Split-crest and immediate implant placement with ultrasonic bone surgery (piezosurgery): 3-year follow-up of 180 treated implant sites (original) (raw)
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The International Journal of Periodontics & Restorative Dentistry, 2014
This multicenter case series introduces an innovative ultrasonic implant site preparation (UISP) technique as an alternative to the use of traditional rotary instruments. A total of 3,579 implants were inserted in 1,885 subjects, and the sites were prepared using a specific ultrasonic device with a 1-to 3-year follow-up. No surgical complications related to the UISP protocol were reported for any of the implant sites. Seventy-eight implants (59 maxillary, 19 mandibular) failed within 5 months of insertion, for an overall osseointegration percentage of 97. 82% (97.14% maxilla, 98.75% mandible). Three maxillary implants failed after 3 years of loading, with an overall implant survival rate of 97. 74% (96.99% maxilla, 98.75% mandible).
Narrow Ridge Management with Ridge Splitting with Piezotome for Implant Placement: Report of 2 Cases
The Journal of Indian Prosthodontic Society, 2012
Narrow dentoalveolar ridges remain a serious challenge for the successful placement of endosseous implants. Several techniques for this procedure may be considered, such as guided bone regeneration, bone block grafting, and ridge splitting for bone expansion. The ridge split procedure provides a quicker method wherein an atrophic ridge can be predictably expanded and grafted with bone allograft or allograft, eliminating the need for second surgical site. Traditionally, osseous surgery has been performed by either manual or motor-driven instruments. Piezosurgery is a relatively new technique for osteotomy and osteoplasty that utilizes ultrasonic vibration which allows clean cutting with precise incisions. This case series describes reports of 2 such cases in which narrow mandibular ridge splitting was carried by mean of piezotome with immediate placement of implants in the osteotomy site. Five months later, the implants were uncovered followed by impression and restored with impant-supported porcelain-fused-to-metal crowns.
BMC Oral Health
Background The preparation of the implant bed has a major influence on the success rate and long-term survival of dental implants. Piezoelectric devices and special implant drilling inserts are now emerging to replace conventional drills showing improved bone response and healing around implants. The purpose of this study is to compare the piezoelectric inserts versus the traditional drills for implant site preparation. Methods Twelve male patients who received a total of twenty-four dental implants have been selected to participate in this split-mouth clinical trial. Each patient received two implants; one installed after piezosurgery assisted osteotomy, while the contralateral side received the implant with the original drilling protocol. The timing of surgery, implant stability, and bone density around the installed dental implants have been evaluated during a follow-up period extended to 4 months. Results a significant difference in terms of time of surgery (p < 0.005) and in...
Piezosurgery-Assisted, Flapless Split Crest Surgery for Implant Site Preparation
Journal of Maxillofacial and Oral Surgery, 2012
Introduction Bucco-lingual resorption of the alveolar ridge can, at times, be predictably corrected at the time of implant placement. Among the different options available to achieve this are a group of surgical techniques described as split crest or split ridge procedures. Most of these procedures require the use of a mallet and some type of chisels and/or osteotomes; they are very technique-sensitive and can be uncomfortable for patients. Recently, alternative tools to split the crest have been presented, and these include the newer bone expanders and the piezoelectric scalpel. A flapless approach to implant dentistry has become popular with the aim to alleviate post treatment side effects, accelerate healing and avoid bone resorption caused by flap elevation. Methods We present a technique combining the use of a piezoelectric scalpel and a tapered bone expander in a flapless fashion as a novel way to perform split crest procedures with an aim to optimize outcomes and acceptability by patients. Results All implants were successfully placed and the resorbed ridge expanded in the same setting. Findings were confirmed by postoperative cone beam cat scan (CBCT) evaluation. Conclusions This new technique is a predictable approach for split crest procedures and has high acceptability by patients and is technically simple for surgeons.
Materials
Background: Piezosurgery is a surgical procedure that is able to perform osteotomies by a micrometric and selective cut of the bone tissue. The objective of this investigation was to evaluate two different techniques; an ultrasonic device, and a drill approach for implant site preparation. Methods: A total of fifty patients were recruited for the randomized clinical trial to receive dental implants for fixed prosthetic restoration in the posterior mandible and were allotted to two groups. In Group A the implant site was prepared following a drilling technique, while in Group B the implant site was prepared using an ultrasonic device; moreover, the operative duration was recorded. Postoperative pain and swelling were evaluated at 1, 2, 4, and 6 days. The crestal bone resorption was measured at 3 months from implant placement by a three-dimensional tomography evaluation. Results: The findings suggest that osteotomies performed by an ultrasonic device cause less pain and swelling. On t...
Journal of Advances in Medicine and Medical Research, 2021
Aim: To evaluate the behavior of the alveolar ridge split technique in a series of surgical cases. Materials and Methods: One hundred and fifty implants were included in this study for a total of 60 patients. The surgeries consisted of a mid-crestal incision and subsequent bone management with a piezoelectric system. The implants were placed after the alveolar bone was expanded by about 3mm and present bony defects were filled by a mixture of 50% autogenous bone and a xenograft (Bio-Oss®). Bone fracture of the buccal alveolar plate occurred in 8 cases, and those were stabilized with osteosynthesis screws. Implants were simultaneously placed in 140 cases, out of them 4 failures occurred due to membrane exposition. Results: The osseointegration success was estimated to be 97.5%. Conclusion: This study concluded that the bone splitting/expansion seem to be a reliable, predictable, relatively noninvasive technique with limited intraoperative complications. Clinical significance: The st...
Al-Azhar Journal of Dental Science, 2018
The present study was designed to compare clinically and radiographically between the traditional methods and the ultrasound in ridge splitting technique (RST) with simultaneous implant placement into narrow posterior mandibular alveolar ridge. This study was carried out on 20 patients with partial edentulous narrow posterior mandibular alveolar ridge. Patients were divided randomly into two equal groups (group I was treated with RST with osteotome and simultaneous implant placement into their ridges associated with bone graft as a gap filler after splitting; group II was treated with RST by the ultrasound and simultaneous implant placement into their ridges associated with bone graft as a gap filler after splitting). Patients were evaluated clinically to assess probing depth and implant stability quotient, and radiographically to assess the alveolar ridge width and the marginal bone level measurement parameters at 3, 6, 9, and 12 months. The results of the present study showed no significant difference of postpartum depression and significant difference in implant stability quotient between the two groups at the second interval, and there was a superiority of the group ll in marginal bone level between the two groups at the different intervals with statistically significant difference, especially at the end of the observation.
Al-Azhar Assiut Dental Journal, 2019
Aim: This study aims to evaluate the effect of and compare between the piezosurgical ridge splitting and osseodensification in implant primary stability. Subjects and Methods: 28 implants were divided into two groups. Group I: 14 implants in sites received piezosurgery technique. Group II: 14 implants in sites received osseodensification technique. Then, all implants were evaluated clinically for primary stability after implant insertion by Osstell mentor magnetic resonance device and radiographically for peri-implant bone density. Results: unpaired t-test between the two groups showed moderate statistical significant difference in group II when compared with group I in both primary stability and bone density Conclusion: The primary stability in both piezosurgical ridge splitting and osseodensification techniques is within normal range but in favor of osseodensification technique suggesting that osseodensification enhance the bone density thereby improve the implant primary stability.
IP International Journal of Periodontology and Implantology, 2021
Narrow dentoalveolar ridges pose a major challenge for the successful placement of endosseous implants. This case report focuses on a Piezoelectric driven mandibular Ridge Split technique without vertical osteotomy for an immediate implant placement in a narrow alveolar ridge measuring 3.0mm.Following anaesthesia, a mucoperiosteal flap was elevated after giving a mid-crestal incision distal to 35 along the entire edentulous ridge. Then, with the help of a micro-saw and horizontal spreaders, an osteotomy site of required diameter was achieved. Finally twist drills were used and implants were placed in the expanded site.Clinically, healing was uneventful with no step defect in the expanded buccal bone and the final occlusion obtained was satisfactory.The Piezo-electric driven Ridge Split technique promises to be a minimally invasive option for horizontal augmentation of narrow alveolar ridges- predictability within a short interval of time and with minimal risk of fracture.
Piezosurgey applied to implant dentistry: clinical and biological aspects
Journal of Oral Implantology, 2012
Piezosurgery is a new and modern technique of bone surgery in implantology. Selective cutting is possible for different ultrasonic frequencies acting only in hard tissues (mineralized), saving vital anatomical structures. With the piezoelectric osteotomy technique, receptor site preparation for implants, autogenous bone graft acquistition (particles and blocks), osteotomy for alveolar bone crest expansion, maxillary sinus lifting, and dental implant removal can be performed accurately and safely, providing excellent clinical and biological results, especially for osteocyte viability. The aim of this review was, through literature review, to present clinical applications of piezosurgery in implant dentistry and outline their advantages and disadvantages over conventional surgical systems. Moreover, this study addressed the biological aspects related to piezosurgery that differentiate it from those of bone tissue approaches. Overall, piezosurgery enables critical operations in simple and fully executable procedures; and effectively, areas that are difficult to access have less risk of soft tissue and neurovascular tissue damage via piezosurgery.