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1.
Biomed Res Int ; 2019: 4386709, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-30891457

RESUMEN

Although the number of complications and failures in bone augmentation procedures is still relatively high, these problems remain poorly documented. Moreover, the literature concerning reconstructive techniques and the treatment of their complications in the anterior areas rarely considers the final esthetic result. The aim of this paper is to propose a new classification of bone augmentation complications in the esthetic area, providing treatment guidelines useful for the management of these cases. Failures of bony regeneration procedures can be mainly divided into partial failures and complete failures. A partial failure can be solved with a corrective surgical intervention: this second surgery can have success or may not be able to provide the desired esthetic result. When the bone reconstructive procedure fails totally, a complete failure occurs and the whole procedure has to be repeated. This new intervention can have success but also this new reconstructive surgery can fail in the same way as the first, causing important damage and a compromise solution that will hardly be acceptable from an esthetic point of view. Bone augmentation techniques are not completely predictable and are not always able to guarantee the expected result, especially in the atrophic anterior maxilla. Complications and failures can often occur and this possibility must always be clearly explained to those patients with high esthetic demands and expectations.


Asunto(s)
Aumento de la Cresta Alveolar/clasificación , Estética Dental , Maxilar/patología , Maxilar/cirugía , Atrofia , Materiales Biocompatibles/química , Regeneración Ósea , Resorción Ósea/patología , Coronas , Implantes Dentales , Porcelana Dental/química , Humanos , Colgajos Quirúrgicos , Resultado del Tratamiento
2.
Int J Prosthodont ; 27(4): 320-7, 2014.
Artículo en Inglés | MEDLINE | ID: mdl-25010874

RESUMEN

PURPOSE: This study aimed to develop a classification of edentulous jaws for use as a diagnostic tool during implant-prosthodontic treatment planning. MATERIALS AND METHODS: The morphology of 200 fully edentulous alveolar ridges (100 maxillae, 100 mandibles) was assessed with cone beam computed tomography. Generic implants (length: 8 mm; diameter: 4.1 mm) were used. To develop the classification system, the feasibility of virtually placing the implants without vertical ridge augmentation was considered. Potential implant sites were evaluated in terms of ridge width and described as either type A (no horizontal augmentation required) or type B (horizontal augmentation required). A descriptive statistical analysis of subjects' age, sex, and arch classification was performed. RESULTS: In total, 880 implants were virtually planned. Based on alveolar ridge height, four arch patterns were identified (C1 to C4), providing a basis for prosthodontic planning with either removable or fixed implant-supported restorations. The frequencies of each category were as follows: C3 (n = 62, 62%), C4 (n = 16, 16%), C2 (n = 12, 12%), and C1 (n = 10, 10%) for the maxilla and C3 (n = 36, 36%), C4 (n = 31, 31%), C1 (n = 24, 24%), and C2 (n = 9, 9%) for the mandible. CONCLUSION: The proposed classification of the edentulous arch represents a useful tool for communication between clinicians when planning implant-supported rehabilitations.


Asunto(s)
Implantes Dentales/clasificación , Prótesis Dental de Soporte Implantado/clasificación , Diseño de Dentadura , Arcada Edéntula/clasificación , Planificación de Atención al Paciente , Adulto , Anciano , Anciano de 80 o más Años , Proceso Alveolar/diagnóstico por imagen , Aumento de la Cresta Alveolar/clasificación , Tomografía Computarizada de Haz Cónico/métodos , Estudios de Factibilidad , Femenino , Humanos , Arcada Edéntula/diagnóstico por imagen , Arcada Edéntula/rehabilitación , Masculino , Mandíbula/diagnóstico por imagen , Maxilar/diagnóstico por imagen , Persona de Mediana Edad , Terminología como Asunto , Terapia Asistida por Computador , Interfaz Usuario-Computador
3.
J Oral Implantol ; 40 Spec No: 365-70, 2014 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-24575743

RESUMEN

Among many techniques advocated for the horizontally deficient alveolar ridges, ridge-split has many advantages. Here, treatment management strategies of the horizontally collapsed ridges, especially the ridge-split approach, are discussed and a clinically relevant implant-driven classification of the alveolar ridge width is proposed, with the goal to assist an operator in choosing the proper bone augmentation technique. Comparison and advantages of two commonly used techniques, ridge-split and block bone graft, are presented.


Asunto(s)
Pérdida de Hueso Alveolar/clasificación , Proceso Alveolar/patología , Aumento de la Cresta Alveolar/métodos , Pérdida de Hueso Alveolar/diagnóstico por imagen , Pérdida de Hueso Alveolar/cirugía , Proceso Alveolar/diagnóstico por imagen , Aumento de la Cresta Alveolar/clasificación , Autoinjertos/trasplante , Trasplante Óseo/métodos , Cefalometría/métodos , Tomografía Computarizada de Haz Cónico/métodos , Implantes Dentales , Humanos , Imagenología Tridimensional/métodos , Arcada Edéntula/clasificación , Arcada Edéntula/diagnóstico por imagen , Arcada Edéntula/cirugía , Radiografía Panorámica
4.
Artículo en Inglés | MEDLINE | ID: mdl-21837309

RESUMEN

The emergence of implant dentistry has led to the need for bone augmentation procedures. With the removal of a tooth, there is an inevitable three-dimensional (3D) loss of alveolar bone. More often than not, horizontal bone loss occurs at a faster rate and to a greater extent compared to vertical bone loss. This led to the development of several horizontal bone augmentation techniques, such as guided bone regeneration, ridge expansion, distraction osteogenesis, and block grafts. These proposed augmentation techniques aim to place the implant in an ideal 3D position for successful restorative therapy. The literature has shown that horizontal bone augmentation is fairly predictable if certain criteria are fulfilled. However, with numerous techniques and materials currently available, it is difficult to choose the most suitable treatment modality. A search of the literature available was conducted to validate the decision-making process when planning for a horizontal ridge augmentation procedure. The decision tree proposed in this paper stems from the 3D buccolingual bone width available at the site of implant placement (⋝ 3.5 mm, < 3.5 mm, or 4 to 5 mm). In each dimension, techniques are advised after considering factors such as the tissue thickness, the arch position, and the availability of autogenous bone. The decision tree provides insight on how clinicians can choose the most appropriate and predictable horizontal ridge augmentation procedure to minimize unnecessary complications.


Asunto(s)
Aumento de la Cresta Alveolar/métodos , Árboles de Decisión , Planificación de Atención al Paciente , Pérdida de Hueso Alveolar/clasificación , Pérdida de Hueso Alveolar/cirugía , Proceso Alveolar/patología , Aumento de la Cresta Alveolar/clasificación , Materiales Biocompatibles/uso terapéutico , Sustitutos de Huesos/uso terapéutico , Trasplante Óseo/clasificación , Arco Dental/patología , Implantación Dental Endoósea/instrumentación , Implantes Dentales , Diseño de Prótesis Dental , Regeneración Tisular Guiada Periodontal/métodos , Humanos , Mandíbula/patología , Mandíbula/cirugía , Maxilar/patología , Maxilar/cirugía , Membranas Artificiales , Osteogénesis por Distracción/métodos , Resultado del Tratamiento
5.
Int J Periodontics Restorative Dent ; 30(5): 523-9, 2010 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-20814606

RESUMEN

Alveolar ridge defects resulting from tooth loss, trauma, periodontal disease, or congenital lesions often require correction prior to dental implant therapy. Numerous classifications proposed to describe alveolar ridge defects have been limited to describe intra-arch relationships. To provide sufficient jaw-to-jaw alveolar ridge (interarch) relationship information for both restorative and surgical treatment decision-making, this article introduces a new interarch alveolar ridge relationship classification system. This article also discusses cone beam computed tomography and multidisciplinary treatment planning options for approaching each classification.


Asunto(s)
Pérdida de Hueso Alveolar/clasificación , Aumento de la Cresta Alveolar/clasificación , Aumento de la Cresta Alveolar/métodos , Técnicas de Apoyo para la Decisión , Articuladores Dentales , Implantación Dental Endoósea/métodos , Diseño de Prótesis Dental , Recesión Gingival/clasificación , Gingivoplastia/clasificación , Gingivoplastia/métodos , Humanos , Registro de la Relación Maxilomandibular , Dimensión Vertical
6.
Int J Periodontics Restorative Dent ; 28(4): 383-9, 2008 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-18717377

RESUMEN

Edentulism in the posterior maxilla can present with compounding variables that make it a difficult region to restore with implants. Pneumatization of the sinus floor is typically accounted for during surgical treatment planning, but other factors such as horizontal ridge deficiency and vertical defects may be overlooked. This report reviews the different classifications used to treat the posterior maxilla and introduces a new system that incorporates all factors critical for implant success. Class A represents abundant bone with > or = 10 mm bone height below the sinus floor and > or = 5 mm bone width, allowing proper implant placement. Class B indicates barely sufficient bone with 6 to 9 mm bone height below the sinus floor, and this can be further subclassified into division h (horizontal defect; < 5 mm bone width), division v (vertical defect; > 3 mm away from cementoenamel junction), and division c (combined horizontal and vertical defect). Class C indicates compromised bone with < or = 5 mm bone height below the sinus floor, and this can also be subclassified similar to Class B. The ABC classification is a simple system to guide clinicians in proper implant treatment of the posterior maxilla.


Asunto(s)
Aumento de la Cresta Alveolar/clasificación , Maxilar/cirugía , Seno Maxilar/cirugía , Terminología como Asunto , Cefalometría , Implantación Dental Endoósea/métodos , Implantes Dentales , Humanos , Arcada Edéntula/clasificación , Arcada Edéntula/rehabilitación , Arcada Edéntula/cirugía , Maxilar/patología , Seno Maxilar/patología , Planificación de Atención al Paciente
8.
Int J Periodontics Restorative Dent ; 21(3): 220-31, 2001 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-11490399

RESUMEN

A series of 21 men and 41 women received grafts resulting in mean faciolingual augmentation of 5.1 mm and mean vertical augmentation of 3.9 mm. In most patients, bone was obtained from the iliac crest. At the time of implant placement, the bone at the site was restored anatomically to type B in 50 patients and to type C in 12. The patients received from one to ten posterior implants, which were placed simultaneously with (n = 5) or approximately 6 months after grafting. All of the implants were loaded, with the follow-up ranging from 12 to 96 months (mean 37.3 months). Ceramometal restorations were ultimately used in all patients. Five patients suffered partial graft loss at a total of 21 implants, of which five (24%) failed. The total failure rate for implants placed in patients who received sinus + veneer grafts was 4% (9/222). In patients who received sinus and J grafts, the final implant failure rate was 2%. All implants placed in anteroposterior J grafts and mandibular grafts were successful. Overall, including replacement implants, the failure rate was 7% (23/329). Posterior implants can be placed after graft reconstruction with a success rate similar to that obtained without grafting, thereby improving the function and esthetic outcome.


Asunto(s)
Aumento de la Cresta Alveolar , Trasplante Óseo , Implantación Dental Endoósea , Implantes Dentales , Adulto , Anciano , Anciano de 80 o más Años , Aumento de la Cresta Alveolar/clasificación , Aumento de la Cresta Alveolar/métodos , Matriz Ósea/trasplante , Sustitutos de Huesos/uso terapéutico , Pilares Dentales , Prótesis Dental de Soporte Implantado , Fracaso de la Restauración Dental , Durapatita/uso terapéutico , Estética Dental , Femenino , Estudios de Seguimiento , Supervivencia de Injerto , Humanos , Masculino , Mandíbula/cirugía , Maxilar/cirugía , Seno Maxilar/cirugía , Persona de Mediana Edad , Minerales/uso terapéutico , Oseointegración , Osteotomía/métodos , Trasplante Autólogo , Resultado del Tratamiento
9.
Compend Contin Educ Dent ; 22(1): 13-6, 18, 20 passim; quiz 24, 2001 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-11911055

RESUMEN

A diagnostic and therapeutic approach is offered to enable the surgeon and restorative dentist to successfully install endosseous implants into the vertically enhanced ridge. The strategy involves the use of diagnostic and surgical templates to aid in the creation of positive osseous architecture followed by the vertical orientation of the endosseous implant(s). This effort provides optimal hard-tissue and soft-tissue form for the creation of the most favorable crown profiles for implant-supported prostheses.


Asunto(s)
Aumento de la Cresta Alveolar , Implantación Dental Endoósea/métodos , Pérdida de Hueso Alveolar/diagnóstico , Pérdida de Hueso Alveolar/cirugía , Aumento de la Cresta Alveolar/clasificación , Aumento de la Cresta Alveolar/instrumentación , Modelos Dentales , Humanos , Modelos Anatómicos , Planificación de Atención al Paciente , Grupo de Atención al Paciente
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