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Surgical complications and failures in implantology
ICOMS 2011—Abstracts: Oral Papers ANOVA statistic method was used to evaluate differences in molecules expression. Results: Clinically both HG and AG grafts appeared clinically integrated with the host tissue, indicating they can be successfully used as graft in regenerative techniques. Otherwise the expression of molecules specifically involved in neoangiogenesis slightly differs from each other: MMP2 level of expression was statistically higher in HG, while values obtained from MMP9 and VEGF analysis resulted higher in AG than in HG. Conclusions: A greater activity could be noticed in AG graft than in HG, 4 months after grafting, as statistically supported. Moreover, as MMP2 is mostly involved in the initial phases of neo-angiogenesis, while MMP9 and VEGF are enrolled in supporting endothelium, it could be hypothesized that, at the same experimental time point, the regenerative processes proceed more quickly in site regenerated with autologous bone than in that treated with homologous bone graft. Conflict of interest: None declared. doi:10.1016/j.ijom.2011.07.094
94 Surgical complications and failures in implantology M. Galie Unit of Cranio Maxillo Facial Surgery, Center for Orbital Pathology and Surgery, St. Anna Hospital and University, Ferrara, Italy
Introduction: Implants have evolved to a rapidly growing technique for replace the missing teeth. The total number of implants being placed has increased significantly over the years, as the prevalence of complications. In oral implantology, the most serious complications and those most frequently described in the literature occur during surgery. They may result from inadequate planning, overworking of the implant bed, contamination of the implant by incorrect manipulation or mishandling; by poor implant orientation, or by the surgical procedure itself, which is not without risk. The author provides a detailed analysis of the etiology, prevention and treatment of specific complications. Patients and methods: This study includes a retrospective review on patients referred for some complication due to implant placement, loading or pre-surgical grafting techniques. The patients were evaluated and baseline data collected. Results: A spectrum of surgical implant complication is reported. Clinical
data, as data related to etiology, diagnosis and treatment planning were collected. According to the complication patients were treated with appropriate surgery. A detailed analysis of the etiology, prevention and treatment of specific complications is reported. Conclusion: There are several reasons for the increased number of implant complications in the last years. Intraoperative complications may be related with surgery such as hemorrhage, neurosensory alterations, damage to adjacent teeth and mandibular fractures. Otherwise complications may be associated with implant placement such as absence of primary stability, fenestration or displacement into maxillary sinus. Knowledge, learning, and experience are paramount to reducing the number and the severity of implants surgical complications. Conflict of interest: None declared. doi:10.1016/j.ijom.2011.07.095
95 Immunohistochemical and morphological evaluation of the regenerative processes occurring to autologous or heterologous bone grafts in intraoral defects
1053
and the bone graft were more evident in sites treated with heterologous graft. Immunohistochemical analyses showed that BSP, MMP9, and VEGF expression was higher in samples from sites treated with autologous bone graft from calvaria. iNOS levels were higher in samples of heterologous graft. Conclusions: The capability of host tissue to initiate graft revascularization and remodeling was investigated by analyzing changes in expression of molecules involved in this early phases, like BSP, MMP9, and VEGF. Their expression increase after four months from the grafting, the moment of implants insertion, for both investigated graft, but they resulted significantly more expressed in calvaria bone grafts, indicating a more rapid angiogenic and regenerative response. The minor amount of iNOS found in samples from calvaria bone grafts indicated that inflammatory phenomena has almost all disappeared after four months. Conflict of interest: None declared. doi:10.1016/j.ijom.2011.07.096
96 Computer-assisted flapless implant placement may prevent surgery-related bacteraemia: a randomised controlled clinical trial on 64 edentulous patients
S. Tetè 1 , U. Di Tore 1,∗ , V. Zizzari 1 , M. Tumedei 1 , R. Grilli 1 , V. D’Amico 1 , S. Zara 2 , R. Vinci 3 , A. Cataldi 2 , E. Gherlone 3 1 Department of Oral Sciences, Nano and Biotechnology, ‘G.D’Annunzio’ University, Chieti, Italy 2 Department of Drug Sciences, Faculty of Pharmacy, ‘G.D’Annunzio’ University, Chieti, Italy 3 Ateneo Vita-Salute S. Raffaele University, Milan, Milan, Italy
V. Arisan 1,∗ , N. Bolukbasi 1 , L. Oksuz 2 , T. Ozdemir 1 1 Department of Oral Implantology, Faculty of Dentistry, Istanbul University, Istanbul, Turkey 2 Department of Microbiology, Faculty of Medicine, Istanbul University, Istanbul, Turkey
Objectives: The aim of the study was to evaluate the bone regenerative process after AG or HG used as graft to correct intraoral defects in human. Methods: Autologous bone from calvaria and heterologous bone of equine origin were used to recreate adequate bone volumes in the posterior maxilla before implant therapy. Specimens were withdrawn from regenerated sites four months after grafting (T1) and compared to each other by light microscope and SEM. Samples were processed in order to investigate BSP, iNOS, MMP9, and VEGF expression by immunohistochemical analysis. Results: Microscope observation showed that, after four months, remodeling of the graft was quite completed in sites which received autologous extraoral graft, while differences among host tissue
Aim: The aim of this randomised controlled clinical trial was to compare the incidence of bacteraemia in conventional and computer-assisted flapless implant surgery. Materials and methods: Following the recruitment of suitable 64 patients with at least one edentulous jaw, a total of 372 implants were placed using the conventional (conventional group) or stereolithographic template-guided flapless surgery techniques (flapless group). I.V. blood samples taken prior to the surgery and 15 min and 24 h after the surgery were inoculated to aerobic and anaerobic cultures for the detection of bacteraemia. The incidence of bacteraemia in relation with the surgical duration, patients’ age, gender and the number of implants placed was analyzed with the t-
94 Surgical complications and failures in implantology M. Galie Unit of Cranio Maxillo Facial Surgery, Center for Orbital Pathology and Surgery, St. Anna Hospital and University, Ferrara, Italy
Introduction: Implants have evolved to a rapidly growing technique for replace the missing teeth. The total number of implants being placed has increased significantly over the years, as the prevalence of complications. In oral implantology, the most serious complications and those most frequently described in the literature occur during surgery. They may result from inadequate planning, overworking of the implant bed, contamination of the implant by incorrect manipulation or mishandling; by poor implant orientation, or by the surgical procedure itself, which is not without risk. The author provides a detailed analysis of the etiology, prevention and treatment of specific complications. Patients and methods: This study includes a retrospective review on patients referred for some complication due to implant placement, loading or pre-surgical grafting techniques. The patients were evaluated and baseline data collected. Results: A spectrum of surgical implant complication is reported. Clinical
data, as data related to etiology, diagnosis and treatment planning were collected. According to the complication patients were treated with appropriate surgery. A detailed analysis of the etiology, prevention and treatment of specific complications is reported. Conclusion: There are several reasons for the increased number of implant complications in the last years. Intraoperative complications may be related with surgery such as hemorrhage, neurosensory alterations, damage to adjacent teeth and mandibular fractures. Otherwise complications may be associated with implant placement such as absence of primary stability, fenestration or displacement into maxillary sinus. Knowledge, learning, and experience are paramount to reducing the number and the severity of implants surgical complications. Conflict of interest: None declared. doi:10.1016/j.ijom.2011.07.095
95 Immunohistochemical and morphological evaluation of the regenerative processes occurring to autologous or heterologous bone grafts in intraoral defects
1053
and the bone graft were more evident in sites treated with heterologous graft. Immunohistochemical analyses showed that BSP, MMP9, and VEGF expression was higher in samples from sites treated with autologous bone graft from calvaria. iNOS levels were higher in samples of heterologous graft. Conclusions: The capability of host tissue to initiate graft revascularization and remodeling was investigated by analyzing changes in expression of molecules involved in this early phases, like BSP, MMP9, and VEGF. Their expression increase after four months from the grafting, the moment of implants insertion, for both investigated graft, but they resulted significantly more expressed in calvaria bone grafts, indicating a more rapid angiogenic and regenerative response. The minor amount of iNOS found in samples from calvaria bone grafts indicated that inflammatory phenomena has almost all disappeared after four months. Conflict of interest: None declared. doi:10.1016/j.ijom.2011.07.096
96 Computer-assisted flapless implant placement may prevent surgery-related bacteraemia: a randomised controlled clinical trial on 64 edentulous patients
S. Tetè 1 , U. Di Tore 1,∗ , V. Zizzari 1 , M. Tumedei 1 , R. Grilli 1 , V. D’Amico 1 , S. Zara 2 , R. Vinci 3 , A. Cataldi 2 , E. Gherlone 3 1 Department of Oral Sciences, Nano and Biotechnology, ‘G.D’Annunzio’ University, Chieti, Italy 2 Department of Drug Sciences, Faculty of Pharmacy, ‘G.D’Annunzio’ University, Chieti, Italy 3 Ateneo Vita-Salute S. Raffaele University, Milan, Milan, Italy
V. Arisan 1,∗ , N. Bolukbasi 1 , L. Oksuz 2 , T. Ozdemir 1 1 Department of Oral Implantology, Faculty of Dentistry, Istanbul University, Istanbul, Turkey 2 Department of Microbiology, Faculty of Medicine, Istanbul University, Istanbul, Turkey
Objectives: The aim of the study was to evaluate the bone regenerative process after AG or HG used as graft to correct intraoral defects in human. Methods: Autologous bone from calvaria and heterologous bone of equine origin were used to recreate adequate bone volumes in the posterior maxilla before implant therapy. Specimens were withdrawn from regenerated sites four months after grafting (T1) and compared to each other by light microscope and SEM. Samples were processed in order to investigate BSP, iNOS, MMP9, and VEGF expression by immunohistochemical analysis. Results: Microscope observation showed that, after four months, remodeling of the graft was quite completed in sites which received autologous extraoral graft, while differences among host tissue
Aim: The aim of this randomised controlled clinical trial was to compare the incidence of bacteraemia in conventional and computer-assisted flapless implant surgery. Materials and methods: Following the recruitment of suitable 64 patients with at least one edentulous jaw, a total of 372 implants were placed using the conventional (conventional group) or stereolithographic template-guided flapless surgery techniques (flapless group). I.V. blood samples taken prior to the surgery and 15 min and 24 h after the surgery were inoculated to aerobic and anaerobic cultures for the detection of bacteraemia. The incidence of bacteraemia in relation with the surgical duration, patients’ age, gender and the number of implants placed was analyzed with the t-