[EP-27] Comprehensive oral rehabilitation using dental implants and autogenous bone grafts simultaneously in a patient with advanced periodontal disease and severe alveolar ridge defects
[Abstract]
[Introduction]
Oral rehabilitation with implant prostheses in patients with advanced periodontal disease poses significant challenges. The healed edentulous areas in these patients typically exhibit severe ridge defects.1) This clinical report outlines the steps taken to achieve the desired outcome and discusses associated complications that require consideration.
[Case Summary and Treatment Details]
A healthy 62-year-old male presenting a severe alveolar ridge defect in the maxillary posterior region underwent treatment. Using computer-guided implant surgery, 7 dental implants were placed under general anesthesia simultaneously with autogenous bone grafts and sinus augmentation at sites 16, 14, 23, 24, 26, 36, and 46. Vestibuloplasty and soft tissue augmentation were performed 4 months after the initial procedure, followed by the second stage of surgery 6 months later. Screw-cement-retained prostheses were fabricated. Deviated implant position and marginal bone loss were observed.
[Progress and Discussion]
The outcomes suggest that simultaneous implant placement with autogenous bone grafts represents a viable treatment option for patients with severe alveolar ridge defects. This approach not only enhances prosthetic outcomes but also improves patient functionality, reducing the necessity for multiple surgeries and shortening the waiting period.2) However, potential complications may arise. Deviation in implant angulation could inadvertently damage adjacent teeth and complicate subsequent prosthodontic procedures, particularly in regions with less than 3 mm of vertical bone support and facial bone fenestration defects. Additionally, graft volume reduction, leading to marginal bone loss before implant loading, may occur with extraoral bone grafts,characterized by an increased resorption rate and reduced predictability.3) Therefore, simultaneous implant placement with autogenous bone augmentation should be approached cautiously in patients with severe alveolar ridge defects to mitigate associated complications.
[References]
1) Hämmerle C, Tarnow D. The etiology of hard- and soft-tissue deficiencies at dental implants: A narrative review. J Periodontol 2018;45:267-77.
2) Ma G, Wu C, Shao M. Simultaneous implant placement with autogenous onlay bone grafts: a systematic review and meta-analysis. Int J Implant Dent 2021;7(1):61.
3) Idrontino G, Valente NA. Intraoral and extraoral autologous bone block graft techniques: A review of the recent literature. Int J Contemp Dent Med Rev 2016;030316.
[Introduction]
Oral rehabilitation with implant prostheses in patients with advanced periodontal disease poses significant challenges. The healed edentulous areas in these patients typically exhibit severe ridge defects.1) This clinical report outlines the steps taken to achieve the desired outcome and discusses associated complications that require consideration.
[Case Summary and Treatment Details]
A healthy 62-year-old male presenting a severe alveolar ridge defect in the maxillary posterior region underwent treatment. Using computer-guided implant surgery, 7 dental implants were placed under general anesthesia simultaneously with autogenous bone grafts and sinus augmentation at sites 16, 14, 23, 24, 26, 36, and 46. Vestibuloplasty and soft tissue augmentation were performed 4 months after the initial procedure, followed by the second stage of surgery 6 months later. Screw-cement-retained prostheses were fabricated. Deviated implant position and marginal bone loss were observed.
[Progress and Discussion]
The outcomes suggest that simultaneous implant placement with autogenous bone grafts represents a viable treatment option for patients with severe alveolar ridge defects. This approach not only enhances prosthetic outcomes but also improves patient functionality, reducing the necessity for multiple surgeries and shortening the waiting period.2) However, potential complications may arise. Deviation in implant angulation could inadvertently damage adjacent teeth and complicate subsequent prosthodontic procedures, particularly in regions with less than 3 mm of vertical bone support and facial bone fenestration defects. Additionally, graft volume reduction, leading to marginal bone loss before implant loading, may occur with extraoral bone grafts,characterized by an increased resorption rate and reduced predictability.3) Therefore, simultaneous implant placement with autogenous bone augmentation should be approached cautiously in patients with severe alveolar ridge defects to mitigate associated complications.
[References]
1) Hämmerle C, Tarnow D. The etiology of hard- and soft-tissue deficiencies at dental implants: A narrative review. J Periodontol 2018;45:267-77.
2) Ma G, Wu C, Shao M. Simultaneous implant placement with autogenous onlay bone grafts: a systematic review and meta-analysis. Int J Implant Dent 2021;7(1):61.
3) Idrontino G, Valente NA. Intraoral and extraoral autologous bone block graft techniques: A review of the recent literature. Int J Contemp Dent Med Rev 2016;030316.