Localized ridge augmentation with simultaneous implant placement followed by soft tissue augmentation in the maxillary anterior region: A case report

Kumar,Gayathri; Parthasarathy,Harinath; Ponnaiyan,Deepa

doi:10.3892/wasj.2022.166

Localized ridge augmentation with simultaneous implant placement followed by soft tissue augmentation in the maxillary anterior region: A case report

Authors:
- Gayathri Kumar
- Harinath Parthasarathy
- Deepa Ponnaiyan
View Affiliations

Affiliations: Department of Periodontics, SRM Kattankulathur Dental College, SRM Nagar, SRMIST, Chengalpattu, Tamil Nadu 603203, India, Department of Periodontics, SRM Dental College, Chennai, Tamil Nadu 600089, India
Published online on: August 8, 2022 https://doi.org/10.3892/wasj.2022.166
Article Number: 31
Copyright: © Kumar et al. This is an open access article distributed under the terms of Creative Commons Attribution License.

Metrics: Total Views: 0 (Spandidos Publications: | PMC Statistics: )

Metrics: Total PDF Downloads: 0 (Spandidos Publications: | PMC Statistics: )

Cited By (CrossRef): 0 citations Loading Articles...

Abstract

A deficient alveolar ridge in the maxillary anterior site often warrants ridge augmentation prior to prosthetic rehabilitation, in order to enhance functional and esthetic outcomes. In particular, if implant therapy is planned in a deficient jaw, ridge augmentation is preferred before or simultaneous to implant placement in order to overcome the anatomic limitations of the residual jaw bone crest. Guided bone regeneration (GBR) is the gold standard technique for bone regeneration in patients with atrophic ridges, and it is regarded as one of the most predictable techniques for ridge augmentation. Non‑resorbable membranes, such as titanium mesh are preferred in the GBR procedure, due to the enhanced rigidity and microporous structure, facilitating vascularity. However, the most common disadvantage of non‑resorbable membranes, when used in vertical augmentation, is the soft tissue dehiscence. However, tissue stability is essential for the long‑term successful outcomes of GBR. The present study focuses on the evaluation of the clinical and radiographic outcomes of a patient undergoing GBR using customized titanium mesh and xenograft simultaneous to implant placement in the maxillary anterior region. In addition to the hard tissue augmentation, soft tissue augmentation was performed using injectable platelet‑rich fibrin and a collagen membrane. Following 6 months of GBR, the augmentation site exhibited clinically and radiographically significant gain in ridge dimensions, with an average bone gain of 2.8 and 3.1 mm in horizontal and vertical dimensions, respectively with stable soft tissue support.

View Figures

View References

1	Sclar AG, Kannikal J, Ferreira CF, Kaltman SI and Parker WB: Treatment planning and surgical considerations in implant therapy for patients with agenesis, oligodontia, and ectodermal dysplasia: Review and case presentation. J Oral Maxillofac Surg. 67 (11 Suppl):S2–S12. 2009.PubMed/NCBI View Article : Google Scholar
2	Aghaloo TL and Moy PK: Which hard tissue augmentation techniques are the most successful in furnishing bony support for implant placement? Int J Oral Maxillofac Implants. 22 (Suppl):S49–S70. 2007.PubMed/NCBI
3	Cucchi A, Chierico A, Fontana F, Mazzocco F, Cinquegrana C, Belleggia F, Rossetti P, Soardi CM, Todisco M, Luongo R, et al: Statements and recommendations for guided bone regeneration: Consensus report of the guided bone regeneration symposium held in Bologna, October 15 to 16, 2016. Implant Dent. 28:388–399. 2019.PubMed/NCBI View Article : Google Scholar
4	Toledano-Osorio M, Toledano M, Manzano-Moreno FJ, Vallecillo C, Vallecillo-Rivas M, Rodriguez-Archilla A and Osorio R: Alveolar bone ridge augmentation using polymeric membranes: A systematic review and meta-analysis. Polymers (Basel). 13(1172)2021.PubMed/NCBI View Article : Google Scholar
5	Rakhmatia YD, Ayukawa Y, Furuhashi A and Koyano K: Current barrier membranes: Titanium mesh and other membranes for guided bone regeneration in dental applications. J Prosthodont Res. 57:3–14. 2013.PubMed/NCBI View Article : Google Scholar
6	Cucchi A, Sartori M, Parrilli A, Aldini NN, Vignudelli E and Corinaldesi G: Histological and histomorphometric analysis of bone tissue after guided bone regeneration with non-resorbable membranes vs resorbable membranes and titanium mesh. Clin Implant Dent Relat Res. 21:693–701. 2019.PubMed/NCBI View Article : Google Scholar
7	Briguglio F, Falcomatà D, Marconcini S, Fiorillo L, Briguglio R and Farronato D: The use of titanium mesh in guided bone regeneration: A systematic review. Int J Dent. 2019(9065423)2019.PubMed/NCBI View Article : Google Scholar
8	Boyne PJ, Cole MD, Stringer D and Shafqat JP: A technique for osseous restoration of deficient edentulous maxillary ridges. J Oral Maxillofac Surg. 43:87–91. 1985.PubMed/NCBI View Article : Google Scholar
9	von Arx T, Hardt N and Wallkamm B: The TIME technique: A new method for localized alveolar ridge augmentation prior to placement of dental implants. Int J Oral Maxillofac Implants. 11:387–394. 1996.PubMed/NCBI
10	Xie Y, Li S, Zhang T, Wang C and Cai X: Titanium mesh for bone augmentation in oral implantology: Current application and progress. Int J Oral Sci. 12(37)2020.PubMed/NCBI View Article : Google Scholar
11	Lizio G, Corinaldesi G and Marchetti C: Alveolar ridge reconstruction with titanium mesh: A three-dimensional evaluation of factors affecting bone augmentation. Int J Oral Maxillofac Implants. 29:1354–1363. 2014.PubMed/NCBI View Article : Google Scholar
12	Sakkas A, Wilde F, Heufelder M, Winter K and Schramm A: Autogenous bone grafts in oral implantology-is it still a ‘gold standard’? A consecutive review of 279 patients with 456 clinical procedures. Int J Implant Dent. 3(23)2017.PubMed/NCBI View Article : Google Scholar
13	Buser D, Dula K, Hess D, Hirt HP and Belser UC: Localized ridge augmentation with autografts and barrier membranes. Periodontol 2000. 19:151–163. 1999.PubMed/NCBI View Article : Google Scholar
14	Hämmerle CH, Jung RE, Yaman D and Lang NP: Ridge augmentation by applying bioresorbable membranes and deproteinized bovine bone mineral: A report of twelve consecutive cases. Clin Oral Implants Res. 19:19–25. 2008.PubMed/NCBI View Article : Google Scholar
15	Meloni SM, Jovanovic SA, Pisano M, De Riu G, Baldoni E and Tallarico M: One-stage horizontal guided bone regeneration with autologous bone, anorganic bovine bone and collagen membranes: Follow-up of a prospective study 30 months after loading. Eur J Oral Implantology. 11:89–95. 2018.PubMed/NCBI
16	Aghaloo TL, Misch C, Lin GH, Iacono VJ and Wang HL: Bone augmentation of the edentulous maxilla for implant placement: A systematic review. Int J Oral Maxillofac Implants. 31 (Suppl):s19–s30. 2016.PubMed/NCBI View Article : Google Scholar
17	Edelmayer M, Wehner C, Ulm C, Zechner W, Shafer D and Agis H: Which substances loaded onto collagen scaffolds influence oral tissue regeneration?-an overview of the last 15 years. Clin Oral Investig. 24:3363–3394. 2020.PubMed/NCBI View Article : Google Scholar
18	Fujioka-Kobayashi M, Miron RJ, Moraschini V, Zhang Y, Gruber R and Wang HL: Efficacy of platelet-rich fibrin on bone formation, part 2: Guided bone regeneration, sinus elevation and implant therapy. Int J Oral Implantol (Berl). 14:285–302. 2021.PubMed/NCBI
19	Miron RJ, Fujioka-Kobayashi M, Hernandez M, Kandalam U, Zhang Y, Ghanaati S and Choukroun J: Injectable platelet rich fibrin (i-PRF): Opportunities in regenerative dentistry? Clin Oral Investig. 21:2619–2627. 2017.PubMed/NCBI View Article : Google Scholar
20	Abd El Raouf M, Wang X, Miusi S, Chai J, Mohamed AbdEl-Aal AB, Nefissa Helmy MM, Ghanaati S, Choukroun J, Choukroun E, Zhang Y and Miron RJ: Injectable-platelet rich fibrin using the low speed centrifugation concept improves cartilage regeneration when compared to platelet-rich plasma. Platelets. 30:213–221. 2019.PubMed/NCBI View Article : Google Scholar
21	Miller SC: Textbook of Periodontia. 3rd edition. The Blakiston Co., Philadelphia Toronto, 1950.
22	Seibert JS: Reconstruction of deformed, partially edentulous ridges, using full thickness onlay grafts. Part I. Technique and wound healing. Compend Contin Educ Dent. 4:437–453. 1983.PubMed/NCBI
23	Alagl AS and Madi M: Localized ridge augmentation in the anterior maxilla using titanium mesh, an alloplast, and a nano-bone graft: A case report. J Int Med Res. 46:2001–2007. 2018.PubMed/NCBI View Article : Google Scholar
24	Uehara S, Kurita H, Shimane T, Sakai H, Kamata T, Teramoto Y and Yamada S: Predictability of staged localized alveolar ridge augmentation using a micro titanium mesh. Oral Maxillofac Surg. 19:411–416. 2015.PubMed/NCBI View Article : Google Scholar
25	Her S, Kang T and Fien MJ: Titanium mesh as an alternative to a membrane for ridge augmentation. J Oral Maxillofac Surg. 70:803–810. 2012.PubMed/NCBI View Article : Google Scholar
26	Zeynalzadeh F and Zahedpasha A: Vertical ridge augmentation by titanium mesh. In: Stevens MR, Ghasemi S and Tabrizi R (eds). Innovative Perspectives In Oral And Maxillofacial Surgery. Springer, Cham, pp259-265, 2021.
27	Su Z, Chen Y, Wang M and Mo A: Evaluation of immediate implantation and provisionalization combined with guided bone regeneration by a flap approach in the maxillary esthetic zone: A retrospective controlled study. Materials (Basel). 14(3874)2021.PubMed/NCBI View Article : Google Scholar
28	Aprajita B: Guided bone regeneration using a platelet-rich fibrin membrane and sticky bone graft along with implant placement in maxillary anterior region: A case report. J Adv Med Dent Sci Res. 6(2)2018.
29	Melek LN and Taalab MR: The use of injectable platelet rich fibrin in conjunction to guided bone regeneration for the management of well contained ridge defect at the time of extraction. Egypt Dent J. 63:1197–1208. 2017.