Within the limitations of this study (e.g., small sample size, short follow-up duration), the results suggest that regarding success rate, hard/soft tissue responses, and esthetics, DIT and IIT with single Laser-Lok® implants in the anterior maxilla are comparable and predictable options for well-selected patients.
Anorganic bovine bone mineral matrix (ABBMM) has been reported to have osteoconductive properties and no inflammatory or adverse responses when used as grafting material in sinus augmentation procedures. However, controversy remains in regard to degradation rate of ABBMM. The aim of this study was to histologically and histomorphometrically evaluate the degradation of ABBMM in human bone samples obtained in one patient 24 months after sinus augmentation. Materials and Methods: The histologic and histomorphometric analysis was performed by means of light microscopy in three specimens harvested from the same patient, Results: After 24 months the tissue pattern appeared to be composed of residual particles, some in close contact with the newly formed bone, others separated by translucent areas and osteoid tissues. Newly-formed bone presented different levels of maturation and numerous osteocytes, with greater numbers in bone closer to the grafted particles (27.3% vs. 11.2%, p < 0.05). The histomorphometric analysis showed mean values of 40.84% newly-formed bone, 33.58% residual graft material, 23.84% marrow spaces, and 1.69% osteoid tissue, Conclusions: Even though ABBMM underwent considerable resorption, a great amount of residual grafting material was still present after two years of healing following sinus augmentation. This study confirms that the bovine grafts can be classified as long-term degradation materials.
ObjectivesThe aim of this study was to evaluate the clinical, radiographic and histologic results when a highly purified xenogenic bone (Laddec®) was used as grafting material in maxillary sinuses.Material and MethodsIn fifteen patients requiring unilateral maxillary sinus augmentation, the grafting procedure was performed with Laddec®. Forty-two implants were installed after a 6 month healing period. The height of the augmented sinus was measured radiographically immediately after augmentation and postoperatively up to 36 months. At the time of implant placement, a bone core was harvested in each patient for histological examination.ResultsThe cumulative implant survival rate was 97.6%. The original height was 3.65 (SD 0.7) mm and the augmented sinus height was 13.8 (SD 1.4) mm after the surgery. The reduced height of grafted xenogenic material (RDL) at the implant insertion was 0.83 (SD 0.38) mm, and at the final postoperative visit was 0.91 (SD 0.25) mm, showing no significant correlation with the follow-up periods by Spearman’s test (P = 0.118). In addition, no significant difference in the RDL was observed according to the site of implantation (P = 0.682). The mean implant marginal bone loss was 0.38 (SD 0.24) mm. Histological analysis showed the bone cores were composed of 64.72 (SD 3.44)% newly formed bone, 17.41 (SD 2.02)% connective tissue, 16.93 (SD 2.83)% residual graft particles, and 0.94 (SD 0.11)% inflammatory cells.ConclusionsAccording to our data, the highly purified xenogenic bone (Laddec®), used as graft material in the sinus lift procedure, may create adequate bone volume, and appropriate osseointegration of dental implants.
Introduction: A new titanium-reinforced dense polytetrafluoroethylene mesh (TR-dPTFEM) has recently been introduced for vertical ridge augmentation (VRA). Since primary closure is required, the literature lacks information on its behavior in case of premature exposure. To the author's knowledge, this is the first report about TR-dPTFEM complication management. Case Presentation: A TR-dPTFEM was used for the VRA in the molar region of the upper right maxilla. The defect was filled with a mix of particulate autogenous bone and porcine xenograft in a 1:1 ratio. A collagen membrane covered the hole pattern of the TR-dPTFEM to prevent soft tissue growth within the grafted material during the first weeks. After a 4-month uneventful healing period, a 4-mm exposure occurred without infection. Patient was prescribed 0.2% chlorhexidine mouth rinse three times a day and manual cleansing with gauze soaked in 3% hydrogen peroxide, and was recalled for weekly follow-up. One month later, the clinical situation was unchanged and the site was re-entered. After TR-dPTFEM removal, the regenerated tissue appeared to be covered with a thin layer of connective tissue. The favorable bone quality made it possible to obtain the primary stability of two implants. At implant uncovering, a gingival graft augmented the keratinized mucosa width. Two screw-retained crowns were delivered 4 months after implant insertion and the 1-year follow-up showed perfectly maintained hard and soft tissues.
Conclusion:A late TR-dPTFEM exposure, managed under strict hygiene control, did not affect this VRA. The augmented bone remained stable 1 year after prosthetic loading.
K E Y W O R D SBiocompatible materials, bone regeneration, bone substitutes, guided tissue regeneration 84
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