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O.574 Massive sinus-lift procedures using pure TCP. Late results
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Journal of Cranio-Maxillofacial Surgery 36(2008) Suppl. 1
the quality of bone in sufficient quantity. In cases of bony defect a preimplant surgery is needed in the maxilla or the mandible. In patients with important maxillary resorption, there is usually a reversed intermaxillary relationship (Class III) with severe transversal atrophy. In these cases, a Le Fort I osteotomy combined with onlay-inlay bone graft is the adapted solution. Calvaria is commonly used for oral and maxillofacial surgery as an onlay and inlay bone graft. However few studies describe Le Fort I osteotomy with onlay-inlay parietal bone grafts. The aim of our study was to report cases of reconstruction of the severe atrophied maxilla using Le Fort I osteotomy and parietal bone. Methods: Three patients, aged 49.3, underwent this surgical procedure. Twenty-eight oral endosseous implants were inserted after five months. Temporary prostheses were realised. Results: There was no per or post-operative complications. No implant failed to osseointegrate. All patients resumed full-oral rehabilitation. Conclusion: This study confirmes that severe atrophy of the maxilla can be reconstructed using the Le Fort I osteotomy and calvarial bone. O.573 Long-term evaluation of dental implants placed at the time of or after alveolar ridge augmentation with autogenous bone grafts and titanium meshes: a 3-8 year retrospective study
Abstracts, EACMFS XIX Congress Method: prospective study carried out from 02/2002 to 11/2005. 30 patients (totalizing 50 sinuses) needing a sinus-lift procedure before dental implants and who consented to the use of TCP were included in the study. The biomaterial (Cerasorb) was provided free of charge by Curasan (Germany). The mean volume of TCP was 6cc per side (4 to 14cc). The TCP was mixed with plateletrich plasma (PRP), inserted trough a classical vestibular approach and recovered with patelet-rich fibrin membranes (PRF). 48 of these augmented sinuses could be implanted (with a total of 182 implants) at the 6th post-op month on average. 20 of the 30 initial patients (totalizing 33 sinus procedures and 105 implants) accepted to be re-evaluated 4.5 years post-operatively on average (2.5 to 6.5 years). Results: In this group of patients, we noticed 1 partial infection of the biomaterial at the 15th post-op day (3%) and the loss of 4 implants (3 during the osteo-integration period, 1 after loading) allowing an implant success rate of 96.2%. The immediate postop gain of sinus height (mean: 20 mm) showed a 20% overall resorption rate occuring in the first 30 post-op months and leading to a final mean gain of height of 16 mm. Conclusion: Massive sinus floor augmentations using TCP in combination with PRP and PRF showed stable results over time. The complication and implant success rates were simular to those obtained by using classical autologous bone grafts.
O.575 Maxillary reconstruction using Epitec-system
L. Sapigni, F. Pieri, G. Corinaldesi, C. Marchetti. Department of Odontostomatological Sciences, University of Bologna, Bologna, Italy
Y. Yamashita, M. Shigematsu, Y. Yamaguchi, M. Goto. Department of Oral and Maxillofacial Surgery, Saga Medical School, Saga City, Japan
Purpose: The purpose of this retrospective, longitudinal study was to evaluate the survival and success rate of 56 implants consecutively placed in alveolar ridges following a one- or two-stage augmentative procedure, using autogenous bone and titanium micro-meshes. Materials and Methods: This study included 24 consecutive patients treated with 27 micro-meshes and mandibular particulated bone. In 13 patients, 20 implants were placed at the same stage of the reconstructive procedure. In the remaining 11 patients, 36 implants were positioned during a second surgery after 89 months of healing. Follow-up data (implant survival, success rate, marginal bone resorption) were collected after 3-8 years of prosthetic loading. Results: Four of the 27 micro-meshes (complication rate, 14.8%) were exposed prematurely, and were removed before the intended time. The mean vertical bone augmentation obtained was 5.4±1.81 mm for implants placed in simultaneous procedures and 4.5±1.16 mm in delayed procedures. None of the 56 implants was lost during the observation period (cumulative implant survival rate, 100%). Radiographic analysis showed stable marginal bone levels, with a mean bone resorption of 1.58±0.48 mm after 38 years. Only two implants demonstrated increased bone loss (3.12 and 3.37 mm) over the follow-up period, whereas the remaining 54 implants were considered clinically successful, resulting in a cumulative success rate of 96.4%. Conclusions: This study revealed that implant placement in augmented ridges using micro-meshes and autogenous bone provided satisfactory long-term survival and success rates, with minimal bone resorption.
Reconstruction of maxillary and midface defects represents a major challenge to reconstructive surgeons. Reconstructing the maxilla of a patient with a missing segment is quite difficult, but is essential to improve the postoperative quality of life (QOL) for the patient. We encountered 2 cases of malignant tumor on the maxilla that were successfully repaired using the immediate installation of prostheses supported with an Epitec-system during maxilla reconstruction. Originally, the Epitec-system was developed as an implant to maintain facial prostheses. In this study, Epitecplates worked as a strong retention source for the maxillodental prosthesis. However, adapting Epitec-plates after extensive maxillectomy was not easy. To shorten the operation time and improve conformity to remaining bone shape, a craniofacial skull model was fabricated by stereo-lithographic techniques on the basis of data from computed tomography (CT). After trimming the model to simulate segmental resection, Epitec-plates were shaped to match the defect. Moreover, strong retention was facilitated by connecting individual Epitec-plates by laser welding. A united Epitec-plate was fixed to the remaining bone immediately and easily after tumor resection. An immediate maxillary prosthesis was placed and functioned at the end of surgery. The Epitecsystem provides effective materials for immediate prosthesis of extensive maxillary defects.
O.574 Massive sinus-lift procedures using pure TCP. Late results C. Meyer, J.-F. Garnier, T. Camponovo, B. Ricbourg, M. Benaroch. Department for Oral and Maxillofacial Surgery – University Hospital of Besan¸con, Besan¸con Cedex, France Objectives: to evaluate the clinical and radiological long term results of massive sinus floor augmentation using pure TCP.
O.576 Mineral metabolism in dental implantation with acupuncture I. Pohodenko-Chudakova, T.L. Shevela. Belarusian Collaborating Center of EACMFS, Belarusian State Medical University, Minsk, Belarus Objectives: Inorganic components constitutes 70% of bone tissue. Hydroxyapatite consists of potassium phosphate salt. Ions Ca2+, acid phosphatase (AP) activity levels of the fluid medium were used as bone state and its general processes markers. Aim is to study mineral metabolism dynamics (ions Ca2+, AP activity levels) in blood serum while dental implantation operation (experimental case).
Journal of Cranio-Maxillofacial Surgery 36(2008) Suppl. 1
the quality of bone in sufficient quantity. In cases of bony defect a preimplant surgery is needed in the maxilla or the mandible. In patients with important maxillary resorption, there is usually a reversed intermaxillary relationship (Class III) with severe transversal atrophy. In these cases, a Le Fort I osteotomy combined with onlay-inlay bone graft is the adapted solution. Calvaria is commonly used for oral and maxillofacial surgery as an onlay and inlay bone graft. However few studies describe Le Fort I osteotomy with onlay-inlay parietal bone grafts. The aim of our study was to report cases of reconstruction of the severe atrophied maxilla using Le Fort I osteotomy and parietal bone. Methods: Three patients, aged 49.3, underwent this surgical procedure. Twenty-eight oral endosseous implants were inserted after five months. Temporary prostheses were realised. Results: There was no per or post-operative complications. No implant failed to osseointegrate. All patients resumed full-oral rehabilitation. Conclusion: This study confirmes that severe atrophy of the maxilla can be reconstructed using the Le Fort I osteotomy and calvarial bone. O.573 Long-term evaluation of dental implants placed at the time of or after alveolar ridge augmentation with autogenous bone grafts and titanium meshes: a 3-8 year retrospective study
Abstracts, EACMFS XIX Congress Method: prospective study carried out from 02/2002 to 11/2005. 30 patients (totalizing 50 sinuses) needing a sinus-lift procedure before dental implants and who consented to the use of TCP were included in the study. The biomaterial (Cerasorb) was provided free of charge by Curasan (Germany). The mean volume of TCP was 6cc per side (4 to 14cc). The TCP was mixed with plateletrich plasma (PRP), inserted trough a classical vestibular approach and recovered with patelet-rich fibrin membranes (PRF). 48 of these augmented sinuses could be implanted (with a total of 182 implants) at the 6th post-op month on average. 20 of the 30 initial patients (totalizing 33 sinus procedures and 105 implants) accepted to be re-evaluated 4.5 years post-operatively on average (2.5 to 6.5 years). Results: In this group of patients, we noticed 1 partial infection of the biomaterial at the 15th post-op day (3%) and the loss of 4 implants (3 during the osteo-integration period, 1 after loading) allowing an implant success rate of 96.2%. The immediate postop gain of sinus height (mean: 20 mm) showed a 20% overall resorption rate occuring in the first 30 post-op months and leading to a final mean gain of height of 16 mm. Conclusion: Massive sinus floor augmentations using TCP in combination with PRP and PRF showed stable results over time. The complication and implant success rates were simular to those obtained by using classical autologous bone grafts.
O.575 Maxillary reconstruction using Epitec-system
L. Sapigni, F. Pieri, G. Corinaldesi, C. Marchetti. Department of Odontostomatological Sciences, University of Bologna, Bologna, Italy
Y. Yamashita, M. Shigematsu, Y. Yamaguchi, M. Goto. Department of Oral and Maxillofacial Surgery, Saga Medical School, Saga City, Japan
Purpose: The purpose of this retrospective, longitudinal study was to evaluate the survival and success rate of 56 implants consecutively placed in alveolar ridges following a one- or two-stage augmentative procedure, using autogenous bone and titanium micro-meshes. Materials and Methods: This study included 24 consecutive patients treated with 27 micro-meshes and mandibular particulated bone. In 13 patients, 20 implants were placed at the same stage of the reconstructive procedure. In the remaining 11 patients, 36 implants were positioned during a second surgery after 89 months of healing. Follow-up data (implant survival, success rate, marginal bone resorption) were collected after 3-8 years of prosthetic loading. Results: Four of the 27 micro-meshes (complication rate, 14.8%) were exposed prematurely, and were removed before the intended time. The mean vertical bone augmentation obtained was 5.4±1.81 mm for implants placed in simultaneous procedures and 4.5±1.16 mm in delayed procedures. None of the 56 implants was lost during the observation period (cumulative implant survival rate, 100%). Radiographic analysis showed stable marginal bone levels, with a mean bone resorption of 1.58±0.48 mm after 38 years. Only two implants demonstrated increased bone loss (3.12 and 3.37 mm) over the follow-up period, whereas the remaining 54 implants were considered clinically successful, resulting in a cumulative success rate of 96.4%. Conclusions: This study revealed that implant placement in augmented ridges using micro-meshes and autogenous bone provided satisfactory long-term survival and success rates, with minimal bone resorption.
Reconstruction of maxillary and midface defects represents a major challenge to reconstructive surgeons. Reconstructing the maxilla of a patient with a missing segment is quite difficult, but is essential to improve the postoperative quality of life (QOL) for the patient. We encountered 2 cases of malignant tumor on the maxilla that were successfully repaired using the immediate installation of prostheses supported with an Epitec-system during maxilla reconstruction. Originally, the Epitec-system was developed as an implant to maintain facial prostheses. In this study, Epitecplates worked as a strong retention source for the maxillodental prosthesis. However, adapting Epitec-plates after extensive maxillectomy was not easy. To shorten the operation time and improve conformity to remaining bone shape, a craniofacial skull model was fabricated by stereo-lithographic techniques on the basis of data from computed tomography (CT). After trimming the model to simulate segmental resection, Epitec-plates were shaped to match the defect. Moreover, strong retention was facilitated by connecting individual Epitec-plates by laser welding. A united Epitec-plate was fixed to the remaining bone immediately and easily after tumor resection. An immediate maxillary prosthesis was placed and functioned at the end of surgery. The Epitecsystem provides effective materials for immediate prosthesis of extensive maxillary defects.
O.574 Massive sinus-lift procedures using pure TCP. Late results C. Meyer, J.-F. Garnier, T. Camponovo, B. Ricbourg, M. Benaroch. Department for Oral and Maxillofacial Surgery – University Hospital of Besan¸con, Besan¸con Cedex, France Objectives: to evaluate the clinical and radiological long term results of massive sinus floor augmentation using pure TCP.
O.576 Mineral metabolism in dental implantation with acupuncture I. Pohodenko-Chudakova, T.L. Shevela. Belarusian Collaborating Center of EACMFS, Belarusian State Medical University, Minsk, Belarus Objectives: Inorganic components constitutes 70% of bone tissue. Hydroxyapatite consists of potassium phosphate salt. Ions Ca2+, acid phosphatase (AP) activity levels of the fluid medium were used as bone state and its general processes markers. Aim is to study mineral metabolism dynamics (ions Ca2+, AP activity levels) in blood serum while dental implantation operation (experimental case).