The present paper was conducted to a systematic method of surgical guide for dental implant based on computer-aided technology through CT data and dental-cast data. By analyzing the patient's CT data, the implant region was planned using image processing techniques. For the specified implant region, the computer-aided method for the rational allocation of dental implant was addressed in a sense of anatomy. With biomechanical principles as well as aesthetical and functional requirements as preconditions, this method can make full use of bone quantity and quality to produce the optimum implantation axis. The transferring of implant planning to the patient was then realized by registration between CT models and dental-cast models. A case research explained the whole process of the surgical guide. The results validated the correctness and feasibility of this method, which has a great significance to enhance the quality and accuracy of implant surgery.
Computer-Aided Design ; Dental Implantation, Endosseous ; instrumentation ; methods ; Dental Models ; Dental Prosthesis Design ; instrumentation ; methods ; Humans ; Oral Surgical Procedures, Preprosthetic ; methods ; Patient Care Planning ; Surgery, Computer-Assisted ; Tomography, X-Ray Computed

Dental Implantation ; methods ; Humans ; Maxillary Sinus ; Oral Surgical Procedures, Preprosthetic ; Pressure ; Sinus Floor Augmentation ; methods

BACKGROUNDFunctional reconstruction of the jaw defect due to tumor resection poses a challenging problem in maxillofacial surgery. The osteocutaneous fibula free flap in combination with simultaneous or second stage insertion of dental implants has exhibited growing popularity for such reconstructions. This study was aimed at evaluating the clinical status and the success rates of dental implants inserted in fibula-free flaps for orofacial reconstruction following ablation of tumors.

METHODSWe conducted a clinical follow-up study based on 29 patients after oral tumor surgery, who received vascularized fibula bone grafts and endosseous implants for functional jaw reconstruction during a 5-year period. The follow-up protocol included clinical examination and radiological evaluation. The clinical records of the patients were reviewed retrospectively. Information on treatment modalities, dentition, implant parameters, and prostheses was collected and analyzed.

RESULTSIn general, a high primary stability for implants placed into the free fibula grafts was achieved. The 1-year and 5-year cumulative survival rates of the implants were 96% and 91%, respectively, using the Kaplan-Meier method. The 1-year and 5-year cumulative success rates of implants placed into the fibula bone grafts were 95% and 87%, respectively. The main reasons for failure of the dental implants were infection, tumor recurrence and soft tissue proliferation. The fibula flap presents many advantages for implant placement, but its limited height sometimes makes implant-supported prosthetic rehabilitation difficult.

CONCLUSIONSVascularized fibula bone grafts provide a firm basis for the placement of dental implants in jaw reconstruction. Implants placed in fibula bone grafts were shown to integrate normally. The double-barrel technique, or increasing the height of the fibula flap by vertical distraction osteogenesis before implant placement in the mandible, is desirable from a functional and esthetic point of view.

Adult ; Dental Implantation, Endosseous ; methods ; Female ; Fibula ; transplantation ; Humans ; Jaw ; surgery ; Male ; Middle Aged ; Oral Surgical Procedures ; methods ; Reconstructive Surgical Procedures ; methods ; Surgical Flaps

AIMThis paper deals with the treatment of an atrophied toothless mandible with a fixing bridge carried by two nonstandard implant systems.

METHODOLOGYFour bicortical screws were implanted into the frontal part of the mandible and one implant on each side was placed into the distal area of the mandible as a support for a fixing bridge.

RESULTSDuring the years 2002 - 2007 the authors placed a total of 256 bicortical screw and 84 blade implants. During this period only four bicortical screws and one blade implant failed. The primary and secondary surgical success rate was therefore above 98%, while the prosthetic success rate was 100%. (Bridges which had to be re-fabricated due to implant failure were not taken into account.)

CONCLUSIONThis approach is recommended as a highly successful and affordable option for a wide range of patients.

Blade Implantation ; Dental Implantation, Endosseous ; instrumentation ; methods ; Dental Implants ; Dental Prosthesis, Implant-Supported ; Female ; Humans ; Jaw, Edentulous ; rehabilitation ; Male ; Mandible ; surgery ; Middle Aged

OBJECTIVEThe aim of this study is to investigate the effect and complication of immediate implantation of particulate hydroxylapatite artificial bone after teeth extraction.

METHODSParticulate hydroxylapatite artificial bone was implanted into 65 extraction sockets after teeth extraction. All patients were followed up until 3 months after the operation. They are examined with clinical examination and X-ray examination to observe the effect and complication of the implantation operation.

RESULTSThe wound healed well in all cases without any complication. Compared to the alveolar ridge before teeth extraction, and the height of the alveolar ridge after teeth extraction didn't decrease.

CONCLUSIONImplantation of particulate hydroxylapatite artificial bone after teeth extraction could maintain the height of the alveolar ridge and reduce the complication of teeth extraction. It would be helpful for the following prosthetic restoration. The immediate implantation of artificial bone is therefore needed further study.

Adult ; Aged ; Alveolar Bone Loss ; prevention & control ; Alveolar Ridge Augmentation ; methods ; Biocompatible Materials ; Bone Substitutes ; Dental Implantation, Endosseous ; Dental Implants, Single-Tooth ; Denture, Partial, Temporary ; Female ; Humans ; Hydroxyapatites ; Male ; Middle Aged ; Tooth Extraction ; adverse effects

OBJECTIVETo evaluate the clinical result of alveolar vertical distraction osteogenesis for implant.

METHODS19 cases with severe vertical alveolar defects (more than 10 mm defect) underwent vertical distraction procedure before implant placement. 15 cases were male and 4 cases were female. The alveolar bone defects were caused by tumor resection in 10 cases, by trauma in 8 cases, and due to congenital defect in 1 case. The vertical defects in all cases were over 10 mm. X-ray examination were taken prior to operation and in 1 week, 2 week, 4 week, the end of active distraction and before removing distractor. Implants were placed in 17 cases after removing distractors. The prosthesis were finished 6 month later.

RESULTS11 cases out of 19 had implant prosthesis. 6 cases had implant in the jaw but waiting for the prosthesis. Altogether 65 dental implants were placed, 2 cases did not receive further implant treatment because of cost problem. The study showed that new bone formed after distraction in all 19 cases. Average gained height of new bone was 13 mm.

COMPLICATIONSUnexpected mandible fracture in 2 cases, infection in 1 case.

CONCLUSIONSAlveolar vertical distraction is a good alterative for severe alveolar defects. The distractor should be further developed and modified.

Alveolar Ridge Augmentation ; Dental Implantation, Endosseous ; Dental Implants ; Humans ; Mandible ; surgery ; Osteogenesis, Distraction

OBJECTIVETo evaluate the result of bone regeneration due to using PRP in combination with beta-TCP in bone defect adjacent to oral implantation.

METHODSTen patients (6 males, 4 females, with an average age of 49.6 years) participated in this study. Seven of them underwent maxillary sinus augmentations, and 3 underwent GBR for peri-implant bone defects. PRP + beta-TCP was used in 4 cases and beta-TCP in other 6 as control. X-ray examinations were carried out prior to operation and in 1 week, at 3 months, 6 months after operation. After 4 - 6 months, 3 biopsy specimens were obtained at the time of the second stage operation in each group.

RESULTSBone grafts healed well without any infection in all cases. Radiographs showed that bone grafts integrated together with the bone. The histological result showed that new bone was formed among particles of beta-TCP in both groups, but in PRP + beta-TCP group denser and better arranged woven bone was observed, and more new bone was formed into the micropores of the particles.

CONCLUSIONSThe result in this study implied that PRP in combination with beta-TCP can improve bone regeneration in bone defect adjacent to oral implantation.

Adolescent ; Adult ; Aged ; Alveolar Ridge Augmentation ; methods ; Bone Regeneration ; Bone Substitutes ; therapeutic use ; Bone Transplantation ; methods ; Female ; Guided Tissue Regeneration, Periodontal ; methods ; Humans ; Male ; Maxillary Sinus ; surgery ; Middle Aged ; Oral Surgical Procedures, Preprosthetic ; methods ; Platelet Transfusion ; methods ; Treatment Outcome

Implant treatment in the esthetic area requires stable osseointegration and successful esthetic outcomes. Achieving this goal requires careful consideration of accurate implant axis and ideal three-dimensional position. Owing to the high esthetics and the special anatomical structure of the maxillary, a successful implant means a synthesized deli-beration of the residual bone dimensions, soft-tissue thickness, and the relationship of the residual alveolar ridge with the planned restoration. This article offers an in-depth analysis of the clinical decisions and key factors affecting the implant direction in the esthetic area.
Dental Implantation, Endosseous/methods* ; Dental Implants ; Esthetics, Dental ; Alveolar Ridge Augmentation/methods* ; Osseointegration ; Maxilla/surgery* ; Dental Implants, Single-Tooth

Guided bone regeneration (GBR) is an effective and simple method for bone augmentation, which is often used to reconstruct the alveolar ridge when the bone defect occurs in the implant area. Titanium mesh has expanded the indications of GBR technology due to its excellent mechanical properties and biocompatibility, so that the GBR technology can be used to repair alveolar ridges with larger bone defects, and can obtain excellent and stable bone augmentation results. Currently, GBR with titanium mesh has various clinical applications, including different clinical procedures. Bone graft materials, titanium mesh covering methods, and titanium mesh fixing methods are also optional. Moreover, the research of GBR with titanium mesh has led to multifarious progresses in digitalization and material modification. This article reviews the properties of titanium mesh and the difference of titanium mesh with other barrier membranes; the current clinical application of titanium mesh in bone augmentation; common complications and management and prevention methods in the application of titanium mesh; and research progress of titanium mesh in digitization and material modification. Hoping to provide a reference for further improvement of titanium mesh in clinical application and related research of titanium mesh.
Alveolar Ridge Augmentation ; Bone Regeneration ; Bone Transplantation ; Dental Implantation, Endosseous ; Surgical Mesh ; Titanium

Adequate bone volume is the primary condition for successful dental implants. However, sufficient bone volume is often encountered in the vertical direction, but the bone volume in the buccolingual direction is insufficient, making it less suitable to be implanted. If the traditional spitting technique is used in the mandible, fracture and necrosis can easily occur in the labial (buccal) bone plate due to the absence of elasticity, thick cortical bone, poor blood supply, and anastomotic branch. The two-stage ridge splitting technique can be used in patients with narrow alveolar ridge in the mandible. This study summarizes the principles and conditions of application, operational points, clinical efficacy, and analysis of the causes of buccal bone plate absorption.
Alveolar Bone Loss ; Alveolar Process ; Alveolar Ridge Augmentation ; Bone Transplantation ; Dental Implantation, Endosseous ; Dental Implants ; Humans ; Mandible ; surgery