{"id":3716,"date":"2015-10-25T09:46:18","date_gmt":"2015-10-25T09:46:18","guid":{"rendered":"http:\/\/biomedpharmajournal.org\/?p=3716"},"modified":"2020-04-25T09:18:48","modified_gmt":"2020-04-25T09:18:48","slug":"a-case-report-implant-placement-in-resorbed-alveolus","status":"publish","type":"post","link":"https:\/\/biomedpharmajournal.org\/staging\/vol8octoberspledition\/a-case-report-implant-placement-in-resorbed-alveolus\/","title":{"rendered":"A Case Report – Implant Placement In Resorbed Alveolus"},"content":{"rendered":"

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

Bone loss that takes place in the edentulous alveolar ridge over time often impedes the use of standard implant placement protocols, and calls for alternative or additional procedures2<\/sup>.\u00a0\u00a0 This case report supports the theory of\u00a0\u00a0 increased\u00a0 patient acceptance of the rehabilitation procedure by using graftless solutions or nonautogenous sources of graft material. In cases of mild to moderate resorption, shorter and narrower implants3-5<\/sup> as well as angled implant placement 6-9<\/sup> may be effective strategies to avoid bone grafting\u00a0 are usually followed, in this case bone augmentation or split ridge\u00a0 was\u00a0 not used rather, sequential osteotome with drill bits of required size was done ,with care not to cause fracture to the mandible.<\/p>\n

Case Report<\/strong><\/p>\n

A 77 yr old\u00a0 female\u00a0 patient reported with a chief complaint of pain on her temperomandibular joint for past eight months . History reveals that pt is a denture wearer for past\u00a0 29 years . Her Last\u00a0 dentures were fabricated\u00a0 11 yrs back.\u00a0 Patient complaints of floating denture in\u00a0 relation to\u00a0 mandible . On intra oral clinical examination , the ridge exhibited\u00a0 knife -edge ridge in maxilla and mandible and increased\u00a0 vertical dimensions.\u00a0 Patient was advised\u00a0 OPG (fig 1)\u00a0 which\u00a0\u00a0 revealed\u00a0 severe atrophic edentulous maxilla and mandible ,this case was considered to be \u201ccomplex\u201d both in terms of the surgical and restorative aspects. On routine examination, pt was did not have any systemic disorders , patients \u00a0blood pressure was 130\/90mmhg. treatment planning was done . Since the patient\u00a0 had problem with the mandible\u00a0 , implant retained prosthesis was planned,\u00a0 patient was informed in detail about the procedure and informed consent was taken. routine blood investigations were done . Under local anesthesia , dental implants were placed in relation to 34 and 44 region in between the mental foramina. Care was taken not to fracture the mandible since its severely\u00a0 atrophic.\u00a0 primary stability was achieved, cover screw\u00a0 were placed. After six months OPG was taken (fig 2) , radiograph\u00a0\u00a0 revealed no abnormality . Ball abutments was placed and denture retained prosthesis was\u00a0 given. Patient had regular follow up , with which patient did not have any complaints in occlusion\u00a0 nor in\u00a0 pain of\u00a0 temperomandibular\u00a0 joint<\/p>\n\n\n\n
\"figure<\/td>\nFigure 1: Pre Operative Opg<\/strong><\/p>\n

Click here to view full figure<\/a><\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n

 <\/p>\n\n\n\n
\"figure<\/td>\nFigure 2: Post Operative Opg<\/strong><\/p>\n

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 <\/p>\n

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

Autogenous bone remains the “Gold Standard” for grafting. The autogenous graft may be harvested from many intra-oral sites. The maxillary tuberosity, anterior nasal spine, and zygomatic buttress have been reported for the upper jaw10,11,12<\/sup>. The mandibular\u00a0 symphysis, ascending\u00a0 ramus, coronoid process, and horizontal ramus are useful sites from the lower jaw 13<\/sup> , but autogenous bone grafts needs patient consent and some\u00a0 do not accept\u00a0 harvesting bone from the donor site ,in this case elderly patient did not accept for any augmentation ,\u00a0 following this\u00a0 there are more chances of secondary infection\u00a0 following the grafts and\u00a0 non healing of donor site. Thus\u00a0 implants were placed without an grafts , through which fair prognosis of the implant was achieved. In this case of severe atrophy of\u00a0 the maxilla and mandible , the implant was placed in the mandible without any\u00a0 Alveolar ridge reconstruction\u00a0 or\u00a0 Spilt ridge bone augmentation.\u00a0 thus consuming less time and providing accepted results in elderly patients.<\/p>\n

Standard Implant placement protocol\u00a0 with suitable individual modification according to bon quality in surgeons\u00a0 hand can obviate the need for extended surgical procedure.<\/p>\n

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

    \n
  1. Albrektsson T, Branemark P, Hansson H & Lindstrom J. (1981).\u00a0 Osteointegration titanium implants.\u00a0 Acta Orthop Scand 52: 155-159<\/li>\n
  2. Araujo MG, Sonohara M, Hayacibara R, Cardaropoli G, Lindhe J. Lateral ridge augmentation by the use of grafts comprised of autologous bone or a biomaterial. An experiment in the dog. J Clin Periodontol 2002;29:1122\u20131131.<\/li>\n
  3. Arisan V, Bolukbasi N, Ersanli S, Ozdemir T. Evaluation of 316 narrowdiameter implants followed for 5-10 years: A clinical and radiographic retrospective study. Clin Oral Implants Res 2010;21:296\u2013307.<\/li>\n
  4. Menchero-Cantalejo E, Barona-Dorado C, Cantero-Alvarez M,Fernandez-Caliz F, Martinez-Gonzalez JM. Meta-analysis on the\u00a0survival of short implants. Med Oral Patol Oral Cir Bucal 2011;16:\u00a0e546\u2013551.<\/li>\n
  5. Neldam CA, Pinholt EM. State of the art of short dental implants:A systematic review of the literature. Clin Implant Dent Relat Res\u00a02010 Oct 26 [epub ahead of print].<\/li>\n
  6. Aparicio C, Perales P, Rangert B. Tilted implants as an alternative to maxillary sinus grafting : A clinical, radiologic, and periotest study. Clin Implant Dent Relat Res 2001;3:39\u201349.<\/li>\n
  7. Krekmanov L, Kahn M, Rangert B, Lindstrom H. Tilting of posterior mandibular and maxillary implants for improved prosthesis support.\u00a0Int J Oral Maxillofac Implants 2000;15:405\u2013414.<\/li>\n
  8. ten Bruggenkate CM, Sutter F, Oosterbeek HS, Schroeder A. Indications for angled implants. J Prosthet Dent 1992;67:85\u201393.<\/li>\n
  9. Testori T, Del Fabbro M, Capelli M, et al. Immediate occlusal loading and tilted implants for the rehabilitation of the atrophic edentulous maxilla: 1-year interim results of a multicenter prospective study. Clin Oral Implants Res 2008;19:227\u2013232.<\/li>\n
  10. Tolstunov, L. Maxillary Tuberosity Block Bone Graft: Innovative Technique and Case Report. J Oral Maxillofac Surg 2009; 67:1723- 1729.<\/li>\n
  11. Buser,D. “State of the Art Surgical Procedures in Esthetic Implant Dentistry.” Straumann training Lecture. Hong Kong. October 6,2009.<\/li>\n
  12. 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
  13. Soehardi,G. et al. The Potential of the Horizontal Ramus of the Mandible as a Donor Site for Block and Particular Grafts\u00a0 in Preimplant Surgery. Int J Oral Maxillofac Surg 2009; 38:1172-1178<\/li>\n<\/ol>\n","protected":false},"excerpt":{"rendered":"

    Introduction Bone loss that takes place in the edentulous alveolar […]<\/p>\n","protected":false},"author":3,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[20],"tags":[],"class_list":["post-3716","post","type-post","status-publish","format-standard","hentry","category-vol8octoberspledition"],"_links":{"self":[{"href":"https:\/\/biomedpharmajournal.org\/staging\/wp-json\/wp\/v2\/posts\/3716","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\/3"}],"replies":[{"embeddable":true,"href":"https:\/\/biomedpharmajournal.org\/staging\/wp-json\/wp\/v2\/comments?post=3716"}],"version-history":[{"count":5,"href":"https:\/\/biomedpharmajournal.org\/staging\/wp-json\/wp\/v2\/posts\/3716\/revisions"}],"predecessor-version":[{"id":33050,"href":"https:\/\/biomedpharmajournal.org\/staging\/wp-json\/wp\/v2\/posts\/3716\/revisions\/33050"}],"wp:attachment":[{"href":"https:\/\/biomedpharmajournal.org\/staging\/wp-json\/wp\/v2\/media?parent=3716"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/biomedpharmajournal.org\/staging\/wp-json\/wp\/v2\/categories?post=3716"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/biomedpharmajournal.org\/staging\/wp-json\/wp\/v2\/tags?post=3716"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}