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Background:
The use of dental implants for replacement of missing teeth is a realistic option in the rehabilitation of periodontally compromised patients. Sometimes, there is a lack of supporting bone and implant treatment would not be an option without horizontal bone augmentation. In these cases, alveolar ridge augmentation procedures with mandible bone blocks in the lateral compromised edentulous maxilla and mandible are today an integral part of implant treatment.
Aim/Hypothesis:
The aim of this study was to compare long-term outcomes (≥ 5 years) of implants placed in laterally augmented alveolar ridges with autogenous bone block grafts according to the biological concept (Khoury, 2006) in patients treated for chronic periodontitis as well as in periodontally healthy patients.
Material and Methods:
Patients without any severe systemic diseases including non-smokers and with adhesion to regular SPT were classified in two groups: periodontally healthy patients (PHP) and periodontally compromised patients (PCP). All patients showed lateral compromised alveolar ridges and were treated with autogenous bone block grafting after initial therapy, consisting, depending on the cases, of motivation, oral hygiene instruction and scaling/root planning. Surgical protocol was standardized among all patients including retromolar bone block harvesting, block splitting, thinning and fixating on distance with MicroScrews. Gaps between crest and block were filled with particulated bone, following tension free flap adaptation due to submerged healing. In two-staged approaches implant placement (Xive®, Dentsply) followed 3 months later. Soft tissue management and prosthetic reconstruction with implant supported fixed and removable screwed restorations were performed 4 months after implant placement according to patient needs and desires. Treatment of peri-implant biological complications was performed according to cumulative interceptive supportive therapy (Mombelli & Lang, 1998). All patients were selected from SPT examinations. In the final clinical examination, following parameters were collected: peri-implant inflammation (GI), presence of dental plaque (Pl, API), probing depth, bleeding on probing (BOP), recessions, width of the keratinized tissue at facial abutments.
Results:
This study examined the clinical outcomes in 25 periodontally healthy and 25 periodontally compromised successfully treated subjects with severe lateral atrophy following oral implantation with 115 Xive® endosseous implants between 2001 and 2008. During the period of observation (5-13 years, average period: 7.8 years), one implant was removed because of biological complications. The implant survival rate was 99.1 %, 100 % and 97.8 % for all implants (n=115), respectively, for PHP and PCP. At the final examination, mean BOP was 5.31±1.6% in PHP and 13.77±1.92% in PCP. A statistically significant difference was found between PHP and PCP (p<0.001). Significant higher plaque scores (PI) (p<0.05) and more recessions (p<0.001) were associated with "inadequate" (<2mm) width of keratinized mucosa. At implants with ≥2mm of keratinized mucosa there were significantly less bleeding scores (BOP) (p<0.001) and less peri-implant inflammation (GI) (p<0.001). No differences were found for probing depths.
Conclusions and clinical implications:
This investigation indicated that implants in lateral augmented alveolar ridge according to the biological concept reveal similar clinical peri-implant conditions in both PHP and PCP. Autogenous bone block grafts without using biomaterials showed long-term stability in terms of peri-implant conditions. Patients with a history of periodontitis presented a lower implant survival rate. It has to be emphasized that the results can only be obtained on regular SPT basis.
Background:
The use of dental implants for replacement of missing teeth is a realistic option in the rehabilitation of periodontally compromised patients. Sometimes, there is a lack of supporting bone and implant treatment would not be an option without horizontal bone augmentation. In these cases, alveolar ridge augmentation procedures with mandible bone blocks in the lateral compromised edentulous maxilla and mandible are today an integral part of implant treatment.
Aim/Hypothesis:
The aim of this study was to compare long-term outcomes (≥ 5 years) of implants placed in laterally augmented alveolar ridges with autogenous bone block grafts according to the biological concept (Khoury, 2006) in patients treated for chronic periodontitis as well as in periodontally healthy patients.
Material and Methods:
Patients without any severe systemic diseases including non-smokers and with adhesion to regular SPT were classified in two groups: periodontally healthy patients (PHP) and periodontally compromised patients (PCP). All patients showed lateral compromised alveolar ridges and were treated with autogenous bone block grafting after initial therapy, consisting, depending on the cases, of motivation, oral hygiene instruction and scaling/root planning. Surgical protocol was standardized among all patients including retromolar bone block harvesting, block splitting, thinning and fixating on distance with MicroScrews. Gaps between crest and block were filled with particulated bone, following tension free flap adaptation due to submerged healing. In two-staged approaches implant placement (Xive®, Dentsply) followed 3 months later. Soft tissue management and prosthetic reconstruction with implant supported fixed and removable screwed restorations were performed 4 months after implant placement according to patient needs and desires. Treatment of peri-implant biological complications was performed according to cumulative interceptive supportive therapy (Mombelli & Lang, 1998). All patients were selected from SPT examinations. In the final clinical examination, following parameters were collected: peri-implant inflammation (GI), presence of dental plaque (Pl, API), probing depth, bleeding on probing (BOP), recessions, width of the keratinized tissue at facial abutments.
Results:
This study examined the clinical outcomes in 25 periodontally healthy and 25 periodontally compromised successfully treated subjects with severe lateral atrophy following oral implantation with 115 Xive® endosseous implants between 2001 and 2008. During the period of observation (5-13 years, average period: 7.8 years), one implant was removed because of biological complications. The implant survival rate was 99.1 %, 100 % and 97.8 % for all implants (n=115), respectively, for PHP and PCP. At the final examination, mean BOP was 5.31±1.6% in PHP and 13.77±1.92% in PCP. A statistically significant difference was found between PHP and PCP (p<0.001). Significant higher plaque scores (PI) (p<0.05) and more recessions (p<0.001) were associated with "inadequate" (<2mm) width of keratinized mucosa. At implants with ≥2mm of keratinized mucosa there were significantly less bleeding scores (BOP) (p<0.001) and less peri-implant inflammation (GI) (p<0.001). No differences were found for probing depths.
Conclusions and clinical implications:
This investigation indicated that implants in lateral augmented alveolar ridge according to the biological concept reveal similar clinical peri-implant conditions in both PHP and PCP. Autogenous bone block grafts without using biomaterials showed long-term stability in terms of peri-implant conditions. Patients with a history of periodontitis presented a lower implant survival rate. It has to be emphasized that the results can only be obtained on regular SPT basis.
Background:
The use of dental implants for replacement of missing teeth is a realistic option in the rehabilitation of periodontally compromised patients. Sometimes, there is a lack of supporting bone and implant treatment would not be an option without horizontal bone augmentation. In these cases, alveolar ridge augmentation procedures with mandible bone blocks in the lateral compromised edentulous maxilla and mandible are today an integral part of implant treatment.
Aim/Hypothesis:
The aim of this study was to compare long-term outcomes (≥ 5 years) of implants placed in laterally augmented alveolar ridges with autogenous bone block grafts according to the biological concept (Khoury, 2006) in patients treated for chronic periodontitis as well as in periodontally healthy patients.
Material and Methods:
Patients without any severe systemic diseases including non-smokers and with adhesion to regular SPT were classified in two groups: periodontally healthy patients (PHP) and periodontally compromised patients (PCP). All patients showed lateral compromised alveolar ridges and were treated with autogenous bone block grafting after initial therapy, consisting, depending on the cases, of motivation, oral hygiene instruction and scaling/root planning. Surgical protocol was standardized among all patients including retromolar bone block harvesting, block splitting, thinning and fixating on distance with MicroScrews. Gaps between crest and block were filled with particulated bone, following tension free flap adaptation due to submerged healing. In two-staged approaches implant placement (Xive®, Dentsply) followed 3 months later. Soft tissue management and prosthetic reconstruction with implant supported fixed and removable screwed restorations were performed 4 months after implant placement according to patient needs and desires. Treatment of peri-implant biological complications was performed according to cumulative interceptive supportive therapy (Mombelli & Lang, 1998). All patients were selected from SPT examinations. In the final clinical examination, following parameters were collected: peri-implant inflammation (GI), presence of dental plaque (Pl, API), probing depth, bleeding on probing (BOP), recessions, width of the keratinized tissue at facial abutments.
Results:
This study examined the clinical outcomes in 25 periodontally healthy and 25 periodontally compromised successfully treated subjects with severe lateral atrophy following oral implantation with 115 Xive® endosseous implants between 2001 and 2008. During the period of observation (5-13 years, average period: 7.8 years), one implant was removed because of biological complications. The implant survival rate was 99.1 %, 100 % and 97.8 % for all implants (n=115), respectively, for PHP and PCP. At the final examination, mean BOP was 5.31±1.6% in PHP and 13.77±1.92% in PCP. A statistically significant difference was found between PHP and PCP (p<0.001). Significant higher plaque scores (PI) (p<0.05) and more recessions (p<0.001) were associated with "inadequate" (<2mm) width of keratinized mucosa. At implants with ≥2mm of keratinized mucosa there were significantly less bleeding scores (BOP) (p<0.001) and less peri-implant inflammation (GI) (p<0.001). No differences were found for probing depths.
Conclusions and clinical implications:
This investigation indicated that implants in lateral augmented alveolar ridge according to the biological concept reveal similar clinical peri-implant conditions in both PHP and PCP. Autogenous bone block grafts without using biomaterials showed long-term stability in terms of peri-implant conditions. Patients with a history of periodontitis presented a lower implant survival rate. It has to be emphasized that the results can only be obtained on regular SPT basis.
Background:
The use of dental implants for replacement of missing teeth is a realistic option in the rehabilitation of periodontally compromised patients. Sometimes, there is a lack of supporting bone and implant treatment would not be an option without horizontal bone augmentation. In these cases, alveolar ridge augmentation procedures with mandible bone blocks in the lateral compromised edentulous maxilla and mandible are today an integral part of implant treatment.
Aim/Hypothesis:
The aim of this study was to compare long-term outcomes (≥ 5 years) of implants placed in laterally augmented alveolar ridges with autogenous bone block grafts according to the biological concept (Khoury, 2006) in patients treated for chronic periodontitis as well as in periodontally healthy patients.
Material and Methods:
Patients without any severe systemic diseases including non-smokers and with adhesion to regular SPT were classified in two groups: periodontally healthy patients (PHP) and periodontally compromised patients (PCP). All patients showed lateral compromised alveolar ridges and were treated with autogenous bone block grafting after initial therapy, consisting, depending on the cases, of motivation, oral hygiene instruction and scaling/root planning. Surgical protocol was standardized among all patients including retromolar bone block harvesting, block splitting, thinning and fixating on distance with MicroScrews. Gaps between crest and block were filled with particulated bone, following tension free flap adaptation due to submerged healing. In two-staged approaches implant placement (Xive®, Dentsply) followed 3 months later. Soft tissue management and prosthetic reconstruction with implant supported fixed and removable screwed restorations were performed 4 months after implant placement according to patient needs and desires. Treatment of peri-implant biological complications was performed according to cumulative interceptive supportive therapy (Mombelli & Lang, 1998). All patients were selected from SPT examinations. In the final clinical examination, following parameters were collected: peri-implant inflammation (GI), presence of dental plaque (Pl, API), probing depth, bleeding on probing (BOP), recessions, width of the keratinized tissue at facial abutments.
Results:
This study examined the clinical outcomes in 25 periodontally healthy and 25 periodontally compromised successfully treated subjects with severe lateral atrophy following oral implantation with 115 Xive® endosseous implants between 2001 and 2008. During the period of observation (5-13 years, average period: 7.8 years), one implant was removed because of biological complications. The implant survival rate was 99.1 %, 100 % and 97.8 % for all implants (n=115), respectively, for PHP and PCP. At the final examination, mean BOP was 5.31±1.6% in PHP and 13.77±1.92% in PCP. A statistically significant difference was found between PHP and PCP (p<0.001). Significant higher plaque scores (PI) (p<0.05) and more recessions (p<0.001) were associated with "inadequate" (<2mm) width of keratinized mucosa. At implants with ≥2mm of keratinized mucosa there were significantly less bleeding scores (BOP) (p<0.001) and less peri-implant inflammation (GI) (p<0.001). No differences were found for probing depths.
Conclusions and clinical implications:
This investigation indicated that implants in lateral augmented alveolar ridge according to the biological concept reveal similar clinical peri-implant conditions in both PHP and PCP. Autogenous bone block grafts without using biomaterials showed long-term stability in terms of peri-implant conditions. Patients with a history of periodontitis presented a lower implant survival rate. It has to be emphasized that the results can only be obtained on regular SPT basis.