Customized Allogeneic Bone Augmentation Improves Esthetic Outcome in Anteromaxillary Dental Implantation.

Purpose: In cases of severe atrophic maxilla or maxillary involution, augmentation is necessary for implant-supported prosthetics. Using bone grafts is a standard procedure, and using customized allogeneic bone blocks may be a predictable alternative before dental implantation. Clinical Findings. This case study shows the digital workflow, including a preimplantological augmentation by a customized allogeneic block, followed by soft tissue optimization and template-based dental implantation, after six months of healing. It is part of a three-year follow-up study on the resorption rate of allogeneic bone blocks. Outcomes. Allogeneic bone augmentation is an alternative treatment option to autologous bone grafts. It allows predictable advanced backward planning (ABP) even in the maxillary esthetic zone. Diameter-reduced implants show long-term stability of a minimum of three years after loading and excellent results of prosthetic fixtures. Conclusion: Prefabricated customized allogeneic blocks for augmentation may increase the fitting accuracy of the graft, decrease morbidity, and reduce the operation time in esthetic maxillary rehabilitation.

[Evaluation of a structured e-learning-based approach to CT anatomy of the paranasal sinuses for medical students : A pilot study]. / Evaluation eines strukturierten E­Learning-basierten Ansatzes zur Vermittlung der CT-Anatomie der Nasennebenhöhlen bei Medizinstudierenden : Eine Pilotstudie.

BACKGROUND: Computed tomography (CT) anatomy is not an integral part of undergraduate medical training in many countries. Radiology seems to be well suited for new online-based teaching methods. OBJECTIVE: The aim of this study was to evaluate whether e­learning is appropriate for introducing complex learning contents such as sinus CT anatomy to novices and to assess whether identification of relevant anatomical variants in sinus CT scans by medical students can be improved with a sinus CT checklist. MATERIALS AND METHODS: Medical students were asked to assess sinus CT scans for anatomical variants before and after implementation of the CLOSE mnemonic (cribriform plate, lamina papyracea, Onodi cell, sphenoid sinus pneumatization, and [anterior] ethmoidal artery). Sinus CT anatomy and the CLOSE mnemonic were introduced by e­learning. The rate of correctly identified variants and the results of the individual CLOSE items were recorded. A questionnaire was distributed for subjective evaluation of the usefulness of the checklist and e­learning. RESULTS: Ten students took part in this pilot study. The rate of correctly identified variants improved significantly, from 33.3 to 61.1%. The analysis of the individual CLOSE items showed a significant improvement for C, S, and E. The subjective evaluation of the CLOSE mnemonic and e­learning was very positive. CONCLUSION: E­learning was able to transfer complex learning contents in previously non-trained medical students and was evaluated as an appropriate introduction to the topics. Structured assessment of paranasal sinus CT scans using the CLOSE criteria can significantly improve the recognition of anatomical variants.