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(1) Aim: To investigate the effect of synthetic bone substitutes, α-tricalcium phosphate (α-TCP) or bi-layered biphasic calcium-phosphate (BBCP) combined with deproteinized bovine bone mineral (DBBM), on bone formation. (2) Methods: Thirty critical size defects were randomly treated with the following five different treatment modalities: (1) negative control (NC, empty), (2) DBBM, (3) α-TCP + DBBM (1:1), (4) BBCP 3%HA/97%α-TCP + DBBM (1:1), and (5) BBCP 6%HA/94%α-TCP + DBBM (1:1). The samples, at four weeks post-surgery, were investigated by micro-CT and histological analysis. (3) Results: A similar level of new bone formation was demonstrated in the DBBM with α-TCP bone substitute groups when compared to the negative control by histomorphometry. DBBM alone showed significantly lower new bone area than the negative control (p = 0.0252). In contrast to DBBM, the micro-CT analysis revealed resorption of the α-TCP + DBBM, BBCP 3%HA/97%α-TCP + DBBM and BBCP 6%HA/94%α-TCP + DBBM, as evidenced by a decrease of material density (p = 0.0083, p = 0.0050 and p = 0.0191, respectively), without changing their volume. (4) Conclusions: New bone formation was evident in all defects augmented with biomaterials, proving the osteoconductive properties of the tested material combinations. There was little impact of the HA coating degree on α-TCP in bone augmentation potential and material resorption for four weeks when mixed with DBBM. [ABSTRACT FROM AUTHOR]

This study aimed to evaluate the clinical efficacy and histological outcomes of autogenous demineralised dentin matrix (ADDM) as bone graft material compared with Bio-Oss® in bone augmentation for the treatment of patients with oral bone deficits. Eight databases (PubMed, EMBASE, Cochrane Library, Science Direct, Scopus, Web of Science, CNKI, and WFPD) were searched for randomised controlled trials (RCT) performed from the date of inception of each database to July 2021. The Cochrane Collaboration's risk assessment tool was used to conduct the methodological quality assessment. Stata 15.0 software was used to perform data analysis. Seven RCTs including 220 patients were considered eligible for this study. No significant difference was found in the percentage of new bone formation (NBF) and implant stability quotient (ISQ). Patients who received ADDM grafting showed a significantly lower sinus height (SH) and percentage of residual graft material (RGM) compared with Bio-Oss® grafting. ADDM is as effective as Bio-Oss® in bone augmentation for oral bone defects. [ABSTRACT FROM AUTHOR]

Creating an esthetic implant restoration with gingival architecture and an emergence profile that harmoniously blend with the adjacent dentition is a challenge. It is even more difficult when there are multiple missing adjacent teeth. A vital part of the emergence profile is established by the periodontium and its overlying tissue thickness and height; these factors therefore must also be carefully considered to help ensure optimal esthetic results. This article discusses the various factors that affect soft tissue height and thickness and offers strategies for managing and enhancing peri-implant soft tissue esthetics. [ABSTRACT FROM AUTHOR]

The goal of this systematic study was to compare the survival rate (SR), marginal bone loss (MBL) and clinical complications between extra‐short implants (≤6 mm) and 6‐mm‐longer implants in randomized clinical trials. A systematic electronic and manual search was performed using the PubMed, Web of Science, Scopus and DOAJ databases. A meta‐analysis was conducted to compare the SR and MBL between both groups. We have selected 17 studies out of 1016 articles for qualitative and quantitative analysis. The data from 956 patients and 1779 implants were used with an overall mean clinical follow‐up of 3.88 years ranging from 1 to 8 years. Overall, the SR of extra‐short implants (93.12%) was lower than the observed in 6‐mm‐longer implants (95.98%); however, there was no statistical significance on these findings (P > 0.10). MBL analysis showed that extra‐short implants and the 6‐mm‐longer group presented an average of −0.71 and −0.92 mm after 1‐year respectively. Three years follow‐up showed MBL of −0.42 mm (≤6 mm) and −0.43 mm (>6 mm); 5 years follow‐up showed an MBL of −0.69 mm (≤6 mm) and −0.46 mm (>6 mm); and after 8 years of follow‐up, it was found an MBL of −1.58 mm (≤6 mm) and −2.46 mm (>6 mm). Within the limitation of this study, the results indicated that SR of extra‐short implants was similar to 6‐mm‐longer implants. In contrast, MBL and the presence of clinical complications were observed at a lessened rate on extra‐short implants. [ABSTRACT FROM AUTHOR]

Volumetric resorption of the alveolar ridge often occurs in both horizontal and vertical directions following tooth extraction. There is a specific lack of evidence for alveolar ridge reconstruction at molar and premolar sites with severe bone resorption. This randomized controlled trial used 3D and linear analyses to evaluate volumetric changes of the alveolar bone following alveolar ridge reconstruction (ARR) at molar and premolar sites with severe bone resorption as compared to unassisted socket healing before implant placement. A total of 31 patients (15 men, 16 women) with > 50% hard tissue loss in one or more socket walls were recruited and randomized into either a test group (postextraction ARR using deproteinized bovine bone mineral with 10% collagen [DBBM-C] and platelet-rich fibrin [PRF] with a resorbable collagen membrane) or a control group (natural healing after extraction). The clinical, linear, and volumetric implant-related and patient-reported outcomes were analyzed after 4 months of healing. Linear bone assessments revealed significantly greater ridge width gains in the test group (25% in the mesial, midfacial, and distal aspects) and less reduction of vertical bone ridge than in the control group (P < .05). Further, volumetric bone remodeling was significantly higher in the test group (35.1% ± 34.9% for ARR, 14.2% ± 12.8% for control; P < .05). Patient-reported discomfort and keratinized mucosal changes were comparable between groups. ARR with a combination of DBBM-C, PRF, and a resorbable membrane at posterior sites with a severe socket wall deficiency (> 50% bone loss) is a safe and more capable therapeutic method when compared to natural healing and unassisted sockets. Collectively, the present analyses demonstrate that ARR represents an efficient method to maintain and augment crestal bone at posterior extraction sites with severe bone defects when assessed after 4 months of healing.

A labially impacted maxillary canine is a relatively uncommon occurrence. In adult patients, management of impacted maxillary canines becomes necessary when the deciduous canine is lost, or if the impacted tooth becomes symptomatic. Orthodontic realignment is not always the preferred therapeutic approach due to the long treatment duration. Alternatively, prosthetic rehabilitation of the missing tooth with a dental implant can serve as a viable treatment option. This article describes a case involving a labially impacted permanent maxillary canine in a 36-year-old woman, who had a primary complaint of discoloration of the corresponding primary tooth, which was rehabilitated with an immediate implant and bone graft along with treatment of the discolored tooth. This case supports the use of a single implant for replacing an impacted tooth, eliminating the need for conventional tooth preparation in prosthetic rehabilitation or extended orthodontic intervention to reposition the impacted tooth. The treatment resulted in exceptional aesthetic outcomes. The combination of immediate implant placement with hard tissue augmentation facilitated alveolar bone reconstruction and shortened the overall treatment time., Competing Interests: Human subjects: Consent was obtained or waived by all participants in this study. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work., (Copyright © 2024, Dhawan et al.)

Transcrestal maxillary sinus floor elevation is an effective method to solve the problem of insufficient bone height in the posterior maxillary region. However, current methods, such as osteotome sinus floor elevation, cushioned grind-out technique, Smart Drill technique, etc., require specialized surgical tool boxes. In this article, we introduce a new method of transcrestal maxillary sinus elevation that uses built-in reamers of various implant systems to scrap residual bone at the sinus floor and uses the implant to push the sinus membrane during implant placement. This technique is easy to operate and time saving and has a low rate of sinus membrane perforation. After a one-year follow-up observation of 146 people and 175 implants, the endo-sinus bone gains were 5.00 (4.70, 5.30) mm and 2.10 (1.40, 2.70) mm in the group of 3 mm≤residual bone height (RBH)<5 mm and the group of 5 mm≤RBH<8 mm, respectively, which can meet the clinical requirements of implant stability. This technique is suitable in generalizing dental implantation.

Introduction: One of the most challenging cases in implantology is severely atrophic alveolar ridges which do not have adequate bone for implant placement. One common treatment option for dealing with this challenge is LeFort I osteotomy with inlay bone graft which allows implant insertion and correction of the maxillomandibular relationship simultaneously. Although this method has a high success rate, it is somewhat invasive and has potential complications in some cases. In recent decades, implant surgeons have focused on less invasive and more predictable treatment options for bone augmentation and implant rehabilitation. Now a question comes into mind when there are not much discrepancies in maxillomandibular skeletal relationship and inter arch distance, do we really need LeFort I down-grafting and take its risks? Methods: In this study, we present a case who did not need any change in the skeletal relationship of the jaws and inter arch space based on examination and prosthetic consultation, so we implemented bilateral simultaneous sinus and nasal floor augmentation instead of LeFort 1 interpositional inlay bone graft. Results: Six months after the surgery, new radiography showed adequate height and width of augmented bones gained in and under sinuses and nose floor. So there is no limitation on choosing suitable implant lengths and diameters. Conclusion: This study indicated successful augmentation of severely resorbed maxillary alveolar ridge with bilateral sinus and nose floor grafting technique instead of LeFort I interpositional bone graft in a case who didn’t have more discrepancies in skeletal and inter arch space.

Background: An effective regenerative protocol is key to reestablish and maintain the hard and soft tissue dimensions over time. The choice of the graft material and its properties also could have an impact on the results. To prevent alveolar ridge dimensional changes, since numerous graft materials have been suggested and in the past years, a growing interest in teeth material has been observed as a valuable alternative to synthetic biomaterials. Aim: The aim of the study was to explore the histomorphometric outcomes of tooth derivative materials as used as bone substitute material in socket preservation procedure. Methods: After alveolar socket preservation (ASP) procedures using autologous demineralized tooth as graft material prepared by means of an innovative device, was evaluated. A total of 101 histological samples, from 96 subjects, were analyzed by evaluating the total amount of bone (BV), residual tooth material (residual graft, TT), and vital bone (VB). The section from each sample was then split in nine subsections, resulting in 909 subsections, to allow statistical comparison between the different areas. Results: It was not noticed a statistically significant difference between maxillary and mandibular sites, being the amount of VB in upper jaw sites 37.9 ± 21.9% and 38.0 ± 22.0% in lower jaw sites and the amount of TT was 7.7 ± 12.2% in maxilla and 7.0 ± 11.1% in mandibles. None of the other considered parameters, including defect type and section position, were statistically correlated to the results of the histomorphometric analysis. Conclusions: ASP procedure using demineralized autologous tooth‐derived biomaterial may be a predictable procedure to produce new vital bone potentially capable to support dental implant rehabilitation. [ABSTRACT FROM AUTHOR]

Bone graft materials are applied in patients to augment bone defects and enable the insertion of an implant in its ideal position. However, the currently available augmentation materials do not meet the requirements of being completely resorbed and replaced by new bone within 3 to 6 months. A novel electrospun cotton-wool like material (Bonewool®, Zurich Biomaterials LLC, Zurich, Switzerland) consisting of biodegradable poly(lactic-co-glycolic) acid (PLGA) fibers with incorporated amorphous ß-tricalcium phosphate (ß-TCP) nanoparticles has been compared to a frequently used bovine derived hydroxyapatite (Bio-Oss®, Geistlich Pharma, Wolhusen, Switzerland) in vitro. The material composition was determined and the degradation behavior (calcium release and pH in different solutions) as well as bioactivity has been measured. Degradation behavior of PLGA/ß-TCP was generally more progressive than for Bio-Oss®, indicating that this material is potentially completely resorbable. [ABSTRACT FROM AUTHOR]

Alloplastic and xenogeneic bone grafting materials are frequently used for bone augmentation. The effect of these materials on precursor cells for bone augmentation is yet to be determined. The aim of this study was to ascertain, in vitro, how augmentation materials influence the growth rates and viability of human unrestricted somatic stem cells. The biocompatibility of two xenogeneic and one alloplastic bone graft was tested using human unrestricted somatic stem cells (USSCs). Proliferation, growth, survival and attachment of unrestricted somatic stem cells were monitored after 24 h, 48 h and 7 days. Furthermore, cell shape and morphology were evaluated by SEM. Scaffolds were assessed for their physical properties by Micro-CT imaging. USSCs showed distinct proliferation on the different carriers. Greatest proliferation was observed on the xenogeneic carriers along with improved viability of the cells. Pore sizes of the scaffolds varied significantly, with the xenogeneic materials providing greater pore sizes than the synthetic inorganic material. Unrestricted somatic stem cells in combination with a bovine collagenous bone block seem to be very compatible. A scaffold's surface morphology, pore size and bioactive characteristics influence the proliferation, attachment and viability of USSCs. [ABSTRACT FROM AUTHOR]

This study aimed to evaluate the usefulness of a novel titanium membrane (Ti honeycomb membrane), which has ultrafine structures with dense microperforations, for the alveolar bone augmentation including guided bone regeneration (GBR). Fifteen patients with 17 bone defects underwent alveolar bone augmentation surgery using the membranes with autologous bone grafting plus beta-tricalcium phosphate (β-TCP) (n = 9) or with β-TCP alone (n = 8). The membranes were removed at 6–8 months postoperatively, and the regenerated bone was evaluated clinically. In addition, the prognosis of the implants placed in the augmented bones was assessed. Postoperative courses were uneventful in 14 sites without membrane exposures, in which CT analysis showed the bone volume required to place the implants and significantly higher bone density in the sites with autologous bone grafting plus β-TCP than in the sites with β-TCP alone (p = 0.019). In contrast, membrane exposures were found in three sites (17.6%) at< 4 weeks postoperatively (early membrane exposure) and the bone augmentations resulted in failure; however, implants could be placed in two of the three sites. Finally, the overall success rate of bone augmentation and implants placed in the augmented bone were 82.4% and 93.3%, respectively. This membrane was proved to be useful for alveolar bone augmentation, especially when using autologous bone grafting plus β-TCP; however, more efficient operative techniques are required to prevent early membrane exposure. [ABSTRACT FROM AUTHOR]

Background: Implant installation with conventional drilling can create buccal bone defects in areas of limited ridge thickness. Implant installation with osseodensification may aid in preventing buccal bone defects in these situations. This in vitro pilot study evaluated the impact of osseodensification on the increase in alveolar ridge thickness and the prevention of buccal peri-implant defects. Methods: Ten fresh pig mandibles with limited bone thickness were selected for use in an experimental randomized split mouth pilot study. Two site-preparation protocols were used: conventional drilling with cutting burs (CTL, n = 10) and osseodensification with Densah® burs (OD, n = 10). After implant bed preparation, 20 implants (4.5 × 10 mm) were placed in the prepared sites and the insertion torque was recorded. Clinical and photographic analysis evaluated ridge thickness and the extent (height, width, and area) of bone defects in the buccal and lingual bone walls following implant placement. Three-dimensional measurements were performed using STL files to analyze the increase in buccal ridge thickness following site preparation and implant placement. The height of the buccal bone defect was considered as the primary outcome of this study. Defect width, area, implant insertion torque, and linear buccal ridge increase after implant site preparation and installation were also assessed. Non-parametric evaluations were carried out with the Mann–Whitney test to verify intergroup differences. Results: There was no statistically significant difference between groups in the baseline ridge thickness. OD presented a significantly higher insertion torque, associated with reduced buccal and lingual bone defect width, in comparison to CTL. Conclusions: The increase in buccal ridge thickness after site preparation and implant placement was significantly higher in OD compared to CTL. Osseodensification increased the ridge thickness through expansion and reduced buccal bone defects after implant installation. [ABSTRACT FROM AUTHOR]

Objective·To explore the effect of a tent-pole screw technology on reconstruction of severe alveolar bone defect. Methods·Thirty patients underwent tent-pole screw technology to reconstruct severe alveolar bone defects in the Department of Stomatology, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine from January 2018 to January 2021 were enrolled. By analyzing and reconstructing the image data of cone-beam computed tomography (CBCT) before and 8 months after operation, the effects of repairing and reconstructing the horizontal, vertical and mixed alveolar bone defects were counted. The alveolar bone volumetric parameters were evaluated by micro-computed tomography (Micro-CT), and trabecular bone number (Tb. N), trabecular bone thickness (Tb. Th), bone volume/total volume (BV/TV) and bone mineral density (BMD) were calculated to assess the maturity of regenerated bone. The regeneration of alveolar bone and remanent scaffold were calculated by analyzing histological sections. Results·Eight months after using the tent-pole screw, the vertical bone gain value was 4.81 (1.58, 7.66) mm, and the horizontal post-operative width was 3.96 (2.38, 5.67) mm. Additionally, the bone volume gain was 2 157.22 (776.59, 2 831.63) mm³. Micro-CT analysis of bone core, which was collected 8 months after the surgery, and Tb. N was (3.09±0.68)/mm, Tb. Th was (0.08±0.01) μm, BV/TV was (25.24±5.60)% and BMD was (0.24±0.05) g/cm³. Histological sections showed that the percentages of regenerated bone and remanent scaffold were (16.30±3.57)% and 34% (31.75%, 38.25%), respectively. These data suggested good new bone formation in targeted area. There were no complications or adverse events during surgery or post-operative healing. Conclusions·Based on"stability-oriented"alveolar ridge augmentation, using tent-pole screw, membrane pins and packaging structure in a standard operation procedure can achieve beneficial results for bone augmentation, while complications seldom occurre. The tent-pole screw may offer predictable and exceptional outcomes for implantation site preparation, especially for large alveolar defects, which will provide advantages to subsequent implantation and restoration. [ABSTRACT FROM AUTHOR]

Abstract Background There is little information available regarding the decision-making process of clinicians, especially in the choice of therapy for a severely atrophic tooth gap. The aim of this research was to use case vignettes to determine the influence of possible factors on the decision making of maxillofacial and oral surgeons. Methods A total of 250 maxillofacial (MFS) and oral (OS) surgeons in southern Germany were surveyed for atrophic single- or multiple-tooth gap with the help of case vignettes. The influence of different determinants on the therapy decision was investigated. Two case vignettes were designed for this purpose: vignette 1 with determinants “patient age” and “endocarditis prophylaxis” and vignette 2 with determinants “anxiety” and “bisphosphonate therapy”. Furthermore, the specialist designation was assessed for both. The options available to achieve a sufficient implant site were "bone split", "bone block", "augmentation with bone substitute material" and "bone resection". Therapy was either recommended or rejected based on principle. Results A total of 117 participants returned the questionnaire: 68 (58%) were OS and 49 (42%) MFS. “Patient age” and “patient anxiety” were not significantly associated with any therapy decision. However, required “endocarditis prophylaxis” led to significantly higher refusal rates for "bone split", "bone block" and "bone replacement material" and to higher rates of general refusal of a therapy. “Bisphosphonate therapy” was significantly associated with general refusal of therapy, but with no significant correlation with different therapy options. In vignette 1, OS refused therapy significantly more often than MFS, though there was no association with the specialist designation for other therapy modalities. In vignette 2, specialty was not significantly associated with the therapy decision. Conclusion “Patient age” as well as “patient anxiety” appear to have no or little influence on the treatment decision for severely atrophic single- or multiple-tooth gap by specialist surgeons. Surgeons more often refuse treatment for patients with endocarditis prophylaxis and bisphosphonate therapy.

Abstract Background The purpose of the present study was to test the H0-hypothesis of no difference in the clinical and radiographical treatment outcome of single-crown restorations supported by short implants compared with standard length implants in conjunction with maxillary sinus floor augmentation (MSFA) after 1 year of functional implant loading. Forty patients with partial edentulism in the posterior part of the maxilla were randomly allocated to treatment involving single-crown restorations supported by short implants or standard length implants in conjunction with MSFA. Clinical and radiographical evaluation were used to assess survival of suprastructures and implants, peri-implant marginal bone loss (PIMBL), biological, and mechanical complications. Results Both treatment modalities were characterized by 100% survival of suprastructures and implants after 1 year. Mean PIMBL was 0.60 mm with short implants compared with 0.51 mm with standard length implants after 1 year of functional loading. There were no statistically significant differences in survival of suprastructure and implants, PIMBL, and mechanical complications between the two treatment modalities. However, a higher incidence of biological complications was associated with standard length implants in conjunction with MSFA. Conclusion Within the limitations of the present study, it can be concluded that single-crown restorations supported by short implants seems to be comparable with standard length implants in conjunction with MSFA. However, long-term studies are needed before final conclusions can be provided about the two treatment modalities. Trial registration Clinicaltrials.Gov ID: NCT04518020 . Date of registration: August 14, 2020, retrospectively registered.

Abstract Background This systematic review aimed to propose a treatment protocol for repairing intraoperative perforation of the Schneiderian membrane during maxillary sinus floor augmentation (MSFA) procedures with lateral window technique. In turn, to assess subsequent implant survival rates placed below repaired membranes compared with intact membranes and therefore determine whether membrane perforation constitutes a risk factor for implant survival. Material and methods This review was conducted according to PRISMA guidelines. Two independent reviewers conducted an electronic search for articles published between 2008 and April 30, 2020, in four databases: (1) The National Library of Medicine (MEDLINE/PubMed) via Ovid; (2) Web of Science (WOS); (3) SCOPUS; and (4) Cochrane Central Register of Controlled Trials (CENTRAL); also, a complementary handsearch was carried out. The Newcastle-Ottawa Quality Assessment Scale was used to assess the quality of evidence in the studies reviewed. Results Seven articles fulfilled the inclusion criteria and were analyzed. A total of 1598 sinus lift surgeries were included, allowing the placement of 3604 implants. A total of 1115 implants were placed under previously perforated and repaired membranes, obtaining a survival rate of 97.68%, while 2495 implants were placed below sinus membranes that were not damaged during surgery, obtaining a survival rate of 98.88%. The rate of Schneiderian membrane perforation shown in the systematic review was 30.6%. In the articles reviewed, the most widely used technique for repairing perforated membranes was collagen membrane repair. Conclusions Schneiderian membrane perforation during MFSA procedures with lateral approach is not a risk factor for dental implant survival (p=0.229; RR 0.977; 95% CI 0.941-1.015). The knowledge of the exact size of the membrane perforation is essential for deciding on the right treatment plan.

The aim of this study was the evaluation of the osseointegration degree of two synthetic bone augmentation materials, a commercial product and an experimental one, using the optical coherence tomography. We made two study groups composed of 8 laboratory Whistar rats on which we created experimental cavities with a diameter of 3 mm at the level of the parietal bone and mandible. Samples were obtained from both calvaria and the mandible of the animals after two months for first study group and after four months for the other. Optical coherence tomography (OCT) was used for a non-destructive evaluation of the surface and subsurface of bone tissue. The results of our study showed in general a good integration of the inserted materials; in some cases the healing of the augmented cavities with the experimental material was faster, while the commercial material offered a more reproducible healing pattern.

Purpose: To evaluate long-term survival rates and radiographic stability of sinus floor elevations carried out using a two-layer grafting technique. Materials and Methods: Records were analyzed for patients treated with sinus floor elevations using a modified technique. Phycogenic hydroxyapatite (Algipore, Dentsply Sirona Implants) and autogenous bone particles harvested from intraoral sites were grafted in two distinct layers after elevation of the sinus mucosae. In this approach, the basal part of the sinus floor is grafted with autogenous bone, while the cranial part is grafted with the phycogenic hydroxyapatite. In some cases, implants were placed simultaneously, such that the entire surface of each implant was covered by autogenous bone particles. A titanium membrane was used to close the sinus window, and the implants were loaded 3 months later. In two-stage approaches, the implants were inserted 3 to 4 months after the grafting and loaded after 3 additional months. Panoramic radiographs were taken after the grafting procedure, after implant insertion, after the prosthetic restoration, and then annually for 10 years. These radiographs were used to measure the height between the implant shoulders and the top of the graft. Results: Of the 214 sinus floor elevations performed on 129 patients using the bilayering technique, 198 procedures in 118 patients were included in the study (136 one-stage and 62 two-stage). Membrane perforations during surgery occurred in 17.9% of the procedures and were sutured and sealed with fibrin glue. A total of 487 implants were placed in the grafted areas. No severe postoperative complications occurred, but three implants were lost throughout the 10-year follow-up period. A small decrease of vertical height was observed between the grafting surgery and the stage-two surgery (mean: 1.8 mm). After that, no bone height was lost over the 10 years. Conclusion: The layer grafting technique in combination with sinus floor elevation resulted in radiographically stable vertical bone height for 10 years. This technique enabled early placement and loading of implants in the grafted areas. The survival rate obtained with this procedure is similar to that expected for implants placed in nongrafted areas. [ABSTRACT FROM AUTHOR]

Abstract A particular technique can increase the mucosal and peri‐implant bone thickness, prevent compression around implant neck, and obtain proper space for the following prosthetic treatment with an adequate emergence profile.

The need to obtain adequate bone volumes for prosthetic rehabilitation supported by implants, using different techniques and materials, represents an urgent need in modern dentistry. We report a case regarding the management of implant-prosthetic rehabilitation of the first and second upper right molars, in which no less than 4 mm of crestal bone remained to insert two implants. Regeneration of the residual bone was previously performed using a customized titanium barrier and a filler of a blood clot with tricalcium beta phosphate. The bone gain (3 mm) was evaluated by comparing CBCT images, while the implant stability (mean 70) was assessed with the ISQ measurement. A regenerated bone sample was taken for histological analysis. Guided bone regeneration obtained with a titanium barrier and blood clot allowed for the insertion of stable implants in a mature bone without heterologous material.

Aim: To validate in vitro the accuracy of a novel method for bone augmentation of horizontal alveolar bone defects with the help of a surgical guide. Material and methods: Six cone‐beam computed tomography scans of patients requiring horizontal bone augmentation were segmented and 3D printed. Two surgeons performed the bone augmentation surgery twice for each case on 3D‐printed models, using either a conventional or guided protocol. Each surgeon virtually planned the desired graft shape beforehand. The resulting grafts were compared linearly and volumetrically to the plan; graft density and surgical time were also analyzed. Results: There was significantly less graft volume outside the planned volume with the guided protocol (36.8% ± 14.1 vs. 19.6% ± 12.3, p <.01). The use of a guide increased graft accuracy at several measurement points, resulting in less overfill when using the guided protocol (1.7 ± 1.7 mm at the most coronal point, 0.2 mm ± 1.4 at 25%, 0.0 mm ± 0.9 at 50%, 0.1 mm ± 1.1 at 75%, and 0.4 mm ± 1.4 apically). Graft thickness was increased 1 mm coronally from the planned graft (2.8 mm ± 2.3 vs. 1.8 mm ± 2.2, p =.04). Surgical time increased significantly when using a guide (a difference of 2 m 26 s). Conclusion: The technique, tested here in vitro, allows surgeons to improve the accuracy of the resulting graft shape, to better compact material in the coronal portion of the graft, and to reduce the amount of graft material placed outside the planned volume. [ABSTRACT FROM AUTHOR]

Objectives: Buccal bone augmentation in the esthetic zone is routinely used to achieve optimal clinical outcomes. Nonetheless, long‐term data are sparse, and it is unknown how baseline buccal bone volume affects the retention of the augmented volume over time. Material and methods: This is a long‐term follow‐up retrospective case series. After a preoperative computed tomography scan, implants were placed in the anterior maxilla following guided bone regeneration, autogenous block grafting, or both. At the follow‐up, patients received a computed tomography scan and a clinical examination. Buccal bone volume was the primary outcome. Buccal bone thickness, peri‐implant, and esthetic parameters were secondary outcomes. Results: After a median follow‐up of 6.7 years (interquartile range: 4.9–9.4), 28 implants in 19 patients (median age at augmentation: 43.3 years, interquartile range: 34.4–56.7, 53% female) were followed up. Preoperative buccal bone volume at baseline (V0) showed a moderate correlation to final buccal bone volume (Vt, rs =.43) but a strong correlation to the absolute volumetric change (ΔV = Vt–V0, rs = −.80). A linear mixed model for Vt had a large intercept of 91.39 (p <.001) and a rather small slope of.11 for V0 (p =.11). Observed differences between treatments were not statistically significant in the mixed model. V0 above 105 mm3 predicted a negative volume change (ΔV < 0) with a specificity of 100% and a sensitivity of 96%. Conclusions: The results suggest higher gains in sites with lower V0 and point to a cutoff V0 above which the augmented volume is not retained long‐term. [ABSTRACT FROM AUTHOR]

Aim: The purpose of systematic review and meta-analysis was to compare the efficacy of short implant versus conventional long implant with sinus graft in patients rehabilitated for posterior atrophic maxilla. Setting and Design: Systematic review and meta analysis. Materials and Methods: Electronic searches were conducted in Pub Med, Embase, and Medline with supplemented by manual search up to December 2019. The randomized controlled trial (RCTs) comparing short implant (8.5 mm) with sinus graft were included. (Prospero CRD42020186972). Statistical Analysis Used: Random-effect model, fixed-effect model, A funnel plot and the Egger's test. Results: Twenty-two Randomized controlled trials (RCTs) were assessed with 667 patients and 1595 implants (short implant:767, Long implant:835). No significant difference of implant survival rate was recorded for short and long implant (at patient level: RR: 1.01, 95% CI = 0.52-2.0, P = 0.87, I2 = 0%, at implant level RR = 1.09, 95% CI = 0.6-2.0, P = 0.7, I2 = 0%). Similarly marginal bone resorption was reported no difference for short and long implant (MD = 0.16. 95% CI: -0.23 = -0.08, P = 0.00, I2 = 74.83%). Biological complications were marginally higher for long implant (RR = 0.48, 95% CI = 0.23-0.8, P = 0.13, I2 = 29.11%). and prosthetic complications were marginally higher for short implants (RR=1.56, 95% CI=0.85-3.15, P = 0.43, I2 = 0%). Conclusion: There was no significance difference in implant survival rate and marginal bone resorption recorded for both the short implant and long implant with sinus graft, in the patients rehabilitated with posterior atrophic maxilla. Hence, short implant is a suitable alternative to long implant with sinus graft, for the rehabilitation posterior atrophic maxilla.

Tent bone augmentation technology, including the tenting screw technique, autogenous cortical bone tenting technique and implant tent-pole technique, has recently been considered as a type of bone augmentation method to solve serious alveolar bone deficiency. The tenting screw technique is simple to perform and widely used in clinical practice; it can effectively increase bone in both horizontal and vertical directions in local bone defect areas with fewer complications than other techniques. The autogenous cortical bone tenting technique is mainly used for bone augmentation in large bone defect areas. The operation is relatively simple, but it needs to be combined with partial autogenous bone grafting, with high technical sensitivity and complications. The implant tent-pole technique is the most complex method and is mainly used for bone augmentation in severe alveolar ridge absorption areas of the mandible. The maximum vertical bone augmentation height can be obtained by combining this method with autogenous bone grafting, and the number of postoperative complications is relatively high. This article reviews recent research on the application of this technique to repair various alveolar bone defects in order to provide reference for clinical implant treatment.

Background and objectives: In the treatment of severe periodontal destruction, there is a strong demand for advanced scaffolds that can regenerate periodontal tissues with adequate quality and quantity. Recently, we developed a plasma‐ and precursor‐assisted biomimetic process by which a porous collagen scaffold (CS) could be coated with low‐crystalline apatite. The apatite‐coated collagen scaffold (Ap‐CS) promotes cellular ingrowth within the scaffold compared to CS in rat subcutaneous tissue. In the present study, the osteogenic activity of Ap‐CS was characterized by cell culture and rat skull augmentation tests. In addition, the periodontal tissue reconstruction with Ap‐CS in a beagle dog was compared to that with CS. Methods: The plasma‐ and precursor‐assisted biomimetic process was applied to CS to obtain Ap‐CS with a low‐crystalline apatite coating. The effects of apatite coating on the scaffold characteristics (i.e., surface morphology, water absorption, Ca release, protein adsorption, and enzymatic degradation resistance) were assessed. Cyto‐compatibility and the osteogenic properties of Ap‐CS and CS were assessed in vitro using preosteoblastic MC3T3‐E1 cells. In addition, we performed in vivo studies to evaluate bone augmentation and periodontal tissue reconstruction with Ap‐CS and CS in a rat skull and canine furcation lesion, respectively. Results: As previously reported, the plasma‐ and precursor‐assisted biomimetic process generated a low‐crystalline apatite layer with a nanoporous structure that uniformly covered the Ap‐CS surface. Ap‐CS showed significantly higher water absorption, Ca release, lysozyme adsorption, and collagenase resistance than CS. Cell culture experiments revealed that Ap‐CS was superior to CS in promoting the osteoblastic differentiation of MC3T3‐E1 cells while suppressing their proliferation. Additionally, Ap‐CS significantly promoted (compared to CS) the augmentation of the rat skull bone and showed the potential to regenerate alveolar bone in a dog furcation defect. Conclusion: Ap‐CS fabricated by the plasma‐ and precursor‐assisted biomimetic process provided superior promotion of osteogenic differentiation and bone neoformation compared to CS. [ABSTRACT FROM AUTHOR]

Objective: In this article, we will discuss strategies for enhancing peri‐implant soft tissue contours and pontic sites with hard tissue augmentation. Clinical consideration: One of the keys to the esthetic illusion of an implant‐supported restoration is to create an ideal emergence profile. A critical part of any emergence profile is based on the height and thickness of the tissue surrounding the restoration and whether there are any defects in this tissue. Even when there is adequate bone in which to place implants, if any irregular ridge anatomy that supports this tissue is not corrected, then an unesthetic appearance of the restoration can result due to the lack of soft tissue with which to develop a proper emergence profile. Conclusion: Most peri‐implant soft tissue deficiencies represent an underlying bony defect that can be corrected or enhanced through bone augmentation. Clinical significance: Traditional methods of enhancing soft tissue emergence profiles around implants and pontic sites mostly involve the use of soft tissue augmentation techniques. Although there are few reports of the use of bone augmentation for this purpose, soft tissue contours can be enhanced by augmenting the underlying bone contours and, in many instances, may obviate the need for subsequent soft tissue augmentation. [ABSTRACT FROM AUTHOR]

Alveolar ridge augmentation can be used to obtain appropriate alveolar ridge for dental implantation. A variety of bone graft materials including autogenous bone, allograft, xenograft, and alloplastic material are used in alveolar ridge augmentation. Autogenous tooth‐derived bone graft material has received much attention for the past few years, because the structure and physicochemical characteristics of tooth are similar to those of bones. Compared to autogenous tooth, allogenic tooth has the advantage of extensive resources. However, the problem of cell‐derived immunological rejection of allogenic tooth remains unresolved. In the present study, acellular tooth root (ATR) is obtained by an innovative combination procedure. The biocompatibility of ATR is assessed using cytotoxicity test, hemolysis test, intracutaneous reactivity test, and acute systemic toxicity test. Osseointegration is evaluated in vivo by implanting ATR into the rat tibia defect as an allograft material. The results show that the ATR has fine biocompatibility, and there is an osseointegration between ATR and bone bed at 8 weeks post operation. This study demonstrates that the ATR could be used in alveolar ridge augmentation as a kind of new tooth‐derived bone graft material. [ABSTRACT FROM AUTHOR]

OBJECTIVE: At present, there is no consensus on whether to use bone grafts while lifting the macillary sinus, and there are still controversies. This article compared and analyzed the clinical outcome after transalveolar sinus floor elevation with or without grafting materials. METHODS: A computer search was conducted to search all clinical studies on transalveolar sinus floor elevation with and without grafting materials published in CNKI, Wanfang, VIP, CBM, Embase, PubMed, Web of Science and Cochrane. Finally, two reviewers independently extracted study data and conducted quality assessments according to the Cochrane manual and NOS scale, and then used RevMan 5.3 software and Stata 15.1 software to analyze the research data which finally met the inclusion criteria for meta-analysis. RESULTS: (1) A total of eleven articles were included, six were randomized controlled trials and five were prospective cohort studies, including 994 implants, with 399 implants in the graft group and 595 implants in the non-graft group. (2) The results of meta-analysis showed that there was no significant difference in implant failure rate (RR=0.57, 95%CI:0.28-1.18, P=0.13), and marginal bone loss (SMD=0.03, 95%CI:-0.23-0.29, P=0.80) between implants with and without graft materials after transalveolar sinus floor elevation. The risk of membrane perforation in the non-graft group was lower than that in the graft group (RR=0.33, 95%CI:0.12-0.96, P=0.04), but the amount of endo-sinus bone gain in the non-graft group was significantly lower than that in the graft group (SMD=-0.89, 95%CI:-1.08 to -0.70, P < 0.05). CONCLUSION: Transalveolar sinus floor elevation simultaneously implanted with grafting and without grafting can achieve predictable results. There were no statistically significant difference between two groups in implant failure rate and marginal bone loss. There may be a trend toward more endo-sinus bone gain with grafting. However, the sinus membrane perforation rate in the graft group was higher than that in the non-graft group. Therefore, choosing transalveolar sinus floor elevation without grafting during clinical practice has more advantages than that with grafting and the security is high. However, due to the limitation of the quality and many shortcomings of the included literatures, the above conclusions need to be validated by high-quality, multi-center and largesample randomized controlled trials. [ABSTRACT FROM AUTHOR]

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Buccal orthodontic tooth movement (OTM) of the anterior teeth out of the osseous envelope of the alveolar process in case of front teeth crowding may be associated with a higher tendency for developing gingival recessions. The aim of this case report is to present the effectiveness of a minimally invasive preorthodontic corticotomy combined with a buccal bone augmentation according to the rules of periodontally accelerated osteogenic orthodontics (PAOO). The main goal of our therapy is to increase or maintain the buccal bone thickness, which could prevent the development of gingival recessions. Corticotomy possibly have an additional benefit throughout regional acceleratory phenomenon, reducing the duration of OTM in the early treatment phases. A generally and periodontally healthy individual at the age of 17 presenting crowding and thin bone morphotype in the mandibular y front area, who requiresting OTM with incisor proclination, was treated. Surgery was performed under local anesthesia. Three vertical incisions were performed on the midline and on both sides between lateral incisors and canines, with preservation of the papilla integrity. Incisions were connected by tunneling knifes in 2 layers, subperiosteally in the whole length and supraperiosteally apically from the mucogingival junction. Corticocisions were utilized by ultrasonic instrument penetrating through the cortical bone. “Sticky bone” plates, a combinations of platelet rich fibrin (PRF) and xenograft, were used subperiosteally for bone, and PRF membranes supraperiosteally for soft tissue augmentation. Initiation of OTM started 1 week postoperatively, and activation of the multibond appliance was performed activated in 2 weeks. The extent of tooth movement measured on the central incisor was compared followed-up on cephalometric radiographs made taken at the different treatment time appointments, while buccal bone thickness on the 6 front teeth was evaluated in CBCT before and after OTM. The alignment phase ended up at the 20th week due to an initial arch wire sequence using light forces. The buccal bony wall thicknesses showed similar values compared to the initial ones, and there was no radiologically proven substantial vertical bone loss. The presented comprehensive treatment approach promised a good option in the prevention of the periodontal side effects during orthodontic treatment.

Aim: The purpose of this study is to investigate the requirements of hard tissue preparation prior to dental implant placement.Methods: In this retrospective study, the records of 1086 patients who referred to Mustafa Kemal University, Faculty of Dentistry, for dental implant between 2011 and 2015 were investigated. The received frequency of patients’ onlay grafting, autogenous block grafting, socket preservation, guided bone regeneration, open sinus lifting, ridge split osteotomy, alveolar distraction osteogenesis, inferior alveolar nerve repositioning were evaluated in any process of the dental implant. Findings: 3186 dental implants in 1086 patients were included to the study. Among 295 patients, it was observed that the number of men was 144 (48.8%) and number of implants was totally 309 (47.2%) implants, while the number of grafted implants in women of 151 (51.2%) was 346 (52.8%). The numbers of grafting procedures for augmentation are as follows; 286 (43.7%) onlay grafting, 23 (3.5%) socket preservation, 9 (1.4%) guided bone regeneration, 271 (41.3%) open sinus lifting, 62 (9.5%) alveolar ridge splitting, 2 (0.3%) alveolar nerve repositioning and 2 (0.3%) distraction osteogenesis. Conclusion: With ongoing the increasing of developments in dental implant surgery, it will be inevitable that the different grafting procedures can be carried out before and during the implantation.

Abstract Background It is not well-known which pre-implantological procedures are preferred by maxillofacial (MFS) and oral surgeons (OS) for the narrow atrophic alveolar ridge under practice based conditions and, if different training paths in surgery lead to other pre-implantological techniques being preferred. This study aims to identify which procedures are preferred by the respective specialists in which indication. Methods A questionnaire was sent to a total of 300 MFS and OS in southern Germany. The questionnaire examined pre-implantological procedures (bone block, bone grafting material and/or particulate autogenous bone, titanium mesh, bone split, resection) in the edentulous severely atrophic mandible and in the severely atrophic single-tooth gap. Kendall’s Tau-b test was used for statistical analyses. Results One hundred seventeen participants returned the questionnaire. 68 (58%) were OS and 49 (42%) were MFS. In the edentulous mandible, bone substitute material and resection were most preferred by both specialists. Bone blocks were statistically significantly more frequently associated with MFS and bone substitute materials with OS. Bone split was more frequently used in the atrophic single tooth gap than in the edentulous mandible. OS preferred bone blocks in the single tooth gap more often than in the edentulous mandible. MFS and OS preferred resection in the edentulous mandible significantly more frequently than in the single tooth gap. Conclusions MFS in general prefer more invasive pre-implantological therapies with the same initial diagnosis than OS, which seems to be attributed to different training paths.

Autogenous dentin is a promising biological material that can be used as a substitute for autologous bone. It has been used in postextraction site preservation, maxillary sinus floor elevation, and alveolar ridge augmentation. The clinical application methods of autologous dentin have showed great diversity without uniform standard. The present article reviewed the clinical application of autogenous dentin to provide new ideas for its future development. The literature review results show that dentin materials require several preparations before transplantation, among which the demineralization is a common chemical processing method. Demineralization can enhance the osteoconductive and osteoinductive properties of dentin, but the complex and time-consuming operation process has limited its application to a certain extent. Partial demineralization may be a more appropriate choice. During transplantation, the morphology of dentin depends on the condition of the bone defect and the surgical method. Granular materials with different diameters are convenient for filling irregular defects. Block materials are conducive to maintaining the space of the reconstruction site. Hollow frame materials are slightly more complicated to process but can combine the advantages of granular and block grafts. In addition to being used alone, dentin can also be transplanted in combination with multiple biological materials. Platelet-rich plasma combined with dentin materials has shown ideal results in clinical studies. Plaster of paris and calcium phosphate ceramics have also been combined with dentin materials in animal experiments. But since they have not been applied in humans, their clinical effects require further research.

Abstract Background Multiple approaches for fixation of distal radius fractures exist; nonetheless, there is no consensus on the optimal treatment for these injuries. Although using volar locking plates has become increasingly common as a surgical intervention, the usefulness of bone augmentation remains debatable. Therefore, this study aimed to evaluate the necessity of bone augmentation for distal radius fractures fixed with a volar locking plate. Methods This retrospective study enrolled patients with a single distal radius fracture treated with a volar locking plate between January 2014 and December 2016. Overall, 105 fractures were included and divided into two groups (non-bone augmentation: group 1, n = 88; bone augmentation: group 2, n = 17). Images were reviewed, and dorsal cortex collapse, volar tilting, and radial height and inclination were measured immediately after surgery and at the 6-month follow-up. Results Both groups exhibited significant differences in dorsal collapse (p

Aims: The scope of this study was to analyze the influence of clinically feasible implant diameter and length on the stress transmitted to the peri-implant bone in the case of a resorbed and bone augmented mandible through finite element analysis. Settings and Design: The study was carried out in silico. Subjects and Methods: Resorbed and bone-augmented 3D models were derived from in vivo cone-beam computed tomography scans of the same patient. Corresponding implant systems were modeled with the diameter ranging from 3.3 to 6 mm and length ranging from 5 to 13 mm, and masticatory loads were applied on the abutment surface. Statistical Analysis Used: None. Results: In the bone augmented ridge, maximum stress values in the peri-implant region drastically decreased only when using implants of a diameter of 5 mm and 6 mm. Implants up to 4 mm in diameter led to comparable stress values with the ones obtained in the resorbed ridge, when using the larger implants. The increase of length reduced stress in the resorbed mandible, whereas in the bone augmented model, it led to small variations only in implants up to 4 mm in diameter. Conclusions: It was concluded that bone augmentation provides the optimal framework for clinicians to use larger implants, which, in turn, reduces stress in the peri-implant region. Diameter and length play an equally important role in decreasing stress. Implant dimensions should be carefully considered with ridge geometry.

In this study, tissue scaffolds mimicking hierarchical morphology are constructed and proposed for bone augmentation. The scaffolds are fabricated using lyophilization, before coating them with collagen (Col). Subsequently, the Col-coated scaffolds undergo a second lyophilization, followed by silk fibroin (SF) coating, and a third lyophilization. Thereafter, the scaffolds are divided into six groups with varying ratios of Col to SF: Col/SF = 7:3, 5:5, 3:7, 10:0, and 0:10, with an SF scaffold serving as the control group. The scaffold morphology is examined using a scanning electron microscope, while molecular and structural formations are characterized by Fourier transform infrared spectrometer and differential scanning calorimeter, respectively. Physical and mechanical properties including swelling and compression are tested. Biological functions are assessed through in vitro osteoblast cell culturing. Biomarkers indicative of bone formation-cell viability and proliferation, alkaline phosphatase activity, and calcium content-are analyzed. Results demonstrate that scaffolds coated with Col and SF exhibit sub-porous formations within the main pore. The molecular formation reveals interactions between the hydrophilic groups of Col and SF. The scaffold structure contains bound water and SF formation gets disrupted by Col. Physical and mechanical properties are influenced by the Col/SF ratio and morphology due to coating. The biological functions of scaffolds with Col and SF coating show enhanced potential for promoting bone tissue formation, particularly the Col/SF (7:3) ratio, which is most suitable for bone augmentation in small defect areas., (© 2024 IOP Publishing Ltd. All rights, including for text and data mining, AI training, and similar technologies, are reserved.)

New injection-type bone-forming materials are desired in dental implantology. In this study, we added nano-hydroxyapatite (nHAp) and bone morphogenetic protein (BMP) to cross-linkable thiol-modified hyaluronic acid (tHyA) and evaluated its usefulness as an osteoinductive injectable material using an animal model. The sol (ux-tHyA) was changed to a gel (x-tHyA) by mixing with a cross-linker. We prepared two sol–gel (SG) material series, that is, x-tHyA + BMP with and without nHAp (SG I) and x-tHyA + nHAp with and without BMP (SG II). SG I materials in the sol stage were injected into the cranial subcutaneous connective tissues of mice, followed by in vivo gelation, while SG II materials gelled in Teflon rings were surgically placed directly on the cranial bones of rats. The animals were sacrificed 8 weeks after implantation, followed by X-ray analysis and histological examination. The results revealed that bone formation occurred at a high rate (>70%), mainly as ectopic bone in the SG I tests in mouse cranial connective tissues, and largely as bone augmentation in rat cranial bones in the SG II experiments when x-tHyA contained both nHAp and BMP. The prepared x-tHyA + nHAp + BMP SG material can be used as an injection-type osteoinductive bone-forming material. Sub-periosteum injection was expected.

Vertical bone augmentation to create host bone prior to implant placement is one of the most challenging regenerative procedures. The objective of this study is to evaluate the capacity of a UV-photofunctionalized titanium microfiber scaffold to recruit osteoblasts, generate intra-scaffold bone, and integrate with host bone in a vertical augmentation model with unidirectional, limited blood supply. Scaffolds were fabricated by molding and sintering grade 1 commercially pure titanium microfibers (20 μm diameter) and treated with UVC light (200–280 nm wavelength) emitted from a low-pressure mercury lamp for 20 min immediately before experiments. The scaffolds had an even and dense fiber network with 87% porosity and 20–50 mm inter-fiber distance. Surface carbon reduced from 30% on untreated scaffold to 10% after UV treatment, which corresponded to hydro-repellent to superhydrophilic conversion. Vertical infiltration testing revealed that UV-treated scaffolds absorbed 4-, 14-, and 15-times more blood, water, and glycerol than untreated scaffolds, respectively. In vitro, four-times more osteoblasts attached to UV-treated scaffolds than untreated scaffolds three hours after seeding. On day 2, there were 70% more osteoblasts on UV-treated scaffolds. Fluorescent microscopy visualized confluent osteoblasts on UV-treated microfibers two days after seeding but sparse and separated cells on untreated microfibers. Alkaline phosphatase activity and osteocalcin gene expression were significantly greater in osteoblasts grown on UV-treated microfiber scaffolds. In an in vivo model of vertical augmentation on rat femoral cortical bone, the interfacial strength between innate cortical bone and UV-treated microfiber scaffold after two weeks of healing was double that observed between bone and untreated scaffold. Morphological and chemical analysis confirmed seamless integration of the innate cortical and regenerated bone within microfiber networks for UV-treated scaffolds. These results indicate synergy between titanium microfiber scaffolds and UV photofunctionalization to provide a novel and effective strategy for vertical bone augmentation.

Aim; To analyse data on bone augmentation at single-tooth implants with regard to the type of graft materials, the stability of grafts over time, reported time span towards implant placement, implant survival rates, implant marginal bone maintenance and possible complications. Material and methods: A literature review resulted in 585 titles after exclusion of duplicates. Analyses of article titles and abstracts reduced the number to 93 studies, which were subsequently full-text analysed. After the final selection, a total of 24 studies were included, of which 13 reported on single implants and horizontal/vertical augmentation (onlay), 10 focused on single implants and sinus augmentation (inlay), and one study presented the outcome of single implants and distraction osteogenesis. Results: All bone materials, i.e. autografts, allografts, xenografts, and alloplasts, were used with comparable satisfactory results, allowing for placement of 7 to 10 mm-long implants. Stability of bone graft volume over time was sparsely documented. Some onlay autografts tended to resorb early i.e. prior to implant placement, but minor bone resorption was also seen for other grafts over time. A continuous but small bone resorption of inlay autografts and alloplasts was seen over time for the few sites recorded. A staged approach predominated for the onlay grafts, with implants placed 3 to 6 months post-grafting, and overall a majority of these implants (347/363) were submerged. For the inlay graft procedures almost all implants were immediately inserted at the time of grafting, and the majority of these implants (253/256) were submerged. A total of five and two implant failures were registered during the various study periods for the onlays and inlays, respectively. Marginal bone conditions, around implants in grafted sites, were comparable to what has generally been reported for non-grafted sites. Conclusions: Bone augmentation for the single-tooth implant is a viable treatment option with predictable graft and implant outcomes. [ABSTRACT FROM AUTHOR]

Multiple bone augmentation techniques are available to allow implant placement in the atrophic maxilla. However, questions remain, regarding which methods are most predictable and have the best dental implant survival rate (SR) in grafted bone. The aim of this systematic review was to evaluate literature from the last 30 years to determine predictability of bone grafting of the edentulous maxilla for implant placement as well as for implant SR. Materials and Methods: A systematic review was performed of studies conducted during the period 1980 to 2014, specifically focusing on the edentulous maxilla and bone grafting. Surgical techniques discussed in the publications included were guided bone regeneration (GBR), sinus augmentation, onlay bone grafting, nasal floor grafting, and Le Fort I interpositional grafting. All identified articles were evaluated and screened to meet strict inclusion criteria of at least 10 patients, complete maxillary edentulism, 1-year follow-up, and information regarding implant SR. A total of 974 articles were identified with electronic and manual searches. On further evaluation of the titles and abstracts, 44 articles were excluded. Full texts of the articles that met the inclusion criteria were reviewed, of which 40 articles were included in the systematic review. Results: For onlay bone grafting, 16 studies were included and analyzed, and the weighted mean implant SR was 85.2%. For the GBR technique, two studies were included, with a reported SR ranging from 96.1% to 100%. For Le Fort I interpositional grafting, 11 studies were included, with a weighted mean SR of 89.6%. For the sinus augmentation technique, 12 studies were investigated and the weighted mean SR was 91.5%. For the combination technique, six studies were analyzed and the weighted mean SR was 93.6%. Conclusions: All five treatment modalities discussed--onlay bone grafting, GBR, Le Fort I interpositional grafting, maxillary sinus augmentation, and/or nasal floor inlay grafting or the combination approach--can be successfully used to augment edentulous maxillary ridge with high implant SRs. [ABSTRACT FROM AUTHOR]