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Background
According to the literature the placement of dental implants at an early timing after tooth extraction may offer advantages in the preservation of soft and hard tissues compared to immediate or delayed protocols. In fact, several clinical studies present successful results with early implant placement concept followed by bone augmentation with the use of xenogeneic bone graft and resorbable barrier membrane. In contrast, the present case report alters the above augmentation protocol in the early implant placement procedure. The dehiscence-type bone defects were treated with resorbable biphasic alloplastic bone grafting materials composed of 𝛽,-TCP and CS and no barrier membranes were used.
Aims
The purpose of the present case was to assess the long-term survival rate of implants early placed into defective sockets with simultaneous bone grafting with in situ hardening 𝛽,-TCP, following a standardized protocol.
Methods
Under local anaesthesia, a site-specific full thickness flap was raised using vertical releasing incisions, without including the papillae of the adjacent teeth. After flap elevation, the residual root was mobilized and removed with a thin elevator, and the site was thoroughly curetted in order to remove all granulation tissue. An implant (Paltop Advanced 5mm x 10mm) was placed in the optimal position. After placing the cover screw, the site was augmented utilizing an in situ hardening resorbable alloplastic bone grafting material: EthOss® (Regenamed Ltd, London, UK) is a novel biphasic bone substitute consisting of 𝛽,-TCP (65%) and Calcium Sulfate (35%). When mixed with sterile saline the material forms an easily handling mouldable mass that hardens in situ. No barrier membranes were used.
Results
After 10 weeks, the healing was uneventful. The architecture and the dimensions of the ridge were adequately preserved and the site was covered with thick keratinized epithelium. A periapical x-ray showed excellent osseointegration of the implant and consolidation of the grafting material. A tissue punch was used to expose the implant and the secondary stability of the implant was measured by resonance frequency analysis (PenguinRFA). A value of 76 was recorded demonstrating high stability. Subsequently, an open-tray impression was taken and a healing abutment was placed. After 2 weeks, a screw-retained crown was fitted with excellent aesthetic and functional results. Follow-up clinical examination after a year revealed stable peri-implant soft tissues with excellent preservation of the volume of the ridge. A periapical x-ray showed further turnover of the bone around the loaded implant with no signs of residual biomaterial.
Conclusions
In the presented case, an in situ hardening resorbable alloplastic bone substitute was used according to a standardized protocol for bone augmentation in parallel to early implant placement, resulting in pronounced hard tissue regeneration and enhanced implant stability in order to load the implant 12 weeks post-op. The in situ hardening and handling properties of the grafting material may enable clinicians to utilize simplified techniques in achieving successful functional and aesthetic results for implant rehabilitations. Moreover, the fully resorbable nature of this bone substitute ensures that no residual particles of the material will be present in the newly-formed hard tissue in the long term.
Background
According to the literature the placement of dental implants at an early timing after tooth extraction may offer advantages in the preservation of soft and hard tissues compared to immediate or delayed protocols. In fact, several clinical studies present successful results with early implant placement concept followed by bone augmentation with the use of xenogeneic bone graft and resorbable barrier membrane. In contrast, the present case report alters the above augmentation protocol in the early implant placement procedure. The dehiscence-type bone defects were treated with resorbable biphasic alloplastic bone grafting materials composed of 𝛽,-TCP and CS and no barrier membranes were used.
Aims
The purpose of the present case was to assess the long-term survival rate of implants early placed into defective sockets with simultaneous bone grafting with in situ hardening 𝛽,-TCP, following a standardized protocol.
Methods
Under local anaesthesia, a site-specific full thickness flap was raised using vertical releasing incisions, without including the papillae of the adjacent teeth. After flap elevation, the residual root was mobilized and removed with a thin elevator, and the site was thoroughly curetted in order to remove all granulation tissue. An implant (Paltop Advanced 5mm x 10mm) was placed in the optimal position. After placing the cover screw, the site was augmented utilizing an in situ hardening resorbable alloplastic bone grafting material: EthOss® (Regenamed Ltd, London, UK) is a novel biphasic bone substitute consisting of 𝛽,-TCP (65%) and Calcium Sulfate (35%). When mixed with sterile saline the material forms an easily handling mouldable mass that hardens in situ. No barrier membranes were used.
Results
After 10 weeks, the healing was uneventful. The architecture and the dimensions of the ridge were adequately preserved and the site was covered with thick keratinized epithelium. A periapical x-ray showed excellent osseointegration of the implant and consolidation of the grafting material. A tissue punch was used to expose the implant and the secondary stability of the implant was measured by resonance frequency analysis (PenguinRFA). A value of 76 was recorded demonstrating high stability. Subsequently, an open-tray impression was taken and a healing abutment was placed. After 2 weeks, a screw-retained crown was fitted with excellent aesthetic and functional results. Follow-up clinical examination after a year revealed stable peri-implant soft tissues with excellent preservation of the volume of the ridge. A periapical x-ray showed further turnover of the bone around the loaded implant with no signs of residual biomaterial.
Conclusions
In the presented case, an in situ hardening resorbable alloplastic bone substitute was used according to a standardized protocol for bone augmentation in parallel to early implant placement, resulting in pronounced hard tissue regeneration and enhanced implant stability in order to load the implant 12 weeks post-op. The in situ hardening and handling properties of the grafting material may enable clinicians to utilize simplified techniques in achieving successful functional and aesthetic results for implant rehabilitations. Moreover, the fully resorbable nature of this bone substitute ensures that no residual particles of the material will be present in the newly-formed hard tissue in the long term.
Background
According to the literature the placement of dental implants at an early timing after tooth extraction may offer advantages in the preservation of soft and hard tissues compared to immediate or delayed protocols. In fact, several clinical studies present successful results with early implant placement concept followed by bone augmentation with the use of xenogeneic bone graft and resorbable barrier membrane. In contrast, the present case report alters the above augmentation protocol in the early implant placement procedure. The dehiscence-type bone defects were treated with resorbable biphasic alloplastic bone grafting materials composed of 𝛽,-TCP and CS and no barrier membranes were used.
Aims
The purpose of the present case was to assess the long-term survival rate of implants early placed into defective sockets with simultaneous bone grafting with in situ hardening 𝛽,-TCP, following a standardized protocol.
Methods
Under local anaesthesia, a site-specific full thickness flap was raised using vertical releasing incisions, without including the papillae of the adjacent teeth. After flap elevation, the residual root was mobilized and removed with a thin elevator, and the site was thoroughly curetted in order to remove all granulation tissue. An implant (Paltop Advanced 5mm x 10mm) was placed in the optimal position. After placing the cover screw, the site was augmented utilizing an in situ hardening resorbable alloplastic bone grafting material: EthOss® (Regenamed Ltd, London, UK) is a novel biphasic bone substitute consisting of 𝛽,-TCP (65%) and Calcium Sulfate (35%). When mixed with sterile saline the material forms an easily handling mouldable mass that hardens in situ. No barrier membranes were used.
Results
After 10 weeks, the healing was uneventful. The architecture and the dimensions of the ridge were adequately preserved and the site was covered with thick keratinized epithelium. A periapical x-ray showed excellent osseointegration of the implant and consolidation of the grafting material. A tissue punch was used to expose the implant and the secondary stability of the implant was measured by resonance frequency analysis (PenguinRFA). A value of 76 was recorded demonstrating high stability. Subsequently, an open-tray impression was taken and a healing abutment was placed. After 2 weeks, a screw-retained crown was fitted with excellent aesthetic and functional results. Follow-up clinical examination after a year revealed stable peri-implant soft tissues with excellent preservation of the volume of the ridge. A periapical x-ray showed further turnover of the bone around the loaded implant with no signs of residual biomaterial.
Conclusions
In the presented case, an in situ hardening resorbable alloplastic bone substitute was used according to a standardized protocol for bone augmentation in parallel to early implant placement, resulting in pronounced hard tissue regeneration and enhanced implant stability in order to load the implant 12 weeks post-op. The in situ hardening and handling properties of the grafting material may enable clinicians to utilize simplified techniques in achieving successful functional and aesthetic results for implant rehabilitations. Moreover, the fully resorbable nature of this bone substitute ensures that no residual particles of the material will be present in the newly-formed hard tissue in the long term.
Background
According to the literature the placement of dental implants at an early timing after tooth extraction may offer advantages in the preservation of soft and hard tissues compared to immediate or delayed protocols. In fact, several clinical studies present successful results with early implant placement concept followed by bone augmentation with the use of xenogeneic bone graft and resorbable barrier membrane. In contrast, the present case report alters the above augmentation protocol in the early implant placement procedure. The dehiscence-type bone defects were treated with resorbable biphasic alloplastic bone grafting materials composed of 𝛽,-TCP and CS and no barrier membranes were used.
Aims
The purpose of the present case was to assess the long-term survival rate of implants early placed into defective sockets with simultaneous bone grafting with in situ hardening 𝛽,-TCP, following a standardized protocol.
Methods
Under local anaesthesia, a site-specific full thickness flap was raised using vertical releasing incisions, without including the papillae of the adjacent teeth. After flap elevation, the residual root was mobilized and removed with a thin elevator, and the site was thoroughly curetted in order to remove all granulation tissue. An implant (Paltop Advanced 5mm x 10mm) was placed in the optimal position. After placing the cover screw, the site was augmented utilizing an in situ hardening resorbable alloplastic bone grafting material: EthOss® (Regenamed Ltd, London, UK) is a novel biphasic bone substitute consisting of 𝛽,-TCP (65%) and Calcium Sulfate (35%). When mixed with sterile saline the material forms an easily handling mouldable mass that hardens in situ. No barrier membranes were used.
Results
After 10 weeks, the healing was uneventful. The architecture and the dimensions of the ridge were adequately preserved and the site was covered with thick keratinized epithelium. A periapical x-ray showed excellent osseointegration of the implant and consolidation of the grafting material. A tissue punch was used to expose the implant and the secondary stability of the implant was measured by resonance frequency analysis (PenguinRFA). A value of 76 was recorded demonstrating high stability. Subsequently, an open-tray impression was taken and a healing abutment was placed. After 2 weeks, a screw-retained crown was fitted with excellent aesthetic and functional results. Follow-up clinical examination after a year revealed stable peri-implant soft tissues with excellent preservation of the volume of the ridge. A periapical x-ray showed further turnover of the bone around the loaded implant with no signs of residual biomaterial.
Conclusions
In the presented case, an in situ hardening resorbable alloplastic bone substitute was used according to a standardized protocol for bone augmentation in parallel to early implant placement, resulting in pronounced hard tissue regeneration and enhanced implant stability in order to load the implant 12 weeks post-op. The in situ hardening and handling properties of the grafting material may enable clinicians to utilize simplified techniques in achieving successful functional and aesthetic results for implant rehabilitations. Moreover, the fully resorbable nature of this bone substitute ensures that no residual particles of the material will be present in the newly-formed hard tissue in the long term.