fibrin and Jaw--Edentulous--Partially

The aim of this study was to evaluate the success and complications following inferior alveolar nerve (IAN) transposition/reposition for dental implant placement in edentulous or partially edentulous mandibles. This was a multicenter retrospective study; patients who had undergone IAN transposition/reposition at four surgical clinics were retrospectively evaluated. Adverse effects, especially neural disturbances, were recorded and followed. Overall, 68 IAN reposition and 11 nerve transposition procedures were performed in 57 patients (only three patients reported on smoking). The residual bone above the IAN was an average 3.88±1.98mm. A total of 232 dental implants were inserted in the area after transposition/reposition of the nerve. The average follow-up time was 20.62±9.79 months, ranging from 12 to 45 months. One implant loss was observed during the follow-up period. Four patients reported prolonged transient neural disturbances immediately following surgery (5% of the operations). The duration of neural disturbances after the surgery ranged from 1 to 6 months. No permanent neural damage was reported. Thus, within this study's limitations, it can be concluded that IAN transposition and reposition are useful adjunct techniques for managing severely atrophic edentulous or partially edentulous mandibles with dental implants. The risk of neural dysfunction appears to be low.

Topics: Blood Platelets; Cohort Studies; Collagen; Cranial Nerve Diseases; Dental Implantation, Endosseous; Dental Implants; Dental Prosthesis Design; Dental Restoration Failure; Female; Fibrin; Follow-Up Studies; Humans; Jaw, Edentulous; Jaw, Edentulous, Partially; Male; Mandible; Mandibular Nerve; Microdissection; Middle Aged; Osteotomy; Piezosurgery; Postoperative Complications; Retrospective Studies; Smoking; Time Factors; Touch; Treatment Outcome

The rehabilitation of edentulous posterior maxilla is a challenging task that could be complicated by the availability of low-density and reduced height of alveolar bone. Patients were enrolled in this study upon the presence of type IV bone and residual bone height <5 mm in posterior maxilla. Novel procedure for transalveolar sinus floor elevation was described to insert 10 short implants in 4 patients. Neither implant failure nor prosthetic failure was observed during a follow-up of 44 ± 3 months. Mesial bone loss of 0.5 ± 0.6 mm and a distal bone loss 1.3 ± 0.9 mm were measured after 35 ± 4 months of loading.

Topics: Alveolar Process; Atrophy; Bone Density; Cone-Beam Computed Tomography; Dental Implantation, Endosseous; Dental Implants; Dental Prosthesis Design; Dental Prosthesis, Implant-Supported; Denture, Partial, Fixed; Fibrin; Follow-Up Studies; Humans; Jaw, Edentulous, Partially; Maxilla; Middle Aged; Patient Care Planning; Sinus Floor Augmentation; Treatment Outcome

Anorganic bovine bone (Bio-Oss®) particles are one of the most popular grafting materials. The particles are often mixed with platelet-rich fibrin (PRF) or a commercial fibrin (Tisseel®) to form a mouldable graft material. The objective of this study was to compare the potentials of PRF-mixed Bio-Oss® and Tisseel®-mixed Bio-Oss® to enhance bone regeneration in a canine sinus model. Six mongrel dogs were used in this study. After elevating the sinus membrane in both maxillary sinus cavities, an implant was placed into the sinus cavity. In one of the sinus cavities, the PRF/Bio-Oss® composite was grafted, and the Tisseel®/Bio-Oss® composite was grafted in the other sinus cavity. After a 6 month healing period, bone formation in the graft sites and bone-implant contact were evaluated. The mean osseointegration rate was 43.5 ± 12.4% and new bone formation rate 41.8 ± 5.9% in the PRF/Bio-Oss® composite sites. In the Tisseel®/Bio-Oss® composite sites they were 30.7 ± 7.9% and 31.3 ± 6.4%. There were statistically significant differences between the groups. The findings from this study suggest that when platelet-rich fibrin is used as an adjunct to Bio-Oss® particles for bone augmentation in the maxillary sinus, bone formation in the graft sites is significantly greater than when Tisseel® is used.

Topics: Animals; Blood Platelets; Bone Regeneration; Bone Substitutes; Cattle; Dental Implants; Dogs; Female; Fibrin; Fibrin Tissue Adhesive; Jaw, Edentulous, Partially; Maxilla; Minerals; Osseointegration; Osteogenesis; Random Allocation; Sinus Floor Augmentation; Surgical Flaps; Wound Healing

Atrophic edentulous anterior maxilla is a challenging site for implant placement and has been successfully treated surgically by anterior maxillary osteoplasty. This procedure is associated with considerable discomfort, morbidity, and cost-and consequently reduced patient acceptance. The efficacy and safety of minimally invasive bone augmentation of the posterior maxilla has not been extended thus far to the anterior subnasal maxilla. We present 2 representative cases in which minimally invasive subnasal floor elevation was performed along with minimally invasive antral membrane balloon elevation. Both segments underwent bone grafting and implant placement during the same sitting. Minimally invasive anterior maxilla bone augmentation appears to be feasible. Designated instruments for alveolar ridge splitting and nasal mucosa elevation are likely to further enhance this initial favorable experience.

Topics: Blood Platelets; Bone Substitutes; Catheters; Dental Implantation, Endosseous; Dental Implants; Female; Fibrin; Follow-Up Studies; Humans; Jaw, Edentulous; Jaw, Edentulous, Partially; Male; Maxilla; Membranes, Artificial; Middle Aged; Minimally Invasive Surgical Procedures; Nasal Mucosa; Osteotomy; Piezosurgery; Sinus Floor Augmentation; Treatment Outcome

This article describes a technique and reports on the early healing for localized sinus augmentation using a crestal approach in combination with an autologous leukocyte- and platelet-rich fibrin (PRF) concentrate.. From November 2008 to January 2010, 138 implants were placed in 110 patients using osteotome-mediated sinus floor elevation (OMSFE) with PRF.. The mean residual subantral bone height of the alveolar ridge was 6.6 mm (range, 4-8 mm). The mean increase in the height of implant sites by OMSFE/PRF was 3.4 mm (range, 2.5-5 mm). A variety of 8- to 11.5-mm long (mean length, 10.1 mm) and 3.5- to 6-mm wide (mean width, 4.4 mm) screw-type implants were used. Of the 138 implants that had been placed, 97 have been restored and in function for an average loading time of 5.2 months (range, 1-11 months). The mean healing time for the loaded implants was 4 months until abutment insertion (range, 3-5 months). Three implants failed before loading for an early survival rate of both loaded and unloaded implants of 97.8%.. Early review of the OMSFE/PRF technique presented for localized sinus floor elevation and implant placement demonstrates a high degree of safety and success at sites with 5- to 8-mm residual subantral bone height.

Topics: Adult; Aged; Aged, 80 and over; Alveolar Ridge Augmentation; Blood Platelets; Dental Abutments; Dental Implantation, Endosseous; Dental Implants; Dental Prosthesis Design; Dental Prosthesis, Implant-Supported; Dental Restoration Failure; Female; Fibrin; Humans; Jaw, Edentulous; Jaw, Edentulous, Partially; Leukocytes; Male; Maxilla; Maxillary Sinus; Middle Aged; Mucous Membrane; Osseointegration; Osteotomy; Survival Analysis; Treatment Outcome; Wound Healing