|What … for? (Indications)|
Implanted oral bone serves as reconstruction of the alveolar (jaw) bone to enable dental implants and/or dentures.
There are no specific numbers available. Suspected 25% of all dental implant procedures go with an augmentation procedure using bone substitutes.
Healing, restructuring times are necessary, before implanted bone structure may be loaded. Usually it takes 3-6 month. In special circumstances shorter or longer healing times are possible.
|Contraindication||behavioral||Systemic bone diseases, poor oral hygiene, smoking, parafunction, no aftercare possible.|
|medical||Diabetes mellitus, infectious diseases, certain systemic/metabolism diseases, low ability for surgery.|
|pharmaceutical||Biphosphonates, chemotherapy, drugs, alcohol, corticosteroids, immune suppression|
|Risks||at surgery||Tissue injury, swallowing/inhaling parts, bone fracture, injury or structures/nervs, ceasing of the surgery.|
|short term||Inflammation, foreign body reactions, allergic reactions, rejection, wound opening with loss of implanted material and even more bone surrounding the infected area.|
|long term||Slow degradation, dislocation, chronic inflammation, chronic pain, reoperation, implant loss.|
|Failures||Risks depend from several preconditions like bone volume, material and reasons in connection with the above contraindications.|
|Materials||autologous||same individual||core drilling blocks, resection, granules, transplantation|
|special techniques||bone collected in cultures distraction osteogenesis|
|isologous||twin as donator|
|allogenic||same species (human)||granules|
|xenogenous||different species (bovine, porcine, equine)||granules|
|bone morpho-genetic proteins|
|Statistics||No specific long-term data available|
|Nyström E et al.: Bone graft remodelling and implant success rate in the treatment of the severely resorbed maxilla: a 5-year longitudinal study. Int J Oral Maxillofac Surg. 2002 Apr;31(2):158-64|
|Literature||– Basic||Buser D et al.: Localized ridge augmentation with autografts and barrier membranes. Periodontol 2000. 1999;19:151-63|
|Esposito M et al.: The efficacy of various bone augmentation procedures for dental implants: a Cochrane systematic review of randomized controlled clinical trials. See comment in PubMed Commons belowInt J Oral Maxillofac Implants. 2006 Sep-Oct;21(5):696-710 |
Von ArxT, Buser D: Clin Oral Implants Res 2006; 17(4): 359-66
|– Problems||Pommer B et al.: To Graft or Not to Graft? Evidence-Based Guide to Decision Making in Oral Bone Graft Surgery, Bone Grafting (2012)|
|– Science/Future||3D-printed blocks, gentech|
|Medical Societies||see here|
|Most implantologic societies also concern augmentation surrounding dental implants – see there.||Very different worldwide dentists, oral surgeons and maxillofacial surgeons work together or not, having borderlines at very different levels or not, having borderlines at very different levels or even no borderlines. In some countries dentists do the whole job and in others here are dentists do the whole job and in others here are restrictions who´s got to do what. However, in more severe cases a trained surgeon might be helpful, who is found among oral surgeons and/or maxillofacial surgeons.|
|Criticism||There are two opposite opinions: Bone may continue getting lost or bone will be stabilized through function, means dental implants in function. The latter may require all parameters to be ok, like orthofunction, general health, oral hygiene, dental prosthetics.|
|Selected patient informations||AAID: On bone augmentation|
|Botiss: Patient information|
|Register for patients||n/a Materials are marked comprehensible and should be comprehensible documented in an implant-passport.|
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