Periodontoloji Uzmanlarının ve Uzmanlık Öğrencilerinin Kemik Ogmentasyonu Açısından Algıları ve Cerrahi Yaklaşımları
Abstract
Amaç: Sistemik ve periodontal hastalıklar, travma ve tümörlerden dolayı oluşan kemik kaybı veya yetersizliği, dental implantların osseointegrasyonu için büyük bir zorluk yaratmaktadır. Osseointegre implantların uzun vadeli prognozu, implantasyon bölgelerinde yeterli miktarda kemik varlığı ile sağlanabilir. Çalışmamızın amacı; periodontoloji uzmanlarının, implant uygulamalarında kullandıkları teknikleri, tedavi planlarını ve yaşadıkları komplikasyonlar karşısındaki çözüm yollarını değerlendirmektir.
Gereç ve Yöntemler: Çalışmaya, 126 periodontoloji uzmanı ve/veya uzmanlık öğrencisi katılmıştır. İmplant uygulamaları ve kemik rejenerasyonu ile ilgili 20 sorudan oluşan anket uygulanmıştır. Kemik rejenerasyonunda ve oluşan komplikasyonların yönetilmesi için kullanılan teknikler, malzemeler ve planlama hakkındaki bilgi ve yöntemlersorgulanmıştır.
Bulgular: Tüm katılımcıların dental implant uygulamalarında kemik rejenerasyonuna ihtiyacı olmaktadır. Rejenerasyon için en çok kullandığı materyal ksenogrefttir (%43,5). Kemik rejenerasyonunda en çok tercih edilen uygulama, kollajen membran ile yönlendirilmiş kemik rejenerasyonudur (YKR) (%78,3). En sık karşılaşılan komplikasyon, membran ekspozürüdür. Komplikasyonları önlemek adına, katılımcıların %77,3’ü yeterli yumuşak doku serbestleştirmesini yaparken, %63,6’sı periodontitis kontrolü yapmaktadır. Komplikasyon yaşandığında en çok kullanılan tedavi seçeneği postoperatif antibiyotik/antiseptik kullanımıdır. Oluşan komplikasyon yönetiminde, katılımcıların %82,6’sı destek almaktadır.
Sonuç: Çalışmamızda periodontoloji uzmanlarının sıkça kemik rekonstrüksiyonu/rejenerasyonu uygularken farklı planlama şekli ve tedavi seçeneklerini seçtikleri görülmüştür. Tedavi yaklaşımları vakaya göre değişebileceğinden, periodontoloji uzmanlık eğitiminde güncel literatürde uygulanan en son tedavi modellerinin yer alması periodontoloji uzmanları için faydalı olacaktır.
Keywords
References
- 1. Newman MG TH, Klokkevold PR, Carranza FA. Clinical Periodontology. 10th ed. Saunders Elsevier; 2006:1133-1148.
- 2. Kammerer PW, Al-Nawas B. Bone reconstruction of extensive maxillomandibular defects in adults. Periodontol 2000. 2023;93(1):340-57.
- 3. Herford AS, Dean JS. Complications in bone grafting. Oral Maxillofac Surg Clin North Am. 2011;23(3):433-42.
- 4. Urban IA, Monje A. Guided Bone Regeneration in Alveolar Bone Reconstruction. Oral Maxillofac Surg Clin North Am. 2019;31(2):331-8.
- 5. Sittitavornwong S, Gutta R. Bone graft harvesting from regional sites. Oral Maxillofac Surg Clin North Am. 2010;22(3):317-30, v-vi.
- 6. Marx RE. Bone and bone graft healing. Oral Maxillofac Surg Clin North Am. 2007;19(4):455-66, v.
- 7. KasapoĞLu MB, ÇAnkaya B, KÖSe T, DİNÇEr KÖSe O, Arsan B, ÇEbİ AT, et al. The Evaluation of Dentists' Awareness and Knowledge in Turkey Regarding Bisphosphonates. Medical Records. 2021;3(2):130-7.
- 8. Erdogan O, Shafer DM, Taxel P, Freilich MA. A review of the association between osteoporosis and alveolar ridge augmentation. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2007;104(6):738 e1-13.
- 9. Hürzeler MB, Kirsch A, Ackermann KL, Quiñones CR. Reconstruction of the severely resorbed maxilla with dental implants in the augmented maxillary sinus: a 5-year clinical investigation. The International journal of oral & maxillofacial implants. 1996;11(4):466-75.
- 10. Erdoğan Ö, Shafer DM, Taxel P, Freilich MA. A review of the association between osteoporosis and alveolar ridge augmentation. Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, and Endodontology. 2007;104(6):738.e1-.e13.
- 11. Artas G, Gul M, Acikan I, Kirtay M, Bozoglan A, Simsek S, et al. A comparison of different bone graft materials in peri-implant guided bone regeneration. Brazilian oral research. 2018;32:e59.
- 12. Sculean A, Nikolidakis D, Nikou G, Ivanovic A, Chapple ILC, Stavropoulos A. Biomaterials for promoting periodontal regeneration in human intrabony defects: a systematic review. Periodontology 2000. 2015;68(1):182-216.
- 13. Jensen SS, Terheyden H. Bone augmentation procedures in localized defects in the alveolar ridge: clinical results with different bone grafts and bone-substitute materials. The International journal of oral & maxillofacial implants. 2009;24 Suppl:218-36.
- 14. Benic GI, Hämmerle CH. Horizontal bone augmentation by means of guided bone regeneration. Periodontol 2000. 2014;66(1):13-40.
- 15. Sanz-Sanchez I, Sanz-Martin I, Ortiz-Vigon A, Molina A, Sanz M. Complications in bone-grafting procedures: Classification and management. Periodontol 2000. 2022;88(1):86-102.
- 16. Ortiz-Vigon A, Suarez I, Martinez-Villa S, Sanz-Martin I, Bollain J, Sanz M. Safety and performance of a novel collagenated xenogeneic bone block for lateral alveolar crest augmentation for staged implant placement. Clin Oral Implants Res. 2018;29(1):36-45.
- 17. Simion M, Jovanovic SA, Trisi P, Scarano A, Piattelli A. Vertical ridge augmentation around dental implants using a membrane technique and autogenous bone or allografts in humans. Int J Periodontics Restorative Dent. 1998;18(1):8-23.
- 18. Bornstein MM, Cionca N, Mombelli A. Systemic conditions and treatments as risks for implant therapy. The International journal of oral & maxillofacial implants. 2009;24 Suppl:12-27.
- 19. Javed F, Kellesarian SV, Abduljabbar T, Abduljabbar AT, Akram Z, Vohra F, et al. Influence of involuntary cigarette smoke inhalation on osseointegration: a systematic review and meta-analysis of preclinical studies. Int J Oral Maxillofac Surg. 2018;47(6):764-72.
- 20. Cesar-Neto JB, Benatti BB, Neto FH, Sallum AW, Sallum EA, Nociti FH. Smoking cessation may present a positive impact on mandibular bone quality and periodontitis-related bone loss: a study in rats. J Periodontol. 2005;76(4):520-5.
- 21. Karoussis IK, Salvi GE, Heitz-Mayfield LJ, Bragger U, Hammerle CH, Lang NP. Long-term implant prognosis in patients with and without a history of chronic periodontitis: a 10-year prospective cohort study of the ITI Dental Implant System. Clin Oral Implants Res. 2003;14(3):329-39.
- 22. Roccuzzo M, De Angelis N, Bonino L, Aglietta M. Ten-year results of a three-arm prospective cohort study on implants in periodontally compromised patients. Part 1: implant loss and radiographic bone loss. Clin Oral Implants Res. 2010;21(5):490-6.
- 23. Roccuzzo M, Bonino F, Aglietta M, Dalmasso P. Ten-year results of a three arms prospective cohort study on implants in periodontally compromised patients. Part 2: clinical results. Clin Oral Implants Res. 2012;23(4):389-95.
- 24. Salgado-Peralvo A-O, Mateos-Moreno M-V, Velasco-Ortega E, Peña-Cardelles J-F, Kewalramani N. Preventive antibiotic therapy in bone augmentation procedures in oral implantology: A systematic review. Journal of Stomatology, Oral and Maxillofacial Surgery. 2022;123(1):74-80.
- 25. Payer M, Tan WC, Han J, Ivanovski S, Mattheos N, Pjetursson BE, et al. The effect of systemic antibiotics on clinical and patient-reported outcome measures of oral implant therapy with simultaneous guided bone regeneration. Clin Oral Implants Res. 2020;31(5):442-51.
- 26. Khouly I, Braun RS, Silvestre T, Musa W, Miron RJ, Demyati A. Efficacy of antibiotic prophylaxis in intraoral bone grafting procedures: a systematic review and meta-analysis. Int J Oral Maxillofac Surg. 2020;49(2):250-63.
- 27. Fontana F, Maschera E, Rocchietta I, Simion M. Clinical classification of complications in guided bone regeneration procedures by means of a nonresorbable membrane. Int J Periodontics Restorative Dent. 2011;31(3):265-73.
Perceptions and Surgical Approaches of Periodontists and Residency Students for Bone Augmentation Procedures
Abstract
Aim: Bone deficiency due to various systemic and periodontal diseases, trauma, and tumors remains a major challenge for osseointegration in implant therapies. To provide implant survival, sufficient bone volume is mandatory. The purpose of the present study is to assess the techniques used by periodontists in implant applications, treatment plans, and solutions to the complications they experience.
Material and Methods: 126 periodontists and/or residency students participated in this study. A questionnaire consisting of 20 questions was used. The knowledge and treatment methods about the technique, materials, and planning they use in bone regeneration and the management of complications were questioned. Descriptive statistics and the Pearson Chi-square test were used to analyze the data.
Results: All participants needed bone regeneration in implant cases. The most used material for regeneration by the participants was xenograft, with 43.5%. The most preferred application in bone regeneration is guided bone regeneration (GBR) using the collagen membrane, with a rate of 78.3%. The most common complication was membrane exposure. In order to prevent complications, 77.3% of the participants performed adequate soft tissue release, while 63.6% controlled periodontitis. The most commonly used treatment option for complications was the use of postoperative antibiotics/antiseptics. 82.6% of the participants received support in the management of complications.
Conclusion: In our study, it was observed that periodontists frequently chose different planning methods and treatment options when performing bone reconstruction/regeneration. It will be beneficial for periodontists to include the latest treatment models applied in the current literature in periodontology residency education.
Keywords
References
- 1. Newman MG TH, Klokkevold PR, Carranza FA. Clinical Periodontology. 10th ed. Saunders Elsevier; 2006:1133-1148.
- 2. Kammerer PW, Al-Nawas B. Bone reconstruction of extensive maxillomandibular defects in adults. Periodontol 2000. 2023;93(1):340-57.
- 3. Herford AS, Dean JS. Complications in bone grafting. Oral Maxillofac Surg Clin North Am. 2011;23(3):433-42.
- 4. Urban IA, Monje A. Guided Bone Regeneration in Alveolar Bone Reconstruction. Oral Maxillofac Surg Clin North Am. 2019;31(2):331-8.
- 5. Sittitavornwong S, Gutta R. Bone graft harvesting from regional sites. Oral Maxillofac Surg Clin North Am. 2010;22(3):317-30, v-vi.
- 6. Marx RE. Bone and bone graft healing. Oral Maxillofac Surg Clin North Am. 2007;19(4):455-66, v.
- 7. KasapoĞLu MB, ÇAnkaya B, KÖSe T, DİNÇEr KÖSe O, Arsan B, ÇEbİ AT, et al. The Evaluation of Dentists' Awareness and Knowledge in Turkey Regarding Bisphosphonates. Medical Records. 2021;3(2):130-7.
- 8. Erdogan O, Shafer DM, Taxel P, Freilich MA. A review of the association between osteoporosis and alveolar ridge augmentation. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2007;104(6):738 e1-13.
- 9. Hürzeler MB, Kirsch A, Ackermann KL, Quiñones CR. Reconstruction of the severely resorbed maxilla with dental implants in the augmented maxillary sinus: a 5-year clinical investigation. The International journal of oral & maxillofacial implants. 1996;11(4):466-75.
- 10. Erdoğan Ö, Shafer DM, Taxel P, Freilich MA. A review of the association between osteoporosis and alveolar ridge augmentation. Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, and Endodontology. 2007;104(6):738.e1-.e13.
- 11. Artas G, Gul M, Acikan I, Kirtay M, Bozoglan A, Simsek S, et al. A comparison of different bone graft materials in peri-implant guided bone regeneration. Brazilian oral research. 2018;32:e59.
- 12. Sculean A, Nikolidakis D, Nikou G, Ivanovic A, Chapple ILC, Stavropoulos A. Biomaterials for promoting periodontal regeneration in human intrabony defects: a systematic review. Periodontology 2000. 2015;68(1):182-216.
- 13. Jensen SS, Terheyden H. Bone augmentation procedures in localized defects in the alveolar ridge: clinical results with different bone grafts and bone-substitute materials. The International journal of oral & maxillofacial implants. 2009;24 Suppl:218-36.
- 14. Benic GI, Hämmerle CH. Horizontal bone augmentation by means of guided bone regeneration. Periodontol 2000. 2014;66(1):13-40.
- 15. Sanz-Sanchez I, Sanz-Martin I, Ortiz-Vigon A, Molina A, Sanz M. Complications in bone-grafting procedures: Classification and management. Periodontol 2000. 2022;88(1):86-102.
- 16. Ortiz-Vigon A, Suarez I, Martinez-Villa S, Sanz-Martin I, Bollain J, Sanz M. Safety and performance of a novel collagenated xenogeneic bone block for lateral alveolar crest augmentation for staged implant placement. Clin Oral Implants Res. 2018;29(1):36-45.
- 17. Simion M, Jovanovic SA, Trisi P, Scarano A, Piattelli A. Vertical ridge augmentation around dental implants using a membrane technique and autogenous bone or allografts in humans. Int J Periodontics Restorative Dent. 1998;18(1):8-23.
- 18. Bornstein MM, Cionca N, Mombelli A. Systemic conditions and treatments as risks for implant therapy. The International journal of oral & maxillofacial implants. 2009;24 Suppl:12-27.
- 19. Javed F, Kellesarian SV, Abduljabbar T, Abduljabbar AT, Akram Z, Vohra F, et al. Influence of involuntary cigarette smoke inhalation on osseointegration: a systematic review and meta-analysis of preclinical studies. Int J Oral Maxillofac Surg. 2018;47(6):764-72.
- 20. Cesar-Neto JB, Benatti BB, Neto FH, Sallum AW, Sallum EA, Nociti FH. Smoking cessation may present a positive impact on mandibular bone quality and periodontitis-related bone loss: a study in rats. J Periodontol. 2005;76(4):520-5.
- 21. Karoussis IK, Salvi GE, Heitz-Mayfield LJ, Bragger U, Hammerle CH, Lang NP. Long-term implant prognosis in patients with and without a history of chronic periodontitis: a 10-year prospective cohort study of the ITI Dental Implant System. Clin Oral Implants Res. 2003;14(3):329-39.
- 22. Roccuzzo M, De Angelis N, Bonino L, Aglietta M. Ten-year results of a three-arm prospective cohort study on implants in periodontally compromised patients. Part 1: implant loss and radiographic bone loss. Clin Oral Implants Res. 2010;21(5):490-6.
- 23. Roccuzzo M, Bonino F, Aglietta M, Dalmasso P. Ten-year results of a three arms prospective cohort study on implants in periodontally compromised patients. Part 2: clinical results. Clin Oral Implants Res. 2012;23(4):389-95.
- 24. Salgado-Peralvo A-O, Mateos-Moreno M-V, Velasco-Ortega E, Peña-Cardelles J-F, Kewalramani N. Preventive antibiotic therapy in bone augmentation procedures in oral implantology: A systematic review. Journal of Stomatology, Oral and Maxillofacial Surgery. 2022;123(1):74-80.
- 25. Payer M, Tan WC, Han J, Ivanovski S, Mattheos N, Pjetursson BE, et al. The effect of systemic antibiotics on clinical and patient-reported outcome measures of oral implant therapy with simultaneous guided bone regeneration. Clin Oral Implants Res. 2020;31(5):442-51.
- 26. Khouly I, Braun RS, Silvestre T, Musa W, Miron RJ, Demyati A. Efficacy of antibiotic prophylaxis in intraoral bone grafting procedures: a systematic review and meta-analysis. Int J Oral Maxillofac Surg. 2020;49(2):250-63.
- 27. Fontana F, Maschera E, Rocchietta I, Simion M. Clinical classification of complications in guided bone regeneration procedures by means of a nonresorbable membrane. Int J Periodontics Restorative Dent. 2011;31(3):265-73.
Details
| Primary Language | English |
|---|---|
| Subjects | Facial Plastic Surgery, Surgery (Other), Dental Materials and Equipment, Oral Implantology, Periodontics |
| Journal Section | RESEARCH ARTICLE |
| Authors | |
| Publication Date | April 30, 2024 |
| Submission Date | August 30, 2023 |
| Acceptance Date | February 5, 2024 |
| Published in Issue | Year 2024 Volume: 6 Issue: 1 |
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