ABSTRACT
Los procedimientos quirúrgicos para la aplicación de los implantes en los sectores latero superiores, están condicionadas por la neumatización del seno y la disponibilidad del huesoresidual. En estos casos el injerto de hueso autólogo permanece como lamejor opción, pero a causa de la morbilidad asociada al sitio donante y a las complicaciones post quirúrgicas, se pusieron a disposición diversas alternativas de sustitutos óseos, que implican sin embargo un aumento de los costos económicos y con limitadas propiedades osteoinductivas. Tales defectos pueden ser compensados con nuevas estrategias de regeneración biológica y mecánica de los tejidos a loscuales fue dirigida la ingeniería biológica y mecánica en los últimos años.Se presenta una nueva posibilidad terapéutica en la aplicación de los implantes en el maxilar superior con disponibilidad ósea inferior a los 4 mm, mediante la utilización de andamios 3D confeccionados en cartilago de cerdo libre de antígenos obtenido según la tecnica Fit-Lock. Se realizo un estudio longitudinal en 18 casos consecutivosevidenciando al cabo de un año de la carga implantológica, un éxito del 95,2 por ciento. Las ventajas en esta nueva técnica son: 1)La recuperación funcionaly anatómica del antro del maxilar 2).La aplicación inmediata de los implantes; 3)Reducción de los tiempos quirúrgicos; 4) Ausencia de morbilidad para el paciente; 5) Uso de anestesia local; 6)Uso de implantes con diámetros superiores a los 4 mm
Subject(s)
Humans , Male , Female , Middle Aged , Cartilage , Dental Implants , Sinus Floor Augmentation/methods , Maxilla/surgery , Bone Regeneration/physiology , Bone Substitutes/therapeutic use , Anesthesia, Dental , Anesthesia, Local , Dental Prosthesis Design , Dental Prosthesis Retention , Dental Restoration Failure , Follow-Up Studies , Tissue Engineering/methods , Longitudinal Studies , Prospective Studies , Tissue Scaffolds , Treatment OutcomeABSTRACT
The surgical procedures for implant applications on the lateral-upper areas depend on sinus pneumatization and availability of the residual bone. In these cases, autologous bone grafting remains the gold standard. Nevertheless, because of the morbidity associated to the donor site and the post-surgical complications, several alternative bone substitutes have been introduced, which, however, imply additional costs and show limited osteoinductive properties. Such limitations can be compensated with new regeneration strategies for biological and mechanical tissue restoration, a subject which has been addressed by tissue engineering in recent years. The authors present a new therapeutic option for implant application in the upper maxilla with bone availability less than 4 mm by using 3D scaffolds obtained from antigen-free porcine cartilage in the fit-lock technique. A longitudinal study on 18 consecutive cases was performed, with a 95.2% success rate one year after the implant. The advantages of this new technique are: 1) Functional and anatomical recovery of the maxillary antrum, 2) Immediate application of the implants; 3) Reduction of surgical times; 4) Absence of patient morbidity; 5) Local anesthesia; 6) Use of implants with a diameter > 4 mm.
Subject(s)
Bone Regeneration/physiology , Cartilage , Dental Implants , Maxilla/surgery , Sinus Floor Augmentation/methods , Tissue Scaffolds , Anesthesia, Dental , Anesthesia, Local , Bone Substitutes/therapeutic use , Dental Prosthesis Design , Dental Prosthesis Retention , Dental Restoration Failure , Female , Follow-Up Studies , Humans , Longitudinal Studies , Male , Middle Aged , Operative Time , Prospective Studies , Sinus Floor Augmentation/instrumentation , Tissue Engineering/methods , Treatment OutcomeABSTRACT
The surgical procedures for implant applications on the lateral-upper areas depend on sinus pneumatization and availability of the residual bone. In these cases, autologous bone grafting remains the gold standard. Nevertheless, because of the morbidity associated to the donor site and the post-surgical complications, several alternative bone substitutes have been introduced, which, however, imply additional costs and show limited osteoinductive properties. Such limitations can be compensated with new regeneration strategies for biological and mechanical tissue restoration, a subject which has been addressed by tissue engineering in recent years. The authors present a new therapeutic option for implant application in the upper maxilla with bone availability less than 4 mm by using 3D scaffolds obtained from antigen-free porcine cartilage in the fit-lock technique. A longitudinal study on 18 consecutive cases was performed, with a 95.2
success rate one year after the implant. The advantages of this new technique are: 1) Functional and anatomical recovery of the maxillary antrum, 2) Immediate application of the implants; 3) Reduction of surgical times; 4) Absence of patient morbidity; 5) Local anesthesia; 6) Use of implants with a diameter > 4 mm.
Subject(s)
Bone Regeneration/physiology , Cartilage , Dental Implants , Maxilla/surgery , Sinus Floor Augmentation/methods , Tissue Scaffolds , Anesthesia, Dental , Anesthesia, Local , Bone Substitutes/therapeutic use , Dental Prosthesis Design , Dental Prosthesis Retention , Dental Restoration Failure , Female , Follow-Up Studies , Humans , Longitudinal Studies , Male , Middle Aged , Operative Time , Prospective Studies , Sinus Floor Augmentation/instrumentation , Tissue Engineering/methods , Treatment OutcomeABSTRACT
The implant-supported rehabilitation ofposterosuperior sectors may be sometimes conditioned by the pneumatization of the para-nasal sinuses, which decreases the possibility of implant placement when the bone height is < or = 4 mm. (prerequisite for primary stabilization). Sinus lift surgery with simultaneous application of implants is the procedure which provides the best chance of success compared to the application of the filling material only. There are many surgical techniques which combine autogenous bone grafting (ilium crest, calvaria,fibula) with implant placement. The objective of this report is to present a new technique which aims to minimize invasive bone grafting and patient morbidity. The authors performed a longitudinal study on 21 cases with a 94.5% success rate, exemplified by one clinical case. The advantages of this technique are: 1) Functional and anatomical recovery of the jaw cavity. 2) Simultaneous application of implants when the bone is < or = 4mm. 3) Reduction of surgical times. 4) Reduced patient morbidity. 5) Local anesthesia.
Subject(s)
Bone Transplantation , Dental Implantation/methods , Maxilla/surgery , Aged , Bone Transplantation/methods , Female , Humans , Longitudinal Studies , Male , Middle AgedABSTRACT
La rehabilitación implanto soportada de los sectores posterosuperiores resulta, a veces, condicionada por la neumatizaciòndel seno maxilar, reduciendo la posibilidad de la aplicación delos implantes cuando la disponibilidad ósea es inferior a los 4 mm. (Condición Límite para la estabilidad primaria).El levantamiento del seno maxilar y la aplicación simultánea de los implantes es con seguridad la condición que mejorgarantiza el éxito, respecto a la sola aplicación del material de relleno. Muchas son las técnicas quirúrgicas desarrolladas en la utililizaciòn del hueso autòlogo (cresta iliaca, calota craneana, peroné) y la aplicación de los implantes. En este artículo se presenta una nueva técnica para reducir almínimo la invasividad de la toma del material óseo de injerto autólogo y la morbilidad del paciente. Se ha realizado un estudio longitudinal sobre 21 casos consecutivos, mostrando un éxito del 94,5 por ciento. Las ventajas de esta técnica son: 1) Recuperación funcional y anatómica del seno maxilar. 2) Aplicación inmediata de los implantes con un espesor residuo de hueso de piso de seno menor a los 4 mm. 3) Reducciónde los tiempos quirúrgicos. 4) Menor Morbilidad del paciente. 5) Anestesia loco regional.
