scholarly journals The Alveolar Ridge Splitting Technique on Maxillae: A Biomechanical Human Cadaveric Investigation

2020 ◽  
Vol 2020 ◽  
pp. 1-7
Author(s):  
Fabian Duttenhoefer ◽  
Peter Varga ◽  
Dominik Jenni ◽  
Leonard Grünwald ◽  
Luisa Thiemann ◽  
...  
Keyword(s):  
Failure Modes ◽  
Quantitative Computed Tomography ◽  
Biomechanical Testing ◽  
Peripheral Quantitative Computed Tomography ◽  
Fracture Mechanisms ◽  
Testing System ◽  
Alveolar Ridge ◽  
Splitting Technique ◽  
Ridge Augmentation ◽  
Augmentation Techniques

The alveolar ridge splitting technique (ARST) offers an alternative to classic ridge augmentation techniques for successful insertion of dental implants. However, the buccal lamella is at risk of fracturing during ARST distraction. To better understand the fracture mechanisms and displacement limits of the split lamella, this study conducted biomechanical tests on human cadaveric maxilla specimens having extremely atrophied alveolar ridges treated with ARST. A total of 12 standardized alveolar splits were prepared on the maxillae of 3 elderly female donors using an oscillating piezoelectric saw. Mimicking the surgical distraction process of the lamella, each split was tested to failure using a dental osteotome attached to the crosshead of an electromechanical testing system. All specimens were scanned by means of high-resolution peripheral quantitative computed tomography prior to and post testing to evaluate split geometries and failure modes. Split stiffness, failure force, and displacement were 27.4 ± 18.7  N/mm, 12.0 ± 8.4  N, and 0.97 ± 0.31  mm, with no significant differences between anatomical sides and split locations ( p ≥ 0.17 ). Stiffness correlated significantly with failure force ( R 2 = 0.71 , p < 0.01 ). None of the alveolar split widths correlated significantly with the outcomes from biomechanical testing ( p ≥ 0.10 ). The results suggest that simple geometrical measures do not predict the allowed extent of lamella distraction prior to failure. More sophisticated methods are required for surgical planning to optimize the ARST outcomes. Still, the present study may advocate a clinical protocol for the maxilla where the implant site is prepared directly after osteotomy setting and immediately before full lamella dislocation, when the lamella is still stable, resistant to mechanical stress, and bone loss caused by the abrasion of the burr is minimized.

scholarly journals Horizontal Ridge Augmentation: A Comparison between Khoury and Urban Technique

Biology ◽  
2021 ◽  
Vol 10 (8) ◽  
pp. 749
Author(s):  
Javier Sánchez-Sánchez ◽  
Finn Niclas Pickert ◽  
Luis Sánchez-Labrador ◽  
Francisco GF Tresguerres ◽  
José María Martínez-González ◽  
...  
Keyword(s):  
Meta Analysis ◽  
Descriptive Analysis ◽  
Cochrane Central Register ◽  
Complication Rates ◽  
Alveolar Ridge ◽  
Ridge Augmentation ◽  
Manual Search ◽  
Central Register ◽  
Augmentation Techniques ◽  
Bone Gain

Purpose. The objective of this systematic review was to evaluate and compare the clinical efficacy of horizontal alveolar ridge augmentation techniques described by Khoury and Urban. Methods. A systematic electronic search in the MEDLINE databases, SCOPUS, WOS, and the Cochrane Central Register of Controlled Trials (CENTRAL) as well as a manual search, were conducted independently by two reviewers up to July 2021. Results. Six studies met the pre-established inclusion criteria and were included in the descriptive analysis. Due to the heterogeneity found across the included studies, meta-analysis could not be performed. Horizontal bone gain was between 3.93 ± 0.9 mm and 5.02 ± 0.8 mm with the Khoury technique and between 3.9 ± 0.9 mm and 5.68 ± 1.42 mm with the Urban technique. Similar complication rates were reported in both groups: infection (7%), in the Khoury technique, and membrane exposure (3.2–13.6%), in the Urban technique, being the most frequent events. Conclusions. Both techniques were found to be effective, in terms of clinical bone gain, for horizontal alveolar ridge gain. Nevertheless, available literature is limited, and there is a lack of comparative studies to better evaluate the results.

Horizontal Augmentation Through the Ridge-Split Procedure: A Predictable Surgical Modality in Implant Reconstruction

2013 ◽  
Vol 39 (1) ◽  
pp. 59-68 ◽  
Author(s):  
Len Tolstunov ◽  
Bruce Hicke
Keyword(s):  
Alveolar Bone ◽  
Inferior Alveolar Nerve ◽  
Bony Defect ◽  
Alveolar Ridge ◽  
Bone Augmentation ◽  
Ridge Augmentation ◽  
Augmentation Techniques ◽  
Ridge Split ◽  
Maxilla And Mandible ◽  
Careful Manipulation

Among alveolar ridge augmentation techniques, the ridge-split procedure demonstrates many benefits, including no need for a second (donor) surgical site, rare risk of inferior alveolar nerve injury, and less pain and swelling, and others. Lateral bone augmentation through the ridge-split works best in a localized lateral bony defect intended for 1 or 2 implants and where the ridge is vertically intact. In this article, the authors present a detailed description of the implant-driven technique of alveolar ridge-split procedure in small and large bone deficiencies, in maxilla and mandible, supplemented by multiple photographs. The authors emphasize the need for careful manipulation of the thin ridge based on knowledge of precise surgical principles and stress that a practitioner needs specialized training and experience to perform this type of alveolar bone augmentation.

scholarly journals Using Magnetic Resonance for Predicting Femoral Strength: Added Value with respect to Bone Densitometry

2015 ◽  
Vol 2015 ◽  
pp. 1-5 ◽  
Author(s):  
Olivia Louis ◽  
Yves Fierens ◽  
Maria Strantza ◽  
Robert Luypaert ◽  
Johan de Mey ◽  
...  
Keyword(s):  
Linear Regression ◽  
Multiple Linear Regression ◽  
Failure Load ◽  
Quantitative Computed Tomography ◽  
Biomechanical Testing ◽  
Peripheral Quantitative Computed Tomography ◽  
Multiple Regression Model ◽  
Added Value ◽  
Mineral Density ◽  
Femoral Strength

Background and Purpose. To evaluate the added value of MRI with respect to peripheral quantitative computed tomography (pQCT) and dual energy X-ray absorptiometry (DXA) for predicting femoral strength.Material and Methods. Bone mineral density (BMD) of eighteen femur specimens was assessed with pQCT, DXA, and MRI (using ultrashort echo times (UTE) and the MicroView software). Subsequently biomechanical testing was performed to assess failure load. Simple and multiple linear regression were used with failure load as the dependent variable.Results. Simple linear regression allowed a prediction of failure load with either pQCT, DXA, or MRI in anr2range of 0.41–0.48. Multiple linear regression with pQCT, DXA, and MRI yielded the best prediction (r2=0.68).Conclusions. The accuracy of MRI, using UTE and MicroView software, to predict femoral strength compares well with that of pQCT or DXA. Furthermore, the inclusion of MRI in a multiple-regression model yields the best prediction.

scholarly journals Finite Element Analysis and Biomechanical Testing to Analyze Fracture Displacement of Alveolar Ridge Splitting

2018 ◽  
Vol 2018 ◽  
pp. 1-7 ◽  
Author(s):  
Andres Stricker ◽  
Daniel Widmer ◽  
Boyko Gueorguiev ◽  
Dieter Wahl ◽  
Peter Varga ◽  
...  
Keyword(s):  
Finite Element ◽  
Testing Machine ◽  
Biomechanical Testing ◽  
Fe Model ◽  
Alveolar Ridge ◽  
Element Analysis ◽  
Good Correspondence ◽  
Fracture Force ◽  
Splitting Technique ◽  
Fracture Displacement

The alveolar ridge splitting technique enables reconstruction of atrophied alveolar ridges prior implantation. However, in cases of severe atrophy, there is an unpredictable risk of fracturing the buccal lamella during the expansion. Currently, there is no preoperative assessment to predict the maximum distraction of the lamella. The aim of this study was to develop a biomechanical model to mimic the alveolar ridge splitting and a finite element (FE) model to predict the experimental results. The biomechanical testing was conducted on porcine mandibles. To build the FE model high resolution peripheral quantitative computer tomography scans of one specimen was performed after the osteotomy outline, but before the lamella displacement. A servo-electric testing machine was used for the axial tension test to split the lamellae. Results showed, in line with clinical observations, that the lamellae broke primarily at the base of the splits with a median displacement of 1.27 mm. The FE model could predict fracture force and fracture displacement. Fracture force showed a nonlinear correlation with the height of the bone lamella. In conclusion, good correspondence between mechanical testing and virtual FE analysis showed a clinically relevant approach that may help to predict maximum lamella displacement to prevent fractures in the future.

scholarly journals Alveolar Ridge Augmentation Techniques in Implant Dentistry

2020 ◽  
Author(s):  
Melike Aytekin ◽  
Volkan Arisan
Keyword(s):  
Alveolar Bone ◽  
Treatment Plan ◽  
Bone Defects ◽  
Alveolar Ridge ◽  
Alveolar Ridge Augmentation ◽  
Sinus Augmentation ◽  
Ridge Augmentation ◽  
Augmentation Techniques ◽  
Implant Dentistry ◽  
Reconstruction Of Bone Defects

Implant supported restorations have become an ideal treatment alternative for the rehabilitation of edentulous sites. However alveolar bone defects due to resorption, trauma or oncologic diseases may considerably affect favorable implant positioning and prosthetic outcomes. Various alveolar ridge augmentation procedures are available to gain enough bone volume and apply the ideal treatment plan afterwards. Guided bone regeneration, ridge splitting, distraction osteogenesis, maxillary sinus augmentation and autogenous block bone grafting are main techniques which have successful outcomes in reconstruction of bone defects. It’s difficult to demonstrate that one augmentation procedure offers better outcomes than another. Studies documenting augmentation techniques seem to be comparable and state favorable results for each procedure.

Scanning electron microscopy of composite hydroxylapatite/plaster implants for bone reconstruction

1986 ◽  
Vol 44 ◽  
pp. 326-327
Author(s):  
J. S. Hanker ◽  
B. L. Giammara
Keyword(s):  
Tooth Extraction ◽  
Alveolar Ridge ◽  
Small Particles ◽  
Alveolar Ridge Augmentation ◽  
Sintered Ceramic ◽  
Ridge Augmentation ◽  
Fibrovascular Tissue ◽  
Infrabony Defects ◽  
Edentulous Patients ◽  
Scanning Electron

Nonresorbable sintered ceramic hydroxylapatite (HA) is widely employed for filling defects in jaw bone. The small particles used for alveolar ridge augmentation in edentulous patients or for infrabony defects due to periodontal disease tend to scatter when implanted using water or saline as the vehicle. Larger blocks of this material used for filling sockets after tooth extraction don't fit well. Studies in our laboratory where we compared bovine serum albumin, collagen and plaster of Paris as binders to prevent particle scatter during implantation suggested that plaster was most useful for this purpose. In addition to preventing scatter of the particles, plaster enables the formation of implants of any size and.shape either prior to or during surgery. Studies with the PATS reaction have indicated that plaster acts as a scaffold for the incorporation of HA particles into bone in areas where the implant contacts either host bone or periosteum. The shape and integrity of the implant is maintained by the plaster component until it is replaced over a period of days by fibrovascular tissue.

High resolution peripheral quantitative computed tomography (HR-pQCT) und die klinische Relevanz der Resultate

2013 ◽  
Vol 22 (01) ◽  
pp. 13-17
Author(s):  
J. M. Patsch ◽  
R. Kocijan ◽  
H. Resch ◽  
J. Haschka
Keyword(s):  
Computed Tomography ◽  
High Resolution ◽  
Quantitative Computed Tomography ◽  
Peripheral Quantitative Computed Tomography ◽  
Klinische Relevanz

ZusammenfassungKnochenstabilität ist durch Knochenvolumen und Mikroarchitektur des Knochens determiniert. Mittels HR-pQCT (high resolution peripheral quantitative computed tomography) steht eine nicht invasive Methode zur Verfügung, um die Mikroarchitektur des Knochens darzustellen. Die Resultate aus zahlreichen Studien geben Rückschlüsse auf unterschiedliche Strukturalterationen im Rahmen von Erkrankungen, die mit einem erhöhten Frakturrisiko einhergehen. Die Knochendichtemessung mittels DXA spiegelt das Frakturrisiko oft nicht adäquat wider. Umso entscheidender ist es, Risikofaktoren in der Wahl der Therapie zu berücksichtigen. Die klinische Relevanz der Resultate aus HR-pQCT-Messungen besteht derzeit dahingehend, dass wertvolle Informationen über Veränderungen der Mikroarchitektur auf Forschungsebene erhoben werden.

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