Single-Tooth Morse Taper Connection Implant Placed in Grafted Site of the Anterior Maxilla: Clinical and Radiographic Evaluation

Abstract

The aim of this study was to achieve aesthetically pleasing soft tissue contours in a severely compromised tooth in the anterior region of the maxilla. For a right-maxillary central incisor with localized advanced chronic periodontitis a tooth extraction followed by reconstructive procedures and delayed implant placement was proposed and accepted by the patient. Guided bone regeneration (GBR) technique was employed, with a biphasic calcium-phosphate (BCP) block graft placed in the extraction socket in conjunction with granules of the same material and a resorbable barrier membrane. After 6 months of healing, an implant was installed. The acrylic provisional restoration remained in situ for 3 months and then was substituted with the definitive crown. This ridge reconstruction technique enabled preserving both hard and soft tissues and counteracting vertical and horizontal bone resorption after tooth extraction and allowed for an ideal three-dimensional implant placement. Localized severe alveolar bone resorption of the anterior maxilla associated with chronic periodontal disease can be successfully treated by means of ridge reconstruction with GBR and delayed implant insertion; the placement of an early-loaded, Morse taper connection implant in the grafted site was effective to create an excellent clinical aesthetic result and to maintain it along time.

Ridge Preservation Using Composite Alloplastic Materials: A Randomized Control Clinical and Histological Study in Humans

“…An ideal bone substitute should be biocompatible, osteoconductive, and osteoinductive, easy to shape and manipulate safe and bioresorbable. Biphasic calcium-phosphates meets all these criteria: it's structure and chemical composition is very similar to that of hydroxy appetite [19][20][21][22][23] ; it is biocompatible, osteoconductive and possesses osteoinductive properties [20][21][22][23] ; it possesses appropriate porosity for vascular invasion and nutrient diffusion from surrounding tissue and has surface chemistry to allows cells to adhere and express osteogenic phenotype. [20][21][22][23] It is characterized appropriate mechanical properties; it is synthetic and cost effective, is able to form a suitable shape easily, and ultimately replaces the bone within a short period.…”

“…[20][21][22][23] It is characterized appropriate mechanical properties; it is synthetic and cost effective, is able to form a suitable shape easily, and ultimately replaces the bone within a short period. [19][20][21][22][23] The addition of BCS improves the handling characteristics of BCP by acting as a binder between HA and TCP particles. Furthermore, the rapid resorption of BCP leaves porosity that would enhance the ingrowth of bone.…”

Custom-Made Computer-Aided-Design/Computer-Aided-Manufacturing Biphasic Calcium-Phosphate Scaffold for Augmentation of an Atrophic Mandibular Anterior Ridge

“…The new CT datasets were immediately transferred to the 3D reconstruction software (Mimics, Materialise, Leuven, Belgium) for the segmentation of the mandible (Figures 4(a) - 4(b) ). After that, the vertical and horizontal bone gain was radiographically evaluated by comparing the 3D reconstruction of the preoperative CT scan with that obtained 1 year later, using a method previously described [ 10 , 26 ]. In brief, data from the preoperative and the postoperative CT scans were segmented using the aforementioned 3D reconstruction software.…”

“…Different surgical techniques have been used to overcome alveolar ridge atrophy, including onlay/inlay bone grafting [ 6 – 8 ], guided bone regeneration (GBR) [ 9 , 10 ], ridge split technique/ridge expansion [ 11 ], and distraction osteogenesis [ 7 , 12 ].…”

“…However, the use of autografts as onlays has drawbacks, such as additional surgery for harvesting, limited availability, donor site morbidity (which includes risk of infection, bleeding, pain, swelling, and damage to nerves and blood vessels), and high resorption rate of the graft [ 5 , 13 ]. To overcome these limitations, bone substitute materials such as allografts [ 8 ], xenografts [ 14 ], and synthetic bone grafts [ 3 , 10 , 15 ] have been introduced.…”