Bone quality at the implant site after reconstruction of a local defect of the maxillary anterior ridge with chin bone or deproteinised cancellous bovine bone

The purpose of this study was to investigate the quality of bone at grafted implant sites in the anterior maxilla. Grafting of these sites was necessary because of insufficient bone volume in a buccopalatinal direction (width at the top of the crest 1 - 3 mm).Reconstruction was performed with chin bone (N = 5), chin bone and a resorbable Bio-Gide (R) GBR membrane (N = 5) or Bio-Oss (R) spongiosa granules in combination with a Bio-Gide (R) GBR membrane (N = 5). Biopsies were taken prior to implantation, i e. 3 months after grafting with chin bone, and 6 months after grafting with Bio-Oss (R). Evaluation was done by assessing the histological and histomorphometric characteristics of full-length biopsies taken from the actual implant site.Both areas with non-vital bone and areas with apposition of bone and remodelling phenomena were observed in the chin bone group at the time of placement of the implants. Similar results were observed at implant sites reconstructed with a chin bone graft covered by a membrane. In the chin bone group without and with a GBR membrane, the mean total bone volume (TBV) was 55.2 +/- 6.8% and 57.7 +/- 11.5%, respectively; the marrow connective tissue volume (MCTV) was 44.8 +/- 6.8% and 42.3 +/- 11.5%, respectively. Remnants of the resorbable GBR membrane were not detected. In the Bio-Oss (R) group, at implant placement some newly formed bone was observed in the connective tissue suffounding the Bio-Oss (R) particles (mean TBV (newly formed bone) 17.6 +/- 14.5%), but most particles were surrounded by connective tissue. No convincing signs of remodelling were observed (mean remaining Bio-Oss (R) volume 40.5 +/- 9.3%; mean MCTV 41.9 +/- 13.1%). No implants were lost during follow up (12 months).At the time of placement of the implants the grafting material (either chin bone or Bio-Oss (R)) is still not fully replaced by new vital bone. In case of Bio-Oss (R), most of the grafting material is even still present. Despite these differences, the 1-year clinical results were very good and comparable between the various grafting techniques applied.</p

Overkappingsprothese op implantaten versus volledige prothese zonder en met mondbodemvestibulumplastiekTevredenheid en subjectief kauwvermogen

Het doel van dit gerandomiseerd klinisch onderzoek was om gedurende 5 jaar klinische resultaten, tevredenheid en subjectief kauwvermogen te evalueren na 3 behandelingsmethoden bij een edentate onderkaak. Deze methoden waren: een overkappingsprothese op 2 implantaten in de onderkaak (IMP-groep, 61 patiënten), een conventionele volledige prothese (VP-groep, 60patiënten) en een volledige prothese vervaardigd na een mondbodemvestibulumplastiek (MVP-groep, 28 patiënten). Geconcludeerd werd dat 2 enossale implantaten in een edentate onderkaak, als retentie voor een overkappingsprothese, na 5 jaar een hoog overlevingspercentage hebben (93%). De tevredenheid van de VP-groep blijft lager dan van de IMP-groep. De tevredenheid van de MVP-groep is ook lager dan die van de IMP-groep

Fabrication, workflow and delivery of reconstruction: Summary and consensus statements of group 4. The 6th EAO Consensus Conference 2021.

Objectives: To report assessments of four systematic reviews (SRs) on (i) clinical outcomes of all-ceramic implant-supported crowns (iSCs), (ii) production time, effectiveness, and costs of computer-assisted manufacturing (CAM), (iii) computer-assisted implant planning and surgery (CAIPS) time and costs, and (iv) patient-reported outcome measures (PROMS). Material and methods: An author group consisting of experienced clinicians and content experts discussed and evaluated the SRs and formulated consensus on the main findings, statements, clinical recommendations, and need for future research. Results: All four SRs were conducted and reported according to PRISMA and detailed comprehensive search strategies in at least three bibliometric databases and hand searching. The search strategies were deemed reproducible. Variation was noted regarding language restrictions and inclusion of grey literature, but the search comprehensiveness appeared persuasive. The SRs included bias risk assessments of the primary studies, and their study methodology impacted the interpretations of the extracted data. Conclusions: (i) There is limited evidence (49 NRCT) showing that veneered and monolithic all-ceramic iSCs have excellent outcomes observed up to 3 years. (ii) There is no evidence evaluating production time and effectiveness comparing subtractive and additive CAM of implant models, abutments and crowns. (iii) There is limited evidence (4 RCT) that CAIPS involves more time and costs when considering the entire workflow and for diagnostics, manufacturing, and insertion of the restoration. Time seems to be the decisive factor for higher costs. (iv) Patients' comfort increases when optical compared to conventional impressions are used for fabricating iSCs and short-span FPDs (2 RCT, 5 NRCT)