Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 3.208
Filtrar
1.
Cient. dent. (Ed. impr.) ; 17(2): 121-127, mayo-ago. 2020. ilus, tab
Artículo en Español | IBECS | ID: ibc-195100

RESUMEN

INTRODUCCIÓN: la reabsorción vertical de la zona posterior del maxilar supone un reto terapéutico para el profesional, ya que son necesarias técnicas regenerativas para poder colocar implantes den-tales. La elevación de seno atraumática permite la colocación de implantes dentales de manera simultánea al procedimiento regenerativo, pero hay controversia en la necesidad o no de emplear materiales de injerto asociados a esta técnica. Ganancia ósea: al comparar la utilización o no de materiales de injerto en elevaciones de seno atraumáticas, se obtiene una ganancia ósea de 1-6.8 mm cuando no se emplean biomateriales, y 3.07-8.5 mm al utilizarlos. Pérdida ósea marginal: los estudios reflejan una pérdida ósea marginal de 0.5-1.54 mm al no emplear materiales de injerto, respecto a 0.7-1.67 mm cuando se utilizan. Supervivencia de implantes: ambas técnicas de elevación de seno atraumática presentan tasas de supervivencia imlantarias similares, superiores al 90 %.Complicaciones: la tasa de complicaciones en esta técnica regenerativa es baja, siendo la más frecuente la perforación de la membrana de Schneider, no suponiendo en la mayoría de los casos un impedimento para la colocación de implantes dentales. CONCLUSIONES: la técnica de elevación de seno sin relleno presenta menor ganancia ósea y pérdida ósea marginal en comparación a la técnica de elevación de seno con relleno, pero ambas técnicas presentan tasas de supervivencia implantarias similares, y una baja tasa de complicaciones, por lo que la utilización o no de biomateriales asociados debe decidirse en función de todas estas variables


INTRODUCTION: vertical resorption of posterior maxilla is a therapeutic challenge for dentists, since regenerative techniques are necessary to be able to place dental implants. Atraumatic sinus lift augmentation allows simultaneous dental implants placement to regenerative procedure, but it is not clear nowadays if it is or not necessary to use associated graft materials. Bone gain: scientific evidence reports a bone gain of 1-6.8 mm without using graft materials, versus 3.07-8.5 mm when authors use graft materials in atraumatic sinus lift augmentations procedures. Marginal bone loss: similar bone loss is expected in both techniques, but atraumatic sinus lift augmentation presents 0.5-1.54 mm when graft material is not used, versus 0.7-1.67 mm when graft material is used. Implant survival: both techniques present similar survival implant rates, greater than 90 %.Complications: low complications rate is reported, being the most frequent complication Schneider membrane perforation. Nevertheless, dental implant placement is possible in spite of this complication. CONCLUSIONS: atraumatic sinus lifting without graft materials presents lower bone gain and marginal bone loss in comparison to atraumatic sinus lifting with graft materials. Both techniques present similar survival implant rates and low complication rates, so using or not grafting materials should be decided analyzing all these variables


Asunto(s)
Humanos , Implantes Dentales , Aumento de la Cresta Alveolar/métodos , Osteotomía , Resorción Ósea/diagnóstico por imagen , Resorción Ósea/terapia , Pérdida de Hueso Alveolar , Seno Maxilar/diagnóstico por imagen , Seno Maxilar/cirugía , Radiografía Panorámica , Tomografía Computarizada de Haz Cónico
2.
Med. oral patol. oral cir. bucal (Internet) ; 25(2): e291-e298, mar. 2020. tab, graf
Artículo en Inglés | IBECS | ID: ibc-196260

RESUMEN

BACKGROUND: This systematic literature review aimed to evaluate the efficacy of allogeneic bone blocks for ridge augmentation by assessing block survival rates and subsequent implant survival, including post-surgical complications and histomorphometric analysis. MATERIAL AND METHODS: An electronic and manual search among references, was conducted up to April 2019 by two independent authors. Inclusion criteria were: human clinical trials in which the outcomes of allogeneic bone block grafts were evaluated by means of their survival rates and subsequent implant success rates. RESULTS: Seven articles fulfilled the inclusion criteria and were analyzed. A total of 323 allogeneic block grafts were monitored for a minimum of 12 months follow-up after surgery, of which thirteen (4.02%) failed. Regarding the cumulative implant survival rate, the weighted mean was 97.36%, computed from 501 implants. Histologic and histomorphometric analysis showed that allogeneic block grafts presented some clinical and microstructural differences in comparison with autologous block grafts. CONCLUSIONS: Atrophic alveolar crest reconstruction with allogeneic bone block grafts would appear a feasible alternative to autologous bone block grafts, obtaining a low block graft failure rate, similar implant survival rate and fewer postoperative complications. Further investigations generating long term data are needed to confirm these findings


No disponible


Asunto(s)
Humanos , Masculino , Femenino , Aumento de la Cresta Alveolar/métodos , Trasplante Óseo/métodos , Trasplante Homólogo/métodos , Complicaciones Posoperatorias , Resultado del Tratamiento , Sesgo
3.
Rev. cuba. estomatol ; 57(1): e2199, ene.-mar. 2020. tab
Artículo en Español | LILACS, CUMED | ID: biblio-1126481

RESUMEN

RESUMEN Objetivo: Comparar los cambios dimensionales de los tejidos peri-implantarios en la zona estética, después de la segunda etapa quirúrgica de injertos de tejido conectivo autógeno comparados con una matriz de colágeno xenogénica, después de 3 meses de cicatrización. Métodos: En una serie de casos de seis pacientes con defectos del reborde alveolar, se realizó un procedimiento de aumento de volumen de tejidos blandos, asignando al azar dos modalidades de tratamiento: injerto de tejido conectivo subepitelial y matriz de colágeno dérmica acelular. Para evaluar los cambios dimensionales se tomaron impresiones antes del aumento y a los 90 días; estas fueron vaciadas para obtener modelos de yeso que fueron digitalizados; las dos imágenes fueron superpuestas; y tras la definición de tres puntos de interés, se calculó mediante un Software (D500 3D dental scanner - 3Shape, Copenhague, Dinamarca), los cambios dimensionales en milímetros. Se indagó por el dolor experimentado por los pacientes usando una escala visual análoga. Resultados: A los 90 días de realizada la cirugía, se observó un aumento en el grosor de los tejidos blandos peri-implantarios de 0,77 mm (rango 0,0-1,3) para el injerto de tejido conectivo, y 0,89 mm (rango 0,3-1,5) para la matriz dérmica acelular. No se encontraron diferencias estadísticamente significativas entre las dos modalidades de tratamiento, en ninguno de los tres puntos evaluados por paciente (p= 0,83; p= 0,83; p= 0,51). En cuanto al dolor experimentado entre el primer y séptimo días, no se encontraron diferencias estadísticamente significativas en la zona receptora intergrupo (p= 0,07; p= 0,12); intragrupo, injerto (p= 0,11) y matriz (p= 0,32); ni en la zona donante del grupo del injerto (p= 0,11). Conclusiones: El aumento en el grosor de los tejidos peri-implantarios fue similar después de 90 días en los dos grupos del estudio(AU)


ABSTRACT Objective: Compare the dimensional changes of peri-implant tissues from the esthetic zone after the second surgical stage of autogenous connective tissue grafting vs. a xenogenic collagen matrix after three months' healing. Methods: A case-series of six patients with alveolar ridge defects underwent a soft tissue volume augmentation procedure, randomly assigning two treatment modes: subepithelial connective tissue graft and acellular dermal collagen matrix. Impressions were taken before augmentation and at 90 days to evaluate the dimensional changes. These were then emptied to obtain plaster models which were then digitalized. The two images were superimposed, and upon definition of three points of interest, the dimensional changes were estimated in millimeters with the software D500 3D dental scanner (3Shape, Copenhagen, Denmark). Inquiries were made about the pain experienced by patients using a visual analogue scale. Results: Ninety days after surgery, increase in thickness of peri-implant soft tissues was 0.77 mm (range 0.0-1.3) for the connective tissue graft and 0.89 mm (range 0.3-1.5) for the acellular dermal matrix. No statistically significant differences were found between the two treatment modes at any of the three points evaluated per patient (p= 0.83, p= 0.83, p= 0.51). With respect to the pain experienced between the first and the seventh days, no statistically significant differences were found in the recipient zone intergroup (p= 0.07, p= 0.12), the graft intragroup (p= 0.11) and the matrix (p= 0.32), or in the donor zone of the graft group (p= 0.11). Conclusions: Increase in the thickness of peri-implant tissues after 90 days was similar in the two study groups(AU)


Asunto(s)
Humanos , Implantes Dentales/efectos adversos , Trasplante de Tejidos/métodos , Aumento de la Cresta Alveolar/métodos , Epidemiología Descriptiva , Estudios Observacionales como Asunto
4.
BMC Oral Health ; 20(1): 36, 2020 02 03.
Artículo en Inglés | MEDLINE | ID: mdl-32013940

RESUMEN

BACKGROUND: Recommendations for soft tissue management associated with customized bone regeneration should be developed. The aim of this study was to evaluate a new protocol for customized bone augmentation in a digital workflow. METHODS: The investigators implemented a treatment of three-dimensional bone defects based on a customized titanium mesh (Yxoss CBR®, ReOSS, Filderstadt, Germany). Patients and augmentation sites were retrospectively analysed focussing on defect regions, demographic factors, healing difficulties and potential risk factors. An exposure rate was investigated concerning surgical splint application, A®- PRF and flap design. RESULTS: In total, 98 implants could be placed. Yxoss CBR® was removed after mean time of 6.53 ± 2.7 months. Flap design was performed as full flap preparation (27.9%), full flap and periosteal incision (39.7%), periosteal incision (1.5%), poncho/split flap (27.9%) and rotation flap (2.9%). In 25% of the cases, exposures of the meshes were documented. Within this exposure rate, most of them were slight and only punctual (A = 16.2%), like one tooth width (B = 1.5%) and complete (C = 7.4%). A®- PRF provided significantly less exposures of the titanium meshes (76.5% no exposure vs. 23.5% yes, p = 0.029). Other parameters like tobacco abuse (p = 0.669), diabetes (p = 0.568) or surgical parameters (mesh size, defect region, flap design) did not influence the exposure rate. Surgical splints were not evaluated to reduce the exposure rate (p = 0.239). Gender (female) was significantly associated with less exposure rate (78,4% female vs. 21.6% male, p = 0.043). CONCLUSIONS: The results of this study suggest that the new digital protocol including patient-specific titanium meshes, resorbable membranes and bone grafting materials was proven to be a promising technique. To improve soft tissue healing, especially A®-PRF should be recommended.


Asunto(s)
Aumento de la Cresta Alveolar , Trasplante Óseo , Mallas Quirúrgicas , Titanio , Aumento de la Cresta Alveolar/instrumentación , Aumento de la Cresta Alveolar/métodos , Trasplante Óseo/instrumentación , Trasplante Óseo/métodos , Femenino , Alemania , Humanos , Masculino , Embarazo , Estudios Retrospectivos , Titanio/química
5.
BMC Oral Health ; 20(1): 22, 2020 01 28.
Artículo en Inglés | MEDLINE | ID: mdl-31992277

RESUMEN

BACKGROUND: Periodontally accelerated osteogenic orthodontics (PAOO) is a treatment for bone defects associated with a lack of bone graft stability, especially in coronal locations. This study aimed to compare a modified technique of membrane fixation that utilizes periosteal sutures (using a pouch design) with the traditional approach, which does not use membrane fixation. METHODS: Twenty-eight patients with a total of 168 teeth treated were divided into two groups: 1-A, in which patients were treated using the modified technique (with membrane fixation), and group 2-B, in which patients were treated using the traditional technique (without membrane fixation). The postoperative bone thickness was evaluated via radiographic examination. RESULTS: Postoperative improvements in bone augmentation were detected in both groups. At 12 months, the values of the CHBT (measured from the midpoint of the coronal third to the labial cortical surface, 0.84 ± 0.33 mm) and the values of VBL (measured from the alveolar crest to the cemento-enamel junction, - 2.35 ± 0.80 mm)were significantly greater in the modified technique group than those in the traditional technique group (CHBT:0.12 ± 0.21 mm and VBL:-1.39 ± 0.99 mm; P = 0.00 and P = 0.01). CONCLUSIONS: This study shows that compared to the traditional technique, the modified PAOO technique with membrane fixation using periosteal sutures provides improved graft stabilization, superior coronal augmentation and satisfactory vertical volume.


Asunto(s)
Proceso Alveolar/cirugía , Trasplante Óseo/métodos , Ortodoncia Correctiva/métodos , Procedimientos Quirúrgicos Ortognáticos/métodos , Osteogénesis/fisiología , Osteotomía/métodos , Aumento de la Cresta Alveolar/métodos , Humanos , Ortodoncia Correctiva/instrumentación , Técnicas de Movimiento Dental/métodos , Resultado del Tratamiento
6.
Biomed Res Int ; 2019: 7679319, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-31531367

RESUMEN

Aims: To assess the bone dimensional changes after extraction and alveolar ridge preservation (ARP) using primary coverage (closed flap technique, CFT) or healing by secondary intention (open flap technique, OFT). Materials and Methods: Ten patients (split mouth design) were planned for extraction and ARP. All sites received ARP with freeze-dried bone allograft (FDBA) and nonresorbable membrane after extraction. Clinical standardized measurements were used to assess the dimensional alterations of the alveolar ridge. Results: All patients completed the study, and a total of 20 sites were randomized to CFT or OFT group. Center height (mean difference of 8.1 mm, SD =1.9 CFT, and 7.5 mm, SD= 1.8 OFT) and buccal height (mean difference of 0.8 mm, SD =1.0 CFT, and 0.3 mm, SD= 1.1 OFT) were significantly different within the same group. However, there was no statistically significant difference between groups. In the OFT group, the keratinized tissue width was higher and the pain VAS scores at 24 hours were lower compared with the CFT (p = 0.004 and p = 0.006, respectively). Conclusions: Leaving the flap open did not have any effects on the dimensional changes of bone height or width. However, there was a wider band of keratinized tissue and less pain with the CFT compared with the OFT. The study protocol was registered at ClinicalTrials.gov, Identifier NCT03136913.


Asunto(s)
Proceso Alveolar/cirugía , Aumento de la Cresta Alveolar/métodos , Preservación Biológica/métodos , Colgajos Quirúrgicos/fisiología , Anciano , Trasplante Óseo/métodos , Femenino , Liofilización/métodos , Humanos , Masculino , Membranas Artificiales , Persona de Mediana Edad , Proyectos Piloto , Extracción Dental/métodos
7.
Rev. esp. cir. oral maxilofac ; 41(3): 126-137, jul.-sept. 2019. tab, graf
Artículo en Español | IBECS | ID: ibc-191776

RESUMEN

OBJETIVO: El propósito de esta revisión fue evaluar sistemáticamente la literatura científica sobre los resultados que se obtienen al combinar la fibrina rica en plaquetas (PRF) y rellenos óseos en la regeneración ósea guiada. MATERIALES Y MÉTODOS: Búsqueda detallada en las bases de datos PubMed, Scopus, Web of Science, ScienceDirect, Cochrane y SciELO para obtener la información más actualizada de los resultados (grado de relleno óseo, éxito de la cirugía, movilidad del implante, complicaciones posquirúrgicas, supervivencia del implante) entre los casos tratados con PRF y los casos donde se combinó PRF con algún tipo de relleno óseo. RESULTADOS: De las 965 publicaciones identificadas inicialmente, se excluyeron reportes clínicos, revisiones, estudios observacionales, etc. Se incluyeron 12 ensayos clínicos que contrastaron las variables entre la técnica con PRF solo y la combinación con un relleno óseo. CONCLUSIÓN: La combinación entre PRF más rellenos óseos promueve la neoformación ósea, aumenta el trabeculado y mejora los tiempos de cicatrización; sin embargo, al cabo de 6 meses de control los resultados no son diferentes significativamente de los de los grupos que no utilizaron PRF en el procedimiento de levantamiento de piso de seno maxilar con técnica de ventana lateral. Respecto a la preservación de reborde alveolar, los distintos estudios no son concluyentes: algunos indican que la mezcla de PRF con un relleno óseo parece mejorar las proporciones volumétricas; sin embargo, otros refirieron pérdidas óseas en anchura e incluso mayor grado de inflamación


OBJECTIVE: To evaluate systematically the results obtained by combining platelet rich fibrin (PRF) and bone fill in guided bone regeneration, according to scientific literature. MATERIALS AND METHOD: Detailed search of database from PubMed, Scopus, Web of Science, ScienceDirect, Cochrane and SciELO to obtain the most updated information of clinical results (bone filling degree, surgical success, implant mobility, post-surgical complications, and implant survival) of the cases treated with PRF and the cases where the platelet rich fibrin was combined with a bone filler. Those results registered and compared. RESULTS: From the 965 files initially identified, were excluded clinical reports, reviews, observational studies, comments, studies with pediatric patients and so on. There were included 12 clinical essays where the variables of the technique with PRF and the technique where the PRF was combined with a bone filler were contrasted. CONCLUSION: The combination of PRF plus bone filler promotes bone neoformation, increased trabecular bones, and improved healing times; however, after 6 months of monitoring, the results were not significantly different with the groups that did not use the PRF in the procedure of maxillary sinus floor lift with lateral window technique. Regarding the preservation of alveolar ridge the different studies are not conclusive: some indicate that the mixture of a concentrate with a bone filling seems to improve the volumetric proportions; however, other studies report bone loss in width and even greater degree of inflammation


Asunto(s)
Humanos , Fibrina Rica en Plaquetas/fisiología , Sustitutos de Huesos/farmacocinética , Regeneración Tisular Guiada Periodontal/métodos , Plasma Rico en Plaquetas/fisiología , Regeneración Ósea/efectos de los fármacos , Pérdida de Hueso Alveolar/cirugía , Aumento de la Cresta Alveolar/métodos , Implantación Dental Endoósea/métodos
8.
Am J Orthod Dentofacial Orthop ; 156(2): 266-274, 2019 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-31375237

RESUMEN

Adult orthodontic treatment involving maxillary transverse deficiency is a challenge for an interdisciplinary team. Surgically assisted rapid palatal expansion to segment the maxilla was once the treatment of choice, but the invasiveness, bone deficiency, and gingival recession hindered its acceptance. Corticotomy-assisted rapid maxillary arch expansion with ridge augmentation has the advantage of augmenting alveolar bony housing to accommodate and facilitate tooth movement. This approach was used to correct a severely constricted maxilla with bilateral posterior crossbite and anterior crowding in a 46-year-old man. Treatment time was 14 months. The accelerated arch expansion overcame the crossbite in 7 months, increasing intercanine distance by 5.2 mm and intermolar distance by 9.8 mm. Subsequent implant prosthesis was able to be restored in a functional normal occlusion. Satisfactory and stable clinical outcome was followed for 7 years. Corticotomy-assisted rapid maxillary arch expansion with alveolar bone augmentation is a novel and effective interdisciplinary approach for correcting adult maxillary transverse deficiency. Well controlled prospective clinical trails are warranted for further investigation.


Asunto(s)
Aumento de la Cresta Alveolar/métodos , Maloclusión/terapia , Técnica de Expansión Palatina , Técnicas de Movimiento Dental/métodos , Cefalometría , Modelos Dentales , Oclusión Dental , Estudios de Seguimiento , Humanos , Masculino , Maloclusión/diagnóstico por imagen , Maloclusión/patología , Maloclusión/cirugía , Maloclusión de Angle Clase II/diagnóstico por imagen , Maloclusión de Angle Clase II/patología , Maloclusión de Angle Clase II/cirugía , Maloclusión de Angle Clase II/terapia , Maloclusión de Angle Clase III/diagnóstico por imagen , Maloclusión de Angle Clase III/patología , Maloclusión de Angle Clase III/cirugía , Maloclusión de Angle Clase III/terapia , Maxilar/anomalías , Maxilar/patología , Maxilar/cirugía , Persona de Mediana Edad , Aparatos Ortodóncicos , Soportes Ortodóncicos , Alambres para Ortodoncia , Paladar (Hueso)/cirugía , Planificación de Atención al Paciente , Estudios Prospectivos , Resultado del Tratamiento
9.
J Craniomaxillofac Surg ; 47(11): 1787-1792, 2019 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-31451343

RESUMEN

For horizontal bone deficiency alveolar ridge osteotomy is considered an option for augmentation. Major advantages are the option for a one-stage approach and the absence of donor site morbidity. However, the conventional technique is associated with complications such as perforations and fractures of the cortical bone. A case using a 3D based modified, full-guided alveolar ridge expansion is described to explain the technique step by step. Main features of modified technique: successive application of surgical guides for ridge osteotomy and expansion - implementation of virtually determined splitting vector, which allows guided bone splitting along a guide surface of template in an ideal direction - osteotomy as deep as implant length. The example shows that the 3D based modified alveolar ridge osteotomy is a suitable alternative to the conventional technique as it has several advantages such as fewer fractures and perforations of the cortical vestibular bone. The individualized preoperative planning helps to minimize complications. However, long-term outcomes and a study, conducted on a study group, is needed to evaluate the benefits of our presented treatment protocol.


Asunto(s)
Aumento de la Cresta Alveolar/métodos , Trasplante Óseo , Implantación Dental Endoósea/métodos , Implantes Dentales , Trasplante Óseo/métodos , Imagenología Tridimensional , Osteotomía
10.
Georgian Med News ; (291): 45-49, 2019 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-31418729

RESUMEN

The objective of the research consisted in the evaluation of the possibility and effectiveness of fibre matrix use in order to maintain the original geometric parameters of the osseous crest in the places of alveolar sockets of the extracted teeth. Patients in the study group underwent filling of a post-extraction alveolar socket by fibre matrix, developed by the authors of the article, with further overlapping with a polymeric membrane (KLS Martin), which was modified in each certain case according to the peculiarities of defect configuration by means of thermoactive pressing method (Patent for invention of Ukraine №114143). Filling or overlapping of the post-extraction alveolar sockets were not performed in patients of the control group. Computed tomography in patients under research was made 4 months after the initial surgical intervention. Analysis of the parameters of the osseous tissue in the places of the alveolar sockets of the removed teeth was conducted 4 months after the extraction on the basis of the cone-beam computed tomography (CBCT) results in the ImageJ software (Wayne Rasband (NIH)) using the specialized BoneJ plugin. In the study group, the average level of resorption of the medial bone wall of the post-extraction socket was 0.6±0.4 mm (range of indices - 0.3-0.8 mm), distal bone wall - 0.4±0.3 mm (range of indices - 0.2-0.6 mm), vestibular bone wall - 1.4±0.7 mm (range of indices - 0.9-2.0 mm), lingual bone wall - 1.2±0.7 mm (range of indices - 0.8-1.9 mm). In the control group, the average level of bone resorption reached 1.4±0.5 mm (range of indices - 0.8-1.7 mm) from the medial side, 0.9±0.6 mm (range of indices - 0.7-1.5 mm) from the distal side, 2.2±0.4 mm (range of indices - 1.5-2.6 mm) from the vestibular side, 2.1±0.6 mm (range of indices - 1.3-2.4 mm) from the oral side. Obtained results indicate a more pronounced effect of an alveolar socket preservation when using fibre matrix compared with the ordinary healing of the tooth extraction region, which was confirmed by the results of the CBCT examination. Therefore, this approach can be recommended for introduction into practice to optimize the conditions for delayed implantation in the area of the teeth removed due to endodontic, periodontal, traumatic lesions or extensive caries pathology with the pronounced inflammatory changes at the time of intervention.


Asunto(s)
Pérdida de Hueso Alveolar/prevención & control , Aumento de la Cresta Alveolar/métodos , Extracción Dental , Alveolo Dental/cirugía , Humanos , Ucrania
11.
Niger J Clin Pract ; 22(7): 977-981, 2019 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-31293264

RESUMEN

Background: An insufficient bone volume at the maxillary anterior region often restricts dental implant treatment and commonly leads to poor aesthetic outcomes. The defective site requires bone grafting as an initial surgical intervention before dental implant placement. In dental implantology, reconstructing osseous defects using autologous block bone grafts, biomaterials, or a combination of both is a routine surgical procedure. This study aims to evaluate the efficacy of autogenous, symphyseal, bone ring block grafts after the augmentation of defective sockets and clinical application of grafts in the maxillary anterior region with immediate insertion of a dental implant in a single surgical procedure. Materials and Methods: The study included eight patients (five females and three males) with 12 defective sockets. The technique included removing the bone from the chin region for transplant, fitting the three-dimensional bone rings in the prepared sockets of the maxillary anterior region, and screwing the dental implants through the rings. Patients underwent postoperative clinical examinations every day during the first week and then every month for 6 months. Results: In two cases, the wound dehisced but healed by secondary intervention during the follow-up period. In one case, the ring graft sequestrated because of infection in postoperative month 2, the osseous defect was reconstructed with biomaterials. The remaining cases healed with no infection, and no other case failed during the first year. Conclusion: This technique showed promising and advantageous results, and thus, could be an alternative treatment to other autogenous graft techniques, particularly for defective sockets.


Asunto(s)
Aumento de la Cresta Alveolar/métodos , Trasplante Óseo/métodos , Implantes Dentales , Maxilar/cirugía , Alveolo Dental/cirugía , Trasplante Autólogo , Adulto , Anciano , Mentón , Femenino , Humanos , Masculino , Persona de Mediana Edad , Osteotomía , Resultado del Tratamiento
12.
Oral Maxillofac Surg Clin North Am ; 31(3): 473-487, 2019 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-31133506

RESUMEN

Traditional reconstruction of major alveolar ridge deficiency has required autogenous cortical cancellous particulate bone grafts, often augmented with particulate allogeneic components. Now there is a new concept to consider, that of orthoalveolar form. This paradigm shift involves components of the tissue engineering triad of inductive growth factors combined with a matrix and stem cells, together with osteotomies or devices designed for space maintenance. Reported here is early experience with computer technology used to redesign deficient alveolar ridges deriving ideal alveolar-shaped bone-forms made from powdered titanium, sintered by laser at high temperature using rapid prototype technology.


Asunto(s)
Aloinjertos/irrigación sanguínea , Proceso Alveolar/cirugía , Aumento de la Cresta Alveolar/métodos , Proteína Morfogenética Ósea 2/uso terapéutico , Trasplante Óseo/métodos , Titanio , Implantación Dental Endoósea , Humanos , Péptidos y Proteínas de Señalización Intercelular/uso terapéutico , Procedimientos Quirúrgicos Reconstructivos/métodos , Cirugía Asistida por Computador
13.
Oral Maxillofac Surg Clin North Am ; 31(2): 163-191, 2019 May.
Artículo en Inglés | MEDLINE | ID: mdl-30947846

RESUMEN

Bone deficiency is the major obstacle in implant dentistry. Guided bone regeneration (GBR) with particulate bone and barrier membranes has been the primary surgical technique used to regenerate alveolar bone for dental implant therapy. This procedure has been used in implant dentistry for more than 30 years and continues to be developed and refined for more predictable surgical outcomes. This article reviews GBR and alternative ride expansion procedures and reviews the use of various particulate graft materials. Alveolar distraction osteogenesis, used as an augmentation technique, is also presented.


Asunto(s)
Pérdida de Hueso Alveolar/cirugía , Aumento de la Cresta Alveolar/métodos , Trasplante Óseo/métodos , Regeneración Tisular Guiada Periodontal/métodos , Proceso Alveolar , Implantación Dental Endoósea , Humanos , Osteogénesis por Distracción/métodos
14.
Oral Maxillofac Surg Clin North Am ; 31(2): 331-338, 2019 May.
Artículo en Inglés | MEDLINE | ID: mdl-30947850

RESUMEN

Guided bone regeneration is an effective alternative for the reconstruction of atrophic ridges. Adequate flap management together with immobilization of the barrier membrane and graft are crucial to ensure successful regenerative radiographic and clinical outcomes. Moreover, tension-free flap closure should be accomplished to guarantee to maximize the effectiveness of guided bone regeneration.


Asunto(s)
Pérdida de Hueso Alveolar/cirugía , Aumento de la Cresta Alveolar/métodos , Implantes Dentales , Regeneración Tisular Guiada Periodontal/métodos , Procedimientos Quirúrgicos Reconstructivos/métodos , Regeneración Ósea , Trasplante Óseo , Humanos , Colgajos Quirúrgicos
15.
PLoS One ; 14(4): e0215092, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-30986268

RESUMEN

Recent improvements in additive manufacturing technologies may facilitate the use of customized 3D printed grafts for horizontal and vertical augmentation of the atrophic alveolar ridge. The accurate fit of such grafts could reduce the clinical treatment time and contribute optimal bone regeneration. The aim of this in vitro study was to evaluate the marginal and internal fit of 3D printed resin grafts as they could be used for alveolar ridge augmentation. Alveolar ridge morphologic data were derived from the Cone Beam Computed Tomography (CBCT) scans of six patients with alveolar bone defects. These data were transferred to a segmentation program to produce virtual 3D reconstructions of the alveolar ridge models. Using a Computer Aided Design (CAD) program, the alveolar bone defects were defined and customized grafts were designed and both the defects as well as the grafts generated (CAM) as 3D projects. These projects were imported into a 3D printer and were manufactured in resin. Hereafter, the grafts were fitted to the defect sites of the corresponding models and new CBCT scans were performed. Based on these scans, measurements were made at the marginal and internal part of the fitted grafts to evaluate the marginal and internal fit, respectively. The statistical analysis revealed that the mean marginal fit was significantly better (P < 0.05) than the mean internal fit. The fit of the grafts was dependent on the shape and on the size of the grafts. Specifically, the total void surface between the fitted graft and the corresponding defect site was significantly larger in the large-defect grafts than the small-defect grafts (P < 0.05). Within the limitations of the study, it could be demonstrated that it is possible to fabricate 3D printed resin grafts with acceptable fit in customized shapes, when combining CBCT scans and computer aided design and 3D printing techniques.


Asunto(s)
Pérdida de Hueso Alveolar/cirugía , Aumento de la Cresta Alveolar/métodos , Trasplante Óseo/instrumentación , Diseño Asistido por Computadora , Impresión Tridimensional/instrumentación , Pérdida de Hueso Alveolar/diagnóstico por imagen , Regeneración Ósea , Tomografía Computarizada de Haz Cónico , Diseño de Prótesis Dental , Humanos , Técnicas In Vitro , Proyectos Piloto
16.
Int J Oral Maxillofac Implants ; 34(2): 471-480, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-30883623

RESUMEN

PURPOSE: The aim of this clinical study was to evaluate the long-term outcome of the split bone block (SBB) technique for vertical bone augmentation in the posterior maxilla in combination with sinus floor elevation using a tunneling approach. MATERIALS AND METHODS: Patients were treated for extensive vertical and horizontal alveolar bone defects without simultaneous implant placement and followed up for at least 10 years postoperatively. Autogenous bone blocks were harvested from the mandibular retromolar area following the MicroSaw protocol. The harvested bone blocks were split longitudinally according to the SBB technique. Implants were inserted and exposed after every 3 months, and prosthetic restoration was performed. RESULTS: One hundred forty-two consecutively treated patients, 154 grafted sites, and 356 inserted implants were documented. Minimal graft exposure (1 to 3 mm) 4 to 8 weeks postoperatively was documented in two sites; infection of the grafted area occurred in one other case. The mean preoperative clinical vertical defect was 7.8 ± 3.9 mm, and the mean horizontal width was 3.1 ± 2.2 mm. Postoperatively, the mean vertical gained dimension was 7.6 ± 3.4 mm (maximum: 13 mm), and the mean width was 8.3 ± 1.8 mm. Implants could be inserted in all sites, with additional local small augmentation in 21 cases. The amount of maximum vertical bone resorption was 0.21 ± 0.18 mm after 1 year, 0.26 ± 0.21 mm after 3 years, 0.32 ± 0.19 mm after 5 years, and 0.63 ± 0.32 mm after 10 years. As part of a total patient dropout of 16.9%, four implants were lost within 10 years. The mean vertically gained bone was stable at 6.82 ± 0.28 mm (maximum: 12 mm). The resorption rate after 10 years was 8.3%. CONCLUSION: The described tunneling flap approach allows a hermetic soft tissue closure, characterized by a reduction of dehiscence and a secure bone graft healing. The combination of thin autogenous bone blocks and bone particles according to the SBB technique allows an acceleration of transplant revascularization, and thus, of graft regeneration, allowing a shortening of the patient treatment time as well as long-term three-dimensional volumetric bone stability.


Asunto(s)
Aumento de la Cresta Alveolar/métodos , Trasplante Óseo/métodos , Implantación Dental Endoósea/métodos , Maxilar/cirugía , Elevación del Piso del Seno Maxilar/métodos , Adulto , Anciano , Anciano de 80 o más Años , Resorción Ósea/patología , Femenino , Humanos , Estudios Longitudinales , Masculino , Mandíbula/cirugía , Persona de Mediana Edad , Procedimientos Quirúrgicos Reconstructivos/métodos , Colgajos Quirúrgicos/cirugía
17.
Oral Maxillofac Surg Clin North Am ; 31(2): 317-330, 2019 May.
Artículo en Inglés | MEDLINE | ID: mdl-30852175

RESUMEN

Bone grafting has become an integral part of implant dentistry. To achieve a predictable long-term outcome for osseointegrated implants, a sufficient volume and quality of alveolar bone must be present at implant recipient sites. Resorption of the alveolar ridge and postsurgical or post-traumatic defects of the residual alveolar bone can prevent ideal placement of a dental implant. Thus, in many cases, alveolar bone grafting is the real challenge in implant reconstruction. This article will discuss the various techniques and graft materials for alveolar ridge reconstruction of the mandible. It also compares and contrasts these techniques by reviewing the current literature.


Asunto(s)
Aumento de la Cresta Alveolar/métodos , Trasplante Óseo , Implantes Dentales , Mandíbula/cirugía , Autoinjertos/trasplante , Implantación Dental Endoósea , Humanos
18.
Oral Maxillofac Surg Clin North Am ; 31(2): 299-308, 2019 May.
Artículo en Inglés | MEDLINE | ID: mdl-30852176

RESUMEN

The edentulous posterior maxilla poses challenges to reconstruction. Posterior forces are great, yet bone quality and quantity are diminished. There is frequent loss of bone resulting from ridge resorption as well as sinus pneumatization. There are also advantages of placing implants in the posterior maxilla compared with the anterior maxilla, such as improved hygiene, esthetics and phonetics, and biomechanical load distribution. This article will present strategies and techniques for improving implant support in the posterior maxilla through various grafting techniques.


Asunto(s)
Pérdida de Hueso Alveolar/cirugía , Aumento de la Cresta Alveolar/métodos , Trasplante Óseo/métodos , Implantes Dentales , Arcada Edéntula , Maxilar/cirugía , Implantación Dental Endoósea , Prótesis Dental de Soporte Implantado , Estética Dental , Humanos , Arcada Edéntula/patología , Arcada Edéntula/cirugía , Maxilar/patología , Resultado del Tratamiento
19.
Oral Maxillofac Surg Clin North Am ; 31(2): 309-315, 2019 May.
Artículo en Inglés | MEDLINE | ID: mdl-30852177

RESUMEN

There are several methods of regenerating the maxillary and mandibular ridge to achieve orthoalveolar form with bone grafting procedures, including block onlay grafting and guided bone regeneration. Traditionally, guided bone regeneration has focused on creating a space for bone regeneration to occur. The use of a formed titanium mesh to regenerate alveolar defects was popularized in the 1980s. With the advent of other adjuncts, such as resorbable membranes, and growth factors, such as recombinant human bone morphogenetic protein 2, the predictability of the procedure has increased and a wide variety of defects can be restored using this technology.


Asunto(s)
Pérdida de Hueso Alveolar/cirugía , Aumento de la Cresta Alveolar/métodos , Proteína Morfogenética Ósea 2/uso terapéutico , Trasplante Óseo/métodos , Implantes Dentales , Mallas Quirúrgicas , Titanio , Materiales Biocompatibles/química , Proteína Morfogenética Ósea 2/administración & dosificación , Implantación Dental Endoósea/métodos , Humanos , Procedimientos Quirúrgicos Reconstructivos , Trasplante Autólogo , Resultado del Tratamiento
20.
Clin Oral Investig ; 23(12): 4263-4287, 2019 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-30859329

RESUMEN

AIM: The aim of this systematic review was to critically evaluate the currently existing clinical evidence on the efficacy of autogenous teeth (AT) for the reconstruction of alveolar ridge deficiencies. MATERIALS AND METHODS: A search protocol was developed to answer the focused question: "In patients exhibiting alveolar ridge deficiencies and being in need of an implant retained restoration, what is the efficacy of reconstructive procedures employing AT on changes in ridge dimensions compared with control measures?" Uncontrolled studies were also included to assess the overall efficacy of AT for specific procedures. RESULTS: A total of six studies (one randomized, one non-randomized controlled, two observational, one controlled case series, one retrospective) were identified. Two studies used AT for staged lateral augmentation, whereas four studies used AT as a demineralized dentin matrix (AutoBT) for the simultaneous grafting of dehiscence-type defects, vertical augmentation of post-extraction sockets, and lateral/transcrestal sinus floor elevation. The reported clinical outcomes following the application of either AT or AutoBT were within the range of those data noted in the respective control groups. Adverse events were commonly not observed. CONCLUSIONS: The available limited studies involved relatively small patient samples and short follow-up periods but pointed to the potential of AT to serve as an alternative material for the reconstruction of alveolar ridge deficiencies. CLINICAL RELEVANCE: AT appear to be effective in reconstructing alveolar ridge deficiencies.


Asunto(s)
Aumento de la Cresta Alveolar/métodos , Trasplante Óseo , Implantación Dental Endoósea , Reconstrucción Mandibular/métodos , Proceso Alveolar , Humanos , Elevación del Piso del Seno Maxilar
SELECCIÓN DE REFERENCIAS
DETALLE DE LA BÚSQUEDA
...