Silvio Mario Meloni1, Sascha Alexander Jovanovic2, Istvan Urban2,3, Edoardo Baldoni1, Milena Pisano4, Marco Tallarico5. 1. School of Dentistry, University of Sassari, Sassari, Italy. 2. Loma Linda University, Loma Linda, California. 3. University of Szeged, Hungary. 4. Private Practice, Arzachena, Italy. 5. Implantology and Prosthetic Aspects, Master of Science in Dentistry Program, Aldent University, Tirana, Albania.
Abstract
BACKGROUND: Cawood-Howell class IV atrophies, also known as "knife-edge" ridges, represent a serious horizontal defect, making the placement of regular implants challenging. AIM: To clinically and radiographically evaluate bone regeneration of severe horizontal bone defects with 3 years of follow-up. MATERIALS AND METHODS: This study was designed as a single cohort, prospective clinical trial. Patients having horizontal bone width of 4 mm or less in the posterior mandible or maxilla were treated with resorbable collagen membranes and a 1:1 mixture of anorganic bovine bone (ABB) and autogenous bone. Implants were inserted and loaded 7 months later. Outcomes were implant and prosthetic survival rates, any biological and prosthetic complications, horizontal and volumetric bone dimensional changes measured on cone beam computer tomography (CBCT), peri-implant marginal bone level (MBL) changes measured on periapical radiographs, plaque index (PI), and bleeding on probing (BOP). RESULTS: Eighteen patients received 55 implants. No patient dropped-out. No implant and prosthetic failures and no complications were recorded. Super imposition of pre and 7-month postoperative CBCT scans revealed an average horizontal bone gain of 5.03 ± 2.15 mm (95% CI: 4.13-5.92 mm). After 3 years, mean MBL was 1.15 ± 0.28 mm (95% CI 0.84-1.22 mm). The PI was 11.6%, and BOP was 5.2%. CONCLUSION: Within the limitations of the present study, high implant survival rate and high average bone augmentation seem to validate the use of collagen resorbable membranes with a 1:1 mixture of particulate ABB and autogenous bone for the reconstruction of Cawood-Howell class IV alveolar ridge atrophies.
BACKGROUND: Cawood-Howell class IV atrophies, also known as "knife-edge" ridges, represent a serious horizontal defect, making the placement of regular implants challenging. AIM: To clinically and radiographically evaluate bone regeneration of severe horizontal bone defects with 3 years of follow-up. MATERIALS AND METHODS: This study was designed as a single cohort, prospective clinical trial. Patients having horizontal bone width of 4 mm or less in the posterior mandible or maxilla were treated with resorbable collagen membranes and a 1:1 mixture of anorganic bovine bone (ABB) and autogenous bone. Implants were inserted and loaded 7 months later. Outcomes were implant and prosthetic survival rates, any biological and prosthetic complications, horizontal and volumetric bone dimensional changes measured on cone beam computer tomography (CBCT), peri-implant marginal bone level (MBL) changes measured on periapical radiographs, plaque index (PI), and bleeding on probing (BOP). RESULTS: Eighteen patients received 55 implants. No patient dropped-out. No implant and prosthetic failures and no complications were recorded. Super imposition of pre and 7-month postoperative CBCT scans revealed an average horizontal bone gain of 5.03 ± 2.15 mm (95% CI: 4.13-5.92 mm). After 3 years, mean MBL was 1.15 ± 0.28 mm (95% CI 0.84-1.22 mm). The PI was 11.6%, and BOP was 5.2%. CONCLUSION: Within the limitations of the present study, high implant survival rate and high average bone augmentation seem to validate the use of collagen resorbable membranes with a 1:1 mixture of particulate ABB and autogenous bone for the reconstruction of Cawood-Howell class IV alveolar ridge atrophies.
Authors: Stefan P Bienz; Michael Payer; Jenni Hjerppe; Jürg Hüsler; Norbert Jakse; Patrick R Schmidlin; Christoph H F Hämmerle; Ronald E Jung; Daniel S Thoma Journal: Clin Oral Implants Res Date: 2021-09-28 Impact factor: 5.021