engleski

Autologous tooth roots for lateral alveolar ridge augmentation – 1 year follow up a pilot clinical study

Background : A recent series of animal studies employing a canine model investigated the efficacy of extracted tooth roots for lateral alveolar ridge augmentation and two- stage implant placement Histological, immunohistochemical and micro- computed tomographic analyses of various outcome measures did not reveal any significant differences between tooth roots and autologous bone grafts used for lateral ridge augmentation (Becker et al., 2017 ; Schwarz et al., 2016 ; Schwarz et al., 2016). Aim/Hypothesis : The aim of this pilot clinical study was to assess efficacy and predictability of autologous tooth roots for lateral alveolar ridge augmentation and two- stage implant placement. Materials and Methods : In this pilot clinical case series, a total of 15 patients with 20 defects were included. Inclusion criteria were : age 18 to 60 years, candidate for lateral ridge augmentation, insufficient bone ridge width at the recipient site for implant placement, sufficient bone height at the recipient site for implant placement and healthy oral mucosa. Preoperative CBCT was made for every patient. After surgical removal of impacted tooth or periodontally compromised tooth and during the same surgery, the crown was decapitated at the cemento- enamel junction using a rotating carbide bur under water cooling and the exposed pulp was preserved. The separated tooth root was adapted to match the size and shape of the bone defect area. Grafts were drilled and fixed using one to two titanium osteosynthesis screw. After 6 months of healing commercially available Straumann BLT titanium implants were inserted and 3 months after screw- retained crowns were made. Results : After 6 months post implantation CBCT scans were obtained as part of the standard procedure. The radiographic images of the target areas revealed no signs for a graft separation from the recipient site. Clinical re- entry confirmed a homogeneous integration of tooth root grafts in the former defect area. This was evidenced by a firm graft connection to the host bone and a circumferential hard tissue formation. After 6 months CBCT scans were obtained as part of the standard procedure. The radiographic images of the target areas revealed no signs for a graft separation from the recipient site. Clinical re- entry confirmed a homogeneous integration of tooth root grafts in the former defect area. This was evidenced by a firm graft connection to the host bone and a circumferential hard tissue formation. In follow up period 1 year after there was no complications regarding implants or crowns. Conclusions and Clinical Implications : Within its limitations, the present pilot clinical study revealed that autologous tooth roots may serve as an alternative graft to support lateral alveolar ridge augmentation and two- stage implant placement.

autologous tooth roots ; lateral alveolar ridge augmentation ; dental implants

nije evidentirano