Оглавление
Группа авторов. Bone and Soft Tissue Augmentation in Implantology
Bone and Soft Tissue. Augmentation in Implantology
Foreword
Foreword of the first edition
Preface
Acknowledgments
Editors and Contributors
Contributors (in alphabetical order)
Table of Contents
1. Biology of bone regeneration in augmentative procedures
1.1 Introduction
1.2 Cells of bone remodeling
1.2.1 Osteoblasts
1.2.2 Osteocytes
1.2.3 Osteoclasts
1.3 Biology of bone regeneration
1.3.1 Osseointegration of dental implants
1.3.2 Autogenous bone grafts
1.3.2.1 Bony lid technique
1.3.2.2 Split bone block (SBB) technique
1.3.2.3 Bone core technique
1.4 Autograft resorption
1.5 Osteoconductive characteristics of autografts
1.6 Osteogenic properties of autografts
1.7 Osteoinductive properties of autografts
1.8 Summary
Acknowledgments
1.9 References
2. Diagnosis and planning of the augmentation procedure. 2.1 Introduction
2.2 Patient consultation
2.3 Anamnesis
2.3.1 Nicotine consumption
2.3.2 General medical findings
2.3.2.1 Antiresorptive therapy
2.3.2.2 Specific antibody therapy
2.3.2.3 Albert Schoenberg’s disease
2.3.2.4 Osteitis deformans (Paget’s disease)
2.3.2.5 Medications
2.3.2.6 Cardiovascular diseases
2.3.2.7 Hemorrhagic diathesis
2.3.2.8 Diabetes mellitus
2.3.2.9 Other metabolic diseases
2.4 Specific findings
2.4.1 Genetic findings
2.4.2 Extraoral examination
2.4.3 Intraoral examination
2.4.3.1 Soft tissue findings
2.4.3.2 Dental findings
2.4.3.3 Structure of the bone
2.4.4 Radiologic findings
2.4.4.1 Radiologic techniques
Periapical radiographs
Panoramic radiographs
Skull radiographs
Computed tomography
Cone beam computed tomography
2.4.4.2 Indications for 3D diagnostics
Simulation of the prosthetic setup
Construction parameters for a 3D radiographic template
2.5 Choice of grafting technique
2.5.1 Bone atrophy
2.5.1.1 Horizontal bone atrophy
2.5.1.2 Vertical bone defects
2.5.1.3 Multiple horizontal and vertical bony defects
2.6 Conclusion
2.7 References
3. Soft tissue management and bone augmentation in implantology. Soft tissue management during augmentation, implantation, and second-stage surgery. 3.1 Introduction
3.1.1 Anatomy and vascularization of the soft tissue
3.1.1.1 Gingiva
3.1.1.2 Peri-implant mucosa
3.1.1.3 Biologic width
3.1.1.4 Tissue biotype
3.1.1.5 Attached and keratinized tissue
3.2 The basics of incisions, suturing techniques, and soft tissue healing
3.2.1 Cellular and molecular healing mechanisms
3.2.1.1 Inflammation phase (day 0 to 3)
3.2.1.2 Proliferative and fibroblastic phase (day 3 to 12)
3.2.1.3 Maturation phase (day 6 to 14)
3.2.2 The reactions of tissue to sutures
3.3 Instruments
3.4 Soft tissue management before augmentation
3.4.1 Incisions before augmentation
3.4.2 The split-thickness tunnel technique
3.4.3 Free connective tissue grafts before augmentation
3.4.4 Punch technique
3.4.5 Palatal pedicle connective tissue flaps
3.5 Soft tissue management during augmentation and implantation
3.5.1 Incisions during augmentation and implantation
3.5.2 The tunnel technique
3.5.3 The lateral tunnel technique (lateral approach)
3.5.4 The Kazanjian vestibuloplasty
3.5.5 Free connective tissue grafts during augmentation and implantation
3.5.6 Palatal pedicle connective tissue flaps
3.5.7 Vestibular pedicle connective tissue flap
3.5.8 Pedicle periosteal flaps
3.6 Soft tissue management during implant exposure. 3.6.1 Incisions for implant exposure
3.6.2 Displacement during implant exposure
3.6.3 The so-called ‘M incision’
3.6.4 The roll flap
3.6.5 The apically repositioned advanced flap
3.6.6 Apically advanced flap in combination with a connective tissue graft
3.6.7 Free gingival grafts during exposure
3.6.8 Papilla construction during implant exposure
3.6.9 Papilla reconstruction technique in the anterior maxilla
3.6.10 Emergence profile shaping
3.6.11 Clinical and laboratory procedures for the creation of temporary crowns
3.7 Soft tissue management following prosthetic restoration
3.7.1 Free gingival grafts following prosthetic reconstruction
3.7.2 Coverage of peri-implant recessions with the tunnel technique
3.7.3 Coverage of peri-implant recessions with a coronally advanced flap
3.7.4 Coverage of peri-implant recessions with palatal flaps
3.8 References
4. Mandibular bone block grafts. 4.1 Introduction
4.2 Biologic procedure for mandibular bone grafting
4.3 Techniques and methods for intraoral bone harvesting. 4.3.1 Introduction
4.3.2 Preoperative clinical examination and radiography
4.3.3 Patient preparation
4.3.4 Instruments for bone harvesting and bone augmentation
4.3.5 Intraoral bone harvesting techniques for grafting small defects
4.3.6 Intraoral bone harvesting techniques for reconstruction of large defects
4.3.6.1 Harvesting bone from the mandibular retromolar area
4.3.6.2 Harvesting bone from the chin
4.3.6.3 Harvesting bone from edentulous areas
4.3.7 Results
4.3.8 Discussion
4.4 Augmentation techniques
4.4.1 Bony lid technique
4.4.1.1 Surgical procedure
4.4.2 Preserving the extraction socket (socket preservation)
4.4.3 Augmentation of small bone defects
4.4.3.1 Bone core technique
Surgical procedure
4.4.4 Extensionplasty, bone splitting, and bone spreading
4.4.4.1 Surgical procedure
4.4.5 Lateral bone block augmentation
4.4.5.1 Surgical procedure
4.4.6 Onlay bone grafts and 3D bone reconstructions
4.4.6.1 Surgical procedure
4.4.7 Nose floor elevation in combination with 3D augmentation
4.4.8 Sinus floor augmentation
4.4.8.1 Surgical procedure
4.4.9 Lateralization of the mandibular nerve
4.4.9.1 Surgical procedure
4.5 Bone remodeling and volume changes after grafting
4.6 Conclusion
4.7 References
Special Appendix
A. Use of the maxillary tuberosity (MT) in the immediate dentoalveolar restoration (IDR) technique
Immediate dentoalveolar restoration (IDR)
References
B. The palatal bone block graft (PBBG)
References
C. Alumni case reports. C.1 Vertical bone augmentation in the anterior maxilla after severe periodontal disease
C.2 Three-dimensional bone augmentation in the anterior maxilla after traumatic injury
C.3 Bilateral 3D bone augmentation in the posterior mandible
C.4 Vertical bone augmentation in the posterior maxilla
C.5 Three-dimensional bone augmentation in the posterior maxilla
C.6 Three-dimensional bone augmentation in the anterior maxilla and minimally invasive augmentation in the anterior mandible
5. Bone grafts from extraoral sites. 5.1 Introduction
5.2 Bone harvesting from the calvaria
5.2.1 Patient preparation
5.2.2 Surgical procedure
5.2.3 Possible complications
5.3 Bone harvesting from the tibia
5.3.1 Indications
5.3.2 Patient preparation
5.3.3 Surgical procedure
5.3.4 Postoperative care
5.3.5 Complications and postoperative morbidity
5.3.6 Conclusion
5.4 Bone harvesting from the iliac crest
5.4.1 Indications
5.4.2 Patient preparation
5.4.3 Surgical technique
5.4.4 Clinical cases
5.4.4.1 Lateral approach
5.4.4.2 Tunnel approach
5.4.5 Complications
5.4.5.1 Postoperative hematoma and wound healing disorders
5.4.5.2 Fracture of the ilium
5.4.5.3 Resorption
5.4.6 Conclusion
5.5 References
6. Clinical and scientific background of tissue regeneration via alveolar callus distraction. 6.1 Introduction
6.2 History of the callus distraction
6.3 Principles of the callus distraction
6.4 Devices
6.5 Surgical technique
6.6 Distraction in different areas
6.6.1 Single tooth distraction
6.6.2 Distraction in the posterior mandible
6.6.3 Distraction of segments with the presence of teeth or implants
6.4 Conclusion
6.5 References
7. Complex implant-supported rehabilitation from the temporary to the definitive restoration. 7.1 Introduction
7.2 Specific aspects of temporary restorations
7.3 Treatment planning
7.4 Classification of temporary restorations
7.4.1 Treatment procedure
7.5 Restorative concept. 7.5.1 Maxilla
7.5.2 Mandible
7.6 Fixed complex restoration: step by step. 7.6.1 Initial treatment phase
7.7 Long-term provisional
7.8 Surgical procedures
7.9 Final restoration
7.9.1 First session: transfer impression, preliminary bite check
Laboratory procedure
7.9.2 Second session: splinted pick-up impression, screw-retained centric check-bite, and arbitrary facebow transfer
Laboratory procedure
7.9.3 Third session: functional and esthetic try-in, check of interocclusal relationship
Laboratory procedure
7.9.4 Fourth session: insertion of the final restoration
7.9.5 Follow-up
7.10 Concluding remarks
7.11 References
8. Risk factors and complications in bone grafting procedures. 8.1 Introduction
8.2 Risk factors
8.2.1 General risk factors
8.2.1.1 Influence of smoking
8.1.1.2 Diabetes
8.2.1.3 Corticosteroid medication
8.2.1.4 Bisphosphonate therapy
8.2.1.5 Bone systematic diseases
8.2.1.6 Hemorrhagic diathesis
Platelet aggregation inhibition
Oral anticoagulation
Bridging
8.2.1.7 Influence of vitamin D on bone healing and osseointegration
8.2.1.8 Influence of cholesterol (dyslipidemia) on bone growth and healing
8.2.1.9 Infection prophylaxis and penicillin allergy
8.2.2 Local risk factors. 8.2.2.1 Radiotherapy
8.2.2.2 Periodontitis
8.2.2.3 Bone quality and quantity
8.2.2.4 Soft tissue quality
8.3 Intraoperative complications
8.3.1 Burned Bone Syndrome
8.3.2 Complications during bone harvesting procedures
8.3.2.1 Complications during bone harvesting from the retromolar region
8.3.2.2 Complications during bone harvesting from the chin
8.3.2.3 The flying bone block
8.3.3 Complications during alveolar extension and bone-splitting techniques
8.3.4 Complications during sinus floor elevation
8.3.4.1 Heavy bleeding
8.3.4.2 Perforations of the sinus mucosa
8.3.4.3 Septum
8.3.4.4 Difficult elevation of the antral mucosa
8.3.4.5 Sinus perforation during implant site preparation after sinus grafting
8.3.5 Complications during bone block augmentation
8.3.6 Complications during wound closure over the grafted area
8.4 Postoperative complications. 8.4.1 Pain
8.4.2 Bleeding
8.4.3 Swelling
8.4.4 Hematomas
8.4.5 Candidiasis
8.4.6 Healing complications
8.4.6.1 Early graft exposure
Photodynamic therapy is based on decontamination by a photochemical process
8.4.6.2 Late graft exposure
8.4.6.3 Graft exposure after implant placement
8.4.6.4 Screw exposure
8.4.6.5 Membrane complications
8.4.6.6 Abscess or fistula after bone block augmentation
8.4.6.7 Abscess or fistula after sinus floor elevation
8.5 Complications during implant placement after bone grafting
8.5.1 Incomplete graft healing
8.5.2 Resorption of the graft
8.5.3 Mobility of the graft
8.6 Complications during implant exposure
8.6.1 Graft exposure
8.6.2 Bleeding
8.6.3 Peri-implant bone resorption
8.6.4 Flap necrosis
8.7 Late complications after prosthetic restoration. 8.7.1 Peri-implant soft tissue recession
8.7.2 Soft tissue hyperplasia
8.7.3 Peri-implant mucositis due to lack of keratinized gingiva
8.7.4 Peri-implantitis
8.8 References
Index
