approach involves raising a mucoperiosteal flap to gain access and see the underlying alveolar bone, instead there is this procedure which does not involve the reflection of the flap. Both the techniques are known to have their individual benefits and shortcomings. The present study was aimed to evaluate the longitudinal comparison and evaluation of hard tissue changes around endosseous implants placed using flapped as well as flapless surgical procedures in mandibular first molar region. Materials and Methods: A total of 10 healthy patients with bilateral mandibular first molar were involved in the study and 20 endosseous implants were inserted (10 in each group). Radiographic assessment was done for deviations in the marginal bone levels on both mesial and distal side and their average value was calculated at 1 month, and 3 months. All these parameters were statistically analyzed using the paired Student t test, and two-way ANOVA test and were considered to be significant if the p value was ≤ 0.05. Results: During the 3 months observation period, the change in crestal bone height around the implants placed by flapless and flap surgery were statistically significant. The flapless group showed less reduction in the crestal bone height compared to the flap group. Conclusion: Both flap and the flapless techniques of endosseous implant placement had statistically significant effect on peri-implant bone loss over the 3 month period.

Considerations regarding the osseointegration of endosseous dental implants

Implant osseointegration has not been accepted over time, considering that in fact the implant integration is performed only in the soft tissue of the host. For this reason, the implant has never been sufficiently integrated into the host tissue immediately after insertion. Experiments performed in Branemark laboratories in the early 1960s, with a new type of implant, which required a direct anchorage to bone tissue for clinical function, this anchorage was called osseointegration. It has been shown that it is possible to achieve direct osseointegration if the Branemark method is considered, which was published a few years later in the first clinical report. The authors of this article come up with new contributions that validate the implant osseointegration process. Inside this article we present our methodology for evaluating the osseointegration of endosseous implants: ESEM (environmental scanning electron microscope) studies of the implant-bone tissue interface.

A review of the determinants of a successful endosseous implants

The periods after the groundbreaking work of Branemark saw a rising number of dental implants. Thetraditional treatment of dental removal is being increasingly replaced by the modern technology-leddental implants. The insertion of prothesis, however, experience success and sometimes failure. In orderto make the success rate high, there is large number of researches that attempted to the identification ofthe success factors of the dental implants. As the number of the dental implants are rising, it becamecrucial to know the success factors of the implants. The objective of our research was to review theliterature to identify factors that contribute to the success ratio of the dental implants. After theinvestigation of the literature, we find that the success factors can be classified intro three broad classes.The first class of success factor are the factors ingirted in the patients such as gander and age of thepatients. The second class of the success factors are associated with the organ itself such as the maxillaryof mandibular quality. The third success factors are associated with the quality of dental operation andthe combability of prosthesis. This research analyzes and discusses these three success factors.

Macrophage Control of Incipient Bone Formation in Diabetic Mice

Both soft and hard tissue wound healing are impaired in diabetes. Diabetes negatively impacts fracture healing, bone regeneration and osseointegration of endosseous implants. The complex physiological changes associated with diabetes often manifest in immunological responses to wounding and repair where macrophages play a prominent role in determining outcomes. We hypothesized that macrophages in diabetes contribute toward impaired osseous wound healing. To test this hypothesis, we compared osseous wound healing in the mouse calvaria defect model using macrophages from C57BL/6J and db/db mice to direct osseous repair in both mouse strains. Initial analyses revealed that db/db mice macrophages showed an inflamed phenotype in its resting state. Incipient bone regeneration evaluated by μCT indicated that bone regeneration was relatively impaired in the db/db mouse calvaria and in the calvaria of C57BL/6J mice supplemented with db/db macrophages. Furthermore, osteogenic differentiation of mouse mesenchymal stem cells was negatively impacted by conditioned medium from db/db mice compared to C57BL/6J mice. Moreover, miR-Seq analysis revealed an altered miRNA composition in db/db macrophages with up regulated pro-inflammatory miRNAs and down regulated anti-inflammatory miRNAs. Overall, this study represents a direct step toward understanding macrophage-mediated regulation of osseous bone regeneration and its impairment in type 2 diabetes mellitus.

Chemical Fixation Importance of Histologic Samples for Staining of Proliferated Bone During Implant Osseointegration

This study aimed to obtain as much and as accurate information as possible about the process of osseointegration of titanium implants, through histological processing. For this purpose, the combination of a mercury chloride fixator (Stieve mixture) and a complex staining method (Goldner’s trichrome) was used, which can highlight the microscopic structures in several colors and shades. The Stieve mixture proved to have distinguished qualities both in the preservation of basophilic and acidophilic structures and especially in the chemical preparation of the substrate for the binding of each structural component with a specific acidophilic dye. On the substrate thus prepared, the acidophilic dyes used in the Goldner’s trichrome staining highlighted the structural components in different colors and shades, offering the possibility of high precision assessment of the newly proliferated bone, in different stages of proliferation, consolidation and reshaping. Complex information was obtained, which allows the appreciation of osseointegration for endosseous implants and the amount of proliferated bone at the bone-implant interface, the stage of proliferation, consolidation and reshaping of the mature bone, the degree of fixation to deep bone structures. The possibility of complex assessment of the osseointegration process for endosseous implants at a given time is of great practical importance for correct assessment of the waiting time required for safe installation of prosthesis. The combination of Stieve fixator mixture with Goldner’s trichrome staining method has proven to be very effective in histology, highlighting on excellent level the existing structural components of each stage, in which the osseointegration process goes through. A very important role in this combination was achieved by mercury chloride mixture, which prepared the substrate for specific reaction with dyes. Regarding the results obtained, we recommend this combination for histological investigations aimed on bone proliferation and repair.

REVIEW AND SUCCESS RATE OF ENDOSSEOUS IMPLANTS IN MAXILLOFACIAL PROSTHESIS

Aim: Endosseous osseointegrated implants have enormously increased the potential for reconstruction of the patients with varied soft and hard tissue maxillofacial defects. This review focuses on the survival rate of endosseous implants in maxillofacial prosthesis. Background: In recent years, the endosseous implants for prosthetic rehabilitation of maxillofacial defects with acquired and congenital conditions have become more common practice with higher percentage of long-term success. Endosseous implants have been used for retention in the maxillofacial defects can offer excellent support and retention thereby eliminating the usage of adhesives. Review results: Maximum number of systematic reviews has been compiled by different authors on the success rate of endosseous implants. However, endosseous osseointegrated implants can remain in service for a long term, and many techniques are reliable and predictable. Conclusion: This article highlights the long-term outcomes of endosseous implants used to retain the various types of maxillofacial prosthesis. Keywords: Craniofacial defects, endosseous implants, maxillofacial prosthesis, osseointegration, maxillofacial defects.