Ramus blok grefti ile geç ve eş zamanlı implant yerleştirme prosedürlerinin karşılaştırılması: Retrospektif kohort çalışması

Year 2024, Volume: 29 Issue: 3, 318 - 328, 23.09.2024

Senem Askın Ekıncı , Ceren Küçük , Gokhan Gocmen

https://doi.org/10.21673/anadoluklin.1453783

Abstract

Amaç: Bu çalışmada, otojen greftlerle eş zamanlı ve geç yerleştirilen implantlarda greft stabilitesi ve implant başarısı karşılaştırılmıştır.

Yöntemler: Çalışma örneklemi, mandibula ramusu kullanılarak otojen blok kemik grefti uygulanan hasta popülasyonundan oluşmuştur. Bir yıllık takip verilerine sahip hastalar implantasyon yaklaşımına göre iki gruba ayrılmıştır: geç implantasyon ve eş zamanlı implantasyon. Sonuç değişkenleri 3B hacim değişiklikleri (implantasyon sonrası ve 1 yıllık takipteki kemik grefti hacimleri, rezorpsiyon hacmi ve kemik greftinin rezorpsiyon oranı), 2B lineer değişiklikler (implantasyon sonrası ve 1 yıllık takipteki kemik grefti genişliği, 2B rezorpsiyon miktarı ve kemik greftinin rezorpsiyon oranı), marjinal kemik kaybı ve implant başarısı idi.

Bulgular: Nihai örneklem 21 denekten oluşmuş ve 33 implant incelenmiştir. Toplamda, %51,5’i (n=17) eşzamanlı ve %48,5’i (n=16) geç implantasyon yaklaşımla yerleştirilmiştir. Eş zamanlı yaklaşım, geç implantasyona kıyasla hem 3B hem de 2B ölçümlerde daha yüksek greft rezorpsiyonu oranıyla sonuçlanmıştır (sırasıyla p=0,001 ve p=0,014). İki grup arasında 1 yıllık takipte greft hacmi, greft genişliği, marjinal kemik kaybı veya implant başarısı açısından fark yoktu (sırasıyla p=0.958, p=0.039, p=0.168 ve p=1.000).

Sonuç: Eş zamanlı implantasyon, geç implantasyona göre daha yüksek rezorpsiyon oranıyla sonuçlansa da, 1 yıllık takipte greft hacmi ve genişliği, marjinal kemik kaybı ve implant başarısı benzerdi.

Keywords

Alveolar kemik grefti, alveoler bombe ögmentasyonu, diş implantasyonu, üç boyutlu görüntü

Delayed versus simultaneous implant placement with ramus block grafts: A retrospective cohort study

Abstract

Aim: This study compared the graft stability and implant success of delayed implantation versus simultaneous implantation with autogenous grafts.

Methods: The study sample comprised a population of patients who underwent autogenous block bone grafting using the ramus of the mandible. Patients with data from 1 year of follow-up were divided into two groups according to implantation approach: delayed implantation and simultaneous implantation. Outcome variables were 3D volume changes (the bone graft volumes at post-implantation and 1-year follow-up, resorption volume, and resorption rate of the bone graft), 2D linear changes (the bone graft width at post-implantation and 1-year follow-up, 2D resorption amount, and resorption rate of the bone graft), marginal bone loss, and implant success.

Results: The final sample comprised 21 subjects, and 33 implants were investigated. In total, 51.5% (n=17) were placed with a simultaneous approach and 48.5% (n=16) with a delayed approach. The simultaneous approach resulted in a higher rate of graft resorption in both the 3D and 2D measurements compared to the delayed implantation (p=0.001 and p=0.014, respectively). There was no difference between the two groups in terms of graft volume, graft width, marginal bone loss, or implant success at the 1-year follow-up (p=0.958, p=0.039, p=0.168, and p=1.000, respectively).

Conclusion: Although simultaneous implantation resulted in a higher resorption rate than delayed implantation, the graft volume and width, marginal bone loss, and implant success were similar at the 1-year follow-up.

Keywords

Alveolar bone grafting, alveolar ridge augmentation, dental implantation, three-dimensional image

References

• Khoury F, Khoury C. Mandibular bone block grafts: diagnosis, instrumentation, harvesting techniques and surgical procedures. In: Khoury F, Antoun H, Missika P, editors. Bone Augmentation in Oral Implantology. 1st ed. Germany: Quintessence Publishing Co Ltd; 2007. p. 115-212.
• Ma G, Wu C, Shao M. Simultaneous implant placement with autogenous onlay bone grafts: a systematic review and meta-analysis. Int J Implant Dent. 2021;7(1):61.
• Tunkel J, Würdinger R, de Stavola L. Vertical 3D Bone Reconstruction with Simultaneous Implantation: A Case Series Report. Int J Periodontics Restorative Dent. 2018;38(3):413-21.
• Kang YH, Kim HM, Byun JH, et al. Stability of simultaneously placed dental implants with autologous bone grafts harvested from the iliac crest or intraoral jaw bone. BMC Oral Health. 2015;15:172.
• Verhoeven JW, Ruijter J, Cune MS, Terlou M, Zoon M. Onlay grafts in combination with endosseous implants in severe mandibular atrophy: one year results of a prospective, quantitative radiological study. Clin Oral Implants Res. 2000;11(6):583-94.
• Aloy-Prósper A, Peñarrocha-Oltra D, Peñarrocha-Diago M, Camacho-Alonso F, Peñarrocha-Diago M. Peri-implant Hard and Soft Tissue Stability in Implants Placed Simultaneously Versus Delayed with Intraoral Block Bone Grafts in Horizontal Defects: A Retrospective Case Series Study. Int J Oral Maxillofac Implants. 2016;31(1):133-141.
• osun E, Avağ C, Başlarlı Ö, Kiriş S, Öztürk A, Akkocaoğlu M. Comparison between peri-implant bone level changes of implants placed during and 3 months after iliac bone grafting. Oral Surg Oral Med Oral Pathol Oral Radiol. 2018;125(2):e12-6.
• Clementini M, Morlupi A, Agrestini C, Barlattani A. Immediate versus delayed positioning of dental implants in guided bone regeneration or onlay graft regenerated areas: a systematic review. Int J Oral Maxillofac Surg. 2013;42(5):643-50.
• McAllister BS, Haghighat K. Bone augmentation techniques. J Periodontol. 2007;78(3):377-96.
• Michalczik V, Terheyden H. Stabilität des Knochenniveaus an Implantaten nach Augmentation mit Unterkiefer Blocktransplantaten. Z Zahnärztl Implantol. 2007;23:266-279.
• eñarrocha-Diago M, Aloy-Prósper A, Peñarrocha-Oltra D, Calvo-Guirado JL, Peñarrocha-Diago M. Localized lateral alveolar ridge augmentation with block bone grafts: simultaneous versus delayed implant placement: a clinical and radiographic retrospective study. Int J Oral Maxillofac Implants. 2013;28(3):846-53.
• Stricker A, Jacobs R, Maes F, Fluegge T, Vach K, Fleiner J. Resorption of retromolar bone grafts after alveolar ridge augmentation-volumetric changes after 12 months assessed by CBCT analysis. Int J Implant Dent. 2021;7(1):7.
• Cansiz E, Haq J, Manisali M, Cakarer S, Gultekin BA. Long-term evaluation of three-dimensional volumetric changes of augmented severely atrophic maxilla by anterior iliac crest bone grafting. J Stomatol Oral Maxillofac Surg. 2020;121(6):665-71.
• Gultekin BA, Cansiz E, Borahan MO. Clinical and 3-Dimensional Radiographic Evaluation of Autogenous Iliac Block Bone Grafting and Guided Bone Regeneration in Patients With Atrophic Maxilla. J Oral Maxillofac Surg. 2017;75(4):709-22.
• Kloss FR, Offermanns V, Kloss-Brandstätter A. Comparison of allogeneic and autogenous bone grafts for augmentation of alveolar ridge defects-A 12-month retrospective radiographic evaluation. Clin Oral Implants Res. 2018;29(11):1163-75.
• Chang CC, Kim SK, Lee CT. A novel approach to assess volumetric bone loss at immediate implant sites and comparison to linear measurements: A pilot study. J Dent. 2022;120:104083.
• Misch CE, Perel ML, Wang HL, et al. Implant success, survival, and failure: the International Congress of Oral Implantologists (ICOI) Pisa Consensus Conference. Implant Dent. 2008;17(1):5-15.
• Vandenbroucke JP, von Elm E, Altman DG, et al. Strengthening the Reporting of Observational Studies in Epidemiology (STROBE): explanation and elaboration. Epidemiology. 2007;18(6):805-35.
• Cawood JI, Howell RA. A classification of the edentulous jaws. Int J Oral Maxillofac Surg. 1988;17(4):232-6.
• Fedorov A, Beichel R, Kalpathy-Cramer J, et al. 3D Slicer as an image computing platform for the Quantitative Imaging Network. Magn Reson Imaging. 2012;30(9):1323-41.
• Block MS, Ducote CW, Mercante DE. Horizontal augmentation of thin maxillary ridge with bovine particulate xenograft is stable during 500 days of follow-up: preliminary results of 12 consecutive patients. J Oral Maxillofac Surg. 2012;70(6):1321-30.
• Widmark G, Andersson B, Ivanoff CJ. Mandibular bone graft in the anterior maxilla for single-tooth implants. Presentation of surgical method. Int J Oral Maxillofac Surg. 1997;26(2):106-9.
• Ozaki W, Buchman SR. Volume maintenance of onlay bone grafts in the craniofacial skeleton: micro-architecture versus embryologic origin. Plast Reconstr Surg. 1998;102(2):291-9.
• Antoun H, Sitbon JM, Martinez H, Missika P. A prospective randomized study comparing two techniques of bone augmentation: onlay graft alone or associated with a membrane. Clin Oral Implants Res. 2001;12(6):632-9.
• Cordaro L, Amadé DS, Cordaro M. Clinical results of alveolar ridge augmentation with mandibular block bone grafts in partially edentulous patients prior to implant placement. Clin Oral Implants Res. 2002;13(1):103-11.
• Sbordone L, Toti P, Menchini-Fabris GB, Sbordone C, Piombino P, Guidetti F. Volume changes of autogenous bone grafts after alveolar ridge augmentation of atrophic maxillae and mandibles. Int J Oral Maxillofac Surg. 2009;38(10):1059-65.
• Dasmah A, Thor A, Ekestubbe A, Sennerby L, Rasmusson L. Particulate vs. block bone grafts: three-dimensional changes in graft volume after reconstruction of the atrophic maxilla, a 2-year radiographic follow-up. J Craniomaxillofac Surg. 2012;40(8):654-9.
• Block MS, Kent JN, Kallukaran FU, Thunthy K, Weinberg R. Bone maintenance 5 to 10 years after sinus grafting. J Oral Maxillofac Surg. 1998;56(6):706-15.
• Xu H, Shimizu Y, Onodera K, Ooya K. Long-term outcome of augmentation of the maxillary sinus using deproteinised bone particles experimental study in rabbits. Br J Oral Maxillofac Surg. 2005;43(1):40-5.
• Sanz-Sánchez I, Ortiz-Vigón A, Sanz-Martín I, Figuero E, Sanz M. Effectiveness of Lateral Bone Augmentation on the Alveolar Crest Dimension: A Systematic Review and Meta-analysis. J Dent Res. 2015;94(9 Suppl):128S-42S.
• De Stavola L, Tunkel J. Results of vertical bone augmentation with autogenous bone block grafts and the tunnel technique: a clinical prospective study of 10 consecutively treated patients. Int J Periodontics Restorative Dent. 2013;33(5):651-9.
• Triplett RG, Schow SR. Autologous bone grafts and endosseous implants: complementary techniques. J Oral Maxillofac Surg. 1996;54(4):486-94.
• Nyström E, Ahlqvist J, Gunne J, Kahnberg KE. 10-year follow-up of onlay bone grafts and implants in severely resorbed maxillae. Int J Oral Maxillofac Surg. 2004;33(3):258-62.