Andoni
Jones

Autores · Andoni Jones

This case report shows how to place and restore dental implants in just 6 months in a patient requiring vertical and horizontal hard and soft tissue augmentation, including a lateral window sinus elevation. It highlights the utilization of pure autogenous bone, including the sinus elevation, to shorten the reentry time to just 3 months, as well as the subsequent soft tissue grafting during implant placement to avoid a third surgery. After the bone augmentation, the soft tissue thickness was inadequate for implant placement and the mucogingival line was distorted due to flap advancement. Understanding the available hard tissue grafting techniques and biomaterials is essential for proper treatment planning. Incorporating soft tissue management protocols into implant placement surgeries will reduce the number of surgeries and overall treatment time.

Autores · David Chávarri-Prado, Andoni Jones, Esteban Pérez-Pevida, Markel Diéguez-Pereira, Alejandro Estrada-Martínez, Rodrigo Cabezón-Palacios

Coautores Doctor&Cols · Esteban Pérez Pevida, Markel Diéguez Pereira, Alejandro Estrada Martínez, David Chávarri Prado

Sinus floor augmentation is one of the most common approaches to obtain sufficient bone availability for placing implants in cases with severe bone atrophy in the posterior maxilla. Several bone substitutes are indicated for sinus augmentation, but they may achieve different clinical outcomes. This study aims to compare bovine bone mineral (BBM) with freeze-dried bone allograft (FDBA) in a two-stage lateral window sinus grafting approach. Twenty patients received a lateral window sinus elevation with either FDBA or BBM. Postoperative graft height was measured with CBCT. Implants were placed 6 months later, at which time biopsy samples were taken for histologic analysis and new CBCT scans were performed to measure graft height. The mean height reduction at 6 months was 20.27% ± 4.94% for FDBA samples and 5.36% ± 2.41% for BBM samples. The histologic analysis revealed a mean ratio of newly formed bone of 43.70% ± 5.29% for the FDBA group and 38.11% ± 4.03% for the BBM group. The FDBA group also showed a higher amount of residual biomaterial (17.25% ± 10.10%) and connective tissue (14.63% ± 4.38%) compared to the BBM group (15.53% ± 5.42% and 13.11% ± 4.42%, respectively). The differences between groups were statistically significant for the height reduction and newly formed bone (P ≤ .05) but not for the amounts of residual biomaterial and nonmineralized connective tissue (P ≥ .05). Six months after performing a lateral window sinus elevation, the percentage of newly formed bone was significantly higher when using FDBA than when using BBM, although the graft height reduction was also significantly higher for the FDBA group.

Autores · Jones A

Los implantes en el área estética suponen un reto, especialmente cuando el tejido duro y blando son deficientes al inicio del procedimiento. Existen múltiples técnicas de injerto, cada una con sus fortalezas y limitaciones. El presente artículo describe el tratamiento de un incisivo central maxilar con deficiencia ósea tras la extracción de un diente anquilosado. Se utilizó una lámina ósea palatina para reconstruir la pared vestibular ausente. Tres meses después, se colocó el implante y simultáneamente se aumentó el tejido blando con un injerto de tejido conectivo. El caso se restauró con éxito y un resultado estético satisfactorio, destacando los períodos de curación más cortos y la calidad óptima de los tejidos obtenidos.