Vertical Alveolar Augmentation Using BMP-2/ACS/Allograft with Printed Titanium Shells to Establish an Early Vascular Scaffold

Casap, Nardy; Rushinek, Heli; Jensen, Ole T.

doi:10.1016/j.coms.2019.03.009

Cited by 14 publications

(9 citation statements)

References 35 publications

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“…Vermeeren described a resorption close to 50%, results similar to those obtained by Johansson (22,23). Casap reported a case of alveolar bone augmentation by impression of a titanium shell with BMP-2/allograft with excellent results in graft ossification but with a high rate of mesh exposure (24). Roser studies the accuracy of VSP in 11 patients comparing the distance between the real mandibular osteotomies and the virtual mandibular osteotomies with an accuracy rate of 2.0 ± 1.1 mm (25).…”

Section: Discussionsupporting

confidence: 80%

Mandibular Reconstruction With Fibula Flap and Dental Implants Through Virtual Surgical Planning and Three Different Techniques: Double-Barrel Flap, Implant Dynamic Navigation and CAD/CAM Mesh With Iliac Crest Graft

et al. 2021

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IntroductionVertical discrepancy between the fibula flap and the native mandible results in difficult prosthetic rehabilitation. The aim of this study was to evaluate the outcomes of 3D reconstruction of the mandible in oncologic patients using three different techniques through virtual surgical planning (VSP), cutting guides, customized titanium mesh and plates with CAD/CAM technology, STL models and intraoperative dynamic navigation for implant placement. Material and methodsMaterial and MethodsThree different techniques for mandibular reconstruction and implant rehabilitation were performed in 14 oncologic patients. Five patients (36%) underwent VSP, cutting guides, STL models and a customized double-barrel titanium plate with a double-barrel flap and immediate implants. In six patients (43%), VSP, STL models and a custom-made titanium mesh (CAD/CAM) for 3D reconstruction with iliac crest graft over a fibula flap with deferred dental implants were performed. Three patients (21%) underwent VSP with cutting guides and customized titanium plates for mandibular reconstruction and implant rehabilitation using intraoperative dynamic navigation was accomplished. Vertical bone reconstruction, peri-implant bone resorption, implant success rate, effects of radiotherapy in vertical reconstruction, bone resorption and implant failure, mastication, aesthetic result and dysphagia were evaluated.ResultsSignificant differences in bone growth between the double-barrel technique and iliac crest graft with titanium mesh technique were found (p<0.002). Regarding bone resorption, there were no significant differences between the techniques (p=0.11). 60 implants were placed with an osseointegration rate of 91.49%. Five implants were lost during the osseointegration period (8%). Peri-implant bone resorption was measured with a mean of 1.27 mm. There was no significant difference between the vertical gain technique used and implant survival (p>0.385). Implant survival rates were higher in non-irradiated patients (p<0.017). All patients were rehabilitated with a fixed implant-supported prosthesis reporting a regular diet (80%), normal swallowing (85.7%) and excellent aesthetic results.ConclusionsMulti-stage implementation of VSP, STL models and cutting guides, CAD/CAM technology, customized plates and in-house dynamic implant navigation for mandibular defects increases bone-to-bone contact, resolves vertical discrepancy and improves operative efficiency with reduced complication rates and minimal bone resorption. It provides accurate reconstruction that optimizes implant placement, thereby improving facial symmetry, aesthetics and function.

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Section: Discussionsupporting

confidence: 80%

Mandibular Reconstruction With Fibula Flap and Dental Implants Through Virtual Surgical Planning and Three Different Techniques: Double-Barrel Flap, Implant Dynamic Navigation and CAD/CAM Mesh With Iliac Crest Graft

et al. 2021

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“…Johansson [ 12 ] evaluated the volume of iliac crest grafted at 6-month post-operative controls with an average volume reduction of 47 to 50%, while Smolka [ 13 ] reported a 19% resorption for calvarial grafts at 1-year follow-up. Hertford [ 6 ] evaluated the use of titanium mesh grafting combined with rhBMP-2 for alveolar reconstruction, with optimal results, and Casap [ 14 ] reported the use of printed titanium shell with BMP-2/allograft for vertical alveolar augmentation, showing the bone fill of 90% but with a high rate of mesh exposure. In this study the investigators demonstrate that 3D reconstruction of the fibula can be reliably performed using an iliac crest graft and a titanium mesh planned through VSP and CAD/CAM.…”

Section: Discussionmentioning

confidence: 99%

“…One of the most important factors to achieve an optimal aesthetic and functional result is to use a mesh that allows us to maintain the three-dimensional reconstruction of the bone. Stable space maintenance is an essential component of all bone development, repair and regeneration [ 14 ]. Titanium mesh has been shown to be ideal for this procedure due to its characteristics and benefits: (1) it is a biocompatible material; (2) it maintains space and prevents collapse of the graft due to its rigidity; (3) it is non-resorbable, and prevents the soft tissue invasion into the grafting material; (4) it provides a smooth surface to prevent bacterial colonization; (5) its elasticity prevents compression of the intraoral soft tissue; (6) small pores maintain the blood supply to the grafted defect; and (7) it allows intraoperative modifications.…”

Section: Discussionmentioning

confidence: 99%

Virtual Surgical Planning, Stereolitographic Models and CAD/CAM Titanium Mesh for Three-Dimensional Reconstruction of Fibula Flap with Iliac Crest Graft and Dental Implants

Cuéllar

Rial

Antúnez-Conde

et al. 2021

JCM

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Mandibular reconstruction with fibula flap shows a 3D discrepancy between the fibula and the remnant mandible. Eight patients underwent three-dimensional reconstruction of the fibula flap with iliac crest graft and dental implants through virtual surgical planning (VSP), stereolitographic models (STL) and CAD/CAM titanium mesh. Vertical ridge augmentation and horizontal dimensions of the fibula, peri-implant bone resorption of the iliac crest graft, implant success rate and functional and aesthetic results were evaluated. Vertical reconstruction ranged from 13.4 mm to 10.1 mm, with an average of 12.22 mm. Iliac crest graft and titanium mesh were able to preserve the width of the fibula, which ranged from 8.9 mm to 11.7 mm, with an average of 10.1 mm. A total of 38 implants were placed in the new mandible, with an average of 4.75 ± 0.4 implants per patient and an osseointegration success rate of 94.7%. Two implants were lost during the osseointegration period (5.3%). Bone resorption was measured as peri-implant bone resorption at the mesial and distal level of each implant, with a variation between 0.5 mm and 2.4 mm, and with a mean of 1.43 mm. All patients were rehabilitated with a fixed implant prosthesis with good aesthetic and functional results.

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“…When large defects are re-treated, especially when allograft or xenograft materials are used, it may be advocated to add BMPs or growth factors to assist the bone regeneration process as was done here in the one case (46)(47)(48)(49).…”

Section: Soft and Bony Tissue Regenerationmentioning

confidence: 99%

Re-treatment of failed maxillary implant sites with severe bone loss from peri-implant disease: case series

Alterman¹,

Jensen²,

Mazor³

et al. 2023

Front Oral Maxillofac Med

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associated complications is rising (2).The consensus report of workgroup 4 of the 2017 World Workshop on the Classification of Periodontal and Peri-Implant Diseases and Conditions has defined peri-implantitis as "a plaque-associated pathological condition occurring in tissues around dental implants, characterized by inflammation in the peri-implant mucosa and subsequent progressive loss of supporting bone" (3). It has been estimated that the average rate of peri-implantitis ranges between 15-

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Vertical Alveolar Augmentation Using BMP-2/ACS/Allograft with Printed Titanium Shells to Establish an Early Vascular Scaffold

Cited by 14 publications

References 35 publications

Mandibular Reconstruction With Fibula Flap and Dental Implants Through Virtual Surgical Planning and Three Different Techniques: Double-Barrel Flap, Implant Dynamic Navigation and CAD/CAM Mesh With Iliac Crest Graft

Mandibular Reconstruction With Fibula Flap and Dental Implants Through Virtual Surgical Planning and Three Different Techniques: Double-Barrel Flap, Implant Dynamic Navigation and CAD/CAM Mesh With Iliac Crest Graft

Virtual Surgical Planning, Stereolitographic Models and CAD/CAM Titanium Mesh for Three-Dimensional Reconstruction of Fibula Flap with Iliac Crest Graft and Dental Implants

Re-treatment of failed maxillary implant sites with severe bone loss from peri-implant disease: case series

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