ABSTRACT
Porous coralline hydroxyapatite blocks were implanted in the anterior region of several patients to improve the pontic/ridge relationship for a fixed prosthesis, thereby improving esthetic appearance and oral hygiene performance. A beveled incision on the palate was used to displace the flap coronofacially without leaving an area of denuded bone or graft. Flap margins were sutured to the adjacent palatal tissues. At the 2 1/2- and 3-year postgrafting follow-up, the implant area was healthy and ridge contours have been maintained. The permanent fixed partial denture is functional, and radiographic evaluation indicates the continued presence of the porous coralline hydroxyapatite implant. Three-year results have been promising enough to warrant continuing the procedure in patients requiring localized ridge augmentation.
Subject(s)
Alveolar Ridge Augmentation , Dental Implants , Hydroxyapatites , Aged , Denture, Partial, Fixed , Durapatite , Female , Follow-Up Studies , Humans , Male , Middle Aged , Surgical FlapsABSTRACT
The purpose of this investigation was to evaluate the histologic response to replamineform (porous) hydroxyapatite grafts in chronically inflamed, surgically created, periodontal pockets in Rhesus monkeys. Forty-eight subcrestal defects were surgically created in 8 Rhesus monkeys. Orthodontic wires were adapted to the base of the defects and left in place for 8 weeks. The defects were randomly assigned a treatment modality so that 8 granular porous and 8 block porous hydroxyapatite grafts were done. Eight sites were left as unoperated controls. Twenty-four contralateral sham-operated sites were treated by open curettage. Histometric measurements of the length of regenerated connective tissue attachment were recorded. Block hydroxyapatite, granular hydroxyapatite, and sham-operated sites exhibited similar amounts of regenerated connective tissue attachment, which was significantly greater than that which occurred in unoperated controls. Newly formed bone was observed within the porous channels of the hydroxyapatite grafts as well as in direct apposition on the surface of implant particles. New bone, cementum, and periodontal ligament was observed in grafted sites and in defects treated by open curettage. In some instances healing occurred by means of a long junctional epithelium. Histology confirmed that unoperated defects remained as unhealed, inflamed periodontal pockets. The results of this study suggest that porous hydroxyapatite grafts have the potential to regenerate the attachment apparatus in primates.