VERTICAL RIDGE AUGMENTATION IN THE POSTERIOR MANDIBLE – A CASE REPORT

Antigoni Pavlopoulou, Sofia Gkika, E. Millioni, Athanasia Zahopoulou, Lydia Tsiorva, Konstantinos Samanidis, Stavros Pelekanos, Dimitrios E. V. Papadimitriou
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Abstract

Tooth loss leads to bone resorption and, in some cases, to insufficient alveolar bone, for implant placement. To provide adequate bone volume and ensure an aesthetic result, Guided Bone Regeneration (GBR) often is prerequisite in order to increase alveolar ridge vertically and horizontally. The purpose of this poster is to analyze a case with extended bone loss in the posterior mandible and to present the clinical procedure and outcome of a vertical ridge augmentation followed by the implant placement. An extended vertical bone augmentation was performed, using autogenous graft combined with allograft and xenograft, stabilized by a fibrin sealant made from pooled human plasma. To protect the graft, a non-resorbable high-density PTFE membrane with titanium frame was used, fixed in place with titanium pins. Seven months later, a second surgery took place for the membrane removal and the guided implant placement. Furthermore, due to limited attached keratinized tissues, a free gingival graft from the palatal was placed to the area. After the period of osseointegration, and the effective increase of the attached gingiva, a digitally made monolithic zirconia implant-supported bridge was designed and successfully restored the edentulous area. The rehabilitation of edentulism using implants requires a sufficient bone volume for the purpose of long-term prognosis. GBR is one of the most reliable and predictable methods to reconstruct alveolar ridge even in cases with extended bone loss. However, extended vertical bone augmentation constitutes a serious clinical challenge and has to be carefully executed following the contemporary protocols.
后下颌骨竖脊增高术1例
牙齿脱落导致骨吸收,在某些情况下,导致牙槽骨不足,用于种植体放置。为了提供足够的骨体积并确保美观的结果,引导骨再生(GBR)通常是增加牙槽嵴垂直和水平的先决条件。这张海报的目的是分析一个后下颌延伸性骨质流失的病例,并介绍垂直嵴隆胸后植入种植体的临床过程和结果。采用自体移植物、同种异体移植物和异种移植物结合,用混合人血浆制成的纤维蛋白密封剂稳定,进行了扩展的垂直骨增强。为了保护移植物,使用不可吸收的高密度聚四氟乙烯膜和钛框架,用钛针固定。7个月后,第二次手术进行了膜去除和引导植入物的放置。此外,由于附着的角化组织有限,从腭处放置游离牙龈移植物到该区域。经过一段时间的骨整合和附着龈的有效增加,设计了一种数字制作的整体氧化锆种植体支撑桥,成功修复了无牙区。种植体修复义齿需要足够的骨容量以保证长期预后。GBR是重建牙槽嵴最可靠和可预测的方法之一,即使是在骨质流失的情况下。然而,扩展垂直骨增强构成了一个严重的临床挑战,必须按照当代协议谨慎执行。
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