EVALUATION OF DENTAL IMPLANTS IN MANDIBULAR NARROW RIDGES USING BONE EXPANSION AND BENDING TECHNIQUE

Document Type : Original Article

Authors

1 Resident at Oral and Maxillofacial Surgery Department, Faculty of Dentistry, Alexandria University, Alexandria, Egypt.

2 Professor of Oral and Maxillofacial Surgery, Faculty of Dentistry, Alexandria University, Alexandria, Egypt.

Abstract

INTRODUCTION: Narrow dentoalveolar ridges remain a challenge for the successful placement of implants; success depends largely on the quality and quantity of the available bone in the recipient site. This however may be compromised or unavailable which necessitates the need to manipulate the residual bone by contouring or making dimensional changes to create an intra-bony cavity to form a receptor site for an implant while preserving bone integrity and viability.
OBJECTIVES: Evaluation of the success of dental implants in mandibular narrow ridges (≤ 5mm) after using bone expansion and cortical bone bending technique with a new design of bone expander.
MATERIALS AND METHODS: This clinical study was performed on a total of eight patients with mandibular narrow ridges (≤ 5mm). All implants were followed for 6 months. Clinically, each patient was evaluated for pain, tenderness or discomfort, presence of swelling or infection and mobility of the implant. Also, radiographic investigations were performed for the assessment of marginal bone level, bone width and the bone density around the implant. An implant stability and assessment of the osseointegration progress evaluation was conducted using the resonance frequency analysis technique (Osstell) immediately after implant placement and after three months and after six months.
RESULTS: There was a statistically significant increase in the bone density around the implants throughout the evaluation period and there was increase in implant stability quotient after six months was statistically significant (p=0.008). There were significant decreases in the mean of marginal bone level changes by time in all cases, the increase in bone width quotient after six months was statistically significant p < 0.001.
CONCLUSIONS: using the newly designed star shape bone expanders as a bone expansion and bending technique, showed an adequate clinical and radiographic performance in the mandibular narrow ridges.

Keywords

Main Subjects

References

  1. Tang YL, Yuan J, Song YL, Ma W, Chao X, Li DH. Ridge expansion alone or in combination with guided bone regeneration to facilitate implant placement in narrow alveolar ridges: a retrospective study. Clin Oral Implants Res. 2015;26:204-11.
  2. Demetriades N, Park JI, Laskarides C. Alternative bone expansion technique for implant placement in atrophic edentulous maxilla and mandible. J Oral Implantol. 2011;37:463-71.
  3. Branemark PI. Introduction to osseointegration. In: Branemark PI, Zarb G, Albrektsson T (eds). Tissue integrated prosthesis. Osseointegration in clinical dent. Chicago: Quintessence; 1995. p 11-7.
  4. Raghavendra S, Wood MC, Taylor TD. Early wound healing around endosseous implants: A review of literature. Int J Oral Maxillofac Implants. 2005;20:425-31.
  5. De Boever AL, De Boever JA. A one-stage approach for nonsubmerged implants using a xenograft in narrow ridges: report on seven cases. Int J Periodontics Restorative Dent. 2003;23:169-75.
  6. Basa S, Varol A, Turker N. Alternative bone expansion technique for immediate placement of implants in the edentulous posterior mandibular ridge: A clinical report. Int J Oral Maxillofac Implants. 2004;19:554-8.
  7. Elian N, Jalbout Z, Ehrlich B, Classi A, Cho SC, Al-Kahtani F, et al. A two-stage full-arch ridge expansion technique: review of the literature and clinical guidelines. Implant Dent. 2008;17:16-23.
  8. Chiapasco M, Ferrini F, Casentini P, Accardi S, Zaniboni M. Dental implants placed in expanded narrow edentulous ridges with the extension crest device. A 1-3-year multicenter follow-up study. Clin Oral Implants Res. 2006;17:265-72.
  9. Cullum D. Advances in bone manipulation: Part 2. Osteomobilization for horizontal and vertical implant site development. SROMS. 2010;18:1-44.
  10. Sethi A, Kaus T. Maxillary ridge expansion with simultaneous implant placement: 5-year results of an ongoing clinical study. Int J Oral Maxillofac Implants. 2000;15:491-9.
  11. Demetriades N, Park JI, Laskarides C. Alternative bone expansion technique for implant placement in atrophic edentulous maxilla and mandible. J Oral Implantol. 2011;37:463-71.
  12. IBS implant, Dream Series, H-1 drill - Suppliers of dental implant, fixture from South Korea. IBS Implant. 2010. Available at: http://ibsimplant.blogspot.com.eg/
  13. Meredith N, Alleyne D, Cawley P. Quantitative determination of the stability of the implant-tissue interface using resonance frequency analysis. Clin Oral Implants Res. 1996;7:261–7.
  14. Silverstein LH, Kurtzman GM. A review of dental suturing for optimal soft-tissue management. Compend Contin Educ Dent. 2005;26:163-209.
  15. Le Resche L, Burgess J, Dworkin SF. Reliability of visual analog and verbal descriptor scales for "objective" measurement of temporomandibular disorder pain. J Dent Res. 2000;67:33-6.
  16. Yokobe J, Kitahara M, Matsushima M, Uezono S. Preference for different anchor descriptors on visual analogue scales among Japanese patients with chronic pain. PLoS One. 2014;9:99-1.
  17. Ramachandra SS, Mehta DS, Sandesh N, Baliga V, Amarnath J. Periodontal probing systems: a review of available equipment. Compend Contin Educ Dent. 2011;32:71-7.
  18. Balleri P, Cozzolino A, Ghelli L, Momicchioli G, Varriale A. Stability measurements of osseointegrated implants using Osstell in partially edentulous jaws after 1 year of loading: a pilot study. Clin Implant Dent Relat Res. 2002;4:128-32.
  19. Bischof M, Nedir R, Szmukler-Moncler S, Bernard JP, Samson J. Implant stability measurement of delayed and immediately loaded implants during healing. Clin Oral Implants Res. 2004;15:529-39.
  20. Georgescu CE, Mihai A, Didilescu AC, Moraru R, Nimigean V, Nimigean VR, et al. Cone beam computed tomography as a method of quantitative and qualitative analysis of alveolar crest in the mandibular area. Rom J Morphol Embryol. 2010;51:713-7.
  21. Michaeli E, Weinberg I, Nahlieli O. Dental implants in the diabetic patient: systemic and rehabilitative considerations. Quintessence Int. 2009;40:639-45.
  22. Becker W, Hujoel PP, Becker BE, Willingham H. Osteoporosis and implant failure: an exploratory casecontrol study. J Periodontol. 2000;71:625-31.
  23. Glauser R, Rée A, Lundgren A, Gottlow J, Hämmerle CH, Schärer P. Immediate occlusal loading of Brånemark implants applied in various jawbone regions: a prospective, 1-year clinical study. Clin Implant Dent Relat Res. 2001;3:204-13.
  24. Koth DL, McKinmey RV, Steflik DE, Davis QB. Clinical and statistical analysis of human clinical trials with single crystal aluminum oxide endosteal dental implant: Five year results. J Prosthet Dent. 1988;60:226-34. 
  25. Dhanrajani PJ, Al-Rafee MA. Single-tooth implant restorations: A retrospective study. Implant Dent. 2005;14:125-30.
  26. Sakka S, Coulthard P. Bone quality: a reality for the process of osseointegration. Implant Dent. 2009;18:480-5.
  27. Cassetta M, Sofan AA, Altieri F, Barbato E. Evaluation of alveolar cortical bone thickness and density for orthodontic mini-implant placement. J Clin Exp Dent. 2013;5:245-52.
  28. Bornstein MM, Scarfe WC, Vaughn VM, Jacobs R. Cone beam computed tomography in implant dentistry: a systematic review focusing on guidelines, indications, and radiation dose risks. Int J Oral Maxillofac Implants. 2014;29:55-77.
  29. Chiapasco M, Ferrini F, Casentini P, Accardi S, Zaniboni M. Dental implants placed in expanded narrow edentulous ridges with the Extension Crest device. A 1-3-year multicenter follow-up study. Clin Oral Implants Res. 2006;17:265-72.
  30. Demetriades N, Park JI, Laskarides C. Alternative bone expansion technique for implant placement in atrophic edentulous maxilla and mandible. J Oral Implantol. 2011;37:463-71.
  31. Misch CM. Implant site development using ridge splitting techniques. Oral Maxillofac Surg Clin North Am. 2004;16:65-74.
  32. Hahn J. Clinical uses of osteotomes. J Oral Implantol. 1999;25:23-9.
  33. Eriksson AR, Alberktsson T, Magnusson B. Assessment of bone viability after heat trauma. A histological, histochemical, and vital microscopic study in the rabbit. Scand J Plast Reconstr Surg. 1984;18:261-8.
  34. Brisman DL. The effect of speed, pressure, and time on bone temperature during the drilling of implant sites. Int J Oral Maxillofac Implants. 1996;11:35-7.
  35. Scipioni A, Bruschi GB, Calesini G, Bruschi E, De Martino C. Bone regeneration in the edentulous ridge expansion technique: Histologic and ultrastructural study of 20 clinical cases. Int J Periodontics Restorative Dent. 1999;19:269-77.
  36. Bergkvist G, Koh KJ, Sahlholm S, Klintström E, Lindh C. Bone density at implant sites and its relationship to assessment of bone quality and treatment outcome. Int J Oral Maxillofac Implants. 2010;25:321-8.
  37. Herrero-Climent M, Santos-García R, Jaramillo-Santos R, Romero-Ruiz MM, Fernández-Palacin A, Lázaro-Calvo P, et al. Assessment of Osstell ISQ's reliability for implant stability measurement: a cross-sectional clinical study. Med Oral Patol Oral Cir Bucal. 2013;18: 877-82.
  38. Le Resche L, Burgess J, Dworkin SF. Reliability of visual analog and verbal descriptor scales for "objective" measurement of temporomandibular disorder pain. J Dent Res. 2000;67:33-6.
  39. Sakka S, Baroudi K, Nassani MZ. Factors associated with early and late failure of dental implants. J Investig Clin Dent. 2012;3:258-61. 

Files

Share

How to cite

Statistics