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Time: 4:00 pm-6:00 pm
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CE Credits: 2.0 lecture credits
«Autogenous-only» concept in dental practice. How to manage bone deficiency in different clinical scenarios? When to choose Soft or Hard tissue augmentation? Peri-implantitis. Can this concept stop it? Clinical cases report.
BACKGROUND: Dental rehabilitation of partially or totally edentulous patients with oral implants has become a routine form of treatment over recent decades, with reliable long-term results. However, unfavourable local conditions of the alveolar ridge, due to atrophy, periodontal disease, and trauma sequelae, may provide insufficient bone volume or unfavourable vertical, horizontal, and sagittal intermaxillary relationships, which may render implant placement impossible or incorrect from a functional and aesthetic point of view.
AIM: The purpose of this presentation is to give overview of application of autogenous tissue concept in different clinical situations. The lecture demonstrates its indications, advantages, disadvantages and limitations as well.
METHODS: From 2015 a total of 139 patients underwent 159 autologous tissue augmentation procedures. As grafting material for hard tissue augmentation bone from L.oblique externa or Tuber maxillare were utilized. As grafting material for soft tissue augmentation connective tissue grafts harvested from Tuber maxillare or Palate were used. 83 Augmentations were performed in the maxilla and 73 in the mandible. No bone substitutes were used. 98% implants were placed submerged in a staged approach. Second stage surgery was performed two-three months later. For peri-implantitis treatment in 23 cases the combination of implantoplasty and soft tissue grafting had been used.
RESULTS: 88% of the bone grafts healed successfully with primary intention, and 11% healed with secondary intention. These complicated grafts demonstrated soft tissue dehiscences. As a result partial bone graft resorption in the area of the dehiscence was detected at the time of implant placement. To avoid the risk of peri-implantitis and to increase the volume of biological width, additional simultaneous soft tissue augmentation during implant insertion was performed. 2 bone grafts (less than 1%) had been lost. Connective tissue grafting was successful in 98% cases.
Dental implants demonstrated 98% survival rate in 1-4 years after loading in augmented areas.
Peri-implantitis treatment also showed high efficiency in arresting inflammatory exudate and further bone loss.
CONCLUSION: The results of this clinical cases report prove the reliability and low comorbidity of autogenous tissues grafting procedure in dentistry and 98% survival rate of dental implants in all patients treated during 5 years.The results demonstrate that autogenous tissue grafting could be further considered as the “gold standard” for dentoalveolar reconstructions.
Damir Mukhamadiev DDS, MSc, is an oral surgeon and implantologist in Moscow, Russia. Dr. Mukhamadiev graduated from Heidelberg and Frankfurt Universities, with a Masters of Science in Oral Implantology. He is also certified by the European Association for Osseointegration and the International Congress of Oral Implantologists. Currently, Dr. Mukhamadiev is faculty in the Master of Oral Implantology Program at Frankfurt University.
University of Pennsylvania School of Dental Medicine is an ADA CERP Recognized Provider. ADA CERP is a service of the American Dental Association to assist dental professionals in identifying quality providers of continuing dental education. ADA CERP does not approve or endorse individual courses or instructors, nor does it imply acceptance of credit hours by boards of dentistry.
University of Pennsylvania School of Dental Medicine designates this activity for 2.0 continuing education credits.