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10 pages, 1427 KiB

Open AccessArticle

Regeneration of Intrabony Defects Using a Novel Magnesium Membrane

by David Botond Hangyasi, Győző Körtvélyessy, Marko Blašković, Patrick Rider, Svenja Rogge, Stjepan Siber, Željka Perić Kačarević and Marija Čandrlić

Medicina 2023, 59(11), 2018; https://doi.org/10.3390/medicina59112018 - 16 Nov 2023

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Abstract

Background and Objectives: Due to their specific morphology, the regeneration of intrabony defects (IBDs) represents one of the greatest challenges for clinicians. Based on the specific properties of a magnesium membrane, a new approach for the surgical treatment of IBD was developed. [...] Read more.

Background and Objectives: Due to their specific morphology, the regeneration of intrabony defects (IBDs) represents one of the greatest challenges for clinicians. Based on the specific properties of a magnesium membrane, a new approach for the surgical treatment of IBD was developed. The surgical procedure was described using a series of three cases. Materials and Methods: The patients were healthy individuals suffering from a severe form of periodontitis associated with IBD. Based on radiographic examination, the patients had interproximal bone loss of at least 4 mm. Due to its good mechanical properties, it was easy to cut and shape the magnesium membrane into three different shapes to treat the specific morphology of each IBD. In accordance with the principles of guided bone regeneration, a bovine xenograft was used to fill the IBD in all cases. Results: After a healing period of 4 to 6 months, successful bone regeneration was confirmed using radiological analysis. The periodontal probing depth (PPD) after healing showed a reduction of 1.66 ± 0.29 mm. Conclusions: Overall, the use of the different shapes of the magnesium membrane in the treatment of IBD resulted in a satisfactory functional and esthetic outcome. Full article

(This article belongs to the Special Issue Guided Bone Regeneration in Oral Surgery)

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16 pages, 11904 KiB

Open AccessArticle

The Use of Nano-Hydroxyapatite (NH) for Socket Preservation: Communication of an Upcoming Multicenter Study with the Presentation of a Pilot Case Report

by Roberto Rossi, Elisabetta Carli, Fabrizio Bambini, Stefano Mummolo, Caterina Licini and Lucia Memè

Medicina 2023, 59(11), 1978; https://doi.org/10.3390/medicina59111978 - 09 Nov 2023

Cited by 2 | Viewed by 1123

Abstract

Background and Objectives: The use of biomaterials in dentistry is extremely common. From a commercial perspective, different types of osteoconductive and osteoinductive biomaterials are available to clinicians. In the field of osteoconductive materials, clinicians have biomaterials made of heterologous bones at their [...] Read more.

Background and Objectives: The use of biomaterials in dentistry is extremely common. From a commercial perspective, different types of osteoconductive and osteoinductive biomaterials are available to clinicians. In the field of osteoconductive materials, clinicians have biomaterials made of heterologous bones at their disposal, including biomaterials of bovine, porcine, and equine origins, and biomaterials of natural origin, such as corals and hydroxyapatites. In recent years, it has become possible to synthesize nano-Ha and produce scaffolds using digital information. Although a large variety of biomaterials has been produced, there is no scientific evidence that proves their absolute indispensability in terms of the preservation of postextraction sites or in the execution of guided bone regeneration. While there is no scientific evidence showing that one material is better than another, there is evidence suggesting that several products have better in situ permanence. This article describes a preliminary study to evaluate the histological results, ISQ values, and prevalence of nano-HA. Materials and Methods: In this study, we planned to use a new biomaterial based on nanohydroxyapatite for implantation at one postextraction site; the nano-HA in this study was NuvaBONE (Overmed, Buccinasco, Milano, Italy). This is a synthetic bone graft substitute that is based on nanostructured biomimetic hydroxyapatite for application in oral–maxillofacial surgery, orthopedics, traumatology, spine surgery, and neurosurgery. In our pilot case, a patient with a hopeless tooth underwent extraction, and the large defect remaining after the removal of the tooth was filled with nano-HA to restore the volume. Twelve months later, the patient was booked for implant surgery to replace the missing tooth. At the time of the surgery, a biopsy of the regenerated tissue was taken using a trephine of 4 mm in the inner side and 8 mm deep. Results: The histological results of the biopsy showed abundant bone formation, high values of ISQ increasing from the insertion to the prosthetic phase, and a good reorganization of hydroxyapatite granules during resorption. The implant is in good function, and the replaced tooth shows good esthetics. Conclusions: The good results of this pilot case indicate starting the next Multicentric study to have more and clearer information about this nanohydroxyapatite (NH) compared with control sites. Full article

(This article belongs to the Special Issue Guided Bone Regeneration in Oral Surgery)

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9 pages, 1703 KiB

Open AccessArticle

Odontogenic Sinusitis with Oroantral Communication and Fistula Management: Role of Regenerative Surgery

by Lorenzo Sabatino, Michele Antonio Lopez, Simone Di Giovanni, Michelangelo Pierri, Francesco Iafrati, Luigi De Benedetto, Antonio Moffa and Manuele Casale

Medicina 2023, 59(5), 937; https://doi.org/10.3390/medicina59050937 - 12 May 2023

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Abstract

Objective: The aim of this study is to show our experience with the correct management of patients suffering from odontogenic sinusitis with oroantral communication and fistula. Methods: According to the inclusion criteria, 41 patients were enrolled in this retrospective study with [...] Read more.

Objective: The aim of this study is to show our experience with the correct management of patients suffering from odontogenic sinusitis with oroantral communication and fistula. Methods: According to the inclusion criteria, 41 patients were enrolled in this retrospective study with a diagnosis of odontogenic sinusitis with oroantral communication and fistula; 1 patient with pre-implantological complication, 14 with implantological complications, and 26 with classical complications. Results: Two patients were treated with a fractioned combined approach, 13 patients were treated with an oral approach only, and 26 patients were treated with a combination. There was a complete resolution of the symptoms and closure of the fistula in all the patients enrolled. Conclusions: In our study, in all 41 patients, there was a surgical success. The best option is to use a multidisciplinary approach for patients suffering from odontogenic sinusitis. Full article

(This article belongs to the Special Issue Guided Bone Regeneration in Oral Surgery)

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10 pages, 4022 KiB

Open AccessCase Report

Horizontal and Vertical Defect Management with a Novel Degradable Pure Magnesium Guided Bone Regeneration (GBR) Membrane—A Clinical Case

by Massimo Frosecchi

Medicina 2023, 59(11), 2009; https://doi.org/10.3390/medicina59112009 - 15 Nov 2023

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Abstract

Background and objectives: In guided bone regeneration (GBR), large defects comprising both horizontal and vertical components usually require additional mechanical support to stabilize the augmentation and preserve the bone volume. This additional support is usually attained by using non-resorbable materials. A recently developed [...] Read more.

Background and objectives: In guided bone regeneration (GBR), large defects comprising both horizontal and vertical components usually require additional mechanical support to stabilize the augmentation and preserve the bone volume. This additional support is usually attained by using non-resorbable materials. A recently developed magnesium membrane presents the possibility of providing mechanical support whilst being completely resorbable. The aim of this case report was to describe the application and outcome of the magnesium membrane in combination with a collagen pericardium membrane for GBR. Materials and methods: A 74 year old, in an otherwise good general health condition, was presented with stage 2 grade A periodontitis and an impacted canine. After extraction of the impacted canine, a defect was created with both vertical and horizontal components. The defect was augmented using the magnesium membrane to create a supportive arch to the underlying bone graft and a collagen pericardium membrane was placed on top to aid with the soft tissue closure. Results: Upon reentry at 8 months, complete resorption of the magnesium devices was confirmed as there were no visible remnants remaining. A successful augmentation outcome had been achieved as the magnesium membrane in combination with the collagen membrane had maintained the augmented bone well. Two dental implants could be successfully placed in the healed augmentation. Conclusions: In this case, the magnesium membrane in combination with a collagen pericardium membrane presented a potentially viable alternative treatment to titanium meshes or titanium-reinforced membranes for the augmentation of a defect with both horizontal and vertical components that is completely resorbable. It was demonstrated that it is possible to attain a good quality and quantity of bone using a resorbable system that has been completely resorbed by the time of reentry. Full article

(This article belongs to the Special Issue Guided Bone Regeneration in Oral Surgery)

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25 pages, 18042 KiB

Open AccessCase Report

The Poncho Lamina Technique: A Protocol for Hard and Soft Tissue Augmentation in Atrophic Ridges Receiving Adjacent Implants

by Alexander Tzovairis, Marius Leretter, Bart Vandenberghe and Roberto Rossi

Medicina 2023, 59(11), 1994; https://doi.org/10.3390/medicina59111994 - 13 Nov 2023

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Abstract

The current scientific knowledge and guidelines in bone and soft tissue augmentation suggest the use of staged surgical workflows as the gold standard of regenerative procedures during implant therapy. In this context, the process is always the same, regardless of the techniques applied: [...] Read more.

The current scientific knowledge and guidelines in bone and soft tissue augmentation suggest the use of staged surgical workflows as the gold standard of regenerative procedures during implant therapy. In this context, the process is always the same, regardless of the techniques applied: an alternate series of surgical acts that follow one another after the completion of a specific period of osseointegration or graft maturation. As a result, the overall surgical treatment is often long and invasive and induces scar tissue formation. This article proposes a novel, fast, and less-invasive biphasic protocol with the use of a well-documented cortical barrier mounted on healing screws that are further replaced by customized abutments at an early second stage. Two cases are reported, one for an upper maxillary edentulous area and the other for a mandibular, with a total of four implants placed. The results at 4 months postop showed an optimal soft tissue configuration for both cases, with adequate cervical profile generation and a sufficient supracrestal complex height above the implant platforms. Significant bone gains were also recorded through CBCT data collection, either with alveolar width measurements on axial slices, the superposition of pre-op and post-op datasets, or 3D visualization after bone volume segmentation. Full article

(This article belongs to the Special Issue Guided Bone Regeneration in Oral Surgery)

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10 pages, 3867 KiB

Open AccessCase Report

Possible Applications for a Biodegradable Magnesium Membrane in Alveolar Ridge Augmentation–Retrospective Case Report with Two Years of Follow-Up

by Daniel Palkovics, Patrick Rider, Svenja Rogge, Željka Perić Kačarević and Peter Windisch

Medicina 2023, 59(10), 1698; https://doi.org/10.3390/medicina59101698 - 22 Sep 2023

Cited by 1 | Viewed by 913

Abstract

Background and Objectives: A rigid, resorbable magnesium membrane was recently developed, combining the advantages of resorbable and non-resorbable membranes. Our aim was to describe the application of this membrane for guided bone regeneration (GBR). Materials and Methods: This case report described [...] Read more.

Background and Objectives: A rigid, resorbable magnesium membrane was recently developed, combining the advantages of resorbable and non-resorbable membranes. Our aim was to describe the application of this membrane for guided bone regeneration (GBR). Materials and Methods: This case report described the treatment and 3D evaluation of two cases utilizing a resorbable magnesium barrier membrane. In Case #1, GBR was performed with a bilayer tunnel flap. The magnesium barrier was placed fixed subperiosteally through remote vertical incisions. In Case #2, GBR was performed using a split-thickness flap design. Volumetric and linear hard tissue alterations were assessed by 3D cone-beam computed tomography subtraction analysis, as well as with conventional intraoral radiography. Results: Case #1 showed a volumetric hard tissue gain of 0.12 cm³, whereas Case #2 presented a 0.36 cm³ hard tissue gain. No marginal peri-implant hard tissue loss could be detected at the two-year follow-up. Conclusions: The application of conventional resorbable collagen membranes would be difficult in either of the cases presented. However, the rigid structure of the magnesium membrane allowed for the limitations of conventional resorbable membranes to be overcome. Full article

(This article belongs to the Special Issue Guided Bone Regeneration in Oral Surgery)

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10 pages, 2344 KiB

Open AccessCase Report

The “White Layer Approach”: A Graftless Gingival Augmentation Technique following Vertical GBR with Occlusive Titanium Barriers

by Fabio Perret, Erik D’Aprile and Luca De Stavola

Medicina 2023, 59(10), 1694; https://doi.org/10.3390/medicina59101694 - 22 Sep 2023

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Abstract

Guided bone regeneration surgery always leads to a deformation of the soft tissues consequent to passivation of the flap. In this article, a graftless technique for the restoration of the vestibular depth and for the augmentation of adherent soft tissue, called the “white [...] Read more.

Guided bone regeneration surgery always leads to a deformation of the soft tissues consequent to passivation of the flap. In this article, a graftless technique for the restoration of the vestibular depth and for the augmentation of adherent soft tissue, called the “white layer approach”, is proposed after a vertical GBR procedure in posterior areas. Six patients (five males and one female) with vertical bone atrophy were enrolled in the study and underwent three-dimensional bone augmentation with titanium barriers. After 6 months, during the second-stage surgery, a 0.5 mm thick layer of white pseudo-periosteum was observed underneath the titanium barrier and over the newly formed bone. The buccal portion of the pseudo-periosteum was left intentionally exposed, in order to promote the spontaneous formation of new adherent gingiva and the restoration of the original depth of the fornix. The implant insertion was then planned 3 months after the WLA in a conventional procedure. The buccal adherent soft tissue height was measured from the crestal point to the most apical point, using a periodontal probe, before the barrier removal at 3 months after the white layer approach (WLA). In all patients, a gain in adherent soft tissue varying from 5 to 8 mm was observed; the average adherent soft tissue gain (ASTG) was 6.75 mm. The vertical bone height was measured by CT scans at baseline and before the implant placement, and showed an average vertical bone gain (AVBG) of 4.08 mm. Within the limitations of this study, vertical GBR with titanium occlusive barriers (OTB) associated with the white layer approach (WLA) may represent a simplified technique for hard and soft tissue augmentation in posterior areas, even without a free gingival graft. Full article

(This article belongs to the Special Issue Guided Bone Regeneration in Oral Surgery)

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9 pages, 3674 KiB

Open AccessCase Report

Lateral Peri-Implantitis: Successful Management via Guided Bone Regeneration at Mandibular First Molar Implant

by Won-Bae Park, Michael Villa, Ji-Young Han, Hyun-Chang Lim and Philip Kang

Medicina 2023, 59(9), 1691; https://doi.org/10.3390/medicina59091691 - 21 Sep 2023

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Abstract

Infections occurring around implants are divided into marginal peri-implantitis and retrograde peri-implantitis (RPI). Marginal peri-implantitis starts in the crestal bone and progresses to the apical portion, and RPI starts in the apical bone and progresses to the coronal portion. However, lateral peri-implantitis (LPI) [...] Read more.

Infections occurring around implants are divided into marginal peri-implantitis and retrograde peri-implantitis (RPI). Marginal peri-implantitis starts in the crestal bone and progresses to the apical portion, and RPI starts in the apical bone and progresses to the coronal portion. However, lateral peri-implantitis (LPI) occurring on the side of the implant body has not yet been reported, and the cause is unclear. This 63-year-old male patient is a case of unusual bone resorption that occurred in the lateral portion of the implant body 26 months after lateral bone augmentation. The origin of LPI was an infection at the site of laterally augmented bone. Rather than implant removal, this report demonstrates an alternative treatment option of guided bone regeneration after the enucleation and detoxification of the implant surface with successful clinical and radiographic results for 2 years. Full article

(This article belongs to the Special Issue Guided Bone Regeneration in Oral Surgery)

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15 pages, 8227 KiB

Open AccessCase Report

The Bone Bridge Technique Utilizing Bone from the Lateral Wall of the Maxillary Sinus for Ridge Augmentation: Case Reports of a 1–7 Year Follow-Up

by Won-Bae Park, Ji-Young Han and Philip Kang

Medicina 2023, 59(9), 1626; https://doi.org/10.3390/medicina59091626 - 08 Sep 2023

Cited by 1 | Viewed by 877

Abstract

The post-extraction socket of a periodontally compromised tooth/implant is oftentimes accompanied by a very wide-deep alveolar ridge defect. The commonly utilized treatment is ridge preservation followed by delayed implant placement 4 to 6 months after extraction. In the four cases presented in this [...] Read more.

The post-extraction socket of a periodontally compromised tooth/implant is oftentimes accompanied by a very wide-deep alveolar ridge defect. The commonly utilized treatment is ridge preservation followed by delayed implant placement 4 to 6 months after extraction. In the four cases presented in this study, a novel technique of utilizing a bone block obtained from the lateral wall of the maxillary sinus is introduced. Due to the severe localized vertical ridge deficiency, an intraoral autogenous bone block was obtained from the ipsilateral sinus bony window. After the obtained bone block was properly trimmed, it was fixed in the form of a bridge over the vertical defect by the press-fit method. In two cases, the gap between the autogenous bone and defect was filled with a particulate synthetic bone graft, and in another two cases, the gap was left without grafting. All cases were covered with a resorbable collagen membrane. At the time of re-entry after 5 to 6 months, the bone bridge was well incorporated beside the adjacent native bone and helped by the implant placement. Uncovering was performed after 3 to 6 months, and prostheses were delivered after 2 months. Oral function was maintained without any change in the marginal bone level even after the 1- to 7-year post-prosthesis delivery. This case series showed that the bone bridge technique performed using an ipsilateral sinus bony window for a localized vertical deficiency of a post-extraction socket can be used for successful vertical ridge augmentation (VRA). Full article

(This article belongs to the Special Issue Guided Bone Regeneration in Oral Surgery)

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