Dental Education
Online Dental Education Dental education lectures and videos Online dental ce Dental education articles Expert dental educators Dental products education Dental Community
 
Dental Publication / Article Details

Atrophic Posterior Maxillan and Mandible: Alveolar Ridge Reconstruction with Mandibular Block Autografts Atrophic Posterior Maxillan and Mandible: Alveolar Ridge Reconstruction with Mandibular Block Autografts

Author(s):



Date Added:

1/10/2005


Summary:

Autogenous bone grafts have been used for many years for alveolar ridge augmentation and are still considered to be the gold standard for jaw reconstruction. The use of these grafts with osseointegrated implants was originally discussed by Brånemark et al., who used the iliac crest as the donor site. For repair of most localized alveolar defects, however, bone grafts from the mandible offer advantages over iliac crest grafts. These include the proximity of donor and recipient sites, convenient surgical access, decreased donor site morbidity and decreased cost.

There is usually loss of alveolar bone height in the posterior maxilla and mandible secondary to trauma, pathology and periodontal disease and after tooth removal. Tooth loss results in buccal plate compromise and a reduction in alveolar width. This bone resorption process continues in a medial direction until a knife-edged ridge forms and precludes implant placement. The cortical plate may be minimal or absent, further complicating implant placement. In addition, alveolar height is decreased in the posterior maxilla as a result of pneumatization (partial or complete) of the maxillary sinus after tooth loss. Finally, occlusal forces are greater in the posterior than in the anterior area of the mouth, necessitating appropriate surgical and prosthetic treatment planning for long-term success.

The recipient site must be evaluated for both hard and soft tissue deficiencies, esthetic concerns and the overall health of the adjacent teeth. Some cases require soft tissue procedures to be done prior to or simultaneous with block grafting, as well as in conjunction with implant placement or stage II surgery. These include use of connective tissue grafts, palatal epithelial grafts and human dermis. Conventional radiographs are obtained and include periapical, occlusal, panoramic and lateral cephalometric views. Computed tomography and interactive software are also used for many cases. Mounted models are used to evaluate interocclusal relationships and ridge shape and provide valuable information for implant placement. A diagnostic wax-up of the simulated reconstructed ridge and dentition is a useful guide in obtaining presurgical information concerning graft size and shape, along with evaluating the occlusion. This also provides a base for template fabrication. The primary goal of posterior arch implant reconstruction is to create a biomechanically sound support for the implant prosthetic complex.

This article focuses on posterior maxillary and mandibular osseous augmentation in a staged approach for implant placement. Both horizontal and vertical deficiencies are addressed with the use of symphysis and ramus buccal shelf donor block bone via case presentations.



Related Articles
A Novel Strategy for Bone Integration and Regeneration: Case Studies

A Novel Strategy for Bone Integration and Regeneration: Case Studies
Ultraviolet light treatment of dental implants immediately prior to placement, or photofunctionalization, is a novel clinical tool with the potential to improve implant therapy. Photofunctionalization improves the surface properties of titanium surfaces by removing hydrocarbons, regenerating hydrophilicity, and optimizing electrostatic properties. We photofunctionalizated dental implants and titanium mesh (Ti mesh) in two complex clinical cases requiring simultaneous guided bone regeneration, sinus elevation, immediate implant placement into the extraction socket, and esthetic consideration

Author(s): Akiyoshi Funato, D.D.S.;Ryohei Tonotsuka, DDS; Hitochi Murabe, DDS; Makoto Hirota, DDS, PhD; Takahiro Ogawa, DDS, PhD
View Article>>
A Novel Combined Surgical Approach to Vertical Alveolar Ridge Augmentation with Titanium Mesh, Resorbable Membrane, and rhPDGF-BB: A Retrospective Consecutive Case Series

A Novel Combined Surgical Approach to Vertical Alveolar Ridge Augmentation with Titanium Mesh, Resorbable Membrane, and rhPDGF-BB: A Retrospective Consecutive Case Series
This report demonstrates the remarkable efficacy of guided bone regeneration using a combination of titanium mesh, resorbable collagen membrane, and rhPDGF for vertical ridge augmentation, thus expanding the indications for implant therapy and allowing recovery of the three-dimensional esthetic architecture in a severely absorbed alveolar ridge.

Author(s): Akiyoshi Funato, D.D.S.;Tomohiro Ishikawa, DDS;Hajime Kitajima, DDS; Masahiro Yamada, DDS, PhD; Hidetada Moroi, DMD
View Article>>
The Mandibular Retromolar Area as a Donor Site in Maxillofacial Bone Grafting - Surgical Notes

The Mandibular Retromolar Area as a Donor Site in Maxillofacial Bone Grafting - Surgical Notes
The objective of this article is to review pertinent surgical notes related to the safe harvesting of corticocancellous bone blocks from the retromolar area using a trephine bur technique.

Author(s): Ali Fakhry, DMD, MS
View Article>>
Related Videos
Immediate Implants: Partial / Full Arch Rehabilitation & GBR - Part 2 Premium Member Content

Immediate Implants: Partial / Full Arch Rehabilitation & GBR - Part 2
By scientific studies produced in recent years has been confirmed, in selected cases, the validity of the post-extraction implants. The use of this method implies a lower emotional impact, a single surgery and a healing often better for the patient. We will be discussed traumatic extraction methods, perfect insertion of the implants with or without bone regeneration with bone substitutes and membranes and the opportunity to combine an advanced method as immediate implant with the execution of an immediate loading to restore aesthetics in more complex cases.

Presented By:: Alfonso Coscarella, DDS
Presentation Style: Video
Community Rating:
 
Watch Now>>
Alternative & New Tendencies for Alveolar Reconstruction in Modern Implant Dentistry Premium Member Content

Alternative & New Tendencies for Alveolar Reconstruction in Modern Implant Dentistry
Knowledge of bone biology and physiology are crucial for successful dento-alveolar reconstruction. The presentation will review the natural healing process of the bone and the sequence of events needed for proper regeneration. This process will then be discussed and compare with the present materials and technologies available in the market including alloplastics and allogenic materials. The role of the Stem Cells and rh-BMP2 will be exposed as part of these new trends in alveolar reconstruction for modern implant dentistry. Multiple cases will be presented demonstrating the versatility and outcomes in different clinical situations based on biological, bio-mechanics, and implant aesthetic needs.

Presented By:: Alejandro Vivas-Rojo, DDS, MS;Jesus A. Gomez, DDS
Presentation Style: Video
Community Rating:
 
Watch Now>>
Optimizing Surgical Implant & Augmentation Outcomes Through CBCT Technologies Premium Member Content

Optimizing Surgical Implant & Augmentation Outcomes Through CBCT Technologies
This presentation will focus on challenging bone deficiencies and how pretreatment and post grafting CBCT evaluations can optimize and evaluate the success of our surgical outcomes. Ideal case planning using CBCT data and 3D software will be shown for large horizontal/vertical bone defects, challenging immediate implant surgeries with provisionalization and grafting of buccal plate deficiencies around teeth.

Presented By:: Bradley S. McAllister, DDS, PhD
Presentation Style: Video
Community Rating:
 
Watch Now>>
Related Courses
Surgical & Restorative Management in the Aesthetic Zone Premium Member Content

Surgical & Restorative Management in the Aesthetic Zone
Very often anterior tissue and tooth deficiencies require a multi-disciplinary approach to correct. This presentation reviews several classic techniques in managing these challenging cases including; Orthodontic extrusion, soft tissue and hard tissue augmentation and restorative selection. A quantifiable strategy and case selection is presented as well as several options that should be considered.

Presented By:: Ramon Gomez Meda, DDS
Presentation Style: Online Self-Study Course
CE Hours: 1 Continuing Education Unit (CEU)
Watch Now>>
Current Concepts for the Preservation of the Post-Extraction Alveolar Ridge Premium Member Content

Current Concepts for the Preservation of the Post-Extraction Alveolar Ridge
Different techniques have been presented in literature in order to preserve the post-extraction site; including the use of barrier membranes, tri-dimensional matrix and bone fillers. An “open-healing” approach is nowadays commonly used, combining a proper management of soft tissues with biological integration of biomaterials. Once hard tissue has been successfully augmented, an adequate soft tissue thickness becomes mandatory in order to create healthy and stable peri-implant tissues. An innovative volume-stable collagen matrix provides the opportunity to treat soft tissue defects around implants as an alternative to connective tissue graft.

Presented By:: Daniele Cardaropoli, DDS
Presentation Style: Online Self-Study Course
CE Hours: 1 Continuing Education Unit (CEU)
Watch Now>>
Surgical Management of Posterior Maxilla Premium Member Content

Surgical Management of Posterior Maxilla
Replacement of missing teeth with dental Implants in the posterior maxilla presents unique challenges due to maxillary sinus, less quality of bone, and increased occlusal load. The surgical objectives to meet functional and aesthetic goals include enhancement of both quantity and quality of bone as well as ideal placement of dental implants for restorations that mimic nature. In this presentation, Dr. H. Ryan Kazemi discusses current surgical techniques in implant site development in the posterior maxilla including extraction site grafting, sinus lift, bi-directional bone graft, and osseodensification for bone management.

Presented By:: H. Ryan Kazemi, DMD
Presentation Style: Online Self-Study Course
CE Hours: 1 Continuing Education Unit (CEU)
Watch Now>>
Download Now

Important!

To view this dental publication or article, you must be a registered user of Dental XP. If you are already a member, click here to login.

Registration is free and only takes several minutes. Dental XP will never spam you, or sell your information.

Join For Free









Contact Us | Privacy Policy | Terms of Use
©2022

Preferred Language: English Flag
Contact Us · Login · Register