Bone Atrophy, Alveolar
Conditions
Keywords
bone augmentation, autogenous tooth roots, dental implants
Brief summary
A deficient alveolar ridge segment in prepara¬tion for implant placement can be regenerated by several techniques. The type of graft material for each patient depends on many factors such as the anatomy, the morphology of the bone defect, type of prosthodontic rehabilitation and patient or clinician preferences. Bone graft material should have three properties that made it ideal: a) osteoconduction, it provides scaffolds for bone regeneration; b) osteoinduction, it promotes the recruitment of bone-forming cells and formation of bone and c) osteogenesis, induction of cells in the graft to promote regeneration of the bone. Despite of the development of different types of graft material, autogenous bone is still the gold standard for bone augmentation because it exhibits these three mentioned properties. Although it has many advantages, autologous bone has some disadvantages such as high resorption rate up to 50 %, limited source and donor site morbidity. Allografts, xenografts and alloplastic bone graft are materials that are used in everyday practice and over long period, but their disadvantages are numerous in comparison with autologous bone. Allografts can be carrier of some disease and show lack of osteoproliferation, while alloplasts and xenografts show only osteoconduction. According to these facts, it is obvious that there is a need for development an alternative graft material that will surpass these disadvantages.The reconstruction of deficient alveolar ridge defect by the lateral bone augmentation prior to the dental implant placement is predictable and commonly used method. Except animal studies, recent clinical studies showed that there is no difference in the osseointegration of titanium implants in deficient alveolar ridges reconstructed with autogenous cortical bone blocks or autogenous teeth.
Interventions
PROCEDUREtooth root augmentation
Autogenous tooth roots for lateral alveolar ridge augmentation and staged implant placement.
Sponsors
St. Catherine Specialty Hospital
Study design
Allocation
NA
Intervention model
SINGLE_GROUP
Primary purpose
TREATMENT
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
18 Years to 60 Years
Healthy volunteers
Yes
Inclusion criteria
* age 18 to 60 years * candidate for lateral ridge augmentation * insufficient bone ridge width at the recipient site for implant placement * sufficient bone height at the recipient site for implant placement and (e) * healthy oral mucosa * at least 2 mm keratinized tissue
Exclusion criteria
* general contraindications for dental and/or surgical treatments * inflammatory and autoimmune disease of the oral cavity, * uncontrolled diabetes (HbA1c \> 7%) * history of chemotherapy or radiotherapy within the past five years, * previous immunosuppressant, bisphosphonate or high- dose corticosteroid therapy * smokers * pregnant or lactating women
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| The primary endpoint was defined as the clinical width (CW) of the alveolar ridge | 6 months | The primary endpoint was defined as the clinical width (CW) of the alveolar ridge being sufficient for the placement of an adequately dimensioned dental implant without the need for a secondary grafting at 6 months after surgery in either group. CW was assessed before (CWa) and after (CWb) augmentation healing period of 6 months in cone-beam computed tomography (CBCT) scans. Measurements were performed to the nearest 0.5mm below the crest using a CBCT. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Periimplant tissue stability of augmented sites after prosthetic rehabilitation | 12 months | Usage of periimplant tissue parameters for assessing the conditions around implants placed in augmented sites using pink esthetic score (PES) that evaluates the esthetic outcome of soft tissue around implant-supported single crowns by awarding seven points for the mesial and distal papilla, soft-tissue level, soft-tissue contour, soft-tissue color, soft-tissue texture, and alveolar process deficiency. |
| gain in ridge width (CWg) | 6 months | CWg (mm) = CWb ( ridge after surgery in mm)- CWa ( ridge before surgery in mm) |
| soft tissue dehiscences | 6 months | yes/no for secondary wound healing |
| wound infections | 6 months | monitoring whether there is an increased incidence of inflammatory conditions after the specified procedure |
Countries
Croatia
Outcome results
None listed