Bone Augmentation Techniques for Horizontal and Vertical Alveolar Ridge Deficiency in Oral Implantology

Tolstunov, Len; Hamrick, John F. “Eric”; Broumand, Vishtasb; Shilo, Dekel; Rachmiel, Adi

doi:10.1016/j.coms.2019.01.005

Cited by 119 publications

(97 citation statements)

References 56 publications

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“…It can be assumed that the ingrowth of fibrous tissue from the surrounding soft tissues into the defect and, thus, the formation of pseudarthrosis is effectively prevented by the membrane. This assumption is supported by extensive experience in oral surgery [21,38]. Furthermore, in the present study, it could be demonstrated histologically and radiologically that both examined defect covers kept the transplanted syngeneic cancellous bone local.…”

Section: Discussionsupporting

confidence: 77%

“…The concept of separation of different tissues compartments to avoid ingrowth of soft tissue in the area of bone defects by the use of artificial membranes is commonly and successfully used in the area of oral surgery, as summarised by Sanz et al [20] and Tolstunov et al [21]. The results raise hope that an artificial membrane could also replace the induced membrane for the treatment of long bone defects.…”

Section: Introductionmentioning

confidence: 99%

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From two stages to one: acceleration of the induced membrane (Masquelet) technique using human acellular dermis for the treatment of non-infectious large bone defects

Verboket

Leiblein

Janko

et al. 2020

Eur J Trauma Emerg Surg

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Introduction The induced membrane technique for the treatment of large bone defects is a two-step procedure. In the first operation, a foreign body membrane is induced around a spacer, then, in the second step, several weeks or months later, the spacer is removed and the Membrane pocket is filled with autologous bone material. Induction of a functional biological membrane might be avoided by initially using a biological membrane. In this study, the effect of a human acellular dermis (hADM, Epiflex, DIZG gGmbH) was evaluated for the treatment of a large (5 mm), plate-stabilised femoral bone defect. Material and MethodsIn an established rat model, hADM was compared to the two-stage induced membrane technique and a bone defect without membrane cover. Syngeneous spongiosa from donor animals was used for defect filling in all groups. The group size in each case was n = 5, the induction time of the membrane was 3-4 weeks and the healing time after filling of the defect was 8 weeks. Results The ultimate loads were increased to levels comparable with native bone in both membrane groups (hADM: 63.2% ± 29.6% of the reference bone, p < 0.05 vs. no membrane, induced membrane: 52.1% ± 25.8% of the reference bone, p < 0.05 vs. no membrane) and were significantly higher than the control group without membrane (21.5%). The membrane groups were radiologically and histologically almost completely bridged by new bone formation, in contrast to the control Group where no closed osseous bridging could be observed. Conclusion The use of the human acellular dermis leads to equivalent healing results in comparison to the two-stage induced membrane technique. This could lead to a shortened therapy duration of large bone defects.

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Section: Discussionsupporting

confidence: 77%

Section: Introductionmentioning

confidence: 99%

From two stages to one: acceleration of the induced membrane (Masquelet) technique using human acellular dermis for the treatment of non-infectious large bone defects

Verboket

Leiblein

Janko

et al. 2020

Eur J Trauma Emerg Surg

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show abstract

“…In the absence of adequate bone, three possible solutions presently exist. The first is to use reconstructive materials with techniques identified as onlay/inlay bone grafting [13], guided bone regeneration with non-resorbable [14] or resorbable membranes [15], alveolar ridge split [16], distraction osteogenesis [17] or sinus augmentation [18]. The issue with these techniques is the length of treatment, with the possibility of intra-and postoperative complications, due to the complexity of the procedures.…”

Section: Introductionmentioning

confidence: 99%

Custom-made 3D printed subperiosteal titanium implants for the prosthetic restoration of the atrophic posterior mandible of elderly patients: a case series

et al. 2020

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Purpose: To present the application of custom-made 3D-printed subperiosteal implants for fixed prosthetic restoration of the atrophic posterior mandible of elderly patients. Methods: Between January 2017 and June 2018, all partially edentulous patients aged over 65 years, with two or more missing teeth in the posterior atrophic mandible, and who did not want to undergo bone regenerative procedures, were included in this study. These patients were rehabilitated with custom-made subperiosteal implants, designed from cone beam computed tomography (CBCT) and fabricated in titanium by means of direct metal laser sintering (DMLS). The outcome measures were fit and stability of the implants at placement, duration of the intervention, implant survival, and early and late complications. All patients were followed for 1 year after surgery. Results: Ten patients (four males, six females; mean age 69.6, SD ± 2.8, median 69, 95% CI 67.9-71.6) were included in the study. The fit of the implants was satisfactory, with a mean rating of 7 out of 10 (SD ± 1.6, median 7, 95% CI 6-8). Only two implants had insufficient fit, because of the presence of scattering in the CBCT; however, they were adapted to the sites during the interventions. The mean duration of the intervention was 44.3 min (SD ± 19.4, median 37, 95% CI 32.3-56.3). At the one-year follow-up, no implants were lost (survival rate 100%). One implant presented immediate postoperative complications with pain, discomfort and swelling, and two patients experienced late complications, having their provisional restorations fractured during the temporisation phase. All these complications were minor in nature, but the final complication rate amounted to 30% (three of ten patients). Conclusions: Although this study has limits (small patient sample and short follow-up), DMLS has proven to be an effective method for fabricating accurate subperiosteal implants, with high survival rates. This may represent an alternative treatment procedure in elderly patients with a severely atrophic posterior mandible, since it allows avoidance of regenerative bone therapies. Further studies are needed to confirm these outcomes.

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Section: Introductionmentioning

confidence: 99%

“…Different surgical principles were postulated to solve these dynamic deficiencies; horizontal and vertical bone augmentation, distraction osteogenesis, ridge splitting, and guided bone regeneration are commonly intervened. [1][2][3][4] Khoury and Ponte in 2004 5 described the cortical-shell technique for bone grafting; biologically based on assembling thin cortical bony shells to frame the residual deficient ridge, to confine an outline that would enclose the harvested cancellous bones and compose a barrier that would prevent the fibrous in-growth without jeopardizing the graft vascularity. Although reliable, the procedure is technically demanding and associates donor site morbidity.…”

Section: Introductionmentioning

confidence: 99%

Assessment of 3‐dimensional bone augmentation of severely atrophied maxillary alveolar ridges using patient‐specific poly ether‐ether ketone (PEEK) sheets

Morsy

Barakat

Mekhemer

et al. 2020

Clin Implant Dent Rel Res

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Background This study aimed to analyze the effectiveness of virtually designed polyether‐ether ketone (PEEK) sheets to delineate and maintains the three‐dimensional patient's maxillary alveolar ridge. Materials and methods Fourteen patients (34 implants) with severely atrophied anterior maxillary alveolar ridges underwent rehabilitation using custom‐made CAD/CAM PEEK sheets acting as a containment system for interpositional mix of particulate autogenous and xenogeneic bone graft, fixed by mono‐cortical screws. Radiographic Assessment included measurements of linear changes in the vertical and horizontal dimensions on cross‐sectional cuts of computed tomography (CBCT) using special software. Results Wound healing was uneventful for all the patients except one patient that showed wound break down 2 weeks postoperatively, which did not affect the outcome of the procedure. CBCT scans were interpreted to compare the quantity of both vertical and horizontal bone preoperatively and 6 months postoperatively. Statistical analyses demonstrated a significant difference between the results of both time intervals, with a mean vertical and horizontal bone gain was 3.47 mm(±1.46) and 3.42 (±1.1) with a P‐value of (.0001). The customized sheets were removed 6 months postoperative with the successful placement of dental implants. Conclusion The virtual planning of three‐dimensional maxillary alveolar ridge augmentation utilizing patient‐specific PEEK sheets deemed successful to restore the deficient ridge and to accommodate suitable size dental implants.

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Bone Augmentation Techniques for Horizontal and Vertical Alveolar Ridge Deficiency in Oral Implantology

Cited by 119 publications

References 56 publications

From two stages to one: acceleration of the induced membrane (Masquelet) technique using human acellular dermis for the treatment of non-infectious large bone defects

From two stages to one: acceleration of the induced membrane (Masquelet) technique using human acellular dermis for the treatment of non-infectious large bone defects

Custom-made 3D printed subperiosteal titanium implants for the prosthetic restoration of the atrophic posterior mandible of elderly patients: a case series

Assessment of 3‐dimensional bone augmentation of severely atrophied maxillary alveolar ridges using patient‐specific poly ether‐ether ketone (PEEK) sheets

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