Immediate Implants with Early Loading Accompanying Autogenous Bone Grafting in a Maxilla with Periodontal Destruction: A Case Report

In the case of multiple hopeless teeth and severe bone loss, a conventional healing protocol of 3–4 months has been recommended to prevent the possibility of infection or unpredictable resorption of grafted bone during consolidation of the extraction socket. The use of a provisional denture is inevitable in the case of delayed implant placement, which is a common risk factor for wound dehiscence after a bone graft. Although autogenous bone is still the gold standard for bone grafting because of its excellent biocompatibility and osteogenic potential, there has been controversy in the unpredictable resorption of autogenous bone grafting. We present a case of successful maxillary rehabilitation without the use of provisional dentures by immediate implant placement, with early loading accompanying an extensive autogenous bone graft.

Magnetic mallets – A stroke of luck in implantology: A review

Magnetic mallet was introduced in dentistry by Bonwill in 1873. It was introduced with the aim of increasing the efficacy of hammered gold fillings. Magnetic mallet is a magnetodynamical handpiece with an ergonomical design. It comprises central control with force adjustment, sterilizable handpiece with different replaceable tips, and pedal control. It comes with an entire range of bone expanders/osteotomes, cutter, and other instruments. It is applicable for procedures such as tooth and root extraction, impacted tooth removal, delayed implant placement, bone manipulating and sinus lifting procedures, root apex resection, removal of crowns, bridges, and implant part. The use of magnetic mallet is said to provide with better clinical advantage.

A retrospective preliminary histomorphometric and clinical investigation on sinus augmentation using enzyme-deantigenic, collagen-preserving equine bone granules and plasma rich in growth factors

Background Enzyme-deantigenic equine bone (EDEB) is a substitute of autogenous bone. Mixing it with plasma rich in growth factors (PRGF) seems a viable option to achieve enhanced bone formation in alveolar bone augmentation surgeries. This retrospective study aims to first report the histomorphometric and clinical outcomes achieved when using the EDEB/PRGF mixture for performing sinus augmentation procedures followed by delayed implant placement. Materials and methods Records of 11 patients who underwent 14 sinus augmentation surgeries using EDEB/PRGF followed by delayed implant placement were retrospectively collected and analyzed to assess histomorphometric data concerning newly formed bone (NFB) and residual biomaterial (RB) recorded at implant placement, marginal bone loss (MBL) values of implants placed in the augmented sinuses, and implant and prosthetic success and survival rates. Results At 5.6 ± 1.1 months after grafting, NFB and RB were 34.0 ± 9.1% and 11.3 ± 2.2% respectively, and no histologic signs of inflammation or immune reaction were observed in any of the 34 bone biopsies being collected. Further, 86.5 ± 4.3 months after implant placement, MBL was 0.40 ± 0.07 mm. No implant or prosthesis failed, and the implant success and survival rates were 100% Conclusions Within the limitations of the present study, grafting EDEB/PRGF for lateral sinus augmentation and delayed implant placement seems to be safe. Compared to published data concerning EDEB alone, results of the present study do not suggest that the EDEB/PRGF combination may provide a histomorphometric or medium-/long-term clinical advantage.

Simultaneous implant placement with autogenous onlay bone grafts: a systematic review and meta-analysis

Several authors have suggested that implants can be placed simultaneously with onlay bone grafts without affecting outcomes. Therefore, the purpose of this study was to answer the following clinical questions: (1) What are the outcomes of implants placed simultaneously with autogenous onlay bone grafts? And (2) is there a difference in outcomes between simultaneous vs delayed placement of implants with autogenous onlay bone grafts? Databases of PubMed, Embase, and Google Scholar were searched up to 15 November 2020. Data on implant survival was extracted from all the included studies (single arm and comparative) to calculate point estimates with 95% confidence intervals (CI) and pooled using the DerSimonian–Laird meta-analysis model. We also compared implant survival rates between the simultaneous and delayed placement of implants with data from comparative studies. Nineteen studies were included. Five of them compared simultaneous and delayed placement of implants. Dividing the studies based on follow-up duration, the pooled survival of implant placed simultaneously with onlay grafts after <2.5 years of follow-up was 93.1% (95% CI 82.6 to 97.4%) and after 2.5–5 years was 86% (95% CI 78.6 to 91.1%). Implant survival was found to be 85.8% (95% CI 79.6 to 90.3%) with iliac crest grafts and 95.7% (95% CI 83.9 to 93.0%) with intra-oral grafts. Our results indicated no statistically significant difference in implant survival between simultaneous and delayed placement (OR 0.43, 95% 0.07, 2.49, I2=59.04%). Data on implant success and bone loss were limited. Data indicates that implants placed simultaneously with autogenous onlay grafts have a survival rate of 93.1% and 86% after a follow-up of <2.5 years and 2.5–5years respectively. A limited number of studies indicate no significant difference in implant survival between the simultaneous and delayed placement of implants with onlay bone grafts. There is a need for randomized controlled trials comparing simultaneous and delayed implant placement to provide robust evidence.

Full Mouth Rehabilitation Using Alveolar Ridge Splitting Technique with Immediate Implant Placement in the Maxilla and Delayed Implant Placement in the Mandible: A Case Report with 4 Years Follow-Up

The bone split technique is used to increase the width of a narrow ridge for implant placement with high success rates. This technique was performed on a 53-year-old patient with bilateral mandibular posterior edentulous and fully edentulous maxilla. Implants placement was performed afterward with two-step modus operandi on the mandible and immediate placement on maxilla. A successful prosthetic rehabilitation was done following the healing phase. This approach led to full restoration of function and esthetic with a predictable outcome.

Comparison of Dehydrated Human Amnion-Chorion and Type 1 Bovine Collagen Membranes in Alveolar Ridge Preservation: A Clinical and Histological Study

Alveolar ridge preservation maintains ridge dimensions and bone quality for implant placement. The aim of this randomized controlled clinical study is to compare the use of a human amnion-chorion membrane to a collagen membrane in an exposed-barrier ridge preservation technique. Furthermore, this study will determine if intentional membrane exposure compromises ridge dimensions and bone vitality.Forty-three patients requiring extraction and delayed implant placement were randomly assigned into either the experimental or control group. Twenty-one participants received human amnion-chorion membrane (test) during ridge preservation while twenty-two participants received the collagen membrane (control). In both groups, demineralized freeze-dried bone allografts were used to graft the socket and primary closure was not achieved.The patients underwent implant placement after an average healing period of 19.5 weeks, and 2.7 X 8-mm core bone specimens were obtained for histomorphometric analyses. The clinical ridge dimensions were measured after extraction and at the time of delayed implant placement. No significant difference was observed in the mean vital bone formation between the experimental (51.72 ± 8.46%) and control (49.96 ± 8.31%; P &gt; 0.05) groups. The bone height and width did not differ, as determined by clinical measurements (P &gt; 0.05). Using either a human amnion-chorion membrane or type 1 bovine collagen as the open barrier did not change healing, compromise ridge dimensions, or affect bone vitality between the two groups.