1,721,030 research outputs found
Methods to treat the edentulous posterior maxilla: implants with sinus grafting
No full textProsthetic rehabilitation of the edentulous posterior maxilla with implant-supported prostheses fre-
quently presents a challenge for the oral surgeon because of the lack of bone due to alveolar ridge
resorption or maxillary sinus pneumatization. To overcome these problems, different solutions were
proposed over the years, such as the use of short implants or tilted implants (including zygoma implants),
with the aim of avoiding maxillary sinus floor elevation. Both of these techniques have advantages and
disadvantages that should be evaluated carefully to choose the most appropriate treatment. Zygoma
implants or short/tilted implants are not a panacea for the treatment of patients with inadequate posterior
maxillary bone stock. Instead, treatment should be based on the characterization of resorption patterns
of the posterior maxilla, and may include the need for sinus grafting or other grafting procedures to
reestablish not only adequate bone volume for implant placement, but also a favorable intermaxillary
relationship, to optimize the functional and esthetic outcome of the final prosthetic rehabilitation. The
authors discuss the indications, advantages, and disadvantages of sinus-grafting procedures in association
with or without other reconstructive procedures
Innesti autologhi di apposizione e impianti endoossei per la riabilitazione dei mascellari edentuli e atrofici: revisione critica della letteratura e casistica personale
No full textFailures in jaw reconstructive surgery with autogenous onlay bone grafts for pre-implant purposes: incidence, prevention and management of complications
No full textDental rehabilitation with oral implants has become a routine treatment modality in the last decades, with reliable long-term results. However, insufficient bone volume or unfavorable intermaxillary relationships may render implant placement impossible or incorrect from a functional and esthetic viewpoint. Among the different methods for the reconstruction of deficient alveolar ridges, the use of autogenous bone blocks represents the most frequently used treatment modality both for limited and extended bone defects. Prerequisites for a successful outcome are represented by accurate preoperative planning, proper reconstructive procedure, and adequate prosthetic rehabilitation. Even if all these principles are followed, complications involving the grafts may occur, such as dehiscence, infection, or relevant resorption of the graft. The aim of this article is to present an updated overview on the incidence, prevention and treatment of these complications
Autogenous onlay bone grafts for the rehabilitation of atrophied jaws with oral implants
No full textClinical outcomes of GBR procedures to correct peri-implant dehiscences and fenestrations : a systematic review
No full textObjectives.
To analyze the clinical outcomes of endosseous implants following guided bone regeneration procedures (GBR) to correct dehiscence/fenestration defects associated with implant placement.
Methods/ Search strategy
A Medline search was performed for human studies published in English focusing on GBR procedures for the correction of dehiscence/fenestration defects associated with the placement of screw-shaped titanium implants. The selected studies had to include at least 10 consecutively treated patients with a minimum follow-up of 12 months after the start of prosthetic loading.
The clinical outcome in terms of complication rate of the GBR procedure, implant survival, and stability of marginal soft tissues around implants were evaluated.
Results.
Seven publications were included in this review. A total of 238 patients received 374 implants. Defects were treated with resorbable or non-resorbable membranes, in association with or without graft materials. Patients were followed for 1 to 10 years after the start of prosthetic loading. In the postoperative period, 20% of the non-resorbable membranes and 5% of the resorbable ones underwent exposure/infection. However, in the majority of cases a complete or almost complete coverage of the initial defect was obtained.
The overall survival rate of implants, irrespective of type of membrane and grafting materials, was 95.7% (range: 84.7-100%).
No significant modifications of probing depth and/or variation of clinical attachment level around implants were observed during the follow-up period.
Conclusion.
Despite the favorable results obtained, it was difficult to draw significant conclusion as far as the more reliable grafting material and membrane barrier for the correction of dehiscence/fenestration defects are concerned, due to the limited sample of patients and the wide variety of grafting materials and membranes, used alone or in combination. Moreover, due to the lack of randomized clinical trials, it was impossible to demonstrate that such augmentation procedures are really needed to allow the long-term survival of implants
Augmentation procedures for the rehabilitation of deficient edentulous ridges with oral implants
No full textObjectives: To analyze publications related to augmentation procedures and to evaluate
the success of different surgical techniques for ridge reconstruction and the survival/success
rates of implants placed in the augmented areas.
Material and methods: Clinical investigations published in English involving at least 5
patients and with a minimum follow-up of 6 months were included. The following
procedures were considered: a) Guided bone regeneration (GBR); 2) Onlay bone grafts; 3)
Inlay grafts; 4) Bone splitting for ridge expansion (RE); 5) Distraction osteogenesis (DO);
and 6) Revascularized flaps. Success rates of augmentation procedures and related
morbidity, as well as survival and success rates of implants placed in the augmented sites
were analyzed.
Results: Success rates of surgical procedures ranged from 60% to 100% for GBR, from 92%
to 100% for onlay bone grafts, from 98% to 100% for ridge expansion techniques, from
96,7% to 100% for DO, and was 87.5% for revascularized flaps, whereas survival rates of
implants ranged from 92% to 100% for GBR, from 60% to 100% for onlay bone grafts, from
91% to 97.3% for RE, from 90.4% to 100% for DO, and, finally, was 88.2% for
revascularized flaps.
Conclusion: On the basis of available data it was shown that it was difficult to demonstrate
that a particular surgical procedure offered better outcome as compared to another. The
main limit encountered in this review has been the overall poor methodological quality of
the published articles. Therefore larger well-designed long term trials are needed
Implants in reconstructed bone: a comparative study on the outcome of Straumann® tissue level and bone level implants placed in vertically deficient alveolar ridges treated by means of autogenous onlay bone grafts
No full textPurpose: To evaluate: (1) the survival rate of Straumann (R) Tissue Level and Bone Level implants placed in atrophic edentulous jaws previously reconstructed by means of autogenous onlay bone grafts; (2) to compare peri-implant bone resorption values over time. Materials and Methods: From 2005 to 2010, 50 patients presenting with vertical or tridimensional defects of the edentulous ridges were treated with autogenous bone grafts. Three to 7 months afterward, 192 implants were placed (Group A: 97 Tissue Level implants; Group B: 95 Bone Level implants) in the reconstructed areas. After a further waiting period of 2 to 3 months, patients were rehabilitated with implant-supported fixed prostheses. The follow-up ranged from 12 to 68 months after the start of prosthetic loading (mean: 33 months). Results: No implants were removed (survival rate: 100%), but in Group B 13 implants (8 placed in iliac grafts, 2 placed in ramus grafts, and 3 placed in calvarial grafts) presented peri-implant bone resorption values higher than those proposed by Albrektsson and colleagues. for successful implants: the overall implant success rate was then 100% for Group A and 86.8% for Group B. No prosthetic failures were recorded, thus leading to a 100% prostheses success rate. Conclusion: No significant differences were found between the two types of implants as far as implant survival rate is concerned, but results from this study seem to demonstrate that Tissue Level implants may present better long-term results in terms of peri-implant bone maintenance, as compared with Bone Level implants, when placed in reconstructed areas
Rigenerazione ossea guidata e impianti endossei per la riabilitazione dei mascellari edentuli e atrofici: revisione critica della letteratura e casistica personale
No full textAutogenous onlay bone grafts vs. alveolar distraction osteogenesis for the correction of vetically deficient edentulous ridges : a 2-4 year prospective study on humans
No full textAbstract
Objectives: The purposes of this study were to compare: (a) autogenous bone grafts (ABG)
and distraction osteogenesis (DO) for their ability in correcting vertically deficient
mandibular ridges and their capability in maintaining over time the vertical bone gain
obtained before and after implant placement; and (b) the survival and success rates of
implants placed in the reconstructed or distracted areas.
Material and methods: In a 2-year period (2001–2002), 17 patients presenting with
vertically atrophied partially edentulous mandibles requiring implant-supported prosthetic
rehabilitation, were included in this study. Patients were randomly assigned to two groups.
Eight patients (group 1) were treated with ABG harvested from the mandibular ramus,
while nine patients (group 2) were treated by means of DO. In group 1, patients received
implants 4–5 months after the reconstructive procedure, while in group 2 implants were
placed at the time of distraction device removal (approximately 3 months after the
completion of distraction). A total of 19 endosseous implants were placed in group 1, and
21 implants were placed in group 2 patients. For both groups, after an additional 3–5-
month period, prosthetic rehabilitation was started.
Results: Bone resorption before implant placement was significantly higher in group 1
(P1⁄40.01), while no statistically significant differences were found between the two groups
as far as survival and success rates of implants and peri-implant bone resorption after the
start of prosthetic loading were concerned.
Conclusion: The results suggested that: (a) both techniques may effectively improve the
deficit of vertically resorbed edentulous ridges; (b) survival and success rates of implants
placed in the reconstructed/distracted areas are consistent with those of implants placed in
native bone
Bone augmentation procedures in implant dentistry
No full textPurpose: This review evaluated: a) the success of different surgical techniques for the reconstruction of edentulous deficient alveolar ridges and b) the survival/success rates of implants placed in the augmented areas.
Material and methods: Clinical investigations published in English involving more than 10 consecutively treated patients and mean follow-up of at least 12 months after commencement of prosthetic loading were included. The following procedures were considered: 1) Onlay bone grafts; 2) Sinus floor elevation via a lateral approach; 3) Le Fort I osteotomy with interpositional grafts; 4) Split ridge/ ridge expansion techniques; and 5) Alveolar distraction osteogenesis. Full-text articles were identified using computerized and hand search by key words.
Success and related morbidity of augmentation procedures, and survival/success rates of implants placed in the augmented sites were analyzed.
Results and conclusion: A wide range of surgical procedures were identified. However, it was difficult to demonstrate that a particular surgical procedure offered better outcomes compared to another. Moreover, it is not yet known if some surgical procedures, e.g. reconstruction of atrophic edentulous mandibles with onlay autogenous bone grafts or maxillary sinus grafting procedures in case of limited/moderate sinus pneumatization, improve long-term implant survival. Every surgical procedure presents advantages and disadvantages. Priority should be given to those procedures which look simpler, less invasive, involve less risk of complications, and reach their goals within the shortest time frame. The main limit encountered in this literature review was the overall poor methodological quality of the published articles. Larger well designed long-term trials are neede
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