Research

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Issue: 03/2011 - S. Schulz - S. Dax - D. T. Weinhold - M. Dürholt
Comparison of lateral augmentation techniques

Question: A multitude of surgical techniques for the augmentation of vertical bones in connection with the insertion of dental implants is described in the relevant literature. The objective of the present article is to compare three techniques of vertical ridge augmentation on the basis of our medical records of patients who have undergone the described treatments in the past.

Method: The following methods were examined: spreading the alveolar ridge [12, 13, 14] by means of oscillating saws and spiral osteotomes, bone block grafts taken from the mandibular angle area [1, 4, 6, 11] and the use of absorbable membranes [3, 8]. All patients that complied with the guidelines of the DGZMK for the insertion of dental implants were registered. The patient population was not differentiated in more detail. Complete and partial loss of the augmentation material as well as a dehiscence of the suture were rated as complications [7].

Results: A complication rate of 3% was determined for the spreading of the alveolar ridge, the rate established for bone block grafts was 19% and that of the membrane techniques was 32%.

Conclusion: The spreading of the alveolar ridge showed significantly less complications than the other two augmentation techniques we examined. Due to the design of the study and the inhomogeneity of the patient group, this result was affected by a number of other factors which could not be included in the statistics. Prospective studies regarding this topic are desirable.

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Issue: 02/2011 - C. Arndt - F.-A. Preusse - M. Suhr
Implant repositioning osteotomy for changing the position
of osseointegrated implants

The options in the treatment of fully osseointegrated implants in an incorrect or unusable position include not utilising the implant (“sleeping implant”), surgical removal of the implant and complete replanning, providing it with superstructure and accepting the situation, or performing an implant repositioning osteotomy (IRO). In the latter procedure, emphasis is placed on ensuring an adequate bone- and blood-supply and adequate fixation of the implant-bearing bony segment. This can be accomplished by wire or plate osseosynthesis, fixing abutments into a splint incorporating temporary crowns, or by bone-grafting and impaction. Adequate planning, obtaining an informed consent from the patient with presentation of all the options and frequent and repeated foto-documentation are essential components in ensuring an outcome acceptable to the patient.

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