RESUMO
An increase in soft tissues and alveolar bone in the anterior mandibular area between the canines is necessary to achieve a good esthetic result. The present article describes a technique for gaining bone volume and soft tissue to cover bone defects that would otherwise compromise the final result of prosthetic implant restoration in the anterior mandible. Three patients with anterior mandibular atrophy caused by loss of the mandibular incisors are presented. Particulate autologous bone grafting, the raising of a pediculate connective tissue flap to increase soft tissue, and implant placement were carried out simultaneously. After 2 years of follow-up, the implants were in good clinical and radiologic condition. The problem of atrophy and the lack of soft tissue were thus solved, and an acceptable esthetic outcome was achieved in a single surgical intervention.
Assuntos
Implantes Dentários , Gengiva/transplante , Mandíbula/cirurgia , Retalhos Cirúrgicos , Adulto , Perda do Osso Alveolar/cirurgia , Aumento do Rebordo Alveolar/métodos , Atrofia , Transplante Ósseo , Tecido Conjuntivo/transplante , Estética Dentária , Feminino , Seguimentos , Humanos , Incisivo , Masculino , Mandíbula/patologia , Pessoa de Meia-Idade , Osseointegração/fisiologia , Transplante AutólogoRESUMO
Extensive bone defects complicate the adequate placement of dental implants and the required angulation. In such cases, alveolar-ridge augmentation techniques such as guided bone regeneration, particulate or block grafting, and alveolar bone distraction are needed. The present study describes a case in which a large vertical bone defect in the anterior mandibular zone was corrected via vertical alveolar bone distraction. Six dental implants were posteriorly placed for implant-supported restoration of the mandible, with early implant loading. The clinical and radiologic control showed good implant and soft tissue conditions 12 months later.
Assuntos
Aumento do Rebordo Alveolar/métodos , Implantação Dentária Endóssea/métodos , Prótese Dentária Fixada por Implante , Mandíbula/cirurgia , Osteogênese por Distração , Adulto , Análise do Estresse Dentário , Prótese Total Inferior , Feminino , Humanos , Dimensão Vertical , VestibuloplastiaRESUMO
Los defectos óseos a nivel de la cresta alveolar mandibulardificultan la colocación de los implantes dentales en el lugaridóneo. La reconstrucción quirúrgica mediante injertos de huesoautólogo es una opción que permite la fijación de los implantesde manera estética y funcional.Presentamos un paciente con grandes pérdidas óseas mandibulares,secundarias a procesos inflamatorios periodontales.Se realizó la reconstrucción del proceso alveolar mandibular,empleando injertos en bloque, tipo onlay, tomados de la mandíbula.Los injertos fueron estabilizados al colocar los implantesa través de ellos, consiguiéndose además una buena fijaciónprimaria de los mismos. Tras dos años de seguimiento existeéxito clínico y radiológico.En mandíbula, donde es complicada la regeneración ósea, ennuestro caso conseguimos unos buenos resultados, minimizandoel tiempo de espera al realizar los injertos y la colocación de losimplantes en una cirugía
Bone defects at mandibular alveolar crest level complicate theplacement of dental implants in the ideal location. Surgical reconstructionusing autologous bone grafts allows implant fixationin an esthetic and functional manner.We describe a patient with large mandibular bone loss secondaryto periodontal inflammatory processes. Reconstruction ofthe mandibular alveolar process was carried out using onlayblock bone grafts harvested from the mandible. The grafts werestabilized by positioning the dental implants through them aprocedure that moreover afforded good primary implant fixation.After two years of follow-up the clinical and radiologicaloutcome is good.In the lower jaw, where bone regeneration is complicated, wewere able to achieve good results in this patient minimizing thecorresponding waiting time by grafting and placing the implantsin the same surgical step
