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O.566 Histological comparison of zirconia and titanium implants
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Journal of Cranio-Maxillofacial Surgery 36(2008) Suppl. 1
a successful treatment protocol. Obviously, there is a substantial gain in patient comfort, but more important high marginal bone levels are kept in a quasi maintained alveolar ridge, resulting in good aesthetics and speech. O.564 Fibula flap with implants in mandible reconstruction Y. Chang, F.-C. Wei. Chang-Gung Memorial Hospital & University, Taipei, Taiwan Aim: Present our techniques and result not only esthetic but fuctional adequate in mandible reconstruction using fibula osteoseptocutaneous flap combine with pripary or secondary dental implants. Method: (1) place a reconstruction plate inferior to the fibulaimplant construct and use primary dental implantation [12 patients; total 37 fibula-borne implants], (2) use a double-barrelled fibula construct with primary osseointegration [12 patients total 35 fibula-bone implants], (3) use vertical distraction osteogenesis of fibula and secondary osseointegration [9 cases, 34 implants]. Result: All free tissue transfers were successful. Method (1) and (2), all patients have good esthetic results and have completed prothesis rehabilitation. One young female patient from method (1) group is mildly bothered by palpability of the second reconstruction plate; method (3) – difficulty controlling the distraction vector caused mild implant malpositioning, notably in the first premolar area, no other complication. Conclusion: Each of the presented methods can be useful for increaseing the height of the reconstructed mandibular segment to provide an optimal mandibular reconstruction that restores mechanical functions, facial esthetics and complete dental competence with minimal complications.
Abstracts, EACMFS XIX Congress O.566 Histological comparison of zirconia and titanium implants B. Stadlinger, M. Hennig, R. Mai, U. Eckelt. Department of Oral & Maxillofacial Surgery, Faculty of Medicine, University of Technology Dresden, Dresden, Germany Objectives: Zirconia has been widely discussed to offer a further approach in modern implantology. The aim of this animal study was to analyze the osseointegration of submerged and nonsubmerged zirconia implants in comparison to titanium. Methods: 14 one piece sandblasted zirconia implants (whiteSKY, Bredent) and 7 sandblasted, acid etched titanium implants (Xive, Dentsply, Friadent) were inserted into the mandible of seven minipigs. Zirconia implants were alternately placed submerged and non-submerged. Titanium implants were placed submerged. All implants were allowed to heal for four weeks. After sacrificing the animals, a histological analysis of the soft and hard tissue surrounding the implants and a histomorphometric analysis of the bone-implant contact (BIC) and bone volume density (BVD) were performed. Results: For the submerged zirconia and titanium group, the implant surface showed a tight structural connection to the neighboring bone, reaching both a BIC of 53%. For the nonsubmerged zirconia group, some epithelial downgrowth at the crestal part of the implants could be detected, showing a BIC of 48%. BVD showed highest values for submerged zirconia (80%), followed by titanium (74%) and non-submerged zirconia (63%). Conclusions: Within the limits of this study, the result suggests that the applied zirconia implants osseointegrated well. However no intentional loading on the implants was applied. O.567 Human demineralized bone matrix for sinus lift: a clinical assessment
O.565 Fibular flap versatility for prosthetic rehabilitation
F. Garcia-Marin, Jc. Diaz-Maurino, E. Belinchon. Hospital Central de la Defensa Gomez Ulla, Madrid, Spain
G.-Y. Cho Lee, L. Naval G´ıas, M. Mu˜noz Guerra, F. Rodr´ıguez Campo, V. Escorial Hern´andez, J. Sastre P´erez, A. Capote Moreno, M. Mancha de la Plata, S. Ros´on G´omez, F. D´ıaz Gonz´alez. Department of Oral and Maxillofacial Surgery. University Hospital La Princesa, Madrid, Spain
Objectives: Maxillary sinus lift is a surgical procedure performed to increase the volume of bone mass so that dental implants can be placed in the atrophic maxilla. Several materials have been suggested to be used for this procedure. The purpose of this study was to assess the clinical efectiveness of human demineralized bone matrix in sinus lift. Methods: Forty-one sinus lift procedures were performed in 30 pacients. The graft material in all cases was DBX, a human demineralizated bone matrix, 70% composed of inorganic matter and 30% of collagen and BMP (morphogenetic proteins). Fiftysix implants were placed. Nineteen of them were placed simultaneously with the sinus lift. Results: All 41 sinus lift procedures were successful when visualized and measured by CT. Samples of bone were taken by trephine at the sites of implant placement, demonstrating the formation of a good quantity of new bone. Clinical results showed integration of 54 out of 55 fixtures installed. Discussion: This study confirmed the hypothesis that DBX can be used successfully for sinus floor elevation, showing a great simplicity of the procedure and easy handle of the material. Histological analysis displayed mature bone formation. The surgical time is notoriously shortened as compared with the use of autologous bone. Conclusions: The human demineralized bone matrix seems to be a good option as a biomaterial for the sinus lift procedure.
Objectives: Free vascularized fibula flap is the treatment of choice in mandibular reconstruction for extensive bone defects. When the reconstruction involves a dentate mandible, the fibula has a limit as it does not offer sufficient bone height to restore the alveolar arch up to the occlusal plane. Prosthetic rehabilitation with implants may be affected because of implant overloading which could endanger both the functional and aesthetic long-term results. We encountered this problem in 10 patients. Methods: To overcome this vertical discrepancy, the double barrel fibula flap technique was carried out in 9 patients and 1 patient underwent segmental vertical fibula distraction osteogenesis. The distraction device was applied intraorally. Results: The increase of vertical bone height was stable and enabled placement of implants and prosthetic rehabilitation without any complications in all patients. Conclusions: Both double barrel fibula flap technique and vertical distraction of the fibular bone flap are reliable methods enabling a good prosthetic rehabilitation following the reconstruction of the mandible. However, the first one is technically demanding, with a higher risk of pedicle thrombosis. In case of large defects, the length of the bone segment may not be enough for duplication of the entire reconstructed part. On the other hand, besides augmentation of the alveolar bone, distraction osteogenesis achieves stretching of the soft tissue, but it is more time consuming.
Journal of Cranio-Maxillofacial Surgery 36(2008) Suppl. 1
a successful treatment protocol. Obviously, there is a substantial gain in patient comfort, but more important high marginal bone levels are kept in a quasi maintained alveolar ridge, resulting in good aesthetics and speech. O.564 Fibula flap with implants in mandible reconstruction Y. Chang, F.-C. Wei. Chang-Gung Memorial Hospital & University, Taipei, Taiwan Aim: Present our techniques and result not only esthetic but fuctional adequate in mandible reconstruction using fibula osteoseptocutaneous flap combine with pripary or secondary dental implants. Method: (1) place a reconstruction plate inferior to the fibulaimplant construct and use primary dental implantation [12 patients; total 37 fibula-borne implants], (2) use a double-barrelled fibula construct with primary osseointegration [12 patients total 35 fibula-bone implants], (3) use vertical distraction osteogenesis of fibula and secondary osseointegration [9 cases, 34 implants]. Result: All free tissue transfers were successful. Method (1) and (2), all patients have good esthetic results and have completed prothesis rehabilitation. One young female patient from method (1) group is mildly bothered by palpability of the second reconstruction plate; method (3) – difficulty controlling the distraction vector caused mild implant malpositioning, notably in the first premolar area, no other complication. Conclusion: Each of the presented methods can be useful for increaseing the height of the reconstructed mandibular segment to provide an optimal mandibular reconstruction that restores mechanical functions, facial esthetics and complete dental competence with minimal complications.
Abstracts, EACMFS XIX Congress O.566 Histological comparison of zirconia and titanium implants B. Stadlinger, M. Hennig, R. Mai, U. Eckelt. Department of Oral & Maxillofacial Surgery, Faculty of Medicine, University of Technology Dresden, Dresden, Germany Objectives: Zirconia has been widely discussed to offer a further approach in modern implantology. The aim of this animal study was to analyze the osseointegration of submerged and nonsubmerged zirconia implants in comparison to titanium. Methods: 14 one piece sandblasted zirconia implants (whiteSKY, Bredent) and 7 sandblasted, acid etched titanium implants (Xive, Dentsply, Friadent) were inserted into the mandible of seven minipigs. Zirconia implants were alternately placed submerged and non-submerged. Titanium implants were placed submerged. All implants were allowed to heal for four weeks. After sacrificing the animals, a histological analysis of the soft and hard tissue surrounding the implants and a histomorphometric analysis of the bone-implant contact (BIC) and bone volume density (BVD) were performed. Results: For the submerged zirconia and titanium group, the implant surface showed a tight structural connection to the neighboring bone, reaching both a BIC of 53%. For the nonsubmerged zirconia group, some epithelial downgrowth at the crestal part of the implants could be detected, showing a BIC of 48%. BVD showed highest values for submerged zirconia (80%), followed by titanium (74%) and non-submerged zirconia (63%). Conclusions: Within the limits of this study, the result suggests that the applied zirconia implants osseointegrated well. However no intentional loading on the implants was applied. O.567 Human demineralized bone matrix for sinus lift: a clinical assessment
O.565 Fibular flap versatility for prosthetic rehabilitation
F. Garcia-Marin, Jc. Diaz-Maurino, E. Belinchon. Hospital Central de la Defensa Gomez Ulla, Madrid, Spain
G.-Y. Cho Lee, L. Naval G´ıas, M. Mu˜noz Guerra, F. Rodr´ıguez Campo, V. Escorial Hern´andez, J. Sastre P´erez, A. Capote Moreno, M. Mancha de la Plata, S. Ros´on G´omez, F. D´ıaz Gonz´alez. Department of Oral and Maxillofacial Surgery. University Hospital La Princesa, Madrid, Spain
Objectives: Maxillary sinus lift is a surgical procedure performed to increase the volume of bone mass so that dental implants can be placed in the atrophic maxilla. Several materials have been suggested to be used for this procedure. The purpose of this study was to assess the clinical efectiveness of human demineralized bone matrix in sinus lift. Methods: Forty-one sinus lift procedures were performed in 30 pacients. The graft material in all cases was DBX, a human demineralizated bone matrix, 70% composed of inorganic matter and 30% of collagen and BMP (morphogenetic proteins). Fiftysix implants were placed. Nineteen of them were placed simultaneously with the sinus lift. Results: All 41 sinus lift procedures were successful when visualized and measured by CT. Samples of bone were taken by trephine at the sites of implant placement, demonstrating the formation of a good quantity of new bone. Clinical results showed integration of 54 out of 55 fixtures installed. Discussion: This study confirmed the hypothesis that DBX can be used successfully for sinus floor elevation, showing a great simplicity of the procedure and easy handle of the material. Histological analysis displayed mature bone formation. The surgical time is notoriously shortened as compared with the use of autologous bone. Conclusions: The human demineralized bone matrix seems to be a good option as a biomaterial for the sinus lift procedure.
Objectives: Free vascularized fibula flap is the treatment of choice in mandibular reconstruction for extensive bone defects. When the reconstruction involves a dentate mandible, the fibula has a limit as it does not offer sufficient bone height to restore the alveolar arch up to the occlusal plane. Prosthetic rehabilitation with implants may be affected because of implant overloading which could endanger both the functional and aesthetic long-term results. We encountered this problem in 10 patients. Methods: To overcome this vertical discrepancy, the double barrel fibula flap technique was carried out in 9 patients and 1 patient underwent segmental vertical fibula distraction osteogenesis. The distraction device was applied intraorally. Results: The increase of vertical bone height was stable and enabled placement of implants and prosthetic rehabilitation without any complications in all patients. Conclusions: Both double barrel fibula flap technique and vertical distraction of the fibular bone flap are reliable methods enabling a good prosthetic rehabilitation following the reconstruction of the mandible. However, the first one is technically demanding, with a higher risk of pedicle thrombosis. In case of large defects, the length of the bone segment may not be enough for duplication of the entire reconstructed part. On the other hand, besides augmentation of the alveolar bone, distraction osteogenesis achieves stretching of the soft tissue, but it is more time consuming.