Fogorvosi szemle, 2014 (107. évfolyam, 1-4. szám)
2014-06-01 / 2. szám
58 FOGORVOSI SZEMLE ■ 107. évf. 2. sz. 2014. ban megfelelnek az Atbrektsson és misai [1], valamint Buser és misai [5] által megfogalmazott sikeres implantációs eljárással szemben támasztott kritériumoknak. Ugyanakkor a fent részletezett, zárt gyógyulási szakaszban előforduló csontvesztés elkerülésére célszerűnek látszik csontgraftot, valamint felszívódó membránt alkalmazni. Véleményünk szerint, amit irodalmi adatok is alátámasztanak, csontpótlásra nem elsősorban az implantátumok között képződött rés kitöltésére [13], hanem a repesztési procedúra során túl vékonyra preparált marginalis periimplantális csontlemez megvastagítása miatt lehet szükség. Szerzők megköszönik Széles Károly és Cserba Erzsébet fogtechnikusoknak a kiváló együttműködést, valamint a pontos technikai munkát. Irodalom 1. Albrektsson T, Zarb GA, Worthington P, Eriksson AR: The longterm efficacy of currently used dental implants. A review and proposed criteria of success. Int J Oral Maxillofac Implants 1986; 1: 11-25. 2. Araújo MG, Wennström JL, Lindhe J: Modeling of the buccal and lingual bone walls of fresh extraction sites following implant installation Clinical Oral Implants Research 2006; 17: 606-614. 3. Basa S, Varol A, Turker N: Alternative bone expansion technique for immediate placement of implants in the edentulous posterior mandibular ridge: a clinical report. Int J Oral Maxillofac Implants 2004; 19: 554-558. 4. Blus C, Szmukler-Moncler S: Split-crest and immediate implant placement with ultrasonic bone surgery: A 3-year life-table analysis with 230 treated sites. Clin Oral Implants Res 2006; 17: 700-707. 5. Buser D, Weber HP, Lang NP: Tissue integration of non-submerged implants. 1-year results of a prospective study with 100 ITI hollowcylinder and hollow-screw implants. Clin Oral Implants Res 1990; 1: 33-40. 6. Coatoam GW, Mariotti A: The segmental ridge-split procedure. J Periodontol 2003; 74: 757-770. 7. Donos N, D’Aiuto F, Retzepi M, Tonetti M: Evaluation of gingival blood flow by the use of laser Doppler flowmetry following periodontal surgery. A pilot study. J Periodont Res 2005; 40: 129- 137. 8. Enislidis G, Wittwer G, Ewers R: Preliminary report on a staged ridge splitting technique for implant placementin the mandible: a technical note. Int J Oral Maxillofac Implants 2006; 21: 445- 449. 9. Horrocks GB: The controlled assisted ridge expansion technique for implant placement in the anterior maxilla: A technical note. Int J Periodontics Restorative Dent 2010; 30: 495-501. 10. Nedir R, Bischof M, Briaux, JM, Beyer S, Szmukler-Moncler S, Bernard JP: A 7-year life table analysis from a prospective study on ITI implants with special emphasis on the use of short implants. Results from a private practice. Clinical Oral Implants Research 2004; 15: 150-157. 11. Preti G, Martinasso G, Peirone B: Cytokines and growth factors involved in the osseointegration of oral titanium implants positioned using piezoelectric bone surgery versus a drill technique: A pilot study in minipigs. J Periodontol 2007; 78: 716-722. 12. Scipioni A, Bruschi GB, Calesini G: The edentulous ridge expansion technique: a five-year study. Int J Periodontics Restorative Dent 1994; 14: 451-459. 13. Scipioni A, Bruschi GB, Giargia M, Berglundh T, Lindhe J: Healing at implants with and without primary bone contact. An experimental study in dogs. Clin Oral Implants Res 1997; 8: 39-47. 14. Sethi A, Kaus T: Maxillary ridge expansion with simultaneous implant placement: 5-year results of an ongoing clinical study. Int J Oral Maxillofac Implants 2000; 15: 491 -499. 15. Simion M, Baldoni M, Zaffe D: Jawbone enlargement using immediate implant placement associated with a split-crest technique and guided tissue regeneration. Int J Periodontics Restorative Dent 1992; 12: 462-473. 16. Sohn DS, Lee HJ, Heo JU, Moon JW, Park IS Romanos GE: Immediate and delayed lateral ridge expansion technique in the atrophic posterior mandibular ridge. J Oral Maxillofac Surg 2010; 68: 2283-2290. 17. Vercellotti T: Piezoelectric surgery in implantology: a case report of a new piezoelectric ridge expansion technique. Int J Periodontics Restorative Dent 2000; 20: 359-365. 18. Vercellotti T, Nevins ML, Kim DM, Nevins M, Waoa K, Schenk R, Fiorellini J: Osseous response following respective therapy with piezosurgery. Int J Periodontics Restorative Dent 2005; 25: 543-549. Fazekas R, F azekas L, Fazekas Á Delayed lateral ridge split technique for implant placement in the atrophic posterior mandible by means of piezosurgery Reconstruction of posterior edentulous mandible with dental implants requires residual ridge width of 5,5 mm or more. To achieve such crestal dimension two-stage ridge splitting technique has been used at our patients (n=4) with piezoelectric bone surgery. The first stage consisted of full mucoperiosteal flap elevation to expose the vestibular aspect of the posterior mandible. Two horizontal (crestal and apical) and two vertical corticotomies were created, than the mucoperiosteal flap was reapproximated. After 35 days of healing period using crestal incision lingually full-thickness flap, vestibularly partial-thickness flap was elevated with intact periosteum on the buccal bone plate. In order to separate and lateralize the vestibular cortical plate, the crestal cut was refreshed and with bone expanders widened until a gap of 4-5 mm was established. Implants were inserted conventionally and followed by tension free soft tissue closure. After 5-6 months elapsed, periapical radiographs depicted bone loss of maximum 1,0-1,5 mm around the neck of the implants. At the exposure no implant mobility was observed. Prosthetic loading with final crowns and fixed partial prostheses was successful in all cases, no more bone resorption was registered during the 6 month follow-up. Nevertheless, bone graft application seems to be advisable. Key words: vestibulo-lingual defect, ridge splitting in the mandible, piezosurgery, half-thickness flap preparation, dental implants
