Mandibular ridge augmentation using a mineralized Ilium block: a case letter

Several dental procedures address implant placement in partially or totally edentulate patients. Problems associated with implantation in these patients often arise due to limited bone height or width of the mandible. In such cases, mandibular augmentation is required before implantation can take place. When anatomy dictates, an alternative method of treatment used in ridge augmentation involves a mineralized ilium block, which has demonstrated application in a variety of specialties, including orthopedics, neurosurgery, and craniomaxillofacial procedures. These block allografts have been demonstrated to support missing bone structure and remodel appropriately via normal regenerative pathways.The following case letter involves mandibular augmentation in a 25 year old male. Presenting with partial edentulism in the area of #20 to #28, with #22 and the roots of #25 and #26 remaining, a full thickness dissection, decortication of the buccal aspect of the alveolar ridge, and grafting of the atrophic area was performed using three mineralized human ilium block allografts. At 3 months, three implants were placed. At 10 months, the implanted sites showed good healing and a core was taken for histological analysis.The presented case illustrates a good example of an available treatment option that can be readily performed by an implantologist. Utilizing mineralized human ilium block allografts, this treatment provides a predictable and stable base, even at 3 months, for implant therapy and subsequent dental restoration

Graftless sinus augmentation technique with contextual placement of implants: a case report.

INTRODUCTION: The positioning of implants in the jaw bones with contextual graftless lateral approach sinus lifting is finding an increasingly broad consensus in the literature.Since the 1970s, various clinical research projects have been conducted on applications of biological and synthetic biomaterials in bone regenerative surgery, both in sinus lift procedures and in cystic cavity filling after cystectomy or in bone defects in regenerative periodontal surgery. Currently, we are finding that there is an increasing trend of clinicians aiming to adopt graftless techniques, with satisfactory results in terms of implant survival in the long term.In our study, through a case report, we describe a variant of graftless sinus augmentation technique with contextual implant placement, emphasizing the role of the blood clot, combined with collagen sponges, as a natural scaffold and the osteogenic potential of the subantral membrane in guided bone regeneration, with reduced morbidity of the patient. CASE PRESENTATION: To describe the surgical technique, the clinical case of a 38-year-old Caucasian woman with a lateral posterior edentulism was selected. The rehabilitation was solved by a graftless sinus augmentation technique with a contextual implant placement.For each implant, a resonance frequency analysis evaluation was reported as implant stability quotient values. The performance of the implant stability quotient values followed a gradual increase from time zero to the sixth month, as the clot was differentiated into osteoid tissue and then into bone tissue, due to the scaffold effect conferred by the equine collagen sponge. The stabilization phase took place between the fourth and the sixth month, according to the implant stability quotient values. CONCLUSIONS: Our graftless sinus augmentation technique seems to be very predictable thanks to the osteoconductive principles on which it is based, and in association with the proper management of peri-implant soft tissue, so as to increase the amount of keratinized tissue, which could represent the new gold standard for this type of rehabilitation in the future