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Background
Bone block grafting may be required to restore the alveolar process prior to implant placement in Kennedy Class IV partial edentulism of the anterior mandible.
Purpose
Evaluate the application of allograft cancellous bone blocks for the augmentation of the anterior atrophic mandible.
Materials and Methods
Fourteen consecutive patients underwent augmentation with cancellous bone block allografts in the anterior mandible. A bony deficiency of at least 3 mm horizontally and up to 3 mm vertically according to computerized tomography para‐axial reconstruction served as inclusion criteria. Following 6 months, 26 implants were placed and a cylindrical sample core was collected. All specimens were prepared for histological and histomorphometrical examination. The rehabilitation scheme was two dental implants, placed in the lateral incisor area, supporting a 4‐unit implant‐supported prosthesis.
Results
Twenty‐four blocks were placed in 14 patients. Mean follow‐up was 26 ± 17 months. Mean bone gain was 5 ± 0.5 mm horizontally, and 2 ± 0.5 mm vertically. Twenty‐six implants were used. Marginal bone loss at last follow up did not extend beyond the first thread. Block and implant survival rates were 91.6% and 100%, respectively. All patients but one received a fixed implant‐supported prosthesis. Histomorphometrically, the mean fraction of the newly formed bone was 42%, that of the residual cancellous block‐allograft 17%, and of the marrow and connective tissue 41%.
Conclusions
The potential of cancellous bone block allografts for reconstruction of Kennedy Class IV partial edentulism in the anterior mandible seems promising but still has to be evaluated scientifically in long‐term observations.
Background: Peri-implant disease (PID) has not been directly linked to pathological organ changes. The present study assessed the dynamics of serum biochemical parameters in a model of experimental peri-implantitis in dogs, followed by open flap debridement. Methods: Seven male beagle dogs comprised the study group. Procedures were performed as follows-extractions of two premolars and one molar on each mandibular quadrant (Day 0); bone healing time (week14); placement of four rough-surface endoosseous implants, two on each mandibular side; implant uncovering (week 28); induction of experimental peri-implantitis by the use of three ligatures (weeks 31, 34, 37) followed by open flap debridement (week 42). Serum biochemical analysis following each procedure was compared to baseline. Biochemical parameters were assigned into four subsets of variablesinflammation, renal function, liver function, and blood glucose. Wilcoxon paired tests were conducted in order to identify statistically significant differences between baseline data and values obtained after each procedure Results: Following experimental peri-implantitis, the dynamics of renal parameters and blood glucose were minimal whereas statistically significant (P < 0.05) increases were noted for inflammatory (total protein and albumin concentrations) and hepatic (ALT, AST) parameters. A statistically significant (P < 0.05) decrease was only noted for total bilirubin. After open flap debridement, inflammatory (total protein and albumin concentrations) and hepatic (AST) parameters returned to baseline. Conclusions: Within their limits, the present results indicate that: (a) PID affects inflammatory and hepatic serum biochemical parameters, and (b) following open flap debridement most of the values returned to baseline.
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