Implant Site Development E-Book

• Herausgeber: John Wiley & Sons
• Kategorie: Fachliteratur
• Sprache: Englisch

Seitenzahl: 985

Veröffentlichungsjahr: 2011

Beschreibung

With the desire for dental implant therapy ever escalating, clinicians are faced with the challenge of augmenting deficient natural physiology to provide effective sites for implantation. Implant Site Development helps the clinician decide if, when, and how to create a ridge site amenable to implantation. This practical book offers solutions to many implant site preservation scenarios, discussing different treatment options, timing, a variety of materials and techniques, and their application to the clinical practice. With a unique integrated clinical approach, Implant Site Development covers a range of site development techniques. Highly illustrated, Implant Site Development presents diagrams and clinical photographs to aid with clinical judgment and will prove useful for any dental professional involved in implant therapy, from general practitioners to prosthodontists, but especially surgeons. This literature-based, yet user-friendly, reference will be indispensable to the novice or veteran clinician.

Leseprobe

Table of Contents

Cover

Title page

Copyright page

Dedication

Contributors

Editors

Associate Editor

Contributors

Foreword

Acknowledgments

Chapter 1 Principles of bone biology and regeneration

Introduction

Bone development

Bone cells

Composition of bone

Bone metabolism

Modeling and remodeling

Bone healing

The role of growth factors used in oral bone repair: implications for implant site development

Summary

Acknowledgments

Chapter 2 Bone anatomy

Introduction

CT data set for maxillofacial imaging

Scanning appliances

CT imaging of the maxilla

CT imaging of the mandible

Conclusion

Chapter 3 Treatment philosophy

General tenet #1: resolve what the patient wants with what you want for the patient

General tenet #2: inform patients of the steps involved in and predictability of care

General tenet #3: proceed at a pace and level comfortable for the patient

General tenet #4: treat comprehensively

Implant tenet #1: implants are prosthetically oriented, not anatomically oriented

Implant tenet #2: maximize use of diagnostic tools

Implant tenet #3: complete site development before implant placement

Implant tenet #4: place the greatest number of implants feasible

Implant tenet #5: do not rush the healing period

Implant tenet #6: choose temporization method wisely

Implant tenet #7: do not count on prosthetic manipulation to mask esthetic flaws

Chapter 4 Decision-making algorithm for regeneration of the periodontally compromised tooth: Maintaining these teeth when dental implants provide a compelling alternative treatment option

Introduction

Review of regenerative techniques

Case selection criteria for formulating a decision-making tree (factors associated with successful regenerative outcomes)

Clinical decision tree

Maintenance care: intervals, antibiotics, and plaque control

Complications

Conclusion

Chapter 5 The making of beautiful smiles in perio-implantology

Esthetic implant treatment

Perio-implant interdependence

Implant soft tissue recession

Patient’s biotype

Tridimensional implant position

Conclusion

Chapter 6 CT/CBCT diagnosis and treatment planning concepts for bone grafting applications

Failing maxillary lateral incisor: two case presentations

True 3D planning

Failed apicoectomy: immediate extraction, placement, and restoration

Grafting assessment for the anterior and posterior maxilla

Sinus grafting assessment

Block bone graft assessment

Conclusion

Chapter 7 Implant site development: Socket preservation

Extraction sockets: external dimensional changes

Socket preservation technique

Future approaches

Conclusion

Chapter 8 Implant interactions in orthodontics

Introduction

Orthodontic interactions preparatory to implant placement

Orthodontic interactions after implant placement

Orthodontic implant functional demands

Chapter 9 Guided bone regeneration: Concepts and materials

Guided bone regeneration principles and regulators

Defect type indications

Results of GBR

Effect of complications on the results of GBR

Implant survival in regenerated sites

Materials

Conclusions

Chapter 10 Implant site preparation: Horizontal ridge augmentation using particulate allograft and the principles of guided bone regeneration

History of predictable regenerative therapy

The team approach for a prosthetically driven implant restoration

Guidelines for horizontal ridge augmentation: diagnosis of the site

Common sites for horizontal ridge augmentation

Evidenced-based horizontal ridge reconstruction using GBR principles and the staged approach

Conclusions

Acknowledgments

Chapter 11 Guided bone regeneration: Peri-implantation

Indications

Surgical technique

Conclusions

Chapter 12 Guided bone regeneration: Vertical growth

Distraction osteogenesis

Onlay bone grafting

Scientific documentation of vertical GBR with different grafting materials

Case selection criteria

Description of vertical ridge augmentation surgical procedure

Simultaneous vertical hard and soft tissue augmentation

New perspectives of vertical GBR

Conclusion

Chapter 13 Intraoral bone grafts for dental implants

Introduction

Bone biology

Preoperative evaluation

Preoperative preparation

Bone graft donor sites

Graft recipient site

Implant placement in onlay grafts

Chapter 14 Bone grafting in large bone defects and extreme atrophy situations

Introduction

Historical perspective

Rib

Tibia

Surgical procedure

Calvarium

Iliac crest

Case selection

Surgical procedure

Complications

Implant site

Clinical cases

Acknowledgments

Chapter 15 Sinus elevation: Osteotome-mediated approach

Introduction

Literature review: OMSFE and simultaneous implant placement

Clinical indications

Surgical technique

Preoperative assessment

Flap design/OMSFE procedures

Site preparation for OMSFE and simultaneous implant placement

Postoperative radiograph

Postoperative care

CCE operative protocol

Complications: OMSFE for simultaneous implant placement

Conclusion

Chapter 16 Sinus elevation: Lateral wall approach

Introduction

Preliminary considerations on anatomy

Presurgery study

Surgical considerations in handling the schneiderian membrane

Elevation technique with lateral antrostomy

Clinical characteristics of Mectron-Piezosurgery

Chapter 17 Distraction osteogenesis

Introduction

Techniques available: historical perspective—advantages and limitations

Case studies

Chapter 18 Immediate implant placement: A comprehensive understanding for achieving optimal clinical success

Introduction

Review of immediate implant placement techniques

Review of the literature

Case selection criteria

Surgical protocols

Complications

Conclusion

Chapter 19 Soft tissue augmentation: Pre-, peri-, and postimplantation

Introduction

Basic consideration for esthetic soft tissue augmentation

The microsurgical approach

Surgical techniques for tissue augmentation in the esthetic zone

Conclusion

Chapter 20 Soft tissue enhancement after implant placement

Introduction

Keratinized tissue around dental implants

Introduction to surgical techniques

Surgical techniques: preliminary considerations

Case report #1: apically repositioned partial-thickness flap

Case report #2: extended FGGs at the mandible

Case report #3: extended FGGs at the maxilla

Case report #4: CTGs—the envelope technique

Case report #5: CTGs—modified tunnel technique

Conclusion

Chapter 21 Soft tissue augmentation: Allograft

Indications and timing

Preoperative procedures

Allogenic soft tissue ridge augmentation

Allogenic submucosal soft tissue augmentation

Chapter 22 Soft tissue development with provisional and definitive implant restorations

Introduction

The influence of site preparation and implant placement on sulcular anatomy

Implant-level provisional restorations and soft tissue development

Timing of provisional restorations for optimal soft tissue form

Techniques for implant-level provisional restorations

Surgical indexing

Chairside implant-level provisional restoration

Tooth-supported provisional restoration modified for implant soft tissue development

Capturing the soft tissue form developed with provisional restorations

Definitive abutments and prostheses

Prostheses with gingiva-colored ceramics when soft tissue levels are compromised

Conclusion

Chapter 23 Bioengineering concepts

Introduction

Conclusions

Index

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Library of Congress Cataloging-in-Publication Data

Sonick, Michael.

 Implant site development / Michael Sonick, Debby Hwang, André P. Saadoun.

p. ; cm.

 Includes bibliographical references and index.

 ISBN 978-0-8138-2512-0 (hardcover : alk. paper)

 I. Hwang, Debby. II. Saadoun, André P. III. Title.

 [DNLM: 1. Dental Implantation. 2. Bone Regeneration–physiology. 3. Dental Implants. 4. Esthetics, Dental. 5. Guided Tissue Regeneration, Periodontal. 6. Periodontal Diseases–therapy. WU 640]

617.6'93–dc23

2011037205

A catalogue record for this book is available from the British Library.

Wiley also publishes its books in a variety of electronic formats. Some content that appears in print may not be available in electronic books.

ISBN: 978-0-4709-6318-0 (epdf)

ISBN: 978-0-4709-6319-7 (epub)

ISBN: 978-0-4709-6320-3 (mobi)

Disclaimer

The publisher and the author make no representations or warranties with respect to the accuracy or completeness of the contents of this work and specifically disclaim all warranties, including without limitation warranties of fitness for a particular purpose. No warranty may be created or extended by sales or promotional materials. The advice and strategies contained herein may not be suitable for every situation. This work is sold with the understanding that the publisher is not engaged in rendering legal, accounting, or other professional services. If professional assistance is required, the services of a competent professional person should be sought. Neither the publisher nor the author shall be liable for damages arising herefrom. The fact that an organization or Website is referred to in this work as a citation and/or a potential source of further information does not mean that the author or the publisher endorses the information the organization or Website may provide or recommendations it may make. Further, readers should be aware that Internet Websites listed in this work may have changed or disappeared between when this work was written and when it is read.

Michael Sonick, DMD

To the memory of my father, Jay Sonick, who taught me the value of having integrity in all areas of my life. To my wife, Carole, for her unwavering love and support without whom I would not have completed this book nor enjoyed the capacity for such a happy life. To my children, Becky, Jason, and Jennifer, who are the joy of my life.

Debby Hwang, DMD

To my parents and sister.

Contributors

Editors

Michael Sonick DMDPrivate Practice Fairfield, CT, USA

Debby Hwang DMDPrivate Practice Ann Arbor, MI and Fairfield, CT, USA

Associate Editor

André P. Saadoun DDS, MSDiplomate, American Academy of Periodontology Former Associate Professor, Department of Periodontics University of Southern California Los Angeles, CA, USA Visiting Professor, Department of Periodontics and Implantology Hadassah School of Dental Medicine Jerusalem, Israel

Contributors

Eduardo Anitua MD, DDS, PhDDirector of Anitua’s Dental Research Institute Vitoria, Spain

Michael S. Block DMDPrivate Practice Metairie, LA, USA

Nardy Casap DMD, MDSenior Lecturer and Graduate Program Director Department of Oral and Maxillofacial Surgery Hadassah School of Dental Medicine Hebrew University Jerusalem, Israel

Frank Celenza DDSPrivate Practice New York, NY, USA

Robert A. Faiella DMD, MMScDiplomate, American Board of Periodontology Private Practice Osterville and Duxbury, MA, USA

Stefan Fickl DMD, PhD, Priv.-Doz.Clinical Associate Professor Department of Periodontology Julius-Maximilians-University Würzburg, Germany

Stuart J. Froum DDSClinical Professor and Director of Clinical Research Department of Periodontology and Implant Dentistry New York University, College of Dentistry New York, NY, USA

Scott D. Ganz DMDClinical Assistant Professor, Department of Restorative Dentistry University of Medicine and Dentistry of New Jersey New Jersey Dental School Newark, NJ, USA Prosthodontics, Maxillofacial Prosthetics, and Implant Dentistry Fort Lee, NJ, USA

William V. Giannobile DDS, DMedScNajjar Professor of Dentistry and Director Michigan Center for Oral Health Research School of Dentistry Professor of Biomedical Engineering College of Engineering University of Michigan Ann Arbor, MI, USA

Christopher Haggerty DDS, MDPrivate Practice Kansas City, MO, USA

Markus B. Hürzeler DMD, PhD, Prof. Dr. med. dent.Clinical Associate Professor Department of the Operative Dentistry and Periodontology School of Dental Medicine Albert-Ludwigs-University of Freiburg Freiburg, Germany Private Practice Munich, Germany

Jack T. Krauser DMDPrivate Practice Boca Raton, FL, USA

Robert A. Levine DDSClinical Professor in Postgraduate Periodontics and Implantology Kornberg School of Dentistry Temple University, Philadelphia, PA, USA Private Practice, Pennsylvania Center for Dental Implants and Periodontics Philadelphia, PA, USA

George A. Mandelaris DDS, MSDiplomate, American Board of Periodontology Private Practice, Periodontology and Dental Implant Surgery Park Ridge and Oakbrook Terrace, IL, USA

Craig M. Misch DDS, MDSPrivate Practice in Oral Maxillofacial Surgery and Prosthodontics Sarasota, FL, USA Clinical Associate Professor Periodontology and Implant Dentistry New York University College of Dentistry New York, NY, USA

Gorka Orive PhDAssociate Professor of Pharmacy Head of the Laboratory of Regenerative Medicine at BTI Biotechnology Institute Vitoria, Spain

George Priest DMDDiplomate, American Board of Prosthodontics Private Practice in Prosthodontics Hilton Head Island, SC, USA

Hector F. Rios DDS, PhDAssistant Professor, Division of Periodontology Department of Periodontics and Oral Medicine The University of Michigan, School of Dentistry Ann Arbor, MI, USA

Davide Romeo DDS, PhDResearch Associate Department of Periodontology and Implant Dentistry New York University College of Dentistry New York, NY, USA Private Practice, Milan, Italy

Paul S. Rosen DMD, MSClinical Associate Professor of Periodontics Baltimore College of Dental Surgery University of Maryland Baltimore, MD, USA Private Practice Yardley, PA, USA

Alan L. Rosenfeld DDSDiplomate, American Board of Periodontolology Private Practice in Periodontology and Dental Implant Surgery Park Ridge and Oakbrook Terrace, IL, USA

Yuval Samuni DMD, PhDDepartment of Oral and Maxillofacial Surgery The Barzilai Medical Center Ashkelon, Israel

Avi Schetritt DMDDiplomate, American Board of Periodontology Private Practice Miami, FL, USA

Peter C. Shatz DDS, FICDAssistant Clinical Professor Georgia Health Sciences University Augusta, GA, USA Private Practice Atlanta, GA, USA

Lee H. Silverstein DDS, MS, FACD, FICDAssociate Clinical Professor Department of Periodontology Georgia Health Sciences University Augusta, GA, USA Private Practice Marietta, GA, USA

Christian F.J. Stappert DDS, MS, PhD, Priv.-Doz.Director of Aesthetics and Periodontal Prosthodontics Department of Periodontology and Implant Dentistry New York University College of Dentistry New York, NY, USA

Michael Toffler DDSDiplomate, American Board of Periodontology Private Practice New York, NY, USA

Istvan Urban DMD, MDAdjunct Assistant Professor Advanced Education in Implant Dentistry Loma Linda University Loma Linda, CA, USA Private Practice Budapest, Hungary

Tomaso Vercellotti MD, DDSPrivate Practice Genova, Italy Honorary Professor, Eastman Dental Institute London, England Visiting Professor University of Bologna University of Genova Genova, Italy

Foreword

It is human instinct to strive for rejuvenation. In dentistry, this pursuit is fostering astonishing leaps forward in implant dentistry and bone regeneration. This book introduces and makes clear these recent innovations to all clinicians. It is a decision-making companion, a literate mentor that guides the dentist through treatment planning, therapy, and follow-up. There is no surgical manual as comprehensive, thorough, and clinically slanted, but scientifically sound. Clinical leaders take readers on a photographic journey through cases and facilitate them in answering most fundamental questions regarding patient selection, prosthetic options, ridge augmentation, and implant placement. The collection of experts featured here and the easy-to-digest manner in which they outline clinical procedures will impress all readers. We edge ever closer to restoring to our patients their natural form and function; this text assists us on that mission.

Richard Lazzara, DMD, MScD

Acknowledgments

Michael Sonick and Debby Hwang would like to thank the following people for their steadfast support and general brilliance:

Our unflappable, miracle-working team: Sophia Joyce, Melissa Wahl, and Shelby Allen at Wiley and Janet Hronek at Toppan Best-set Premedia LimitedAll the book authors, who proved themselves to be gifted, accommodating, and graciousThe mentors, teachers, and colleagues who instilled in us the sound knowledge of the scientific rationale that undermines sound clinical judgment, especially Abe Shuster, Tom Van Dyke, Steven Offenbacher, Dennis Tarnow, Kendall Beachum, Richard Lazzara, David Garber, Alan Seel, and William GiannobileOur talented, tolerant restorative colleaguesOur unparalleled staff, especially Patty Bernardos, Liz Correia, Verity Rollins, and Kenisha Taylor

Chapter 1

Principles of bone biology and regeneration

Hector F. Rios DDS, PhD and William V. Giannobile DDS, DMedSc

Introduction

Bone is a dynamic tissue sensitive to a variety of factors with an inherent capacity that allows the translation of mechanical stimuli into biochemical signals, which therefore enhances its ability to adapt and sustain the physiological needs of the osseous structure. (Bonewald and Johnson, 2008; Burger et al., 1995; Duncan and Turner, 1995; Marotti, 2000; Marotti and Palumbo, 2007) This adaptive potential is the result of tightly regulated and synergistic anabolic and catabolic events that lead to proper metabolic and skeletal structural homeostasis (Turner and Pavalko, 1998). Multiple factors exert an effect in this system (e.g., biochemical, hormonal, cellular, biomechanical) that will collectively determine bone quality (Ammann and Rizzoli, 2003; Ma et al., 2008; Wallach et al., 1993). Clinically, bone quality is perceived as an important feature that dictates the mechanical properties of bone over time. Within the skeleton, such characteristics vary from one area to another and are determined by, among many things, cellular density and connectivity, bone density, bone macro- and microarchitecture, and the proportions of organic and inorganic matrix (Ammann and Rizzoli, 2003; Dalle Carbonare and Giannini, 2004; Ma et al., 2008; O’Brien et al., 2005; Viguet-Carrin et al., 2006). Therefore, the success of implant therapy is influenced by the understanding of the basic biological and physiological principles of bone, as it will aid the surgeon in selecting the appropriate techniques to enhance the peri-implant bone homeostasis.

Thus, the purpose of this chapter is to provide the clinician with foundational knowledge of bone development, composition, metabolism, and regeneration that serves as a primer for implant site development.

Bone Development

During embryogenesis, the skeleton forms by either a direct or indirect ossification process. In the case of the mandible and the maxilla, mesenchymal progenitor cells condensate and undergo direct differentiation into osteoblasts, a process known as intramembranous osteogenesis. In contrast, in the mandibular condyle, the long bones and vertebrae form initially through a cartilage template, which serves as an anlage that is gradually replaced by bone. The cartilage-dependent bone formation and growth process is known as endochondral osteogenesis (Ranly, 2000) (Fig. 1.1).

Fig. 1.1 During intramembranous osteogenesis, an ossification center develops through mesenchymal condensation. As the collagen-rich extracellular matrix develops and matures, osteoprogenitor cells undergo further osteoblastic differentiation. A subpopulation of osteoblasts becomes embedded in the mineralizing matrix and gives rise to the osteocyte lacunocanalicular network. Within the craniofacial complex, most bones develop and grow through this mechanism. Onthe other hand, long bones within the skeleton and the mandibular condyle are initially developed through the formation of a cartilaginous template that mineralizes and is later resorbed by osteoclasts and replaced by bone that is laid down afterward. The endochondral bone growth process leads to the formation of primary and secondary ossification centers that are separated by a cartilaginous structure known as the growth plate. As bone develops and matures through these two processes, structural distinct areas of compact bone and trabecular bone are formed and maintained through similar bone remodeling mechanisms.

Alveolar bone lost as a result of an injury, disease, or trauma undergoes a repair process that is essentially a combination of endochondral and intramembranous complementary osteogenic processes (Rabie et al., 1996; Virolainen et al., 1995). A similar process occurs in most of the bone-related implant site development techniques, where osteoconduction, osteoinduction, and osteogenesis are exploited.

Bone Cells

Within bone, different cellular components can be identified. The distinct cell populations include osteogenic precursor cells, osteoblasts, osteoclasts, osteocytes, and hematopoietic elements of bone marrow. The content of this chapter will focus on the three main functional cells that are ultimately responsible for the proper skeletal homeostasis.

Osteoblasts are ultimately the cells responsible for bone formation. They synthesize the organic matrix components and mediate the mineralization of the matrix (Fig. 1.2). Osteoblasts are located on bone surfaces exhibiting active matrix deposition, and as their bone forming activity nears completion, some osteoblasts further differentiate into osteocytes, while others remain in the periosteal or endosteal surface of bone as lining cells. Bone lining cells are elongated cells that cover a surface of bone tissue and exhibit no synthetic activity (Rodan, 1992).