Indications for bone augmentation prior to implantation in patients with hypodontia in the aesthetic section of the maxilla
Journal Title: Forum Ortodontyczne - Year 2017, Vol 13, Issue 3
Abstract
Congenital absence of tooth germs of upper incisors in the maxilla is observed in approximately 2% of the population, and during orthodontic treatment a decision has to be made whether to restore space for implant-supported prosthetic restoration or to replace a missing lateral incisor with a canine. After a decision has been made to embed implants into areas left by missing teeth an earlier assessment of the quality and quantity of the bone tissue is important. <b>Aim.</b> To present and discuss surgical procedures in order to prepare the alveolar process for implantation or to improve aesthetics of restorations in patients with hypodontia in the anterior section of the maxilla. <b>Material.</b> Orthodontic treatment was applied in 24 patients with hypodontia of lateral incisors in the maxilla, and it involved restoring space for implant-supported prosthetic restoration. The study also included one patient who did not receive orthodontic treatment, but it was possible to use implants to restore a missing tooth thanks to beneficial occlusal conditions. When the space for implants was restored the alveolar process bone was assessed, and then one out of four procedures of alveolar process augmentation was applied. In the group I with the smallest bone atrophy the alveolar process was augmented with autogenous bone chips at the same time with implant embedment. In the group II with a slightly greater bone atrophy, but still eligible for implant embedment, at the same time the process was augmented with allogeneic granules. In the group III with a significant horizontal atrophy of the process bone implantation was combined with augmentation of the process with an allogeneic bone block. The last group, IV group, included patients with significant bone hypoplasia in the horizontal or vertical dimension where it was impossible to obtain primary stability. The first stage included bone augmentation always with the bone block, and 3–6 months later an implant was embedded. <b>Results.</b> In total, there were 39 procedures of augmentation of the maxillary alveolar process. There were 9 procedures with the allogeneic bone block, 2 with allogeneic granules and 28 procedures with autologous bone chips. In all cases the process was widened by 3.3 mm on the average, and therefore it was possible to introduce a dental implant in all treated patients. <b>(Krasny K, Krasny M, Zadurska M. Indications for bone augmentation prior to implantation in patients with hypodontia in the aesthetic section of the maxilla. Orthod Forum 2017; 13: 202-12).</b>
Authors and Affiliations
Kornel Krasny, Marta Krasny, Małgorzata Zadurska
Keywords
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