Alveolar ridge augmentation for implant placement in a growing patient.
alveolar bone grafting
alveolar ridge augmentation
dental implant
soft tissue augmentation
Journal
Clinical advances in periodontics
ISSN: 2163-0097
Titre abrégé: Clin Adv Periodontics
Pays: United States
ID NLM: 101597440
Informations de publication
Date de publication:
09 2023
09 2023
Historique:
received:
11
05
2022
accepted:
29
08
2022
medline:
21
9
2023
pubmed:
4
9
2022
entrez:
3
9
2022
Statut:
ppublish
Résumé
Partial edentulism in growing children due to aplasia or trauma poses a difficult situation to manage. We present a case of horizontal ridge augmentation in a growing patient who had trauma in childhood when it was too early to place implants. This patient had a history of trauma, at age 13, that resulted in mandibular fracture and loss of teeth #23-27. The definitive restorative treatment plan was postponed due to the patient's continued growth. At age 18, horizontal bone augmentation was performed in a severely resorbed anterior mandible. After 7 months of healing, 7-8 mm ridge augmentation was achieved, and three implants were placed. Soft tissue augmentation by free gingival graft was performed at implant second stage surgery 4 months later. When considering the timing of implant placement in adolescents, the clinician walks a fine line between waiting as long as possible to place the implants and racing against continued resorption of the edentulous alveolar ridge. 70/30 mineralized/demineralized cortical bone allograft and injectable platelet-rich fibrin mix combined with tenting screws and resorbable membranes are useful measures for horizontal ridge augmentation in growing patients. Why is this case new information? There are insufficient data available when considering implant treatment in younger patients. The present case was managed with a variation of the sausage technique described by Urban. The use of allograft, I-PRF, and tenting screws replaced the use of autogenous bone and resulted in exceptional results. What are the keys to the successful management of this case? Delaying treatment until after the critical growth period has passed. Adequate flap release, tension-free primary flap closure, and space maintenance through the use of tenting screws and tacking the membranes using tacking pins provided support for the grafted site. What are the primary limitations to success in this case? The continued growth may cause infra occlusion of the implant-supported bridge.
Sections du résumé
BACKGROUND
Partial edentulism in growing children due to aplasia or trauma poses a difficult situation to manage. We present a case of horizontal ridge augmentation in a growing patient who had trauma in childhood when it was too early to place implants.
METHODS AND RESULTS
This patient had a history of trauma, at age 13, that resulted in mandibular fracture and loss of teeth #23-27. The definitive restorative treatment plan was postponed due to the patient's continued growth. At age 18, horizontal bone augmentation was performed in a severely resorbed anterior mandible. After 7 months of healing, 7-8 mm ridge augmentation was achieved, and three implants were placed. Soft tissue augmentation by free gingival graft was performed at implant second stage surgery 4 months later.
CONCLUSIONS
When considering the timing of implant placement in adolescents, the clinician walks a fine line between waiting as long as possible to place the implants and racing against continued resorption of the edentulous alveolar ridge. 70/30 mineralized/demineralized cortical bone allograft and injectable platelet-rich fibrin mix combined with tenting screws and resorbable membranes are useful measures for horizontal ridge augmentation in growing patients.
KEY POINTS
Why is this case new information? There are insufficient data available when considering implant treatment in younger patients. The present case was managed with a variation of the sausage technique described by Urban. The use of allograft, I-PRF, and tenting screws replaced the use of autogenous bone and resulted in exceptional results. What are the keys to the successful management of this case? Delaying treatment until after the critical growth period has passed. Adequate flap release, tension-free primary flap closure, and space maintenance through the use of tenting screws and tacking the membranes using tacking pins provided support for the grafted site. What are the primary limitations to success in this case? The continued growth may cause infra occlusion of the implant-supported bridge.
Substances chimiques
Dental Implants
0
Types de publication
Case Reports
Langues
eng
Sous-ensembles de citation
IM
Pagination
149-155Informations de copyright
© 2022 American Academy of Periodontology.
Références
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Urban IA, Nagursky H, Lozada JL, Nagy K. Horizontal ridge augmentation with a collagen membrane and a combination of particulated autogenous bone and anorganic bovine bone-derived mineral: a prospective case series in 25 patients. Int J Periodontics Restorative Dent. 2013;33(3):299-307.