Eitan Mijiritsky1,2, Hadar Ben Zaken3, Maayan Shacham4, Ihsan Caglar Cinar5, Cem Tore5, Katalin Nagy6, Scott D Ganz7,8. 1. Department of Otolaryngology, Head and Neck and Maxillofacial Surgery, Tel-Aviv Sourasky Medical Center, Sackler Faculty of Medicine, Tel Aviv 6139001, Israel. 2. The Maurice and Gabriela Goldschleger School of Dental Medicine, Tel Aviv University, Tel Aviv 6997801, Israel. 3. Department of Periodontology, Hadassah Faculty of Dental Medicine, Hebrew University, Jerusalem 91905, Israel. 4. School of Social Work, Ariel University, Ariel 40700, Israel. 5. Department of Oral Implantology, Faculty of Dentistry, Istanbul University, Istanbul 34093, Turkey. 6. Department of Oral Surgery, Faculty of Dentistry, University of Szeged, Tisza L. krt 64, 6720 Szeged, Hungary. 7. Department of Restorative Dentistry Rutgers, The State University of New Jersey, Newark, NJ 07103, USA. 8. Independent Researcher, Fort Lee, NJ 07024, USA.
Abstract
Edentulism and terminal dentition are still considered significant problems in the dental field, posing a great challenge for surgical and restorative solutions especially with immediate loading protocols. When the implant placement is planned immediately after extraction with irregular bone topography or there is an un-leveled alveolar ridge topography for any other reason, bone reduction may be required to level the alveolar crest in order to create the desired bone architecture allowing for sufficient bone width for implant placement and to insure adequate inter-arch restorative space. Bone reduction protocols exist in analog and digitally planned methodologies, with or without surgical guides to achieve the desired bone level based upon the desired position of the implants with regard to the restorative outcome. The objective of this paper was to scrutinize the literature regarding the practice of bone reduction in conjunction with implant placement, and to review different types of bone reduction surgical guides. Results: The literature reveals different protocols that provide for bone reduction with a variety of bone reduction methods. The digitally-planned surgical guide based on Cone-Beam computerized tomography (CBCT) scan reconstructed data can improve accuracy, reduce surgical time, and deliver the desired bone level for the implant placement with fewer surgical and restorative complications. The clinician's choice is based on personal experience, training, and comfort with a specific guide type. Conclusions: Bone reduction, when required, is an indispensable step in the surgical procedure to attain suitable width of bone in anticipation of implant placement ideally determined by the desired tooth position and required restorative space based on material selection for the chosen framework design, i.e., hybrid, monolithic zirconia. Additionally, bone reduction and implant placement can be accomplished in the same surgical procedure, minimizing trauma and the need for two separate interventions.
Edentulism and terminal dentition are still considered significant problems in the dental field, posing a great challenge for surgical and restorative solutions especially with immediate loading protocols. When the implant placement is planned immediately after extraction with irregular bone topography or there is an un-leveled alveolar ridge topography for any other reason, bone reduction may be required to level the alveolar crest in order to create the desired bone architecture allowing for sufficient bone width for implant placement and to insure adequate inter-arch restorative space. Bone reduction protocols exist in analog and digitally planned methodologies, with or without surgical guides to achieve the desired bone level based upon the desired position of the implants with regard to the restorative outcome. The objective of this paper was to scrutinize the literature regarding the practice of bone reduction in conjunction with implant placement, and to review different types of bone reduction surgical guides. Results: The literature reveals different protocols that provide for bone reduction with a variety of bone reduction methods. The digitally-planned surgical guide based on Cone-Beam computerized tomography (CBCT) scan reconstructed data can improve accuracy, reduce surgical time, and deliver the desired bone level for the implant placement with fewer surgical and restorative complications. The clinician's choice is based on personal experience, training, and comfort with a specific guide type. Conclusions: Bone reduction, when required, is an indispensable step in the surgical procedure to attain suitable width of bone in anticipation of implant placement ideally determined by the desired tooth position and required restorative space based on material selection for the chosen framework design, i.e., hybrid, monolithic zirconia. Additionally, bone reduction and implant placement can be accomplished in the same surgical procedure, minimizing trauma and the need for two separate interventions.
Entities:
Keywords:
alveolar ridge reduction; bone reduction; bone reduction guides; ostectomy; surgical techniques guided surgery
Authors: F Inchingolo; M Tatullo; M Marrelli; A M Inchingolo; V Picciariello; A D Inchingolo; G Dipalma; D Vermesan; R Cagiano Journal: Eur Rev Med Pharmacol Sci Date: 2010-09 Impact factor: 3.507