Simultaneous placement of implant and bone graft in the anterior maxilla: a case report

This article describes a method for harvesting intramembranous bone from the paranasal bone around the piriform aperture for lateral alveolar ridge augmentation and simultaneous implant placement in the anterior maxilla. In particular, the technique is recommended for situations where a maxillary incisal implant is being placed and ridge augmentation is needed to cover exposed threads. Surgical access is simple and can be accomplished by the same incision, and bone harvesting can be accomplished under local anesthesia. Postoperative morbidity is not yet known.     

Focal osteoporotic hematopoietic bone marrow defect formation around a dental implant: a case report

Focal osteoporotic bone marrow defects usually appear as asymptomatic radioluencies in the edentulous posterior mandible of middle-aged women. The exact causative factor in the majority of focal osteoporotic bone marrow defects is still unknown. Because of their radiological similarity with many intraosseous lesions, accurate diagnosis is possible only with histopathological examination. A focal osteoporotic bone marrow defect that occurred 2 years postoperatively apical to an implant is presented with clinical, radiographic, and histopathologic features. According to the literature scan, this is the first case report of this phenomenon caused by a dental implant. Int J Oral Maxillofac Implants 2011;26:e1-e4.     

Guided bone regeneration at immediate implant insertion and loading: a case report

A tapered-end, SLA- (sandblasted and acid-etched) surfaced ITI implant was placed in a compromised ridge at the time of tooth removal. After placement of nonautogenous regenerative materials, the implant was immediately loaded with a provisional restoration within 2 hours of implant insertion. Six-month reentry demonstrated regeneration of lostalveolar bone surrounding the implant and clinical implant immobility. Clinical ramifications of these findings are discussed.     

Ramus graft and 1-stage implant placement: a case report

Althougth hard-tissue grafting protocols have typically recommended a 6-month healing period before placement of any dental implants at the graft site, it may be possible to secure an onlay graft to a wide but shallow alveolar ridge using implants that are then submerged and allowed to osseointegrate. This approach has the advantage of expediting treatment and making it less traumatic for the patient. A case is described in which a portion of an edentulous mandible was augmented with ramus bone secured with 2 dental implants.     

Acellular dermal matrix graft as a membrane for guided bone regeneration: a case report

Guided bone regeneration has been successfully used to treat several types of bone defects. Problems associated with the procedure, such as premature exposure of the membranes to the oral cavity and, consequently, contamination, may occur. The acellular dermal matrix graft material is presently used to treat several soft tissue problems. It could be used for guided bone regeneration with the advantage of forming soft tissue while acting as a barrier membrane. A patient in need of guided bone regeneration for the staged placement of an implant was treated by using the acellular dermal matrix graft material as a barrier membrane. Healing progressed uneventfully with the formation of adequate new bone and an increase in the width of keratinized tissue.     

Intraorally exposed anterior Stafne bone defect: a case report

Anterior Stafne bone defect is a rare lingual bone depression mostly seen in the mandibular canine-premolar region; however, exposure of the defect into the oral cavity is quite rare. In this article, a case of anterior Stafne bone cavity, which can be seen in the intraoral examination, is presented with clinical features. Surgery is not considered for this case and after 2 years of follow-up, the defect remained stable.     

Immunohistochemical characterization of guided bone regeneration at a dehiscence-type defect using different barrier membranes: an experimental study in dogs

Objectives: The aim of the present study was to evaluate immunohistochemically the pattern of guided bone regeneration (GBR) using different types of barrier membranes. Material and methods: Standardized buccal dehiscence defects were surgically created following implant bed preparation in 12 beagle dogs. Defects were randomly assigned to six different GBR procedures: a collagen‐coated bone grafting material (BOC) in combination with either a native, three cross‐linked, a titanium‐reinforced collagen membrane, or expanded polytetrafluorethylene (ePTFE), or BOC alone. After 1, 2, 4, 6, 9, and 12 weeks of submerged healing, dissected blocks were processed for immunohistochemical (osteocalcin – OC, transglutaminase II – angiogenesis) and histomorphometrical analysis [e.g., bone‐to‐implant contact (BIC), area of new bone fill (BF)]. Results: In general, angiogenesis, OC antigen reactivity, and new bone formation mainly arose from open bone marrow spaces at the bottom of the defect and invaded the dehiscence areas along the implant surface and BOC. At 4 weeks, membranes supporting an early transmembraneous angiogenesis also exhibited some localized peripheral areas of new bone formation. However, significantly increasing BIC and BF values over time were observed in all groups. Membrane exposure after 10–12 weeks was associated with a loss of the supporting alveolar bone in the ePTFE group. Conclusion: Within the limits of the present study, it was concluded that (i) angiogenesis plays a crucial role in GBR and (ii) all membranes investigated supported bone regeneration on an equivalent level.     

Management of apical bone loss around a mandibular implant: a case report

Various terms, etiologies, and treatment strategies have been suggested in conjunction with bone loss limited only to the apical portion of an implant that remains otherwise well osseointegrated. Proposed etiologic factors include bone overheating, microbial involvement of adjacent teeth, pre-existing bone infection, and overload. However, the mandible and maxilla seem to have different predispositions in response to these causative agents. Treatment protocols for peri-implant infection have included minimally invasive approaches such as granulation tissue removal and detoxification of the implant surface, as well as more aggressive measures. This case report demonstrates the achievement of osseous healing and reosseointegration in a patient who presented with presented apical bone loss and signs of infection around a mandibular implant. Reosseointegration was achieved following an intraoral apicoectomy-like approach, ie, removal of the infected nonintegrated portion of the implant, and meticulous debridement of the granulation tissue. A literature review of 13 relevant published studies was conducted. The current understandings regarding the etiology and treatment strategies for management of apical bone loss around dental implants are summarized and presented.     

Vertical mandibular alveolar bone distraction and dental implant placement: a case report

Extensive bone defects complicate the adequate placement of dental implants and the required angulation. In such cases, alveolar-ridge augmentation techniques such as guided bone regeneration, particulate or block grafting, and alveolar bone distraction are needed. The present study describes a case in which a large vertical bone defect in the anterior mandibular zone was corrected via vertical alveolar bone distraction. Six dental implants were posteriorly placed for implant-supported restoration of the mandible, with early implant loading. The clinical and radiologic control showed good implant and soft tissue conditions 12 months later.     

Maxillary bone growth and implant positioning in a young patient: a case report

The literature supports the efficacy of osseointegrated implants for partially edentulous patients, but care must be exercised in adolescents with incomplete bone formation. Implants do not follow the normal growth of the jaws, and they behave like ankylosed teeth. They may also interfere with the normal growth of the alveolar process and jeopardize the germs of the adjacent permanent teeth or alter eruption. This case report analyzes the unfavorable clinical and radiographic findings of a single-tooth replacement in a young male over a 15-year period.     

Mandibular bone growth induced by a hydroxylapatite-coated subperiosteal implant: a case report

History of the tripodal mandibular subperiosteal implant and the evolution of its design are discussed. Basic principles of bone physiology are reviewed especially as they relate to bone response to loading. Modeling and remodeling are controlled by a strain-related environment. Modeling can alter the shape and volume of bone. This aspect of bone growth has been reported with transosteal implants. A case report is presented in which apparent bone growth occurred following placement of a hydroxylapatite-coated subperiosteal implant. The implant was successfully revised following an acute infection around one of the permucosal sites.     

Considerations in placement of implants through existing split-thickness skin graft vestibuloplasty: a case report

Many edentulous patients who previously have undergone vestibuloplasty with split-thickness skin grafting to improve denture stability and function seek additional help with dental implants. Problems encountered following the placement of four endosseous root-form dental implants in one such patient are presented. The anatomic and surgical considerations as well as methods available to circumvent these problems are discussed.     

Postoperative maxillary cyst following sinus bone graft: report of a case

Sinus bone grafting with autogenous bone is routinely performed to allow placement of endosseous dental implants. Although numerous maxillary sinuses have been successfully grafted, some complications of this procedure have been reported. These include maxillary sinusitis, resorption, infection and possible failure of grafts, loss of implants after 1-stage surgery, and oroantral fistulae. Only one case of postoperative maxillary cyst developing in the graft has been reported in the literature. Here, the authors report a similar case that necessitated grafting of the cyst with autologous iliac bone.     

A close-up look at an implant fracture: a case report

The authors report on the fracture of a standard endosseous dental implant 11 years after placement. It had been connected to a natural tooth using a nonrigid connector to compensate for the lack of a built-in antirotational system on the prosthetic abutment of the implant restoration. Scanning electron microscopy revealed striations on the fracture surface, suggesting a fatigue-associated failure.     

Simultaneous implant placement and vertical ridge augmentation with a titanium-reinforced membrane: a case report

The present report demonstrates a clinical approach to achieve vertical ridge augmentation around endosseous implants. Two implants were placed, leaving the threads exposed, in the atrophic mandibular right posterior quadrant of a male patient. Both implants were covered with a titanium-reinforced expanded polytetrafluoroethylene (e-PTFE) membrane. Second-stage surgery was performed 12 months after implant placement. Upon membrane removal, growth of mineralized tissue was observed around both implants, covering areas previously not covered by bone. Implants were then progressively loaded and restored. Titanium-reinforced e-PTFE membranes can be satisfactorily used for vertical augmentation of atrophic ridges.     

Simultaneous sinus membrane elevation and dental implant placement without bone graft: a 6-month follow-up study

Background: Previous studies have shown that simultaneous elevation of the sinus mucosal lining and placement of dental implants without graft materials can be a predictable procedure. Nevertheless, few prospective, controlled, and randomized studies have evaluated this technique. The aim of this prospective, controlled, and randomized clinical study is to evaluate whether sinus membrane elevation and simultaneous placement of dental implants without autogenous bone graft can create sufficient bone support to allow implant success 6 months post‐surgically. Methods: Sinus membrane elevation and simultaneous placement of dental implants were performed bilaterally in 15 patients in a split‐mouth design. The sinuses were assigned to two groups: the test group, with simultaneous sinus mucosal lining elevation and placement of dental implants without graft materials; and the control group, with simultaneous sinus mucosal lining elevation and placement of dental implants with intraoral autogenous bone graft. After 6 months of healing, abutments were connected. For each implant, length of implant protrusion into the sinus, resonance frequency analysis, and bone gain were recorded at baseline and 6 months follow‐up. Results: Clinical complications were not observed, except for two postoperative fistulas and suppuration in both groups. Only one implant of the test group was lost, reaching a success rate of 96.4% and 100% for the test and control groups, respectively. After healing, radiographic new peri‐implant bone was observed in both groups ranging between 8.3 ± 2.6 and 7.9 ± 3.6 mm for the control and test groups, respectively (P >0.05). Resonance frequency analysis values were lower for the control group compared to baseline (P <0.05). However, these values were similar at 6 months (P >0.05). A significant positive correlation was found between the protruded implant length/bone gain and implant survival/sinusitis (P <0.0001). Conclusion: Implants placed simultaneously to sinus membrane elevation without graft material resulted in bone formation over a period of 6 months.