{"id":3632,"date":"2015-10-25T09:22:02","date_gmt":"2015-10-25T09:22:02","guid":{"rendered":"http:\/\/biomedpharmajournal.org\/?p=3632"},"modified":"2017-01-06T12:28:27","modified_gmt":"2017-01-06T12:28:27","slug":"comparitive-study-of-immediate-implant-placment-using-autografts-and-nanoparticles","status":"publish","type":"post","link":"https:\/\/biomedpharmajournal.org\/staging\/vol8octoberspledition\/comparitive-study-of-immediate-implant-placment-using-autografts-and-nanoparticles\/","title":{"rendered":"Comparitive Study of Immediate Implant Placment Using Autografts and Nanoparticles"},"content":{"rendered":"

Introduction<\/strong><\/p>\n

Dental implants\u00a0 is the replacement of missing teeth long lasting treatment modality\u00a0 providing functional and esthetic integrity\u00a0\u00a0 ,making dental implants treatment more advanced\u00a0 and ameliorated1 . \u00a0<\/sup>Grafts are widely used in immediate dental implants for stability and deficiency of bone. grafts may be autogenous bone grafts or\u00a0 hydroxyapatite nano particles bone grafts.\u00a0 Hydroxyapatite (HA) nano particles has been widely used as a biocompatible bone graft, \u00a0mainly for contact with bone tissue,\u00a0 has \u00a0resemblance to mineral bone. and \u00a0presents a carbonated and partially substituted apatite, based on nanocrystal aggregates, and associated with collagen, building up 3-D structures present in various bone tissue conformations like trabecullar or cancellous bone. Autogenous bone remains the “Gold Standard” for grafting. Although allogenic bone, xenogeneic bone, bone substitutes, and alloplasts have shown some promise over the years, they do not transplant any osteocompetent cells2<\/sup><\/p>\n

The nanomechanical properties of the surrounding bone were evaluated by nanoindentation. While both implants revealed similar bone-to-implant contact, the nanoindentation demonstrated that the tissue quality was significantly enhanced around the HA-coated implants, validating the postulated hypothesis.<\/p>\n

Discussion<\/strong><\/p>\n

In\u00a0 immediate implants after extraction of the teeth preserving the buccal bone \u00a0the implant will act like a pole to hold the surrounding bones for the primary stability and give its functional requirements necessary to prevent it from undergoing atrophy , but in times it is impossible to\u00a0 regain the primary stability of immediate implants because of bone deficiency due to many factors like infection , trauma from extraction, size discrepancy between the tooth that is extracted . In these cases it is prudent to place a \u201cridge preservation graft.\u201d The \u00a0graft is designed to fill the space left by the extracted tooth and hold the volume of this space while natural bone has the opportunity to proliferate and fill the space with high quality live bone. Depending on the size of the tooth that was extracted and the implant placed . the\u00a0 grafts to be placed\u00a0 can either be autogenous bone graft or hydroxyapatite nano particles .<\/p>\n

The autognous graft may be harvested from many intra-oral sites. The maxillary tuberosity, anterior nasal spine, and zygomatic buttress have been reported for the upper jaw(3,4,5)<\/sup>. The mandibular \u00a0symphysis, ascending \u00a0ramus, coronoid process, and horizontal ramus are useful sites from the lower jaw (6)<\/sup> . Prior to bone graft harvesting and augmentation of the defect, one must have a full appreciation of the defect. A preoperative 3-D CT scan is often imperative and some would argue the standard of care. This enables the clinician to have a full map of the missing bone volume,\u00a0 the vertical and horizontal nature of the defect. The scan can also be used to evaluate the cortical thickness from the potential donor sites. Study models and a diagnostic wax-up with the final crown or prosthesis morphology are important This permits the surgeon to appreciate how much bone\u00a0 is to be grafted. A thorough past medical history should be obtained. Poorly controlled Insulin Dependent Diabetes Mellitus, cigarette smoking, and history of IV Bisphosphonate therapy are a few examples of contraindications7<\/sup>.\u00a0 These grafts are used after explaining\u00a0 the procedure in detail to the patient and obtaining the consent . these grafts help in obtain thee thickness of the bone and stability to the implants.<\/p>\n

Hydroxyapatite\u00a0 nano particles are readily available material that is\u00a0 used in immediate implants for the bone deficiency, these are synthetic\u00a0 bone particles as it is non-toxic but it would not be targeted by the immune system as foreign body. The local tissue inflammation and eventual scarring caused by an immunological response would not be an issue if\u00a0 hydroxyapatite were used.\u00a0 these particles is economically \u00a0acceptable and are\u00a0 used widely . the particles are three times more stronger than cortical bone.<\/p>\n

Conclusion<\/strong><\/p>\n

Our short term\u00a0 study revealed \u00a0that hydroxyapatite\u00a0 nano particles are relatively better than autogenous bone grafts as \u00a0these particles are easy to use\u00a0 and readily available , but autogenous bone grafts needs patient consent and some\u00a0 do not accept \u00a0harvesting bone from the donor site , following this\u00a0 there are more chances of secondary infection \u00a0following the grafts and\u00a0 non healing of donor site.<\/p>\n

Reference<\/sup><\/strong><\/p>\n

    \n
  1. Mahesh L, Narayan TV, Kurtzman G, Shukla S. Microbiology of peri-implant infections.\u00a0 Smile Dent J 2011;6:54-57.<\/li>\n
  2. Marx, R. Philosophy and Particulars of Autogenous Bone Grafting. Oral & Maxilofac Surg Clin N Am 1993; 5:599-612.<\/li>\n
  3. Tolstunov, L. Maxillary Tuberosity Block Bone Graft: Innovative Technique and Case Report. J Oral Maxillofac Surg 2009; 67:1723- 1729.<\/li>\n
  4. Buser,D. “State of the Art Surgical Procedures in Esthetic Implant Dentistry.” Straumann training Lecture. Hong Kong. October 6,2009.<\/li>\n
  5. Gellrich,N. et al. Alveolar Zygomatic Buttress: A New Donor Site for Limited Preimplant Augmentation Procedures. J Oral Maxillofac Surg 2007; 65:275-280.<\/li>\n
  6. Soehardi,G. et al. The Potential of the Horizontal Ramus of the Mandible as a Donor Site for Block and Particular Grafts in Preimplant Surgery. Int J Oral Maxillofac Surg 2009; 38:1172-1178<\/li>\n
  7. Dodson,T. Intravenous Bisphosphonate Therapy and Bisphosphonate-Related Osteonecrosis of the Jaws. J Oral Maxillofac Surg 2009; 67:44-52<\/li>\n<\/ol>\n","protected":false},"excerpt":{"rendered":"

    Introduction Dental implants\u00a0 is the replacement of missing teeth long […]<\/p>\n","protected":false},"author":4,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[20],"tags":[],"class_list":["post-3632","post","type-post","status-publish","format-standard","hentry","category-vol8octoberspledition"],"_links":{"self":[{"href":"https:\/\/biomedpharmajournal.org\/staging\/wp-json\/wp\/v2\/posts\/3632","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/biomedpharmajournal.org\/staging\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/biomedpharmajournal.org\/staging\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/biomedpharmajournal.org\/staging\/wp-json\/wp\/v2\/users\/4"}],"replies":[{"embeddable":true,"href":"https:\/\/biomedpharmajournal.org\/staging\/wp-json\/wp\/v2\/comments?post=3632"}],"version-history":[{"count":4,"href":"https:\/\/biomedpharmajournal.org\/staging\/wp-json\/wp\/v2\/posts\/3632\/revisions"}],"predecessor-version":[{"id":4812,"href":"https:\/\/biomedpharmajournal.org\/staging\/wp-json\/wp\/v2\/posts\/3632\/revisions\/4812"}],"wp:attachment":[{"href":"https:\/\/biomedpharmajournal.org\/staging\/wp-json\/wp\/v2\/media?parent=3632"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/biomedpharmajournal.org\/staging\/wp-json\/wp\/v2\/categories?post=3632"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/biomedpharmajournal.org\/staging\/wp-json\/wp\/v2\/tags?post=3632"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}