Z Stopa1, M Siewert-Gutowska2, K Abed1, D Szubińska-Lelonkiewicz3, A Kamiński4, P Fiedor5. 1. Department of Cranio-Maxillofacial Surgery, Oral Surgery and Implantology, Infant Jesus Teaching Hospital-Medical University of Warsaw, Warsaw, Poland. 2. Department of Cranio-Maxillofacial Surgery, Oral Surgery and Implantology, Infant Jesus Teaching Hospital-Medical University of Warsaw, Warsaw, Poland. Electronic address: martasiew@gmail.com. 3. Department of Dental Surgery, Medical University of Warsaw, Warsaw, Poland. 4. Department of Transplantology and Central Tissue Bank, Medical University of Warsaw, and National Centre for Tissue and Cell Banking, Warsaw, Poland. 5. Department of General and Transplantation Surgery, Transplantation Institute, Warsaw Medical University, Warsaw, Poland.
Abstract
INTRODUCTION: Loss of teeth caused by inflammatory processes or trauma is one of the causes of bone atrophy of the maxilla alveolar process and the alveolar part of the mandible. Often, restoring these deficiencies with dental implants requires additional reconstructive procedures. Methods using autogenous, allogeneic, xenogeneic, or synthetic bone grafts are commonly used. MATERIALS AND METHODS: Patients who had bone atrophy of the maxilla or mandible were qualified for deep-frozen transplantation, radiation-sterilized allogeneic bone from the Bank of Tissues in the form of cortico-spongy bone blocks and spongy bone granules. Bone blocks were stabilized with titanium screws, and the free spaces were additionally supplemented with chips from autogenous bone and covered with allogeneic pericardial transplants and platelet-rich fibrin (PRF). Four months after the bone reconstruction, titanium implants were placed, and then after the osseointegration period prosthetic restoration was performed. Clinical safety and efficacy were determined by analyzing the quantity and quality of the reconstructed bone tissue and the degree of resorption was assessed. RESULTS: The surgical procedures performed confirmed the safety and efficacy of biological material in the reconstruction of the jaw. In two cases, the treatment was not effective and the transplant was removed. In the remaining cases, titanium implants were successfully placed and loaded with prosthetic works. DISCUSSION: Implanting deeply frozen, radiation-sterilized bone is a safe and effective surgical procedure. As an appropriate technique for fixing the allogeneic bone block, additional use of autogenous bone chips and PRF allows one to obtain a good, long-lasting clinical result.
INTRODUCTION: Loss of teeth caused by inflammatory processes or trauma is one of the causes of bone atrophy of the maxilla alveolar process and the alveolar part of the mandible. Often, restoring these deficiencies with dental implants requires additional reconstructive procedures. Methods using autogenous, allogeneic, xenogeneic, or synthetic bone grafts are commonly used. MATERIALS AND METHODS:Patients who had bone atrophy of the maxilla or mandible were qualified for deep-frozen transplantation, radiation-sterilized allogeneic bone from the Bank of Tissues in the form of cortico-spongy bone blocks and spongy bone granules. Bone blocks were stabilized with titanium screws, and the free spaces were additionally supplemented with chips from autogenous bone and covered with allogeneic pericardial transplants and platelet-rich fibrin (PRF). Four months after the bone reconstruction, titanium implants were placed, and then after the osseointegration period prosthetic restoration was performed. Clinical safety and efficacy were determined by analyzing the quantity and quality of the reconstructed bone tissue and the degree of resorption was assessed. RESULTS: The surgical procedures performed confirmed the safety and efficacy of biological material in the reconstruction of the jaw. In two cases, the treatment was not effective and the transplant was removed. In the remaining cases, titanium implants were successfully placed and loaded with prosthetic works. DISCUSSION: Implanting deeply frozen, radiation-sterilized bone is a safe and effective surgical procedure. As an appropriate technique for fixing the allogeneic bone block, additional use of autogenous bone chips and PRF allows one to obtain a good, long-lasting clinical result.