Alveolar Bone Loss Clinical Trial
Official title:
Patient Satisfaction and Bone Gain Following Autogenous Particulate Sticky Bone Preparation With Xenograft Versus Without Xenograft for Grafting of Maxillary Anterior Knife-edge Ridge in Partially Edentulous Patients for Implant Placement
The aim is to evaluate the value and efficiency of sticky bone in the augmentation of alveolar ridge deficiency when being used with or without xenogenic bone graft for esthetic implant placement.
Modern Dentistry aims to restore what is missing, no matter what the difficulty is. As many
patients have lost their teeth to a number of factors, either trauma or disease or lack of
care. Now the individuals are seeking to restore the function and esthetics. The more the
number of teeth is missing along with ridge deficiencies can present serious challenges to
the clinician.
Implant supported prosthesis is an attractive option for restoring edentulous or partially
edentulous patients. However, extensive loss of the alveolar bone is a complex problem that
faces many surgeons. This era has witnessed numerous trials and research for bone
augmentation for the defective alveolar ridge. The goal is to create sufficient space for
endosseous implant placement in a knife edge ridge.
Alveolar bone resorption occurs in either a horizontal or vertical direction. It can also be
composite. There are 3 classes of bone-grafting materials based upon the mode of action.
Autogenous bone is an organic material and forms bone by osteogenesis, osteoinduction, and
osteoconduction.
Allografts such as demineralized freeze-dried bone are osteoinductive and osteoconductive and
may be cortical and/or trabecular in nature.
Alloplasts such as hydroxyapatite and tricalcium phosphate may be synthetic or natural, vary
in size, and are only osteoconductive. They can be divided into three types based upon the
porosity of the product and include dense, macroporous, and microporous materials. In
addition, alloplastic materials may be crystalline or amorphous. These materials have
different properties and therefore indications.
Previous studies have shown that although the autogenous bone is considered as the Gold
Standard of bone grafting for its osteogenic potential, many drawbacks exist which limits its
application. For instance, donor site morbidity is of concern. Bone harvesting procedures may
put adjacent anatomical structures at a risk of damage. During chin bone harvesting, the
mental nerve may be pulled under undue traction and the incisive nerve become interrupted
when the harvesting depth is inordinate. Ramus bone harvesting can damage the inferior
alveolar nerve. In addition, some patients may be reluctant to the harvesting procedures,
especially when extra-oral donor sites are concerned. General anesthesia is mandatory for
such operations.
Recent research studies have looked into modifying the surgical techniques in order to regain
the space for an implant along with finding satisfying esthetic outcomes. The literature
shows the positive use of ridge splitting technique and alveolar distractors, with or without
the aid of xenograft material and/or alloplastic material.
Starting from the early 2000s, a new drift of guided bone regeneration research blew by.
Platelet concentrates (PC); platelet-rich plasma (PRP) and platelet-rich fibrin (PRF)] were
used for surgical procedures in medical and dental fields, particularly in Oral and
Maxillofacial surgery, plastic surgery and sports medicine.
They were utilized to accelerate healing of bone graft over the bony defects, many techniques
utilizing platelet and fibrinogen concentrations have been introduced in the literature.
Platelet is known to contain high quantities of growth factors, such as transforming growth 4
. Factors ß-1 (TGFß-1), platelet-derived growth factor (PDGF), epithelial growth factor
(EGF), insulin growth factor-I (IFG-I) and vascular endothelial growth factors (VEGF), which
stimulates cell proliferation and upregulates angiogenesis.
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