The Journal of Implant & Advanced Clinical Dentistry
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The Art of Block Grafting

  • Journal:The Art of Block Grafting Volume: Vol. 2, No. 2 Date: March 2010
    Authors:Luis J. Pazos Cóppola DDS, MD, Dong-Seok Sohn, DDS, PhD, Paul Maupin, DDS, Ramon Ponce Fayos, DDS, Kenneth Lee BDS, Sungho Jun, DDS, Nicholas Toscano, DDS MS, Nicholas Shumaker, DDS MS, Dan Holtzclaw, DDS MS

    19. Case of the Month Multidisciplinary Restoration of Anterior Maxillary Dentition

    41 year old male patient with no contributory medical history presented with a chief complaint of a broken central incisor (figure 1). After careful oral and radio- graphic examination (figure 2) a periapical lesion in the left central incisor and several old composite restorations in all the other upper incisors were noted. The treatment plan offered to the patient included endodontic treatment of the left central incisor, replacing the right central incisor with an immediately loaded provisional fixed screwed implant crown, and ultimately four ceramic crowns on the four maxillary incisors.

    27. Minimally Invasive Sinus Augmentation using Ultrasonic Piezoelectric Vibration and Hydraulic Pressure

    Background: The atrophic posterior maxilla is a challenging site to place dental implants. Lateral window or crestal approaches are common surgical techniques to overcome the vertical deficiencies of the atrophic posterior maxilla. Sinus augmentation using the lateral window procedure has been predictable for several decades. How- ever, this procedure may result in patient morbidity such as postoperative swelling, pain, and a long edentulous healing period. The crestal approach using a surgical mallet and osteotome is less invasive than the lateral approach, but it has some limitations such as postoperative vertigo, membrane perforation from bone packing to sinus membrane, and limited vertical augmentation due to difficult accessibility. This case series report demonstrates sinus membrane elevation using hydraulic pressure and piezoelectric ultra- sonic vibration.

    45. The Art of Block Grafting: A Review of the Surgical Protocol for Reconstruction of Alveolar Ridge Deficiency

    Alveolar ridge resorption after tooth loss is a common phenomenon. After a tooth is extracted the alveolar ridge decreases in width and height very rapidly, with as much as 50% loss in width during the first year, two-thirds of which occurs in the initial 3 months. Often in clinical practice, the loss of a tooth does not coincide with replacement by a dental implant and there is frequently a lag of months to years before an edentulous site presents for therapy. There- fore it is often required that we perform hard tis- sue ridge augmentation to increase bone volume prior to dental implant placement and restoration. The purpose of this article is to review the modern art of block grafting using the mandibular symphysis and ramus buccal shelf donor sites for alveolar ridge reconstruction in preparation for dental implants. The clinical indications, advantages and disadvantages of each site, and the surgical techniques necessary for optimal outcomes will be discussed. While earlier techniques were rather rudimentary, this article will show how current techniques which integrate the principles of guided bone regeneration ensure minimal resorption during integration and a predictable, time-efficient, and cost effective outcome.

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