RESUMO
The posterior edentulous mandible presents unique challenges for implant reconstruction because of deficiencies in bone quality and quantity. Autogenous mandibular block grafts can be used in a predictable manner to enhance bone volume and density, allowing for placement of maximum diameter implants to facilitate stress distribution for long-term implant survival. This article will feature the importance of staging and recipient site preparation using mandibular block autografts for posterior mandibular edentulous reconstruction.
Assuntos
Aumento do Rebordo Alveolar/métodos , Transplante Ósseo/métodos , Mandíbula/cirurgia , Adulto , Densidade Óssea , Parafusos Ósseos , Implantação Dentária Endóssea , Implantes Dentários , Planejamento de Prótese Dentária , Prótese Dentária Fixada por Implante , Prótese Parcial Fixa , Feminino , Seguimentos , Humanos , Arcada Parcialmente Edêntula/reabilitação , Arcada Parcialmente Edêntula/cirurgia , Pessoa de Meia-Idade , Osteotomia/métodos , Estresse Mecânico , Transplante Autólogo , CicatrizaçãoRESUMO
The in vivo integration strength and degree of bone apposition were compared for oral endosseous implants with different plasma-sprayed hydroxylapatite (HA) coatings. Pullout strength measurements and histological analysis were used to compare two different commercially available coating from the same manufacturer. One coating does not receive a post-plasma-spray treatment and contains about 75% crystalline HA. The other coating is treated with the MP-1 process, a pressurized hydrothermal post-plasma-spray process, which increases the coating composition to approximately 95% crystalline HA without changing the coating's adhesive or cohesive strength. Comparisons were made in dogs after healing times of 3 and 15 weeks in the mandible. No significant differences were found in either case between the two coatings. Two different methods were used to determine the degree of bone apposition at 15 weeks. Both methods confirmed that the MP-1 process does not affect the osseointegration rate of plasma-sprayed HA coatings. Qualitative histology data suggest that the treated coating is more stable than the control coating, especially in cases of direct soft tissue attachment to the implant. The present data suggest that extensive dissolution of calcium phosphate components into surrounding tissue is not a necessary precursor for direct apposition of bone to HA-coated implants.
Assuntos
Materiais Revestidos Biocompatíveis , Implantes Dentários , Durapatita/química , Animais , Cristalização , Implantação Dentária Endóssea , Cães , Teste de Materiais , OsseointegraçãoRESUMO
Maxillary sinus membrane perforation is the most common complication that occurs with the sinus elevation augmentation procedure. Repair of relatively small (5-10 mm) tears is commonly done using fast resorbing collagen membranes and/or by allowing the sinus membrane to overlap on itself. A technique using a cross-linked type I collagen membrane for predictable repair of large perforations (> 10 mm) as well as for circumstances in which no membrane is found is described. This technique has several advantages because of its inherent biologic properties.
Assuntos
Seio Maxilar/lesões , Seio Maxilar/cirurgia , Procedimentos Cirúrgicos Pré-Protéticos Bucais/efeitos adversos , Adulto , Colágeno , Implantação Dentária Endóssea , Regeneração Tecidual Guiada Periodontal , Humanos , Masculino , Membranas Artificiais , Mucosa/lesõesRESUMO
This two-part series focuses on localized ridge augmentation using block autografts from the symphysis and the ramus buccal shelf for posterior maxillary (part I) and mandibular (part II) reconstruction. The various aspects of the surgical technique necessary for predictable results and minimal morbidity are discussed in detail. Emphasis is placed on staging, incision design, and recipient site preparation.
