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Dental implants with versus without peri-implant bone defects treated with guided bone regeneration.

Aloy-Prósper A, Peñarrocha-Oltra D, Peñarrocha-Diago M, Peñarrocha-Diago M - J Clin Exp Dent (2015)

Bottom Line: The guided bone regeneration (GBR) technique is highly successful for the treatment of peri-implant bone defects.No statistically significant differences between both groups were found.Key words:Guided bone regeneration, peri-implant defects, dental implants, marginal bone level, success rate, survival rate.

View Article: PubMed Central - PubMed

Affiliation: DDS, MSc, Collaborating Professor of the Master in Oral Surgery and Implant Dentistry, Stomatology Department, Faculty of Medicine and Dentistry, University of Valencia, Spain.

ABSTRACT

Background: The guided bone regeneration (GBR) technique is highly successful for the treatment of peri-implant bone defects. The aim was to determine whether or not implants associated with GBR due to peri-implant defects show the same survival and success rates as implants placed in native bone without defects.

Material and methods: Patients with a minimum of two submerged dental implants: one suffering a dehiscence or fenestration defect during placement and undergoing simultaneous guided bone regeneration (test group), versus the other entirely surrounded by bone (control group) were treated and monitored annually for three years. Complications with the healing procedure, implant survival, implant success and peri-implant marginal bone loss were assessed. Statistical analysis was performed with non-parametric tests setting an alpha value of 0.05.

Results: Seventy-two patients and 326 implants were included (142 test, 184 control). One hundred and twenty-five dehiscences (average height 1.92±1.11) and 18 fenestrations (average height 3.34±2.16) were treated. At 3 years post-loading, implant survival rates were 95.7% (test) and 97.3% (control) and implant success rates were 93.6% and 96.2%, respectively. Mean marginal bone loss was 0.54 (SD 0.26 mm) for the test group and 0.43 (SD 0.22 mm) for the control group. No statistically significant differences between both groups were found.

Conclusions: Within the limits of this study, implants with peri-implant defects treated with guided bone regeneration exhibited similar survival and success rates and peri-implant marginal bone loss to implants without those defects. Large-scale randomized controlled studies with longer follow-ups involving the assessment of esthetic parameters and hard and soft peri-implant tissue stability are needed. Key words:Guided bone regeneration, peri-implant defects, dental implants, marginal bone level, success rate, survival rate.

No MeSH data available.


Related in: MedlinePlus

Occlusal preoperative view.
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Figure 1: Occlusal preoperative view.

Mentions: Surgical procedures were performed by the same surgeon with an extensive experience in regenerative procedures. All procedures were performed under local anesthesia using 4% articaine 1:100,000 adrenalin (Inibsa, Lliça de Vall, Spain) and intravenous conscious sedation with 1% propofol solution, administered by an anesthesiologist. All patients received antibiotic prophylaxis (amoxicillin and clavulanic acid, 1g every 8 hours starting 1 day preoperatively (14)). An initial incision was made slightly palatal/lingual of the alveolar crest. One or two releasing incisions were made and a mucoperiosteal flap was raised. The exposed alveolar bone was curetted to remove all soft tissues. To enhance primary stability, drills and osteotomes were combined to prepare implant beds. TSATM implants with Avantblast surface (Phibo Dental Solutions S.L., Sentmenat, Barcelona, Spain) were inserted using standard procedures following the manufacturer’s guidelines. These implants have a polished surface portion of 1.5 mm. All implants were placed with adequate primary stability (≥35 Ncm). In implants that did not need bone regeneration, bone width from the implant head to the facial plate was over 1.5 mm. In implants that needed bone regeneration, autologous bone grafts harvested from the conformation of implant beds during drilling and was adjusted to the bone contour. When the autologous bone obtained was of insufficient quantity to cover the peri-implant defects, synthetic bone (Kera-OsTM, Keramat, Coruña, Spain) was added. Grafted bone was protected with a textured collagen membrane (Lyopstic, B Braun, Aesculap, Germany). Periosteal incisions were made to allow flap mobilization and tension free primary wound closure. Implants were left submerged. Flaps were closed with horizontal sutures using Polisoft® 4/0 sutures (Sweden & Martina, Due Carrare, Italy) (Figs. 1-10). Patients were prescribed amoxicillin and clavulanic acid 1g (GlaxoSmithKline, Madrid, Spain) twice daily for six days, 600 mg ibuprofen (Bexistar, Laboratorio Bacino, Barcelona, Spain) three times per day for five days and mouthrinse with chlorhexidine 0.12% (GUM, John O Butler/Sunstar, Chicago, IL, U.S.A.) twice daily, commencing three days prior to surgery and for two weeks thereafter. Patients were instructed in adequate hygiene maintenance and a soft diet was recommended for eight weeks. Patients were not allowed to use removable prostheses for three weeks after bone grafting surgeries. A soft diet was recommended for one week and patients were instructed to avoid brushing or any other trauma to the surgical sites. Sutures were removed two weeks after surgery.


Dental implants with versus without peri-implant bone defects treated with guided bone regeneration.

Aloy-Prósper A, Peñarrocha-Oltra D, Peñarrocha-Diago M, Peñarrocha-Diago M - J Clin Exp Dent (2015)

Occlusal preoperative view.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4554234&req=5

Figure 1: Occlusal preoperative view.
Mentions: Surgical procedures were performed by the same surgeon with an extensive experience in regenerative procedures. All procedures were performed under local anesthesia using 4% articaine 1:100,000 adrenalin (Inibsa, Lliça de Vall, Spain) and intravenous conscious sedation with 1% propofol solution, administered by an anesthesiologist. All patients received antibiotic prophylaxis (amoxicillin and clavulanic acid, 1g every 8 hours starting 1 day preoperatively (14)). An initial incision was made slightly palatal/lingual of the alveolar crest. One or two releasing incisions were made and a mucoperiosteal flap was raised. The exposed alveolar bone was curetted to remove all soft tissues. To enhance primary stability, drills and osteotomes were combined to prepare implant beds. TSATM implants with Avantblast surface (Phibo Dental Solutions S.L., Sentmenat, Barcelona, Spain) were inserted using standard procedures following the manufacturer’s guidelines. These implants have a polished surface portion of 1.5 mm. All implants were placed with adequate primary stability (≥35 Ncm). In implants that did not need bone regeneration, bone width from the implant head to the facial plate was over 1.5 mm. In implants that needed bone regeneration, autologous bone grafts harvested from the conformation of implant beds during drilling and was adjusted to the bone contour. When the autologous bone obtained was of insufficient quantity to cover the peri-implant defects, synthetic bone (Kera-OsTM, Keramat, Coruña, Spain) was added. Grafted bone was protected with a textured collagen membrane (Lyopstic, B Braun, Aesculap, Germany). Periosteal incisions were made to allow flap mobilization and tension free primary wound closure. Implants were left submerged. Flaps were closed with horizontal sutures using Polisoft® 4/0 sutures (Sweden & Martina, Due Carrare, Italy) (Figs. 1-10). Patients were prescribed amoxicillin and clavulanic acid 1g (GlaxoSmithKline, Madrid, Spain) twice daily for six days, 600 mg ibuprofen (Bexistar, Laboratorio Bacino, Barcelona, Spain) three times per day for five days and mouthrinse with chlorhexidine 0.12% (GUM, John O Butler/Sunstar, Chicago, IL, U.S.A.) twice daily, commencing three days prior to surgery and for two weeks thereafter. Patients were instructed in adequate hygiene maintenance and a soft diet was recommended for eight weeks. Patients were not allowed to use removable prostheses for three weeks after bone grafting surgeries. A soft diet was recommended for one week and patients were instructed to avoid brushing or any other trauma to the surgical sites. Sutures were removed two weeks after surgery.

Bottom Line: The guided bone regeneration (GBR) technique is highly successful for the treatment of peri-implant bone defects.No statistically significant differences between both groups were found.Key words:Guided bone regeneration, peri-implant defects, dental implants, marginal bone level, success rate, survival rate.

View Article: PubMed Central - PubMed

Affiliation: DDS, MSc, Collaborating Professor of the Master in Oral Surgery and Implant Dentistry, Stomatology Department, Faculty of Medicine and Dentistry, University of Valencia, Spain.

ABSTRACT

Background: The guided bone regeneration (GBR) technique is highly successful for the treatment of peri-implant bone defects. The aim was to determine whether or not implants associated with GBR due to peri-implant defects show the same survival and success rates as implants placed in native bone without defects.

Material and methods: Patients with a minimum of two submerged dental implants: one suffering a dehiscence or fenestration defect during placement and undergoing simultaneous guided bone regeneration (test group), versus the other entirely surrounded by bone (control group) were treated and monitored annually for three years. Complications with the healing procedure, implant survival, implant success and peri-implant marginal bone loss were assessed. Statistical analysis was performed with non-parametric tests setting an alpha value of 0.05.

Results: Seventy-two patients and 326 implants were included (142 test, 184 control). One hundred and twenty-five dehiscences (average height 1.92±1.11) and 18 fenestrations (average height 3.34±2.16) were treated. At 3 years post-loading, implant survival rates were 95.7% (test) and 97.3% (control) and implant success rates were 93.6% and 96.2%, respectively. Mean marginal bone loss was 0.54 (SD 0.26 mm) for the test group and 0.43 (SD 0.22 mm) for the control group. No statistically significant differences between both groups were found.

Conclusions: Within the limits of this study, implants with peri-implant defects treated with guided bone regeneration exhibited similar survival and success rates and peri-implant marginal bone loss to implants without those defects. Large-scale randomized controlled studies with longer follow-ups involving the assessment of esthetic parameters and hard and soft peri-implant tissue stability are needed. Key words:Guided bone regeneration, peri-implant defects, dental implants, marginal bone level, success rate, survival rate.

No MeSH data available.


Related in: MedlinePlus