Abstract:The aim of this study was to compare the use of autologous bone from tuberosity (TUBER) and deproteinized bovine bone mineral (DBBM) in immediate implants with buccal bone defects. A total of 31 patients with one single tooth in the upper anterior region indicated for extraction presenting tomographic buccal bone defect were analyzed. Immediate implantation was conducted for all patients. In one group, DBBM and a collagen membrane were inserted into the buccal defect; in the other group, a small block of bone … Show more
“…However, as shown in the present case, the missed buccal bone had not limited the implant placement, and the buccal bone reconstruction was performed immediately [2,28]. The reconstruction of the buccal bone wall using the tuberosity bone is limited to small bone defects and patients with sufficient mouth opening [29,30]. Besides, the use of an implant with surface treatment to accelerate the osseointegration process instead of using a machined titanium implant is also recommended [31,32].…”
Contemporary dentistry has increased the demand for predictable functional and esthetic results in a short period of time without compromising the long-term success of rehabilitation. Recent advances in surgical techniques have provided alternatives that allow the prosthetic rehabilitation of complex implant-supported cases through minimally invasive techniques. In this context, immediate dentoalveolar restoration (IDR) was described aiming at restoring function and esthetics through the reconstruction of lost periodontal tissues followed by immediate implant placement in order to minimize treatment time and surgical morbidity in a one-stage approach. Therefore, the aim of this clinical case is to describe the reconstruction and rehabilitation of a hopeless tooth in the maxillary region in a one-stage approach by means of IDR. The proposed steps to rehabilitate the case involved atraumatic dental extraction, immediate implant placement, and hard tissue augmentation by means of cortical-medullary bone graft harvested from the maxillary tuberosity. Afterwards, a provisional restoration was manufactured and installed to the implant allowing immediate prosthesis provisionalization and function in the same operatory time. Six months after the surgical procedure, the final prosthesis was manufactured and installed. The follow-up of nine years demonstrated the preservation of hard and soft tissue without tissue alteration and a successful esthetic outcome. The surgical protocol used allowed the ideal three-dimensional placement of the implant with the restoration of the bone buccal wall, favoring the esthetic and functional outcome of the case with harmony between white and pink esthetics. In conclusion, the employed treatment validated immediate implant-supported restoration of the missing tooth with high predictability. Furthermore, this protocol resulted in fewer surgical interventions, regeneration, and preservation of peri-implant tissues reaching the patient’s expectations.
“…However, as shown in the present case, the missed buccal bone had not limited the implant placement, and the buccal bone reconstruction was performed immediately [2,28]. The reconstruction of the buccal bone wall using the tuberosity bone is limited to small bone defects and patients with sufficient mouth opening [29,30]. Besides, the use of an implant with surface treatment to accelerate the osseointegration process instead of using a machined titanium implant is also recommended [31,32].…”
Contemporary dentistry has increased the demand for predictable functional and esthetic results in a short period of time without compromising the long-term success of rehabilitation. Recent advances in surgical techniques have provided alternatives that allow the prosthetic rehabilitation of complex implant-supported cases through minimally invasive techniques. In this context, immediate dentoalveolar restoration (IDR) was described aiming at restoring function and esthetics through the reconstruction of lost periodontal tissues followed by immediate implant placement in order to minimize treatment time and surgical morbidity in a one-stage approach. Therefore, the aim of this clinical case is to describe the reconstruction and rehabilitation of a hopeless tooth in the maxillary region in a one-stage approach by means of IDR. The proposed steps to rehabilitate the case involved atraumatic dental extraction, immediate implant placement, and hard tissue augmentation by means of cortical-medullary bone graft harvested from the maxillary tuberosity. Afterwards, a provisional restoration was manufactured and installed to the implant allowing immediate prosthesis provisionalization and function in the same operatory time. Six months after the surgical procedure, the final prosthesis was manufactured and installed. The follow-up of nine years demonstrated the preservation of hard and soft tissue without tissue alteration and a successful esthetic outcome. The surgical protocol used allowed the ideal three-dimensional placement of the implant with the restoration of the bone buccal wall, favoring the esthetic and functional outcome of the case with harmony between white and pink esthetics. In conclusion, the employed treatment validated immediate implant-supported restoration of the missing tooth with high predictability. Furthermore, this protocol resulted in fewer surgical interventions, regeneration, and preservation of peri-implant tissues reaching the patient’s expectations.
As a practical and safe substitute for autologous transplants, xenografts and alloplastic bone substitutes are available. Numerous research projects conducted at numerous research centers in various parts of the world have investigated the efficacy of these products.The purpose of the investigation is to determine whether bovine bone blocks are efficient as regenerative bone replacement treatments, specifically whether they are effective in both in vivo and in vitro tests as bone substitutes. A total of 235 publications were found through an electronic search of the Pubmed, Scopus, Science Direct, and Google Scholar databases. Evaluation of complications at the implant site is low (n=13) with only one study showing 8.9% implant failure, 30% unhealthy implant (n=4) and a complication rate of 12.5% with the most common complications being dehiscence, bruising and oedema (n=3). The most commonly used parameter in most studies was vertical bone gain (n=26), with a mean VBG of 4.5mm and new bone formation (n=11), with a mean NFB of 14.5%, indicating adequate integration between graft and host bone. The resorption rate (n=6) was found to be 22% on average or approximately 2.7mm over a 4 month to 3 year observation period. Bovine blocks can serve as a useful bone graft substitute in regenerative surgery and are improved by the addition of BMP-2, PDGF and collagen membrane.
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