Journal of Oral Implantology October 2014 - (Page 601)

CASE REPORT New Method to Increase Inter-alveolar Height With Preservation of Crestal Cortical Bone for Implant Treatment Osman A. Etoz, DDS, PhD Umut Demetoglu, DDS* Hakan Ocak, DDS The aim of this technique is to provide adequate interocclusal distance (3 mm) allowing preprosthetic management. A bone block was cut with piezosurgery and extracted, leaving the crestal cortical bone intact. The free crestal alveolar bone was fixed to the maxilla with 2 dental implants. After 3 months of follow-up, abutment surgery was performed and osseointegration was evident with adequate interocclusal height (7 mm) allowing prosthetic management. Key Words: surgical techniques, guided bone regeneration, dental implants SURGICAL TECHNIQUE A 64 year-old woman with partial edentulous maxilla was referred to our clinic for preprosthetic management. Vertical interocclusal distance was almost 3 mm, which was inadequate for prosthetic treatment. Under local anesthesia horizontal and vertical incisions were made from the alveolar ridge. Mucoperiostal flap was reflected from the vestibule side to avoid periost damage. To protect the marginal cortical bone a rectangular shape corticotomy was made with piezosurgery above 4 mm of the alveolar ridge with a length of 20 mm and a height of 4 mm; osteotomies were made with chisel (Figure 1a). Bone block was extracted in the middle of the alveolus and coronal bone segment was left. The intact alveolar segment and basal segment were drilled together and fixed with two intraosseous dental implants (Figure 1b). Primary stability of the implants was satisfactory. The extracted bone was used as autogenous bone graft onto the Department of Oral and Maxillofacial Surgery, Erciyes University, Kayseri, Turkey. * Corresponding author, e-mail: DOI: 10.1563/AAID-JOI-D-12-00002 osteotomy line and platelet-rich fibrin was applied onto the graft (Figure 1c). Mucoperiostal flap was closed primarily. After 3 months of follow-up radiographic healing was evident. The new vertical interocclusal height increased to 7 mm (Figure 1d). Under local anesthesia healing caps of the osseointegrated implants were placed and the patient was scheduled for prosthetic rehabilitation. Primary stability, which mostly depends on bone quality, is a critical factor for dental implant therapy. Thick cortical plates are essential for achieving primer implant stability. Posterior maxilla especially shows a poor bone quality with low bone density and thin cortical bone plates. Therefore achieving adequate primer stability may be challenging in posterior maxilla. In a cadaver study, average buccal and palatinal cortical thicknesses in posterior maxilla were 1.69 mm 2.06 mm, respectively.1 In addition, it has been reported that crestal cortical bone thickness is a significant factor for optimal stress distribution around implants.2 With this technique, adequate interocclusal height for implant treatment devoid of cortical crestal bone destruction, which allows desired primary stability was provided. This technique may also be used with flapless implant insertion for wider alveoli, which Journal of Oral Implantology 601

Table of Contents for the Digital Edition of Journal of Oral Implantology October 2014

New AAIP Affiliates Increase JOI Readership
Letter to the Editor
Bone Response From a Dynamic Stimulus on a One-Piece and Multi-Piece Implant Abutment and Crown by Finite Element Analysis
Effect of Platelet-Rich Plasma on the Healing of Mandibular Defects Treated With Fresh Frozen Bone Allograft: A Radiographic Study in Dogs
Efficacy of Growth Factor in Promoting Early Osseointegration
Assessment of Candida Species Colonization and Denture-Related Stomatitis in Bar- and Locator-Retained Overdentures
A Simple Solution for Vector Control in Vertical Alveolar Distraction Osteogenesis
Maxillary Ridge Augmentation With Custom-Made CAD/CAM Scaffolds. A 1-Year Prospective Study on 10 Patients
A Retrospective 3- to 5-Year Study of the Reconstruction of Oral Function Using Implant- Supported Prostheses in Patients With Hypohidrotic Ectodermal Dysplasia
Effects of a New Implant Abutment Design on Peri-Implant Soft Tissues
Repair Technique for Fractured Implant-Supported Metal-Ceramic Restorations: A Clinical Report
Full-Mouth Rehabilitation for a Patient With Dentinogenesis Imperfecta: A Clinical Report
New Method to Increase Inter-alveolar Height With Preservation of Crestal Cortical Bone for Implant Treatment
Implant Placement With a Guided Surgery System Based on Stress Analyses Utilizing the Bone Density: A Clinical Case Report
A Novel Technique for Osteotome Internal Sinus Lifts With Simultaneous Placement of Tapered Implants to Improve Primary Stability
Maxillary Sinus Augmentation and Implant Placement Using Venous Blood Without Graft Material: A Case Letter
Modification of Maxillary Sinus Floor With Orthodontic Treatment and Implant Therapy: A Case Letter
A Surgical Guide for Optimal Placement and Immediate Restoration of Implant
Osseointegrated Dental Implants in Growing Children: A Literature Review

Journal of Oral Implantology October 2014