Successful implant placement in augmented sites depends on the appropriate bone volume and quality, as well as careful planning of the procedure. Minimizing risks during the surgical and healing phases is also of great importance. A very promising technique has been introduced, which partially meets the above criteria. This technique is designed to increase the precision and reduce the invasiveness associated with surgical procedures during implantation. The aim of this clinical study was to analyze the accuracy of computer-guided implant surgery in augmented sites in patients treated with dental implants introduced using dynamic implant navigation. Eleven healthy patients who had planned and performed implant-prosthetic treatment after bone augmentation were analyzed. Twenty-three implants were placed with Navident dynamic navigation using the tissue punch flapless technique. This study evaluated the position of the inserted implant relative to the virtual plan and determined the correlation. The treatments were successful in all the treated patients, and the integration period (3 or 6 months) was uneventful and enabled implant-prosthetic treatment. The accuracy values provided in this study are comparable to, but not better than, data provided in the literature on dynamic and static computer-assisted surgery. Dynamic navigation may improve the quality and safety of surgical procedures and reduce the risk of complications.
Dental procedures for alveolar bone augmentation may be carried out using autologous bone graft material derived from the patient’s own tooth. The material obtained is subjected to strict procedures aimed at reducing the amount of bacteria in the autograft. The aim of this study was the evaluation of the efficacy of the autogenous dentine matrix produced by grinding the patient’s own tooth for the augmentation of maxillary bone defects and the evaluation of the microbiological status of the material obtained. Alveolar bone repair was performed with an autogenous dentin matrix in four patients. In each case, an autogenous bone graft substitute obtained by grinding the patient’s own tooth was used. The tooth-derived material was then used for alveolar augmentation. The obtained material was tested to assess its microbiological profile. For the purpose of comparison, other materials and tissues were also subjected to microbiological testing. Bone healing was assessed by CBCT (cone beam computed tomography) scanning before and 6 months after surgery using the Hounsfield scale and the ImageJ software. Analysis of the bone regeneration process based on the bone density score in Hounsfield units showed significant differences in measurements on CBCT scans carried out on the treatment site, before surgery, and 6 months after it, using ImageJ software. All bacteria detected in the bone augmentation material constituted the patient’s bacterial flora. The microorganisms present in the augmentation material were also present in the patient’s bone and soft tissues. The use of an autogenous dentin matrix for alveolar bone repair ensures that the proper volume is obtained and that alveolar bone shape is preserved and does not introduce pathogenic microorganisms into the patient. The procedure for preparing and using an autogenous dentin matrix is described based on one clinical case.
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