Feasibility and needs for simultaneous or staged bone augmentation to place prosthetically guided dental implants after extraction or exfoliation of first molars due to severe periodontitis

Abstract

Background The aim of this study was to retrospectively assess bone volumes, healed ridge topography and possibility to plan prosthetically guided implants (PGI) at least 6 months after extraction or exfoliation of first molars as a consequence of terminal periodontitis (EEFMP). Materials and Methods 45 subjects with stage III‐IV periodontitis providing 74 extraction sites (maxillary = 51 and mandibular = 23) were included. The degree of residual periodontal support on each root was assessed by combining periodontal and radiographic data. Digital planning of PGI with 4.8/4.1 mm diameter, 8 mm long, root‐form dental implant and need for bone augmentation (BA) were performed using CBCT with a radiographic stent. Possibility of standard implant placement (STANDARD) and need for simultaneous or staged BA were assessed. Results Planning PGI placement was possible in all cases. For a 4.8 mm diameter implant, STANDARD was possible in 37.8% of the sites, 33.8% required BA at the time of implant placement, and 28.4% required staged BA before PGI. The use of 4.1 mm rather than 4.8 mm diameter implant allowed STANDARD in an additional 8.1% of cases that originally required simultaneous BA/osteotome sinus floor elevation (OSFE). The level of periodontal bone loss did not predict the complexity of implant placement, but significant differences were observed comparing maxillary with mandibular sites. Conclusion PGI planning at sites with first molar loss due to terminal periodontitis is possible but poses great challenge to rehabilitation, often requiring advanced augmentation procedures and sinus augmentation.

Increased local concentrations of growth factors from leucocyte‐ and platelet‐rich fibrin do not translate into improved alveolar ridge preservation: An intra‐individual mechanistic randomized controlled trial

“…The position of a standard size (Straumann bone level implant 8 mm in length, 3.3 mm in diameter with screw retained restoration) PGI was determined by a single calibrated assessor based on CBCT data, diagnostic wax‐up (or pre‐extraction intraoral scanning showing the original coronal structure), and intraoral digital scanning with the Panmeca Romexis software, version 4.6.2.R (Appendix Figure S5). The possibility of standard PGI placement, the need for simultaneous bone augmentation, or the need for staged PGI placement was determined as previously described (Fok et al, 2020). In brief, the choice was based upon the endosteal portion of the implant being fully planned in native bone with a residual thickness of at least 1.5 mm.…”

“…Areas with no changes during the follow-up period (e.g., the walls of maxillary sinuses, palatine process of maxilla, nasal septum, and mandibular bone) were used as references to superimpose the two datasets. Linear changes were quantified as described by Jung et al (Jung et al, 2013) The possibility of standard PGI placement, the need for simultaneous bone augmentation, or the need for staged PGI placement was determined as previously described (Fok et al, 2020). In brief, the choice was based upon the endosteal portion of the implant being fully planned in native bone with a residual thickness of at least 1.5 mm.…”

Spatial Controls of Ligamentous Tissue Orientations Using the Additively Manufactured Platforms in an In Vivo Model: A Pilot Study

“…Periodontitis is a widespread chronic inflammatory disease that induces tooth-supporting tissue destruction, which is generally initiated by cytokines or biochemicals from oral microorganisms [11,12]. In the case of severe periodontal disease, it is usually necessary to extract teeth and place dental prosthetics with tooth-extraction socket healing [13,14]. For the tooth replacement and stability of dental implants, various approaches have been concentrated on promoting bone regeneration in tooth-extraction sites or inducing osseointegration to the dental implant surfaces using biomaterials, bioactive molecules, or stem Appl.…”