Читать книгу Bone and Soft Tissue Augmentation in Implantology - Группа авторов - Страница 50

In the context of implant therapy, especially in the atrophic jaw, radiologic diagnosis provides the essential information for deciding on the possibilities and scope of the necessary therapy and ensuring the treatment result. Radiologic diagnosis delivers the relevant information for the protection of the anatomical structures in the surgical field. In addition to the purely volumetric assessment of the jaw, the bone structure is also evaluated.

Due to chronic infections, especially after multiple endodontic treatments with revisions of the root fillings, apical root resections or any other infection, sclerotic changes in the jawbone can be seen. As a rule, these are not relevant for further implant therapy because the body’s own immune system has healed the infection through the inflammatory process; in fact, it sometimes repairs more than necessary through new bone apposition. This increases the bone density and the possibility of achieving high primary implant stability. On the other hand, increased bone density makes implant bed preparation more difficult, and in case of insufficient cooling can increase the risk of burning the bone. In rare cases, a more or less pronounced local osteomyelitis may be present.

Osteomyelitis sclerosans Garré is an infectious bacterial chronic event that is sustained by a persistent infection or by itself. Microbiologically, bacterial growth can rarely be detected by an intraoperative swab test. If there is anamnestic evidence of a persistent bony inflammation with symptoms, it is recommended to consider a CBCT (Fig 2-13) or a skeletal scintigraphy to exclude chronic subacute processes.