and 1 other(s)
Background: The oral surgeon is most commonly confronted with situations where little bone defects in the mandibular or maxillary jaw has to be augmented in the vestibular or palatinal and lingual area. To obtain a correct prosthetic position of the implant, it can happen that the implant remains with free threads which has to be adjusted. There are a lot of techniques to correct these minimal expositions around the implants with different biomaterials or mixtures of autogenous bone, biomaterials and membranes. Aim: Our purpose was to introduce a new method to correct small defects until 3mm around the implants both in the lingual area and in the buccal area using only autogenous bone. Materials and methods: 96 small defects were evaluated around the implants and treated with autogenous bone. We considered only cases where the implants could be inserted inside the contour of the bone both in the maxillary and in the mandible jaw. The implant site was prepared with trephine burs , external diameter 3,5 and internal diameter 2,5mm to collect a carrot of bone. We considered 62 defects in the maxillary (21 in the frontal area canine to canine) and 41 in the posterior area (premolar and molar). The rest of 34 defects were treated in the mandible of the bone. 11 defects were present in the frontl area and 23 in the posterior area. After implantation the bone defects were augmented with the bone carrot stabilized with microscrews. Additionally, bone chips were laid around the bone carrot and compressed. Results: After 3 months during the second stage surgery, we evaluated the bone regeneration gained with this technique. In all the cases, we registered a good bone healing. The new bone, regenerated around the implant showed a good revascularization and stability, like the native bone. The average gain that we obtained with this technique was 2,4 mm and this was very important to ensure a minimal thickness of the bone around the implants. In 10 cases ( 7 in the mandible and 3 in the maxilla) we registered an exposure of the microscrew without compromising the bone regeneration. No infections were reported. Conclusions and clinical implications: In cases that do not require a big augmentation, this technique enables the oral surgeon to collect bone with the trephine burs during the implant placement while using it around the implant to graft the bone defect. Therefore, this method represents a safe and simple procedure to reconstruct small bone defects inside the contour.
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