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Elsaieed MT, El-Belasy FA, Ibraheim SA, Yaseen AA, Amer MZ. Implant Stability and Marginal Bone Changes Associated with Different Staged Ridge-splitting Techniques Using Piezoelectric Surgery in Atrophic Posterior Mandible:A Comparative Study. J Contemp Dent Pract 2024; 25:661-668. [PMID: 39533937 DOI: 10.5005/jp-journals-10024-3724] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2024]
Abstract
AIM The ridge-splitting technique is considered one of the common solutions for horizontal ridge augmentation. The study evaluated implant stability and marginal bone loss after two vs three staged ridge-splitting technique. MATERIALS AND METHODS Twelve dental implants were inserted into 10 patients through staged ridge-splitting approach. In group I, six dental implants were inserted through a full mucoperiosteal flap reflection and bony incision. After 3 weeks, a closed buccal plate expansion and grafting were done, with sequential implant insertion 3 months later. While in group II, six dental implants were inserted through the same procedure as the first stage. Then bone expansion, grafting, and implant insertion were made at the second stage. All implants were loaded after 3 months and assessed clinically regarding implant stability and radiographically through marginal bone loss. RESULTS One-way ANOVA test was used. Implant stability quotient (ISQ) values showing highly significant difference (p = 0.003) were recorded at implant placement. In contrast, no statistically significant differences were recorded among the studied groups at the other assessment time intervals (p = 0.219, 0.366, and 0.394, respectively). Meanwhile, group II reported lower marginal bone loss values than group I with a highly significant difference between both groups over all assessment time intervals (p = 0.001, 0.008, and 0.002, respectively). CONCLUSION Two staged ridge-splitting technique offered a shorter treatment time with lower marginal bone loss and comparable implant stability. CLINICAL SIGNIFICANCE Two-staged ridge-splitting technique provided less patients' recall visits with a less surgical intervention than the three-staged technique. This may be prospectively reflected in further research for its clinical merits. How to cite this article: Elsaieed MT, El-belasy FA, Ibraheim SA, et al. Implant Stability and Marginal Bone Changes Associated with Different Staged Ridge-splitting Techniques Using Piezoelectric Surgery in Atrophic Posterior Mandible: A Comparative Study. J Contemp Dent Pract 2024;25(7):661-668.
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Affiliation(s)
- Mena T Elsaieed
- Department of Oral and Maxillofacial Surgery, Faculty of Oral and Dental Medicine, Delta University for Science and Technology, Gamasa, Mansoura, Egypt, Phone: +00201225481886, e-mail: , ORCID: https://orcid.org/0009-0001-5346-8542
| | - Fouad A El-Belasy
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Mansoura University, Mansoura, Egypt
| | - Shaimaa A Ibraheim
- Department of Fixed Prosthodontics, Faculty of Dentistry, Mansoura University, Mansoura, Egypt, ORCID: https://orcid.org/0000-0003-4171-8054
| | - Ayman A Yaseen
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Mansoura University, Mansoura, Egypt, ORCID: https://orcid.org/0000-0003-3420-459X
| | - Mohamed Z Amer
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Mansoura University, Mansoura, Egypt, ORCID: https://orcid.org/0000-0003-2914-3374
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Anis M, Abdelrahman AR, Attia R, Zahran A. Tomographic assessment of bone changes in atrophic maxilla treated by split-crest technique and dental implants with platelet-rich fibrin and NanoBone ® versus platelet-rich fibrin alone: Randomized controlled trial. BMC Oral Health 2024; 24:691. [PMID: 38877464 PMCID: PMC11177399 DOI: 10.1186/s12903-024-04420-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2024] [Accepted: 05/29/2024] [Indexed: 06/16/2024] Open
Abstract
BACKGROUND This study evaluated the clinical benefits of adding NanoBone® with split-crest technique and simultaneous implant placement covered with platelet-rich fibrin membrane in horizontally deficient maxillary ridges in terms of crestal and horizontal bone changes and patient morbidity. METHODS Forty patients indicated for maxillary ridge splitting and simultaneous implant placement were assigned randomly to the study groups: control group (Platelet Rich Fibrin membrane) and test group (Platelet Rich Fibrin membrane + Nanobone®). The Cone Beam Computed Tomography Fusion technique was utilized to assess crestal and horizontal bone changes after five months of the surgical procedure. Patient morbidity was recorded for one week post-surgical. RESULTS Five months post-surgical, buccal crestal bone resorption was 1.26 ± 0.58 mm for the control group and 1.14 ± 0.63 mm for the test group. Lingual crestal bone resorption was 1.40 ± 0.66 mm for the control group and 1.47 ± 0.68 mm for the test group. Horizontal bone width gain was 1.46 ± 0.44 mm for the control group and 1.29 ± 0.73 mm for the test group. There was no significant statistical difference between study groups regarding crestal and horizontal bone changes and patient morbidity. CONCLUSIONS The tomographic assessment of NanoBone® addition in this study resulted in no statistically significant difference between study groups regarding crestal and horizontal bone changes and patient morbidity. More randomized controlled clinical trials on gap fill comparing different bone grafting materials versus no grafting should be conducted. CLINICALTRIALS GOV REGISTRATION NUMBER NCT02836678, 13th January 2017.
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Affiliation(s)
- Maged Anis
- Department of Periodontology, Faculty of Dentistry, Modern Sciences and Arts University, Giza, Egypt
| | - Ahmed Reda Abdelrahman
- Department of Periodontology, Faculty of Dentistry, Modern Sciences and Arts University, Giza, Egypt.
- Department of Periodontology, Faculty of Dentistry, Cairo University, El-Manial, Cairo, 11553, Egypt.
| | - Rasha Attia
- Department of Periodontology, Faculty of Dentistry, Modern Sciences and Arts University, Giza, Egypt
| | - Amr Zahran
- Department of Periodontology, Faculty of Dentistry, Cairo University, El-Manial, Cairo, 11553, Egypt
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Lin Y, Li G, Xu T, Zhou X, Luo F. The efficacy of alveolar ridge split on implants: a systematic review and meta-analysis. BMC Oral Health 2023; 23:894. [PMID: 37986181 PMCID: PMC10662563 DOI: 10.1186/s12903-023-03643-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2023] [Accepted: 11/08/2023] [Indexed: 11/22/2023] Open
Abstract
OBJECTIVES To evaluate the effects of the alveolar ridge split (ARS) technique on gained horizontal width of the alveolar ridge and implant survival rate. MATERIALS AND METHODS Electronic searching was performed in six electronic databases (Pubmed, Embase, the Cochrane Central Register of Controlled Trials, Web of Science, China National Knowledge Infrastructure, and SIGLE) from January 1, 2010, to November 1, 2023. Two authors performed study selection, data extraction, and study qualities (ROBINS-I and RoB 2.0) independently. Meta-analysis was performed by Comprehensive meta-analysis 3.0. RESULTS 24 included studies were observational, and 1 study was a randomized controlled trial (RCT). 14 studies investigated the gained width of the horizontal alveolar ridge, and 17 examined the implants' survival rate. For assessment of risk of bias, nine studies were high risk of bias and 16 studies were moderate risk of bias. Meta-analysis demonstrated that the pooled gained alveolar ridge width was 3.348 mm (95%CI: 4.163 mm, 2.533 mm), and the implant survival rate was 98.1% (95%CI: 98.9%, 96.9%). Seven studies showed seven different complications including exposure, infection, bad split, dehiscence, fracture, paresthesia and soft tissue retraction. CONCLUSION Recent ARS technique seems to be an effective method of bone augmentation with enough gained width and a high implant survival rate. Further long-term and RCTs research remains needed to enhance the study quality. CLINICAL RELEVANCE The ARS technique could generate sufficient bone volume, and implants had a high-level survival rate. Therefore, ARS has been proposed to be a reliable horizontal bone augmentation technique that creates good conditions for the implantation of narrow alveolar crests.
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Affiliation(s)
- Yuanyou Lin
- State Key Laboratory of Oral Diseases, West China School of Stomatology, National Clinical Research Center for Oral Diseases, Sichuan University, Chengdu, 610041, China
| | - Guanlin Li
- State Key Laboratory of Oral Diseases, West China School of Stomatology, National Clinical Research Center for Oral Diseases, Sichuan University, Chengdu, 610041, China
| | - Tingxiang Xu
- State Key Laboratory of Oral Diseases, West China School of Stomatology, National Clinical Research Center for Oral Diseases, Sichuan University, Chengdu, 610041, China
| | - Xuexiao Zhou
- State Key Laboratory of Oral Diseases, West China School of Stomatology, National Clinical Research Center for Oral Diseases, Sichuan University, Chengdu, 610041, China
| | - Feng Luo
- State Key Laboratory of Oral Diseases, West China School of Stomatology, National Clinical Research Center for Oral Diseases, Sichuan University, Chengdu, 610041, China.
- Department of Prosthodontics, West China School of Stomatology, Sichuan University, No. 14, Section 3, Renmin Nanlu, Chengdu, 610041, China.
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Artzi Z. Lateral augmentation of the jaw by the split expansion ridge technique. A critical review. Periodontol 2000 2023; 93:205-220. [PMID: 37736876 DOI: 10.1111/prd.12527] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2023] [Revised: 06/24/2023] [Accepted: 08/15/2023] [Indexed: 09/23/2023]
Abstract
Bone augmentation has become a routine procedure to enhance and/or repair a deficient or resorbed alveolar ridge for predictable and successful implant placement. The split expansion ridge i.e., the alveolar ridge splitting (ARS) procedure, is one of the less invasive procedures, and is characterized by minor morbidity. This would allow to widen narrow ridges in order to allow implant reconstruction in a sufficient bone volume. Its efficacy and long-term stability rely upon clinical opinions and long-term retrospective studies, while prospective comparative studies and randomized controlled trials are rare. This critical review presents the development of this technique, describes the surgical procedure, and provides technical notes and modifications. The learning curve and in-depth knowledge of the oral anatomy, as well as the recognition of incidence and management of complications are of utmost importance in the clinical application of the ARS procedure.
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Affiliation(s)
- Zvi Artzi
- Department of Periodontology and Oral Implantology, School of Dental Medicine, Tel Aviv University, Tel Aviv, Israel
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Kim HY, Park JH, Kim JW, Kim SJ. Narrow Alveolar Ridge Management with Modified Ridge Splitting Technique: A Report of 3 Cases. Case Rep Dent 2023; 2023:9968053. [PMID: 37025608 PMCID: PMC10072968 DOI: 10.1155/2023/9968053] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2022] [Revised: 02/09/2023] [Accepted: 03/11/2023] [Indexed: 03/30/2023] Open
Abstract
Purpose. In this study, we report the usefulness of implant placement with modified ridge splitting technique from three cases of patients with narrow alveolar ridge. Materials and Methods. Three patients were those who visited the Department of Oral and Maxillofacial Surgery of Ewha Medical Center for consultation regarding implant placement. Through clinical and radiographic evaluation, narrowed alveolar ridge after tooth loss was confirmed in all three patients. For them, it was necessary to use the modified ridge split technique with bone augmentation for the implant to be well placed with enough bone width. Results. In all cases, sufficient bone width was confirmed for implant placement, and bone volume was well maintained after prosthetic restoration without any complications. Initial width of alveolar bone was 4.9 mm on average and was well maintained at an average of 7.6 mm at 1-year follow-up after implant installation. Conclusion. Although the number of subjects in this case report was small and was done by only one surgeon, we suggest that modified ridge splitting technique might be a useful surgical method to enhance narrow edentulous alveolar ridges and enable successful implant placement with shorter healing period compared with single guided bone regeneration.
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Custom-Made Direct Metal Laser Sintering Titanium Subperiosteal Implants in Oral and Maxillofacial Surgery for Severe Bone-Deficient Patients—A Pilot Study. Diagnostics (Basel) 2022; 12:diagnostics12102531. [PMID: 36292220 PMCID: PMC9601393 DOI: 10.3390/diagnostics12102531] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2022] [Revised: 10/09/2022] [Accepted: 10/12/2022] [Indexed: 11/26/2022] Open
Abstract
Background: Nowadays, a combination of classical subperiosteal implant designs with 3D imaging and printing allows one to reduce treatment time and provides support for fixed prostheses in cases where other techniques do not provide satisfactory results. This study aims to present a digital technique for the manufacturing of custom-made subperiosteal implants and what complications might appear after this type of surgery. Methods: Sixteen patients treated with a custom-made DMLS titanium subperiosteal implant during the period between October 2021 and February 2022 were enrolled in the study. Orthopantomography (OPT) and cone-beam computer tomography (CBCT) were recorded for all patients. The measurements taken into account in this study were the fit and stability of implants, duration of surgery, implant survival, and early and late complications. Results: The fit of the implants was extremely satisfactory, with a mean rating of 4 out of 5. The mean duration of the intervention was 86.18 min. At the end of the study, one implant was lost due to insufficient fit and recurrent, untreatable infections. Eleven implants (69%) were placed on the maxillary and five (31%) implants were placed on the mandible. Conclusions: Taking this into consideration, custom-made DMLS titanium subperiosteal implants could present satisfactory implant survival and low complication rates.
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Manekar VS, Shenoi SR, Manekar S, Jhon J. Alveolar ridge split and expansion with simultaneous implant placement in mandibular posterior sites using motorized ridge expanders - modified treatment protocol. Natl J Maxillofac Surg 2022; 13:411-420. [PMID: 36683927 PMCID: PMC9851358 DOI: 10.4103/njms.njms_417_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2021] [Revised: 08/31/2021] [Accepted: 09/15/2021] [Indexed: 01/25/2023] Open
Abstract
Purpose "The purpose of the study is to evaluate alveolar ridge split and expansion (ARSE) with simultaneous implant placement in mandibular posterior implant sites using motorized ridge expanders." Background The ARSE is used in the management of horizontally deficient (narrow) alveolar ridge with optimum bone height available. The ARSE procedure in the posterior mandible has limited application as per literature. The successful cases reported are with extensive procedure of the osteo-mobilization with four corticotomies on buccal side. The authors presented the study of mandibular posterior implant sites using motorized ridge expanders. The ARSE performed here was by only crestal osteotomy simple osteo-condensation and immediate implant insertion. Materials and Methods The study was prospective type. The sample size was 15 patients and 31 implant sites. The study population included partially edentulous patients between 18 years and 60 years indicated for implant-supported prosthesis. The outcome variables studied included gain in ridge width, cervical bone loss, success of implant, and survival rate. Successful surgical outcome was evaluated by Buser's criteria. The data collected was evaluated by differential statistics. Conclusion The minimally invasive technique of one-stage ARSE performed with motorized ridge expander and insertion of implant in the same operative procedure decreases the morbidity, treatment time, number of surgical procedures, and the risk of complications, thereby, increasing patient acceptance. In this study, the authors have used this technique in the posterior mandible for narrow ridges (minimum 3 mm) and obtained promising results. The survival rate of the implants was 100% and the gain in ridge width was 3.2 mm. The author has also recommended the protocol according to bone density of mandible.
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Affiliation(s)
- Varsha S Manekar
- Department of Oral and Maxillofacial Surgery (OMFS), Government Dental College and Hospital, Nagpur, Maharashtra, India
| | - S. R. Shenoi
- Department of OMFS, VSPM, Dental College and Research Centre, Nagpur, Maharashtra, India
| | - Sunil Manekar
- Private Practice and Dental Laboratory, Manekar's Multispeciality Dental Clinic, Sidheshwar Dental and Ceramic Laboratory, Nagpur, Maharashtra, India
| | - Janice Jhon
- Department of OMFS, Yogita Dental College and Hospital, Ratnagiri, Maharashtra, India
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Anitua E, Zalduendo M, Troya M, Erezuma I, Lukin I, Hernáez-Moya R, Orive G. Composite alginate-gelatin hydrogels incorporating PRGF enhance human dental pulp cell adhesion, chemotaxis and proliferation. Int J Pharm 2022; 617:121631. [PMID: 35247496 DOI: 10.1016/j.ijpharm.2022.121631] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2021] [Revised: 02/15/2022] [Accepted: 02/28/2022] [Indexed: 12/26/2022]
Abstract
The increasing prevalence of tissue injuries is fueling the development of autologous biological treatments for regenerative medicine. Here, we investigated the potential of three different bioinks based on the combination of gelatin and alginate (GA), enriched in either hydroxyapatite (GAHA) or hydroxyapatite and PRGF (GAHAP), as a favorable microenvironment for human dental pulp stem cells (DPSCs). Swelling behaviour, in vitro degradation and mechanical properties of the matrices were evaluated. Morphological and elemental analysis of the scaffolds were also performed along with cytocompatibility studies. The in vitro cell response to the different scaffolds was also assessed. Results showed that all scaffolds presented high swelling capacity, and those that contained HA showed higher Young's modulus. GAHAP had the lowest degradation rate and the highest values of cytocompatibility. Cell adhesion and chemotaxis were significantly increased when PRGF was incorporated to the matrices. GAHA and GAHAP compositions promoted the highest proliferative rate as well as significantly stimulated osteogenic differentiation. In conclusion, the enrichment with PRGF improves the regenerative properties of the composites favouring the development of personalized constructs.
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Affiliation(s)
- Eduardo Anitua
- BTI-Biotechnology Institute, Vitoria, Spain; University Institute for Regenerative Medicine and Oral Implantology - UIRMI (UPV/EHU-Fundación Eduardo Anitua). Vitoria-Gasteiz, Spain.
| | - Mar Zalduendo
- BTI-Biotechnology Institute, Vitoria, Spain; University Institute for Regenerative Medicine and Oral Implantology - UIRMI (UPV/EHU-Fundación Eduardo Anitua). Vitoria-Gasteiz, Spain
| | - María Troya
- BTI-Biotechnology Institute, Vitoria, Spain; University Institute for Regenerative Medicine and Oral Implantology - UIRMI (UPV/EHU-Fundación Eduardo Anitua). Vitoria-Gasteiz, Spain
| | - Itsasne Erezuma
- NanoBioCel Research Group, School of Pharmacy, University of the Basque Country (UPV/EHU), Vitoria-Gasteiz, Spain; Biomedical Research Networking Centre in Bioengineering, Biomaterials and Nanomedicine (CIBER-BBN). Vitoria-Gasteiz, Spain
| | - Izeia Lukin
- NanoBioCel Research Group, School of Pharmacy, University of the Basque Country (UPV/EHU), Vitoria-Gasteiz, Spain; Biomedical Research Networking Centre in Bioengineering, Biomaterials and Nanomedicine (CIBER-BBN). Vitoria-Gasteiz, Spain
| | - Raquel Hernáez-Moya
- NanoBioCel Research Group, School of Pharmacy, University of the Basque Country (UPV/EHU), Vitoria-Gasteiz, Spain; Biomedical Research Networking Centre in Bioengineering, Biomaterials and Nanomedicine (CIBER-BBN). Vitoria-Gasteiz, Spain
| | - Gorka Orive
- University Institute for Regenerative Medicine and Oral Implantology - UIRMI (UPV/EHU-Fundación Eduardo Anitua). Vitoria-Gasteiz, Spain; NanoBioCel Research Group, School of Pharmacy, University of the Basque Country (UPV/EHU), Vitoria-Gasteiz, Spain; Biomedical Research Networking Centre in Bioengineering, Biomaterials and Nanomedicine (CIBER-BBN). Vitoria-Gasteiz, Spain; Bioaraba, NanoBioCel Research Group, Vitoria-Gasteiz, Spain.
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Sharaf MY, Eskander AE, Elbakery AI. Short-Term Evaluation of Prosthetic Rehabilitation of Thin Wiry Ridge by Ridge Splitting and Simultaneous Implants Placement: Non-randomized Control Trial. Eur J Dent 2021; 16:414-423. [PMID: 34863083 PMCID: PMC9339942 DOI: 10.1055/s-0041-1736292] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Objective
This article evaluates the success of prosthetic rehabilitation of thin wiry ridge and implants placed simultaneously in splitted ridge both clinically and radiographically.
Materials and Methods
Twenty-one participants were enrolled of which 13 patients (8 females and 5 males) were suffering from maxillary ridge atrophy and 8 patients (5 females and 3 males) had mandibular ridge atrophy; a total of 42 implants were performed using the ridge expansion technique. The expansion was performed using the conventional disk technique, piezoelectric corticotomy, and self-threading expanders. Implants were placed and loaded with fixed partial denture after 4 months for the mandible and 6 months for the maxilla. Implant stability quotient (ISQ) was measured at T0 (implant placement) and TL (loading). Crestal bone levels were measured at different times: T0, TL, and T12 (12 months). Evaluation of prosthetic and surgical complications was carried out. Data were analyzed and compared using analysis of variance and paired
t
-tests at a significance level of 5%.
Results
All implants met the criteria for success. All implants showed a higher mean bone loss from T0 to TL (1.259 ± 0.3020) than from TL to T12 (0.505 ± 0.163) with a statistically significant difference (
p
< 0.0001). ISQ values sharply increased at the time of loading (72.52 ± 2.734) than at implant insertion (44.5 ± 4.062) with a significant difference (
p
< 0.0001). Minor prosthetic and surgical complications were reported.
Conclusion
The results from this study support the efficacy of prosthetic rehabilitation of thin wiry ridge using split ridge technique and the success of implants placed simultaneously in splitted ridge.
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Affiliation(s)
- Mohamed Y Sharaf
- Department of Prosthodontics, Faculty of Dentistry, University of Menoufia, Menoufia, Egypt
| | - Asharf Email Eskander
- Department of Prosthodontics, Faculty of Dentistry, University of Cairo, Cairo, Egypt
| | - Ahmed Ibrahim Elbakery
- Department of Prosthodontics, Faculty of Dentistry, University of Ahram Canadian, Cairo, Egypt
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Benefits and Biosafety of Use of 3D-Printing Technology for Titanium Biomedical Implants: A Pilot Study in the Rabbit Model. Int J Mol Sci 2021; 22:ijms22168480. [PMID: 34445182 PMCID: PMC8395183 DOI: 10.3390/ijms22168480] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2021] [Revised: 08/03/2021] [Accepted: 08/04/2021] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Titanium has been used in osteosynthesis for decades and its compatibility and safety is unquestioned. Studies have shown that there is release and collection of titanium in the organ systems with little note of toxicity. The gold standard is considered to be titanium osteosynthesis plate produced by milling methods. The use of customized titanium plates produced with 3D printing, specifically direct metal laser sintering, have found increasing use in recent years. It is unknown how much titanium is released in these printed titanium implants, which is known to be potentially porous, depending on the heat settings of the printer. We hypothesize that the amount of titanium released in printed titanium implants may be potentially more or equal compared to the gold standard, which is the implant produced by milling. METHODS We studied the biosafety of this technology and its products by measuring serum and organ titanium levels after implantation of 3D-printed versus traditionally fabrication titanium plates and screws in a pilot study using the rabbit model. A total of nine rabbits were used, with three each in the control, milled and printed titanium group. The animals were euthanized after six months. Serum and organs of the reticuloendothelial system were harvested, digested and assayed for titanium levels. RESULTS Organ and serum titanium levels were significantly higher in rabbit subjects implanted with titanium implants (milled and printed) compared to the control group. However, there was no significant difference in organ and serum titanium levels of subjects implanted with milled and traditionally fabricated titanium implants. CONCLUSIONS The biosafety of use of 3D-printed titanium implants and traditionally fabricated titanium implants are comparable. With this in mind, 3D-printed custom implants can not only replace, but will very possibly surpass traditionally fabricated titanium implants in the mode and extent of use.
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Autogenous Bone and Bioactive Glass around Implants Placed Simultaneously with Ridge Splitting for the Treatment of Horizontal Bony Defects: A Randomised Clinical Trial. Int J Dent 2021; 2021:2457328. [PMID: 34367287 PMCID: PMC8337152 DOI: 10.1155/2021/2457328] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2021] [Accepted: 07/20/2021] [Indexed: 11/17/2022] Open
Abstract
Objective To compare using autogenous bone with or without bioactive glass in ridge splitting of horizontal bone defects combined with simultaneous implant placement. Materials and Methods In control group, bone expansion was performed and autogenous bone was used to augment the intercortical bone defect. In study group, autogenous bone was mixed with bioactive glass (1 : 1 in volume). In both groups, the implants were inserted simultaneously with ridge splitting. Six months following implant insertion, bone width and height were evaluated. Statistical analysis utilizing paired Student's t-test was used for comparing results within the same group, whereas independent samples t-test was used for intergroup variables comparison. Results The mean bone width and labial and mesiodistal crestal bone height values were increased significantly in both groups from baseline to 6 months postoperatively. Comparing the two groups showed nonstatistical significant difference regarding the labial crestal bone loss, while the ridge width gain values were significantly higher in the study group than in the control group. The mesiodistal bone loss was significantly higher in control group than in study group. Conclusion Autogenous bone was mixed with bioactive glass (1 : 1 in volume) to fill intercortical defect created after ridge splitting to decrease peri-implant bone resorption associated with autogenous bone alone. This trial is registered with clinical trial registration: NCT04814160.
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Rashad A, Schwan S, Nasirpour A, Schmitz I, Hanken H, Friedrich RE, Gosau M. Bone Micromorphology and Material Attrition After Sonic, Ultrasonic and Conventional Osteotomies. In Vivo 2021; 35:1499-1506. [PMID: 33910827 DOI: 10.21873/invivo.12402] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Revised: 03/17/2021] [Accepted: 03/31/2021] [Indexed: 11/10/2022]
Abstract
BACKGROUND/AIM Osteotomy as the first step in surgery, provides access to the field and its application could influence the outcome. Nowadays, the conventional burr reduction is being challenged by newer sonic and ultrasonic methods. We investigated the bone structural integrity and metal attrition residues both in bone and the irrigation fluid. MATERIALS AND METHODS Bovine ribs were cut using three methods. Bone cuts were studied using Environmental Scanning Electron Microscopy (ESEM) for tissue discrepancies and Scanning Electron Microscopy/Energy Dispersion X-Ray Microanalysis (SEM/EDX) for organic and inorganic debris. RESULTS Better preservation of bone architecture was seen in piezo and sono surgery while metal attrition was not conclusive (p>0.05). Unlike in bone analyses, both bur and ultrasonic osteotomies showed statistically significant higher median inorganic detection per analysis (p=0.021 and p=0.037, respectively). CONCLUSION Sono and piezo surgery proved to be less invasive while attrition properties were the same.
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Affiliation(s)
- Ashkan Rashad
- Department of Oral, Maxillofacial and Facial Plastic Surgery, RWTH Aachen University Hospital, Aachen, Germany.,Department of Oral and Maxillofacial Surgery, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Stefan Schwan
- Fraunhofer Institute for Microstructure of Materials and Systems (IMWS), Halle (Saale), Germany
| | - Alireza Nasirpour
- Department of Oral and Maxillofacial Surgery, Tehran University of Medical Sciences, Tehran, Iran
| | - Inge Schmitz
- Department of Pathology, Ruhr University Bochum, Bochum, Germany
| | - Henning Hanken
- Department of Oral and Maxillofacial Surgery, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Reinhard E Friedrich
- Department of Oral and Maxillofacial Surgery, University Medical Center Hamburg-Eppendorf, Hamburg, Germany;
| | - Martin Gosau
- Department of Oral and Maxillofacial Surgery, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
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Li J, Chen Z, Mendonça G, Chan HL, Sinjab K, Wang HL. Potential of Using an Implant Fixture as a Ridge Expander for Minor Ridge Augmentation: An Ex Vivo Randomized Controlled Study. J ORAL IMPLANTOL 2021; 47:125-130. [PMID: 32663269 DOI: 10.1563/aaid-joi-d-19-00224] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
To place implants with minimal trauma is what the patient and clinician are seeking. Hence, the aim of this study was to quantify the potential of using an implant fixture as a ridge expander in an underprepared osteotomy. Thirty-eight edentulous sites in 12 human cadaver jaws with ridge widths ranging from 4 to 6 mm and with type 3 or type 4 bone density were randomly assigned into 2 groups. In the ridge expansion group (RE), each osteotomy was drilled to a width of 2.8 mm and depth of 11.5 mm. In the non-ridge expansion (NE) control group, each osteotomy was drilled to a width of to 3.4 mm and depth of 11.5 mm. A 3.7 mm × 11.5 mm tapered implant was inserted into each site. The ridge width before (RW1) and after (RW2) implant placement as well as the buccal plate thickness (BPT) post-insertion were measured and analyzed. In the RE group, the average RW1 and RW2 were 4.69 ± 0.45 mm and 5.54 ± 0.35 mm, respectively, corresponding to a statistically significant ridge expansion of 0.85 mm (P < .01). In the NE group, no ridge width gain was observed (RW1: 4.79 ± 0.40 mm, RW2: 4.88 ± 0.42 mm). Compared to NE, RE resulted in a statistically greater BPT (1.08 ± 0.28 mm after RE vs 0.71 ± 0.37 mm after NE, P < .001). Our study determined that it was physically possible to widen a ridge by an average of 0.85 mm by osteotomy underprepation in ridge with type 3 or type 4 bone density, which effectively turned the implant upon insertion into a ridge expander. The physiological consequences of this method of ridge expansion in a living person must be established before drawing further conclusions about its clinical indications or efficacy.
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Affiliation(s)
- Junying Li
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Disease, West China Hospital of Stomatology, Sichuan University, Chengdu, China.,Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, Mich
| | - Zhaozhao Chen
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Disease, West China Hospital of Stomatology, Sichuan University, Chengdu, China.,Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, Mich
| | - Gustavo Mendonça
- Department of Biologic & Materials Sciences, Division of Prosthodontics, University of Michigan School of Dentistry, Ann Arbor, Mich
| | - Hsun-Liang Chan
- Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, Mich
| | - Khaled Sinjab
- Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, Mich
| | - Hom-Lay Wang
- Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, Mich
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Anitua E, Fernández-de-Retana S, Alkhraisat MH. Platelet rich plasma in oral and maxillofacial surgery from the perspective of composition. Platelets 2020; 32:174-182. [PMID: 33350883 DOI: 10.1080/09537104.2020.1856361] [Citation(s) in RCA: 37] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
The application of platelet-rich plasma (PRP) in oral and maxillofacial surgery has been thoroughly studied in the last two decades. Currently, different types of PRP are applied in the clinical practice, being the presence or absence of leukocytes one of the classification criteria. However, there is poor evidence assessing the influence of the PRP composition in their efficacy. In this context, the aim of this narrative review is to compile the existing evidence covering the efficacy of PRP in oral and maxillofacial surgery, starting from a systematic literature search and to qualitatively describe the efficacy outcomes from the composition perspective. According to the results of this review, the application of PRP in oral and maxillofacial surgery is a potential strategy to improve soft- and hard-tissue regeneration, observing differences in the efficacy of PRP depending on its composition and the studied application. P-PRP (the absence of leukocytes) has been more consistent in achieving beneficial effects in alveolar ridge preservation, management of post-extraction complications, bone augmentation and temporomandibular joint disorders. For that, the composition and methodology used to prepare the PRP should be a critical point when evaluating the efficacy of PRP.
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Affiliation(s)
- Eduardo Anitua
- Regenerative Medicine Department, BTI Biotechnology Institute, Vitoria, Spain.,Clinical research, University Institute for Regenerative Medicine and Oral Implantology (UIRMI), Vitoria, Spain
| | - Sofía Fernández-de-Retana
- Regenerative Medicine Department, BTI Biotechnology Institute, Vitoria, Spain.,Clinical research, University Institute for Regenerative Medicine and Oral Implantology (UIRMI), Vitoria, Spain
| | - Mohammad H Alkhraisat
- Regenerative Medicine Department, BTI Biotechnology Institute, Vitoria, Spain.,Clinical research, University Institute for Regenerative Medicine and Oral Implantology (UIRMI), Vitoria, Spain
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15
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Li XM, Bao JB, Xie ZG. [Application of two-stage ridge splitting technique in atrophic mandibular alveolar ridge]. HUA XI KOU QIANG YI XUE ZA ZHI = HUAXI KOUQIANG YIXUE ZAZHI = WEST CHINA JOURNAL OF STOMATOLOGY 2020; 38:338-342. [PMID: 32573145 PMCID: PMC7296381 DOI: 10.7518/hxkq.2020.03.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 05/21/2019] [Revised: 12/19/2019] [Indexed: 11/21/2022]
Abstract
Adequate bone volume is the primary condition for successful dental implants. However, sufficient bone volume is often encountered in the vertical direction, but the bone volume in the buccolingual direction is insufficient, making it less suitable to be implanted. If the traditional spitting technique is used in the mandible, fracture and necrosis can easily occur in the labial (buccal) bone plate due to the absence of elasticity, thick cortical bone, poor blood supply, and anastomotic branch. The two-stage ridge splitting technique can be used in patients with narrow alveolar ridge in the mandible. This study summarizes the principles and conditions of application, operational points, clinical efficacy, and analysis of the causes of buccal bone plate absorption.
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Affiliation(s)
- Xiao-Mei Li
- Dept. of Implantology, The Affiliated Stomatological Hospital of Kunming Medical University, Kunming 530102, China
| | - Ji-Bo Bao
- Dept. of Implantology, The Affiliated Stomatological Hospital of Kunming Medical University, Kunming 530102, China
| | - Zhi-Gang Xie
- Dept. of Implantology, The Affiliated Stomatological Hospital of Kunming Medical University, Kunming 530102, China
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16
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Stumbras A, Kuliesius P, Darinskas A, Kubilius R, Zigmantaite V, Juodzbalys G. Bone regeneration in rabbit calvarial defects using PRGF and adipose-derived stem cells: histomorphometrical analysis. Regen Med 2020; 15:1535-1549. [PMID: 32452715 DOI: 10.2217/rme-2019-0123] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023] Open
Abstract
Aim: The aim of this study was to evaluate the osteogenic potential of adipose-derived stem cells (ADSCs) and to assess the influence of plasma rich in growth factors (PRGF) on bone regeneration using ADSCs. Materials & methods: Bone defects were randomly allocated to the five treatment modalities: spontaneous healing, natural bovine bone mineral (BBM), BBM loaded with PRGF, BBM loaded with ADSCs and BBM loaded with a combination of ADSCs and PRGF. Results: The PRGF significantly enhanced the biomaterial-to-bone contact. Defects treated with ADSCs and PRGF or a combination of both showed the greatest bone regeneration. Conclusion: Combining PRGF and ADSCs boosts the bone graft regenerative potential at the earliest period of healing.
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Affiliation(s)
- Arturas Stumbras
- Department of Maxillofacial Surgery, Faculty of Odontology, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Povilas Kuliesius
- Department of Maxillofacial Surgery, Faculty of Odontology, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Adas Darinskas
- Laboratory of Immunology, National Cancer Institute, Lithuania
| | - Ricardas Kubilius
- Department of Maxillofacial Surgery, Faculty of Odontology, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Vilma Zigmantaite
- Animal Research Centre, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Gintaras Juodzbalys
- Department of Maxillofacial Surgery, Faculty of Odontology, Lithuanian University of Health Sciences, Kaunas, Lithuania
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Chu S, Xu H, Li X, Guo T, Ting Z, Zhou Y. Application of modified alveolar ridge augmentation technique for horizontal bone augmentation in posterior mandibular region: Report of 3 cases. Clin Case Rep 2019; 7:2548-2564. [PMID: 31893099 PMCID: PMC6935621 DOI: 10.1002/ccr3.2548] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2019] [Revised: 09/23/2019] [Accepted: 10/11/2019] [Indexed: 12/13/2022] Open
Abstract
Three cases with severe horizontal bone deficiency on mandibular posterior region were committed by modified alveolar ridge augmentation. The therapeutic outcomes show that it is an effective methodology in cases with compromised horizontal bone.
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Affiliation(s)
- Shunli Chu
- Department of Dental ImplantologySchool and Hospital of StomatologyJilin UniversityChangchun CityChina
| | - Hongwei Xu
- Department of Dental ImplantologySchool and Hospital of StomatologyJilin UniversityChangchun CityChina
| | - Xianjing Li
- Department of Dental ImplantologySchool and Hospital of StomatologyJilin UniversityChangchun CityChina
| | - Tianqi Guo
- Department of Dental ImplantologySchool and Hospital of StomatologyJilin UniversityChangchun CityChina
| | - Zhu Ting
- Department of Dental ImplantologySchool and Hospital of StomatologyJilin UniversityChangchun CityChina
| | - Yanmin Zhou
- Department of Dental ImplantologySchool and Hospital of StomatologyJilin UniversityChangchun CityChina
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Donos N, Dereka X, Calciolari E. The use of bioactive factors to enhance bone regeneration: A narrative review. J Clin Periodontol 2019; 46 Suppl 21:124-161. [DOI: 10.1111/jcpe.13048] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2018] [Revised: 11/08/2018] [Accepted: 12/20/2018] [Indexed: 12/17/2022]
Affiliation(s)
- Nikos Donos
- Centre for Oral Immunobiology & Regenerative Medicine & Centre for Oral Clinical Research (COCR); Institute of Dentistry, Barts & The London School of Medicine & Dentistry; Queen Mary University of London (QMUL); London UK
| | - Xanthippi Dereka
- Centre for Oral Immunobiology & Regenerative Medicine & Centre for Oral Clinical Research (COCR); Institute of Dentistry, Barts & The London School of Medicine & Dentistry; Queen Mary University of London (QMUL); London UK
- Department of Periodontology; School of Dentistry; National and Kapodistrian University of Athens; Athens Greece
| | - Elena Calciolari
- Centre for Oral Immunobiology & Regenerative Medicine & Centre for Oral Clinical Research (COCR); Institute of Dentistry, Barts & The London School of Medicine & Dentistry; Queen Mary University of London (QMUL); London UK
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19
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Anitua E, Alkhraisat MH. 15-year follow-up of short dental implants placed in the partially edentulous patient: Mandible Vs maxilla. Ann Anat 2019; 222:88-93. [DOI: 10.1016/j.aanat.2018.11.003] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2018] [Revised: 11/06/2018] [Accepted: 11/06/2018] [Indexed: 12/17/2022]
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Custom-Made Direct Metal Laser Sintering Titanium Subperiosteal Implants: A Retrospective Clinical Study on 70 Patients. BIOMED RESEARCH INTERNATIONAL 2018; 2018:5420391. [PMID: 29998133 PMCID: PMC5994585 DOI: 10.1155/2018/5420391] [Citation(s) in RCA: 50] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/09/2018] [Accepted: 04/23/2018] [Indexed: 11/17/2022]
Abstract
Purpose To present a digital technique for the fabrication of custom-made subperiosteal implants and to report on the survival and complication rates encountered when using these fixtures. Methods The data used for this retrospective clinical study were derived from the medical records of five different private dental practices. Inclusion criteria were patients over the age of 60, treated with custom-made direct metal laser sintering (DMLS) titanium subperiosteal implants (Eagle-Grid®, BTK, Dueville, Vicenza) during a two-year period (2014-2015) and restored with fixed restorations; all enrolled patients needed to have complete pre- and postoperative clinical and radiographic documentation, with at least 2 years of follow-up. Exclusion criteria were smoking and bruxism. The main outcomes looked at were implant survival and complications. Results Seventy patients (39 males and 31 females, aged 62-79 years) who had been treated with custom-made DMLS titanium subperiosteal implants were enrolled in this study. After 2 years of follow-up, three implants were lost due to recurrent, untreatable infections; the survival rate was therefore 95.8% (67/70 implants). Four patients reported pain/discomfort/swelling after implant placement; the incidence of immediate postoperative complications was therefore 5.7% (4/70 implants). During the follow-up period, one patient suffered from recurrent infections classified as a biologic complication; the incidence of biologic complications was therefore 1.4% (1/67 surviving implants). Finally, four patients experienced prosthetic problems with their implant-supported restorations during the provisional phase (fracture of the acrylic restoration) and two patients had ceramic chipping of the definitive restoration; the incidence of prosthetic complications was therefore 8.9% (6/67 surviving implants). Conclusions Within the limits of the present study (limited follow-up time and low number of patients treated, retrospective design), the application of custom-made DMLS titanium subperiosteal implants showed satisfactory implant survival (95.8%) and low complication rates. Further studies are needed to confirm the positive outcomes found in this research.
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21
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Alveolar Ridge Splitting Versus Autogenous Onlay Bone Grafting: Complications and Implant Survival Rates. IMPLANT DENT 2018; 26:284-287. [PMID: 28114264 DOI: 10.1097/id.0000000000000541] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
PURPOSE To compare the complications and implant survival rates of localized alveolar ridge deficiencies in the horizontal dimension reconstructed by alveolar ridge splitting (ARS) or autogenous onlay bone grafting (OBG). MATERIALS AND METHODS Twenty-eight ARS and 28 OBG were performed. The survival rate of the all included implants was evaluated using the clinical and radiographical evaluation criteria of Misch et al. Temporary exposure of graft, mild infection, temporary paresthesia, and bad split were defined as minor complications; permanent exposure of graft, loss of graft, and permanent paresthesia were defined as major complications. Major and minor complications of ARS and OBG groups were statistically compared. RESULTS When the minor and major complication rates are considered, there was not any statistically significant difference between OBG (P = 0.099) and ARS (P = 0.241) groups. The satisfactory survival rate of OBG group was 92% and was 100% in the ARS group, and the difference was not statistically significant (P = 0.116). CONCLUSION When reconstructing vertically sufficient but horizontally insufficient alveolar ridges, ridge splitting technique could shorten the treatment period, decrease postoperative swelling and pain, eliminate the need for a second surgical site, reduce the treatment cost, and ease the patient cooperation to the surgery.
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22
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Types of devices used in ridge split procedure for alveolar bone expansion: A systematic review. PLoS One 2017; 12:e0180342. [PMID: 28732054 PMCID: PMC5521746 DOI: 10.1371/journal.pone.0180342] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2017] [Accepted: 06/14/2017] [Indexed: 11/19/2022] Open
Abstract
The aim of this systematic review was to evaluate instrumentation procedures of the alveolar ridge expansion technique (ARST) with or without Guided Bone Regeneration (GBR) and to identify the most used instruments for successful outcome. An electronic as well as manual literature search was conducted in several databases including Medline, Embase, and Cochrane Central Register of Controlled Trials, for articles written in English up to September 2016. The question in focus was to identify the type of device for ridge expansion that is most frequently used and provides adequate bone expansion and implant success rate. To meet the inclusion criteria, the studies were analysed for the following parameters: prospective or retrospective studies, cohort or case studies/series, cases with 5 or more human subjects, type of device used for surgery, location of defect, and minimum follow up period. The frequency of osteotome usage in this study was approximately 65%, and on average, the implant success was 97%. The motorized expanders and ultrasonic surgery system are easier to use and cause less trauma to the bone compared to the traditional/conventional instruments like mallets and osteotomes. However, their cost is a limiting factor; hence, osteotomes remain a popular mode of instrumentation.
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23
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Anitua E, Mendinueva-Urkia M, Galan-Bringas S, Murias-Freijo A, Alkhraisat MH. Tooth autotransplantation as a pillar for 3D regeneration of the alveolar process after severe traumatic injury: A case report. Dent Traumatol 2017. [DOI: 10.1111/edt.12354] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Affiliation(s)
- Eduardo Anitua
- Private Practice in Oral Implantology; Vitoria Spain
- BTI Biotechnology Institute; Vitoria Spain
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24
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Lateral Ridge Splitting (Expansion) With Immediate Placement of Endosseous Dental Implant Using Piezoelectric Device. J Craniofac Surg 2017; 28:434-439. [DOI: 10.1097/scs.0000000000003229] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Waechter J, Leite FR, Nascimento GG, Carmo Filho LC, Faot F. The split crest technique and dental implants: a systematic review and meta-analysis. Int J Oral Maxillofac Surg 2016; 46:116-128. [PMID: 27639295 DOI: 10.1016/j.ijom.2016.08.017] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2015] [Revised: 08/17/2016] [Accepted: 08/25/2016] [Indexed: 10/21/2022]
Abstract
This systematic review aimed to determine: (1) the expected bone volume gain with the split crest technique, and (2) how the use of surgical instruments affects the performance of this technique. An electronic search was performed in the Cochrane Central Register of Controlled Trials, ClinicalTrials.gov, Embase, PubMed/MEDLINE, Scopus, and Web of Science databases. Twenty-seven articles met the selection criteria and were subjected to meta-analysis of bone gain and survival rate; 17 reported the use of conventional surgical instruments and nine the use of surgical ultrasound. A total of 4115 implants were installed in 1732 patients (average patient age 52 years). The overall implant survival rate was 97%. The average bone gain in studies that used conventional surgical instruments was 3.61mm, while this was 3.69mm in those that used ultrasound. Only two studies presented a low risk of bias. The greatest problems identified during the qualitative analysis were related to random selection of the population and the absence of statistical analysis. The split crest technique appears to be a promising and effective technique to gain bone width, regardless of the surgical instruments used. Considering the diversity of the studies and implant types, no definitive recommendations can be made, especially with regard to the best instruments and implant design to be used.
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Affiliation(s)
- J Waechter
- Graduate Program in Dentistry, School of Dentistry, Federal University of Pelotas, Pelotas, Rio Grande do Sul, Brazil
| | - F R Leite
- Graduate Program in Dentistry, School of Dentistry, Federal University of Pelotas, Pelotas, Rio Grande do Sul, Brazil
| | - G G Nascimento
- Graduate Program in Dentistry, School of Dentistry, Federal University of Pelotas, Pelotas, Rio Grande do Sul, Brazil
| | - L C Carmo Filho
- Graduate Program in Dentistry, School of Dentistry, Federal University of Pelotas, Pelotas, Rio Grande do Sul, Brazil
| | - F Faot
- Graduate Program in Dentistry, School of Dentistry, Federal University of Pelotas, Pelotas, Rio Grande do Sul, Brazil.
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Micromorphometric analysis of bone blocks harvested with eight different ultrasonic and sonic devices for osseous surgery. J Craniomaxillofac Surg 2016; 44:1143-51. [DOI: 10.1016/j.jcms.2016.04.024] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2016] [Revised: 03/16/2016] [Accepted: 04/14/2016] [Indexed: 12/15/2022] Open
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Anitua E, Alkhraisat MH. Is Alveolar Ridge Split a Risk Factor for Implant Survival? J Oral Maxillofac Surg 2016; 74:2182-2191. [PMID: 27474462 DOI: 10.1016/j.joms.2016.06.182] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2016] [Revised: 06/23/2016] [Accepted: 06/23/2016] [Indexed: 11/25/2022]
Abstract
PURPOSE There is a paucity of studies that have assessed the long-term outcomes of the alveolar ridge split (ARS). This study evaluated the intraoperative and postoperative complications and assessed the placed dental implant and prosthesis. MATERIALS AND METHODS A retrospective study of the ARS was conducted in a single private dental clinic. The predictor variable was the ARS technique (1 stage vs 2 stages). The primary outcome was the dental implant survival rate. Secondary outcomes were intraoperative complications, marginal bone loss, prosthetic complications, and prosthesis success rate. Descriptive analysis was performed for patients' demographic data, implant details, and prosthetic complications. The Kaplan-Meier method was used to assess implant survival rate and prosthesis success rate. RESULTS Twenty patients (mean age, 55 ± 6 yr) had a mean follow-up time of 5 years. Delayed implant placement was performed when the residual alveolar bone width was narrower than 3 mm. No intraoperative or postoperative complications were reported. The survival rate of the 31 implants was 100% and the prosthesis success rate was 96.8%. CONCLUSIONS The ARS is an effective technique for horizontal bone augmentation in the mandible. Delayed dental implant placement when the alveolar bone width is narrower than 3 mm could minimize the risk of buccal wall fracture.
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Affiliation(s)
- Eduardo Anitua
- Department Head, Eduardo Anitua Foundation; Scientific Director, BTI Biotechnology Institute; Private Practice in Oral Implantology, Vitoria, Spain.
| | - Mohammad H Alkhraisat
- Clinician Researcher, Eduardo Anitua Foundation; Scientist, BTI Biotechnology Institute, Vitoria, Spain
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Jung GU, Kim JH, Lim NH, Yoon GH, Han JY. Biomechanical comparison of a novel engine-driven ridge spreader and conventional ridge splitting techniques. Clin Oral Implants Res 2016; 28:689-696. [PMID: 27217278 DOI: 10.1111/clr.12864] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/15/2016] [Indexed: 11/30/2022]
Abstract
OBJECTIVES Ridge splitting techniques are used for horizontal ridge augmentation in implant dentistry. Recently, a novel engine-driven ridge splitting technique was introduced. This study compared the mechanical forces produced by conventional and engine-driven ridge splitting techniques in porcine mandibles. MATERIAL AND METHODS In 33 pigs, mandibular premolar areas were selected for the ridge splitting procedures, designed as a randomized split-mouth study. The conventional group underwent a chisel-and-mallet procedure (control group, n = 20), and percussive impulse (Newton second, Ns) was measured using a sensor attached to the mallet. In the engine-driven ridge spreader group (test group, n = 23), a load cell was used to measure torque values (Newton centimeter, Ncm). Horizontal acceleration generated during procedures (control group, n = 10 and test group, n = 10) was compared between the groups. RESULTS After ridge splitting, the alveolar crest width was significantly increased both in the control (1.23 ± 0.45 mm) and test (0.98 ± 0.41 mm) groups with no significant differences between the groups. The average impulse of the control group was 4.74 ± 1.05 Ns. Torque generated by rotation in the test group was 9.07 ± 2.15 Ncm. Horizontal acceleration was significantly less in the test group (0.82 ± 1.05 g) than the control group (64.07 ± 42.62 g) (P < 0.001). CONCLUSIONS Narrow edentulous ridges can be expanded by novel engine-driven ridge spreaders. Within the limits of this study, the results suggested that an engine-driven ridge splitting technique may be less traumatic and less invasive than a conventional ridge splitting technique.
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Affiliation(s)
- Gyu-Un Jung
- Department of Periodontology, Korea University Anam Hospital, Seoul, Korea
| | - Jun Hwan Kim
- Department of Mechanical Convergence Engineering, Hanyang University, Seoul, Korea
| | - Nam Hun Lim
- Department of Mechanical Convergence Engineering, Hanyang University, Seoul, Korea
| | - Gil Ho Yoon
- Department of Mechanical Convergence Engineering, Hanyang University, Seoul, Korea
| | - Ji-Young Han
- Department of Periodontology, College of Medicine, Hanyang University, Seoul, Korea
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Chang HH, Lee MS, Hsu YC, Tsai SJ, Lin CP. Comparison of clinical parameters and environmental noise levels between regular surgery and piezosurgery for extraction of impacted third molars. J Formos Med Assoc 2015; 114:929-35. [DOI: 10.1016/j.jfma.2014.02.003] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2014] [Revised: 01/29/2014] [Accepted: 02/07/2014] [Indexed: 11/29/2022] Open
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Rodella LF, Bonazza V. Platelet preparations in dentistry: How? Why? Where? When? World J Stomatol 2015; 4:39-55. [DOI: 10.5321/wjs.v4.i2.39] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/13/2015] [Revised: 04/08/2015] [Accepted: 04/30/2015] [Indexed: 02/06/2023] Open
Abstract
The aim of this article is to review the outcomes of platelet preparations in dentistry. A structured electronic search discovered 348 articles, which described the use of autologous platelet concentrates with a relevance to clinical dentistry. Among these articles, 220 articles investigated platelet rich plasma, 99 investigated platelet rich fibrin, 22 investigated plasma rich in growth factors and 7 investigated the use of concentrated growth factors. Several studies reported beneficial treament outcomes in terms of enhanced bone and soft tissue regeneration.
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Bassetti MA, Bassetti RG, Bosshardt DD. The alveolar ridge splitting/expansion technique: a systematic review. Clin Oral Implants Res 2015; 27:310-24. [PMID: 25586966 DOI: 10.1111/clr.12537] [Citation(s) in RCA: 60] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/21/2014] [Indexed: 12/01/2022]
Abstract
PURPOSE The aim of this systematic review was to evaluate clinical, radiological and histological outcomes of the alveolar ridge splitting/expansion technique (ARST) with or without GBR. MATERIALS AND METHODS A screening of two databases MEDLINE (PubMed) and EMBASE (OVID) and hand search of articles were performed. Human and animal studies reporting on dental implants placed with simultaneous ARST up to May 31st 2014 were considered. Quality assessment of selected full-text articles was performed according to the ARRIVE guidelines and the Cochrane collaboration's tool to assess risk of bias. RESULTS Overall, 18 human and six animal studies (risk of bias: high/unclear) were included in this review. No randomized controlled trials were found. Due to the heterogeneity of study designs, definitions of success criteria, outcome variables, observation times and surgical procedures, no meta-analysis was performed. Reported survival (18 studies) and success (nine studies) rates ranged from 91.7 to 100% and 88.2 to 100%, respectively, with a mean follow-up of 1-10 years. Crestal bone level changes (∆CBL) in some studies indicate slightly higher bone loss before and after loading. Histologic and histomorphometric data from six animal studies confirm the crestal bone loss, particularly at buccal sites. CONCLUSIONS Within the limitations of this review, ARST seems to be a well-functioning one-stage alternative to extended two-stage horizontal grafting procedures. Data indicate that during healing and first year of loading, increased ∆CBL particularly at buccal sites must be anticipated. Additional horizontal GBR can help to preserve buccal bone height and width.
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Affiliation(s)
- Mario A Bassetti
- Department of Periodontology, University of Bern, Bern, Switzerland
| | - Renzo G Bassetti
- Department of Oral and Maxillofacial Surgery, Lucerne Cantonal Hospital, Lucerne, Switzerland
| | - Dieter D Bosshardt
- Department of Periodontology, University of Bern, Bern, Switzerland.,Robert K. Schenk Laboratory of Oral Histology, School of Dental Medicine, University of Bern, Bern, Switzerland
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Clinical use of ridge-splitting combined with ridge expansion osteotomy, sandwich bone augmentation, and simultaneous implantation. Br J Oral Maxillofac Surg 2014; 52:703-8. [DOI: 10.1016/j.bjoms.2014.03.028] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2013] [Accepted: 03/30/2014] [Indexed: 11/22/2022]
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Are there specific indications for the different alveolar bone augmentation procedures for implant placement? A systematic review. Int J Oral Maxillofac Surg 2014; 43:606-25. [PMID: 24451333 DOI: 10.1016/j.ijom.2013.12.004] [Citation(s) in RCA: 182] [Impact Index Per Article: 16.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2013] [Revised: 12/12/2013] [Accepted: 12/18/2013] [Indexed: 12/12/2022]
Abstract
Bone resorption following tooth loss often interferes with dental implant placement in a desired position, and requires additional bone augmentation procedures. Many techniques have been described to augment and reconstruct alveolar ridge width and height. The aim of this study was to systemically review whether there is evidence to provide indications for the various bone augmentation procedures based on defect dimension and type. An electronic search of the Medline database and Cochrane library, complemented by a manual search, was performed. Inclusion criteria for partial edentulism were: clinical trials on bone augmentation procedures in preparation or at the time of implant placement, reporting preoperative and postoperative dimensions of the ridge. For edentulous patients, studies were included when providing the data on ridge and defect description, or the amount of augmentation achieved. The search yielded 53 publications for partially edentulous patients and 15 publications for edentulous patients. The literature provides evidence that dehiscence and fenestrations can be treated successfully with guided bone regeneration (GBR) at the time of implant placement (mean implant survival rate (MISR) 92.2%, mean complication rate (MCR) 4.99%). In partially edentulous ridges, when a horizontal defect is present, procedures such as staged GBR (MISR 100%, MCR 11.9%), bone block grafts (MISR 98.4%, MCR 6.3%), and ridge expansion/splitting (MISR 97.4%, MCR 6.8%) have proved to be effective. Vertical defects can be treated with simultaneous and staged GBR (MISR 98.9%, MCR 13.1% and MISR 100%, MCR 6.95%, respectively), bone block grafts (MISR 96.3%, MCR 8.1%), and distraction osteogenesis (MISR 98.2%, MCR 22.4%). In edentulous patients, there is evidence that bone block grafts can be used (MISR 87.75%), and that Le Fort I osteotomies can be applied (MISR 87.9%), but associated with a high complication rate. The objective of extracting specific indications for each procedure could not be fully achieved due to the heterogeneity of the studies available. Further studies on bone augmentation procedures should report precise preoperative and postoperative measurements to enable a more exact analysis of the augmentation procedure, as well as to provide the clinician with the rationale for choosing the most indicated surgical approach.
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