Safety and performance of a novel collagenated xenogeneic bone block for lateral alveolar crest augmentation for staged implant placement.

OBJECTIVES: To evaluate the performance and safety of placing a collagenated xenogeneic bone block (CXBB) graft for the lateral bone augmentation of the alveolar crest prior to implant placement. MATERIAL & METHODS: In patients with single or multiple tooth gaps and a severe horizontal collapse of the alveolar ridge, a ridge augmentation procedure was performed using CXBB fixated with osteosynthesis screws to the atrophic bone crest and complemented with deproteinized bovine bone mineral particles (DBBM) and a native bilayer collagen membrane (NBCM). Patients were examined with CBCT prior to and 24 weeks after the augmentation. Twenty-six weeks postoperatively, a re-entry procedure was performed to evaluate the bone width and availability for adequate implant placement. RESULTS: Fifteen patients received 28 CXBB, and in 13 patients, a re-entry procedure was performed. Eleven patients (84.6%) gained enough bone volume for implant insertion without additional contouring or secondary bone augmentation. The mean crest width at baseline was 2.83 mm (SD 0.57), and the mean crest width at re-entry was 6.90 mm (SD 1.22), with a mean ridge width increase of 4.12 mm (SD 1.32). Soft tissue dehiscence occurred during the follow-up in 5 of 14 patients (35.7%) at various time points. In addition, there was a high incidence of early implant loss (30.8% [patient-based]). CONCLUSIONS: CXBB achieved significant horizontal crestal width gains allowing a secondary implant placement in the majority of the patients. However, the occurrence of soft tissue dehiscence may notably affect the outcome of the subsequent implant therapy.

Lateral alveolar ridge augmentation with autogenous block grafts fixed at a distance versus resorbable Poly-D-L-Lactide foil fixed at a distance: A single-blind, randomized, controlled trial.

OBJECTIVES: The aim of this study was to compare bone block grafts fixed at a distance (BBG-D) with the SonicWeld Rx shell technique (Poly-D-L-Lactide foil fixed at a distance, augmented with autogenous and deproteinized bovine bone particles (SWST)) for lateral alveolar ridge augmentation. METHODS: In this single-blinded, randomized, controlled trial, 30 patients with a bucco-palatal bone width of ≤3 mm were randomized into the treatment groups: "BBG-D" and "SWST". Bone width was measured with cone beam computed tomography (CBCT). One implant was placed at each grafted site. Frequencies of complications, bone gain and bone resorption in the CBCT were assessed as outcomes. RESULTS: Fifteen sites were augmented in each treatment group. One graft (7%) in the BBG-D group and five (33%) in the SWST group were lost (p = 0.17). In the SWST group, two implants (20%) were lost and none in the BBG-D group (p = 0.18). The rate of pooled severe complications (loss of graft and/or implant) was different (p = 0.035). Five (33%) wound dehiscences happened in the SWST group and none in the BBG-D group (p = 0.042). Seven (47%) nonsevere complications (wound dehiscence, inflammation, transient nerve injury) happened in the SWST group and one (7%) in the BBG-D group (p = 0.035). At the one-year evaluation, there were no significant differences in bone loss at the mesial, distal or buccal implant shoulder between treatment groups. CONCLUSIONS: Within the limitations of this study, the BBG-D method remains the gold standard for lateral alveolar ridge augmentation compared to the shell technique because of the lower complication rates.

Long-term Retrospective Study based on Implant Success Rate in Patients with Risk Factor: 15-year Follow-up.

AIM: The purpose of this retrospective study is to assess implant success rates with various risk factors. MATERIALS AND METHODS: Two hundred patients with a total of 650 implants were selected. Risk factors, such as smoking, antidepressants, bruxism, diabetes, and bone augmentation procedures were considered, and patients were followed up for a period of 8 to 15 years. RESULTS: Of 650 implants placed, the success rate was 88%, i.e., a total of 572 implants were successful. A total of 78 implants were considered failure; and out of 78, twenty implants were surgically removed. CONCLUSION: Based on this study's results, it is concluded that risk factors, such as smoking, bruxism, diabetes, and bone augmentation play an important role in success rate of dental implants. CLINICAL SIGNIFICANCE: Several factors, such as bruxism, diabetes, and supporting bone can play an important role in dental implant success.

Hard and soft tissue changes following alveolar ridge preservation: a systematic review.

OBJECTIVE: Two focused questions were addressed within this systematic review. Q1) What is the effect of alveolar ridge preservation on linear and volumetric alveolar site dimensions, keratinised measurements, histological characteristics and patient-based outcomes when compared to unassisted socket healing. Q2) What is the size effect of these outcomes in three different types of intervention (guided bone regeneration, socket grafting and socket seal). MATERIALS AND METHODS: An electronic search (MEDLINE, EMBASE, Cochrane Central Register LILACS, Web of Science) and hand-search was conducted up to June 2015. Randomised controlled trials (RCT) and controlled clinical trials (CCT); with unassisted socket healing as controls: were eligible in the analysis for Q1. RCTs, CCTs and large prospective case series with or without an unassisted socket healing as control group were eligible in the analysis for Q2. RESULTS: Nine papers (8 RCTs and 1 CCTs) were included in the analysis for Q1 and 37 papers (29 RCTs, 7 CCTs and 1 case series) for Q2. The risk for bias was unclear or high in most of the studies. Q1: the standardised mean difference (SMD) in vertical mid-buccal bone height between ARP and a non-treated site was 0.739 mm (95% CI: 0.332 to 1.147). The SMD when proximal vertical bone height and horizontal bone width was compared was 0.796mm (95% CI: -1.228 to 0.364) and 1.198 mm (95% CI: -0.0374 to 2.433). Examination of ARP sites revealed significant variation in vital and trabecular bone percentages and keratinised tissue width and thickness. Adverse events were routinely reported, with three papers reporting a high level of complications in the test and control groups and two papers reporting greater risks associated with ARP. No studies reported on variables associated with the patient experience in either the test or the control group. Q2: A pooled effect reduction (PER) in mid-buccal alveolar ridge height of -0.467 mm (95% CI: -0.866 to -0.069) was recorded for GBR procedures and -0.157 mm (95% CI: -0.554 to 0.239) for socket grafting. A proximal vertical bone height reduction of -0.356 mm (95% CI: -0.490 to -0.222) was recorded for GBR, with a horizontal dimensional reduction of -1.45 mm (95% CI: -1.892 to -1.008) measured following GBR and -1.613 mm (95% CI: -1.989 to -1.238) for socket grafting procedures. Five papers reported on histological findings after ARP. Two papers indicated an increase in the width of the keratinised tissue following GBR, with two papers reporting a reduction in the thickness of the keratinised tissue following GBR. Histological examination revealed extensive variations in the treatment protocols and biomaterials materials used to evaluate extraction socket healing. GBR studies reported a variation in total bone formation of 47.9 ± 9.1% to 24.67 ± 15.92%. Post-operative complications were reported by 29 papers, with the most common findings soft tissue inflammation and infection. CONCLUSION: ARP results in a significant reduction in the vertical bone dimensional change following tooth extraction when compared to unassisted socket healing. The reduction in horizontal alveolar bone dimensional change was found to be variable. No evidence was identified to clearly indicate the superior impact of a type of ARP intervention (GBR, socket filler and socket seal) on bone dimensional preservation, bone formation, keratinised tissue dimensions and patient complications.

Performance and safety of collagenated xenogeneic bone block for lateral alveolar ridge augmentation and staged implant placement. A monocenter, prospective single-arm clinical study.

OBJECTIVES: To assess the clinical safety and performance of collagenated xenogeneic bone block (CXBB) for lateral alveolar ridge augmentation and two-stage implant placement. MATERIAL & METHODS: In ten patients exhibiting a single-tooth gap, the surgical procedure included the preparation of mucoperiosteal flaps, a rigid fixation of CXBB (Geistlich Bio-Graft® ) using an osteosynthesis screw, and contour augmentation. After 24 weeks of submerged healing, the primary endpoint was defined as the final ridge width sufficient to place an adequately dimensioned titanium implant at the respective sites. Secondary outcomes included, for example, the gain in ridge width (mm). Clinical parameters (e.g., bleeding on probing - BOP, probing depth - PD, mucosal recession - MR) were assessed immediately after the cementation of the crown and at the final visit. RESULTS: At 24 weeks, implant placement could be achieved in 8 of 10 patients exhibiting a mean gain in ridge width (mean ± SD) of 3.88 ± 1.75 mm. Histological analysis has pointed to a homogeneous osseous organization of CXBB. The changes of mean BOP, PD, and MR values at the final visit amounted to 16.62 ± 32.02%, 0.04 ± 0.21 mm, and -0.04 ± 0.12 mm, respectively. CONCLUSIONS: CXBB may be successfully used to support lateral alveolar ridge augmentation and two-stage implant placement.

Alveolar Ridge Splitting Versus Autogenous Onlay Bone Grafting: Complications and Implant Survival Rates.

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.

Evaluation of the treatment modalities for neurosensory disturbances of the inferior alveolar nerve following retromolar bone harvesting for bone augmentation.

SUBJECTS: The purpose of this study was to evaluate the treatment modalities for neurosensory disturbances (NSDs) of the inferior alveolar nerve occurring after retromolar bone harvesting for bone augmentation procedures before implant placement. METHODS: One hundred four patients, of which 49 and 55 exhibited vertical or horizontal alveolar ridge defects in the mandible and maxilla, respectively, were enrolled. Nineteen patients underwent block bone grafting, 38 underwent guided bone generation or autogenous bone grafting combined with titanium mesh reconstruction, and 47 underwent sinus floor augmentation. Using a visual analog scale, we examined subjective symptoms and discomfort related to sensory alteration within the area of the NSDs in these patients. NSDs were clinically investigated using a two-point discrimination test with blunt-tipped calipers. In addition, neurometry was used for evaluation of trigeminal nerve injury. We tested three treatment modalities for NSDs: follow-up observation (no treatment), medication, and stellate ganglion block (SGB). RESULTS: A week after surgery, 26 patients (25.0%) experienced NSDs. Five patients received no treatment, 10 patients received medication, and 11 patients received SGB. Three months after surgery, patients in the medication and SGB group achieved complete recovery. Current perception threshold values recovered to near-baseline values at 3 months: recovery was much earlier in this group than in the other two groups. SGB can accelerate recovery from NSDs. CONCLUSIONS: Our results justify SGB as a reasonable treatment modality for NSDs occurring after the harvesting of retromolar bone grafts.

Ridge expansion alone or in combination with guided bone regeneration to facilitate implant placement in narrow alveolar ridges: a retrospective study.

OBJECTIVE: To evaluate the long-term outcomes of ridge expansion technique in dealing with horizontal bony insufficiency of alveolar ridges for implant placement. MATERIALS AND METHODS: During the period 2004-2009, 168 patients with width insufficiency of alveolar ridges were treated using the ridge expansion technique to obtain an improved bony base for implant placement. Depending on the severity of width insufficiency, the surgical procedures were classified into two groups: ridge expansion alone (Group 1) and ridge expansion in combination with guided bone regeneration (Group 2). After 4-6 months of unloaded healing, the implants were restored. The patients were followed up until 2013 with clinical and radiographic examinations. RESULTS: Among the 168 patients, 11 patients underwent a fracture of labial/buccal bony plate during surgery, which was corrected by changing the procedure into bone grafting, yielding a surgical failure rate of 6.5%. In the remaining 157 patients successfully treated by ridge expansion alone or in combination with GBR, 226 implants were simultaneously placed as planned. No implant failed over 2.8 years (6 months to 8 years) of follow-up, yielding a cumulative implant survival rate of 100% in each group. Six implants in Group 1 and 4 implants in Group 2, although osseointegrated and in function, did not fulfill success criteria: Cumulative implants' success rates were 93.2% in Group 1 and 95.6% in Group 2. The mean marginal bone losses during the first year in Group 1 and Group 2 were 0.69 and 0.43 mm, respectively, followed by an annual loss of ~ 0.06 and 0.07 mm, respectively, in the following years. No clinical parameter was abnormal. Twenty-two (10.4%) implants were exposed to peri-implant mucositis, whereas 19 (11.0%) implant-supported restorations were involved in prosthetic complications. CONCLUSIONS: The preliminary results of this retrospective study indicate that ridge expansion alone or in combination with GBR can be considered an effective and safe procedure for treatment of width insufficiency of alveolar ridges on the purpose of implant application.

Surgical Correction of the Malpositioned Segment After Alveolar Distraction in the Edentulous Patient.

This study examined a female patient with a lower edentulous state, who had undergone a previous alveolar distraction. A lingually malpositioned segment was found after the alveolar distraction. Therefore, an osteotomy of the distracted segment was performed and the segment was corrected into the labial side and fixed with miniplates. Good results in correcting the malpositioned segment were achieved in this edentulous patient using the osteotomy and fixation after an alveolar distraction.

Removal Rates of Dental Implants Placed in Conjunction With Autologous Bone and Xenogeneic and Synthetic Alloplastic Materials in Finland Between 1994 and 2012.

PURPOSE: This study aimed to assess the use of bone augmentation materials in Finland from 1994 to 2012 by assessing removal rates of implants placed in combination with autologous bone, xenogeneic grafts, and synthetic alloplastic materials. MATERIALS AND METHODS: The National Institute for Health and Welfare in Finland granted permission to access raw data of the Finnish Dental Implant Register for implant augmentation materials and removal rates of implants placed in augmented sites from April 1994 to April 2012. RESULTS: A total of 198,538 implants were placed in Finland between 1994 and 2012 in 110,543 operations. A total of 3318 (1.7%) of the placed implants were removed during the observation period. Augmentations were performed on 20,812 (18.8%) operations during 1994-2012. The removal rates of implants placed at sites augmented with autologous bone were 2.31%, xenogeneic materials 0.91%, and synthetic alloplastic materials 2.80%. The removal rate was 1.87% when no augmentation material was used. CONCLUSIONS: The placement of dental implants in conjunction with bone augmentation materials is predictable with a low complication rate.

Complications in the treatment with alveolar extraosseous distractors. Literature review.

BACKGROUND: To review the literature that analyses the types and frequency of complications associated with the use of extraosseous alveolar distraction from 2007 to 2013. MATERIAL AND METHOD: Review of the literature in PubMed, using these keywords; alveolar ridge, alveolar distraction osteogenesis, complication, literature review. Inclusion criteria were: articles published between 2007 and 2013 that included the distraction protocol, the complications encountered and the time when they occurred. RESULTS: According to the above criteria, 12 articles were included in this review, where 334 extraosseous distractors were placed and 395 complications were encountered, of which 19 (4.81%) were intraoperative, 261 (66.07%) postoperative and 115 (29.11 %) were post-distraction. The most common complication was the incorrect distraction vector found in 105 cases (26.58%), in 23 cases (5.82%) there were severe complications, of which 14 (3.54%) were mandibular fracture and 9 (2.27%) were fractures of the distractor elements. CONCLUSIONS: According to this review, although alveolar distraction is a safe and predictable technique, it can cause complications; however, they are usually minor and easily resolved without affecting the treatment outcome.

Comparison of morbidity-related parameters between autologous and allogeneic bone grafts for alveolar ridge augmentation from patients' perspective-A questionnaire-based cohort study.

INTRODUCTION: Alveolar ridge augmentation is often required before dental implant placement. In this context, autologous bone grafts are considered the biological gold standard. Still, bone block harvesting is accompanied by some serious potential disadvantages and possible complications, such as pain, bleeding, and nerve irritation. Several studies aimed to compare autologous to allogeneic bone grafts concerning bone quality and implant survival rates; this is the first prospective study analyzing and comparing morbidity-related parameters after alveolar ridge augmentation using autogenous and allogeneic bone blocks from patients' perspective. METHODS: Using a questionnaire, 36 patients were asked to evaluate the surgery as well as the post-operative period concerning pain, stress, sensibility deficits, satisfaction with, and consequences from the surgery as well as the preferred procedure for future alveolar ridge augmentations. RESULTS: No significant differences were shown regarding stress and pain during and after surgery, whereas the rate of nerve irritations was twice as high in the autologous group. The swelling was significantly higher in patients with autologous bone blocks (p = 0.001). Nevertheless, the overall satisfaction of patients of both groups was very high, with over 8/10 points. CONCLUSIONS: The swelling was the main reason for patients' discomfort in both groups and was significantly higher after autologous bone augmentation. Since this side effect seems to be a highly relevant factor for patients' comfort and satisfaction, it needs to be discussed during preoperative consultation to allow shared decision-making considering the anticipated morbidity.

Bone augmentation using titanium mesh: A systematic review and meta-analysis.

PURPOSE: To review and compare the available literature on bone regeneration using titanium mesh and map the current evidence on bone gain outcomes and complications while comparing this scaffold with collagen membranes. MATERIALS AND METHODS: A comprehensive electronic and manual search was performed to identify randomised and non-randomised prospective controlled clinical trials that involved the use of titanium mesh in at least one arm, with outcomes including complications and vertical and/or horizontal bone gain. The focused questions were defined as follows: What are the outcomes of using titanium mesh in ridge augmentation compared to other types of barrier membrane, and what is the complication rate (membrane exposure and infection) when titanium mesh is used in these procedures? RESULTS: A total of 22 articles were included in the qualitative analysis. Overall, the studies that measured bone gain resulted in 3.36 mm vertical (196 subjects; 95% confidence interval 2.44 to 4.64 mm, range 1.4 to 5.7 mm) and 3.26 mm horizontal augmentation (81 subjects; 95% confidence interval 2.93 to 3.63 mm, range 2.6 to 3.7 mm), with variability among studies. The most commonly noted complication was mesh exposure, regardless of the type of mesh used, and the second most common was graft failure. The overall pooled complications rate reported in clinical trials was 10.8%. The meta-analysis comparing titanium mesh and collagen membranes, controlling for the type of bone regeneration (staged or simultaneous with implant placement), failed to show a significant difference in horizontal bone gain between the two techniques. CONCLUSIONS: Within the limitations of the present study and acknowledging the heterogeneity among the articles included, titanium mesh can serve as a feasible protective scaffold for bone regeneration with a relatively acceptable complication rate and in defects requiring around 4 mm 3D reconstruction. Data on patient-reported outcomes were scarce. CONFLICT-OF-INTEREST STATEMENT: None of the authors have any financial interests, either directly or indirectly, in the products or information mentioned in the present article.

[Risk factors and prevention for implant treatment in patients with periodontitis].

In patients with periodontitis, due to problems of periodontal tissue infection as well as soft and hard tissues defects, it may lead to implant infection, gingival papilla loss, soft tissue recession and poor coordination with adjacent teeth. For such patients, periodontal infection should be actively controlled before dental implant therapy. In consideration of insufficient soft and hard tissues, alveolar ridge preservation and soft tissue augmentation procedure can be used to preserve or increase soft and hard tissues as much as possible. Multi-disciplinary treatment is often needed for occlusion problems and coordination with adjacent tooth. Periodontal maintenance treatment of implants and natural teeth is also necessary after implant therapy. This paper discussed these risk factors and strategies for prevention and control, in order to provide some clinical guidances for the implant treatment of periodontitis patients.

Assessment of short dental implants restored with single-unit nonsplinted restorations.

OBJECTIVES: To investigate the survival rate of short (≤9 mm) implants restored with single-unit, nonsplinted crowns after an average follow-up of 37 months (21-94 months). MATERIALS AND METHODS: Two hundred and twenty-one implants placed in 168 patients (74 men, 94 women, aged 34-87 years, mean = 61 years). Implant lengths were 6 (n = 16), 8 (n = 166), 8.5 (n = 2), or 9 mm (n = 34). The implant diameters ranged from 3.7 to 5.6 mm. Implants were placed in the maxillary (n = 44) and mandibular arches (n = 176). RESULTS: Survival rate was 94.1% (maxilla [88.6%] and mandible [96.0%]) and 12 early failures (first 4 months) and 1 late failure (4.5 years in the maxillary molar region) observed. Of the 12 early failures, 4 were in the maxilla (2 premolars and 2 molars) and 8 in the mandible (2 premolars and 6 molars). The early failures were 11 implants of 8 mm long and a 9-mm implant. Smoking cigarettes, diabetes mellitus, and bone augmentation procedures were not associated with implant failure significantly (P > 0.05). CONCLUSIONS: Survival rate of short implants restored with single-unit, nonsplinted restorations over an average period of 37 months was favorable and comparable with longer implants.

Complications associated with vertical bone augmentation techniques in implant dentistry: A systematic review of clinical studies published in the last ten years.

Vertical bone augmentation procedures are increasingly necessary in daily practice. However, it has been reported that vertical ridge augmentation is one of the least predictable techniques in terms of complications. The aim of this systematic review was to evaluate and compare complications in relation to the different procedures used for vertical bone augmentation prior to implant placement. This review was conducted according to PRISMA guidelines. An electronic search was carried out in four databases: The National Library of Medicine (MEDLINE/PubMed); Web of Science; SCOPUS; and Cochrane Central Register of Controlled Trials (CENTRAL). The Newcastle-Ottawa Quality Assessment Scale, the Cochrane Collaboration tool for assessing risk of bias, and The Joanna Briggs Institute Critical Appraisal tool were used to assess the quality of evidence in the studies reviewed. Twenty-five studies with a total of 749 vertically augmented sites were included in the review. Complication rates varied among the different procedures: 51.02% for distraction osteogenesis, 38.01% for bone blocks, and 16.80% for guided bone regeneration. Vertical bone augmentation procedures prior to implant placement are associated with frequent surgical complications and should be approached with caution due to their possible impact on clinical treatment success.

Current perspectives of residual ridge resorption: Pathological activation of oral barrier osteoclasts.

PURPOSE: Tooth extraction is a last resort treatment for resolving pathological complications of dentition induced by infection and injury. Although the extraction wound generally heals uneventfully, resulting in the formation of an edentulous residual ridge, some patients experience long-term and severe residual ridge reduction. The objective of this review was to provide a contemporary understanding of the molecular and cellular mechanisms that may potentially cause edentulous jawbone resorption. STUDY SELECTION: Clinical, in vivo, and in vitro studies related to the characterization of and cellular and molecular mechanisms leading to residual ridge resorption. RESULTS: The alveolar processes of the maxillary and mandibular bones uniquely juxtapose the gingival tissue. The gingival oral mucosa is an active barrier tissue that maintains homeostasis of the internal organs through its unique barrier immunity. Tooth extraction not only generates a bony socket but also injures oral barrier tissue. In response to wounding, the alveolar bone socket initiates regeneration and remodeling through coupled bone formation and osteoclastic resorption. Osteoclasts are also found on the external surface of the alveolar bone, interfacing the oral barrier tissue. Osteoclasts in the oral barrier region are not coupled with osteoblastic bone formation and often remain active long after the completion of wound healing, leading to a net decrease in the alveolar bone structure. CONCLUSIONS: The novel concept of oral barrier osteoclasts may provide important clues for future clinical strategies to maintain residual ridges for successful prosthodontic and restorative therapies.

Therapeutic Strategies in the Management of Nonresorbable Membrane and Titanium Mesh Exposures Following Alveolar Bone Augmentation: A Systematic Scoping Review.

PURPOSE: The exposure of nonresorbable membranes following alveolar bone augmentation is one of the most frequently occurring complications. This review aimed to investigate the treatments that can be adopted to manage the exposure of polytetrafluoroethylene-based membranes (PTFE-ms) and titanium meshes (TMs) and their outcomes. MATERIALS AND METHODS: Two independent reviewers electronically and manually searched the EMBASE, PubMed/MEDLINE, Scopus, and Cochrane bibliographic databases to retrieve pertinent articles available between January 2000 and March 2021. Only human studies describing the type of treatment and the soft tissue outcome following exposure of PTFE-ms or TMs were included. RESULTS: Overall, 11 articles in the PTFE-ms group and 24 in the TM group were included for data analysis. Results indicated that, in both groups, two distinct therapeutic strategies are mostly applied in case of exposure, namely, pharmacologic and mechanical treatments. Other options have been identified seldomly. Statistically significant evidence of an association between the type of barrier membrane and the exposure rate (28.7% vs 38.5% for TMs and PTFE-ms, respectively; P = .019) and between the type of exposed device and the treatment outcome in terms of removal rate following therapy (11.9% and 44.4% for TMs and PTFE-ms, respectively; P < .001) was noted. CONCLUSION: In both groups, chlorhexidine applications and meticulous plaque control may lead to improved healing conditions after exposure. Surgical removal of the exposed portion can be considered to promote secondary intention healing. The beneficial effects of systemic antibiotics could not be demonstrated in the management of the exposure but should be evaluated in case of graft infection.

Immediate postoperative complications after lateral ridge augmentation - a clinical comparison between bone shell technique and sticky bone.

Nowadays, implant dentistry is strongly interconnected to bone augmentation procedures. Lateral ridge augmentation is often an imperative treatment stage for successful, prosthetic-driven implant placement. This study aimed to comparatively analyze the immediate postoperative complications of two horizontal bone grafting procedures: sticky bone and bone shell technique. Records of patients with lateral ridge augmentation were analyzed to identify immediate postoperative complications. The study group included 80 patients divided into 40 control (bone-shell technique - BS) and 40 tests (sticky bone -SB). More patients reported moderate and severe pain in the BS - group (11 patients - 27.5%) than in the SB group (6 patients - 15%). In the BS group, the incidence of severe and moderate trismus, neurosensory disturbances, and important hematoma was higher. There was an increased inflammatory response following the bone shell technique, while the sticky bone technique proved reduced surgical morbidity. There was no difference between the two groups in the risk of dehiscence or infection.

Effect of sinus membrane perforation on dental implant integration: a retrospective study on 128 patients.

A common complication of sinus augmentation is perforation of the sinus membrane during augmentation and/or implant placement. This retrospective study examines the effect of sinus membrane perforation with regard to graft survival and implant integration. A total of 175 sinuses were augmented with 115 of the membranes being reported intact at the time of surgery. A total of three infections occurred in patients who sustained perforated sinuses and one infection occurred in a patient who had an intact sinus. All four infections resolved after culture sensitivity and placement of the patient on an appropriate antibiotic for 10 days. Of 438 dental implants placed in the augmented sinuses, five implants failed, four of which were associated with perforated sinuses and and which was not associated with a perforated grafted sinus.