Article 13

Immediate Loading with Many Complicated Factors (severe periodontal disease, collapsed occlusion, Immediate extraction)

 

INTERNATIONAL JOURNAL OF FUTURE DENTISTRY

2022:Vol. 2:No. 1: 71-78

Dr. Myungho Lee

The patient was born in 1970 and had a good systemic condition. He visited our clinic due to severe periodontal disease at a young age. He is doing a lot of work. Based on the diagnosis, it was decided to extract all his teeth. As he is young, implants are chosen over dentures. (Fig. 1,2,3)

1.JPG
2.JPG

Among the many options for a treatment plan, all the upper and lower teeth are extracted at once. (Fig. 4, 5)

3.JPG

Fig. 4 Immediate extraction at mandible

Fig. 5 Immediate extraction at maxillary

Different types of implants are used, including internal and external implant types. Various implant threads are also used. For slightly soft bone, Any Ridge threads work well for primary stability. When using an implant with a platform between the implant and the abutment post, the bone surrounding the implant can be preserved. The implants are placed in the maxilla
and mandible with bone grafting on the day of surgery. (Fig. 6)

4.JPG

Various bone types are used for the bone grafting. The structure of the bone is considered the most important.. It should have good porosity, and good wettability facilitates the formation of blood vessels. However, some products are treated at high temperatures to remove organic materials, which changes the bone material structure leaving no pores.

Growth factors (BMP, PRP) are utilized. The outcome seems to be better when autogenous bone is mixed. Membranes are hardly used. They are only used for space maintenance when a lot of bone is grafted horizontally and vertically. (Fig. 7, 8)

5.JPG

Various bone types are used for the bone grafting. The structure of the bone is considered the most important.. It should have good porosity, and good wettability facilitates the formation of blood vessels. However, some products are treated at high temperatures to remove organic materials, which changes the bone material structure leaving no pores.

Growth factors (BMP, PRP) are utilized. The outcome seems to be better when autogenous bone is mixed. Membranes are hardly used. They are only used for space maintenance when a lot of bone is grafted horizontally and vertically. (Fig. 7, 8)

REFERENCES
 
1. Position paper. Tissue banking of bone allografts used in periodontal regeneration. J Periodontol 2001;72:834-8.
2. Boyan BD, Ranly DM, Schwartz Z. Use of growth factors to modify osteoinductivity of demineralized bone allografts: lessons for tissue engineering of bone. Dent Clin North Am 2006;50:217–28.
3. Schwartz Z, Somers A, Mellonig JT, Carnes DL Jr, Dean DD, Cochran DL, Boyan BD.
Ability of commercial demineralized freeze-dried
bone allograft to induce new bone formation is dependent on donor age but not gender. J Periodontol1998;69:470–78.
4. Ehrl P, Fürst U, Happe A, Khoury F, Kobler P, Konstantinovic V et al. Cologne Classification of Alveolar Ridge Defects (
CCARD). 2013:1-10.
5. Berglundh T, Lindhe J. Healing around implants placed in bone defects treated with Bio-Oss. An experimental study in the dog. Clin Oral Implants Res 1997;8:117–124.
6. Piattelli A, Podda G, Scarano A. Clinical and histological results in alveolar ridge enlargement using coralline calcium carbonate. Biomaterials 1997;18:623–627.
7. Callan DP, Rohrer MD. Use of bovine-derived hydroxyapatite in the treatment of edentulous ridge defects: a human clinical and histologic case report. J Periodontol1993;64:575–582.
8. Mellonig J. Human histologic evaluation of a bovine derived xenograft in the treatment of periodontal osseous defects. Int J Periodontics Restorative Dent 2002;20:19–29.
9. Zitzmann NU, Scharer P, Marinello CP, Schupbach P, Berglundh T. Alveolar ridgementation with Bio- Oss: a histologic study in humans. Int J Periodontics Restorative Dent 2001;21:288–295.
10. Paolantonio M. Combined periodontal regenerative technique in human intrabony defects by collagen membranes and anorganic bovine bone. A controlled clinical study. J Periodontol2002;73:158–166.
11. Orsini G, Traini T, Scarano A, Degidi M, Perrotti  V, Piccirilli M, Piattelli A. Maxillary sinusmentation with Bio-Oss particles: a light, scanning, and
transmission electron microscopy study in man. J Biomed Mater Res B ApplBiomater2005;74:448–457.
12. Tadjoedin ES, de Lange GL, Bronckers AL, Lyaruu DM, Burger EH.Deproteinizedcancellous bovine bone (Bio-Oss) as bone substitute
for sinus floor elevation. A retrospective, histomorphometrical study of five cases. J ClinPeriodontol2003;30:261–270.
13. Valentini P, Abensur D. Maxillary sinus floor elevation for implant placement with demineralized freeze-dried bone and bovine bone (Bio-Oss): a clinical study of 20 patients. Int J Periodontics Restorative Dent 1997;17:232–241.