RBone volume reconstruction in atrophic edentulous ridges: placement method of graft-implant unity in single step together with endogenous growth factors.

AIM: The methods of inserting osseointegrated implants in atrophic edentulous ridges need first bone tissue graft and subsequently the insertion of fixtures. These methods need a long period of time before a prosthesis can be made: for this reason the researchers experimented different techniques to reduce times of prosthetic loading. Our experimented method makes it possible to shorten the prosthetic period notably. METHODS: During surgery an implant is inserted in the symphysis area and then it is removed by trephine bur having a diameter greater than 1 mm compared to the receiving site and by using irrigation with 4 degrees C physiological solution. After 75 days, the implant is loaded by temporary prosthesis and subsequently a final restoration is applied after 4-6 months, depending on bone quality. RESULTS: Our surgical method, in spite of being conditioned by the anatomical conformation of the edentulous ridge and anatomical limits, proved to be predictable and with the same success percentages as other surgical techniques used for morphological reconstruction of atrophic edentulous ridges, shortening prosthetic loading times notably. CONCLUSIONS: Despite the small number of patients treated and the short control period do not give enough elements to consider this new method applicable in all types of atrophies, our results confirm the validity of this technique if well used. In the future further studies and experimentations on greater number of patients and for at least 5 year follow-up are needed.

Tissue reactions, fluids, and bacterial infiltration in implants retrieved at autopsy: a case report.

A 72-year-old patient underwent the placement of 2 screw-type implants. After 5 months the patient died of a massive stroke, and a block section of the portion of the mandible containing the implants was done. The specimen was treated to obtain thin ground sections. A 1- to 5-micron gap was present between the implant and the healing cover screw, and this space was filled by bacteria and calculus; bacteria were also present in the most apical portion of the hollow part of the implant. An inflammatory infiltrate was present in the connective peri-implant tissues. The spaces between all implant components (implant, abutment, and healing screw) can act as conduits and reservoirs for bacteria, which could cause inflammation of the peri-implant soft tissues. In conclusion, the histologic data from this autopsy case may help to confirm the penetration by fluids and bacteria into the internal portion of the implants, obtained from previous in vitro and in vivo studies.