Biomedical subjects

Periklis Proussaefs

Publications and source records attributed to Periklis Proussaefs.

28 records · Page 2Linked to original sources

PubMed2002

Evaluation of two vitallium blade-form implants retrieved after 13 to 21 years of function: a clinical report.

This article describes the clinical, radiographic, and histologic evaluation of 2 immediately loaded Vitallium blade-form implants retrieved from the posterior maxilla of 2 patients after 21 and 13 years of function. Neither implant demonstrated mobility or signs of pathosis, and both appeared to have integrated well with surrounding bone. The hydroxyapatite coating of the second implant, which was retrieved after 13 years of function, showed no dissolution. These observations suggest that immediately loaded dental implants have the potential to achieve and maintain osseointegration and that hydroxyapatite coatings can resist degradation over long-term service.

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PubMed2002

Histologic evaluation of a hydroxyapatite onlay bone graft retrieved after 9 years: a clinical report.

Because of the limited observations of published studies, the condition of hydroxyapatite after a long period of intraoral function remains a concern. This clinical report describes the histologic evaluation of a 9 year-old hydroxyapatite specimen retrieved from a human subject. The residual hydroxyapatite particles showed no sign of resorption, and tight contact with the surrounding bone was observed.

Alveolar Ridge Augmentation↗

PubMed2002

Conversion of a complete denture to a provisional implant-supported, screw-retained fixed prosthesis for immediate loading of a completely edentulous arch.

This article describes the fabrication of a provisional implant-supported, screw-retained restoration for immediate loading of a completely edentulous arch. The technique can be applied to patients with partially edentulous arches as well. Until immediate loading of dental implants becomes a well-documented treatment modality, the described method should not be applied on a routine basis or without careful evaluation.

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PubMed2002

Clinical radiographic, and histologic evaluation of maxillary bone reconstruction by using a titanium mesh and autogenous iliac graft: a case report.

The current clinical report describes the use of titanium mesh for maxillary alveolar ridge augmentation. Autogenous bone graft was harvested from the iliac crest and was loaded on a titanium mesh that was left in the patient's maxilla for 7 months before it was removed. Twelve months after the bone grafting procedure the patient received 10 implants on the maxilla, and a biopsy was taken from the augmented ridge. CT scan examination was performed before and after the maxillary ridge augmentation. Clinical evaluation revealed successful integration of the graft. The radiographic analysis demonstrated that a 10-mm vertical ridge augmentation had been achieved. Histologic evaluation revealed remnants of the autogenous bone graft still present, whereas the grafted area had a reduced remodeling activity. The clinical report demonstrated the potential of the titanium mesh to achieve extensive alveolar ridge augmentation, whereas the augmented ridge may possess an inferior capability forbone remodeling.

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PubMed2002

A clinical and histologic evaluation of a block onlay graft in conjunction with autogenous particulate and inorganic bovine mineral (Bio-Oss): a case report.

This article describes a clinical case report in which an autogenous intraorally harvested block graft was used in combination with particulate autogenous and inorganic bovine mineral for localized alveolar ridge augmentation. No barrier was used above the graft material. Clinical evaluation revealed excellent integration of the graft material to the recipient site, while histologic analysis indicated that the block graft was vital and undergoing an active remodeling process. Excellent integration of the inorganic bovine mineral with the newly formed bone was also observed, suggesting that this material can be used as a filler for onlay grafting procedures.

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PubMedDate not supplied

The use of ramus autogenous block grafts for vertical alveolar ridge augmentation and implant placement: a pilot study.

PURPOSE: This study presents a clinical, radiographic, laboratory, and histologic/histomorphometric analysis of the use of mandibular ramus block autografts for vertical alveolar ridge augmentation and implant placement. MATERIALS AND METHODS: Autogenous block autografts were fixed at the recipient site with fixation screws while a mixture of autogenous bone marrow and inorganic bovine material (Bio-Oss) was used at the periphery. All grafts appeared well incorporated at the recipient site during reentry surgery. RESULTS: Radiographic measurements revealed an average of 6.12 mm vertical ridge augmentation 1 month after surgery and 5.12 mm 4 to 6 months after surgery. Laboratory volumetric measurements revealed an average of 0.91 mL alveolar ridge augmentation 1 month after surgery and 0.75 mL 6 months postoperatively. Linear laboratory measurements revealed 6.12 mm of vertical ridge augmentation 1 month postoperatively and 4.37 mm 4 to 6 months after surgery. Histologic evaluation indicated signs of active remodeling in all the specimens. Histomorphometric analysis of the peripheral particulate bone indicated bone present at 34.33% of the grafted area, while 42.17% of the area was occupied by fibrous tissue and 23.50% by residual Bio-Oss particles. DISCUSSION: The results demonstrated the potential of mandibular block autografts harvested from the ascending ramus to maintain their vitality. Volumetric resorption rate of 17.58% and radiographic resorption rate of 16.34% were in accordance with previously published literature. Early exposure appeared to compromise the results, while late exposures did not affect the vitality of the block autografts. CONCLUSION: Mandibular block autografts can maintain their vitality when used for vertical alveolar ridge augmentation. Inorganic bovine mineral (Bio-Oss) can be used at the periphery of the block graft when mixed with autogenous bone marrow.

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PubMedDate not supplied

Effects of immediate loading with threaded hydroxyapatite-coated root-form implants on single premolar replacements: a preliminary report.

PURPOSE: This prospective study evaluated the immediate loading of single, threaded, root-form implants placed in the maxillary premolar area. MATERIALS AND METHODS: Ten human subjects were included in this preliminary report. In all cases, a screw-retained temporary acrylic resin crown was placed immediately after implant surgery. The definitive screw-retained metal-ceramic crown was placed 6 months later. RESULTS: Standardized radiographs demonstrated 0.58, 0.73, 0.84, and 0.90 mm mean marginal bone loss at 1, 3, 6, and 12 months after implant surgery, respectively. Implant mobility was evaluated with the Periotest device. At the day of surgery, mean mobility was -3.3, while minor changes were observed thereafter: mean values of -3.77, -3.47, and -3.63 were recorded at 3, 6, and 12 months after implant surgery, respectively. Sulcus depth appeared relatively stable after the 3rd month when the implant platform was used as a reference. Recession of 0.43 mm was recorded between the 3rd and 12th month; when the depth of the peri-implant sulcus was measured from the implant platform, 0.1 mm of change was seen between the 3rd and 12th month. Probing depth measurements revealed that 3 months after implant placement, average probing depth was 3.60 mm, while at 12 months it was 3.20 mm. DISCUSSION: The peri-implant soft tissue parameters (bleeding on probing, probing depth, peri-implant soft tissue level), mobility, and marginal bone level appeared to be similar to findings of previous studies regarding the conventional 2-stage loading protocol. CONCLUSION: Results of the current study provided evidence that, under the condition of this investigation, single root-form implants can be immediately loaded when placed in the maxillary premolar area.

Alveolar Bone Loss↗

PubMedDate not supplied

Repair of the perforated sinus membrane with a resorbable collagen membrane: a human study.

PURPOSE: The purpose of this study was to evaluate the results of the repair of perforated sinus membranes with resorbable collagen membrane. MATERIALS AND METHODS: A split-mouth design was followed. Twelve subjects requiring bilateral sinus grafting were included in the study; one site had been accidentally perforated during sinus augmentation and the other site had not been perforated. The perforated sites were repaired with a resorbable collagen membrane. Dental implants were placed during a second surgery, and biopsy samples were harvested from both sinuses during implant placement. New bone formation was measured for all sites. Implant survival was recorded at second-stage surgery. Panoramic radiographs were taken before and after sinus grafting and after implant placement. RESULTS: Nonperforated sites demonstrated significantly more bone formation (33.58% +/- 7.45%) than perforated sites (14.17% +/- 7.06%) (P < .0001). Perforated sites demonstrated significantly more soft tissue formation (63.58% +/- 12.96%) than nonperforated sites (48.5% +/- 12.57%) (P = .006). In nonperforated sites, residual graft particles had more of their surface in contact with bone (40.17% +/- 14.92%) than perforated sites (14.5% +/- 12.03%) (P < .0001). The implant survival rate at second-stage surgery was superior for nonperforated sites (100%) in comparison to perforated sites (69.56%) (P = .0028). DISCUSSION: This study suggested that repairing the perforated site of the sinus membrane with a resorbable collagen membrane may result in reduced bone formation and implant survival rate. A different technique and/or materials than those used in the current study may offer better results for the repair of the perforated sinus membrane. CONCLUSION: The study demonstrated that perforation and repair of the sinus membrane may compromise new bone formation and implant survival.

Absorbable Implants↗

PubMedDate not supplied

Use of the frontal process of the maxillary bone for implant placement to retain a nasal prosthesis: a clinical report.

Implant placement to provide support and retention for nasal prostheses has been described in the literature. The anatomic sites that have been utilized for implant placement are the nasal bones, the premaxillary area through the nasal fossae, and the anterior wall of the frontal sinus. In the patient described, after a presurgical computerized tomography scan to determine adequacy of bone volume, 1 conventional threaded hydroxyapatite-coated root-form implant, created for intraoral use, was placed in the frontal process of the maxillary bone and 2 additional conventional implants were placed in the premaxillary area through the nasal fossa. Six months after implant placement, second-stage surgery was completed. A single bar connecting the 3 implants was fabricated. The removable nasal prosthesis was retained on the bar with 2 clips. An examination 1 year postsurgery revealed no clinical signs of pathosis. Long-term clinical follow-up of this case should continue and a sufficient number of additional cases should be investigated before use of the frontal process of the maxillary bone for implant retention can be recommended on a routine basis.

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PubMedDate not supplied

Vertical alveolar ridge augmentation prior to inferior alveolar nerve repositioning: a patient report.

This report describes treatment of a patient using vertical alveolar ridge augmentation performed prior to transposition of the inferior alveolar nerve (IAN). A preoperative computerized tomographic (CT) scan revealed 2 to 3 mm of bone above the canal in the left mandibular molar region. An autogenous bone graft harvested from the chin area was utilized along with a titanium mesh for vertical alveolar ridge augmentation in this area. CT scan after bone grafting revealed 5 mm of vertical ridge augmentation. Bone height above the IAN was 7 to 8 mm after bone grafting procedure. For IAN transposition, an osteotomy was performed to obtain a lateral access window located 4 mm below the crestal bone along the lateral side of the mandible. Two cylindric hydroxyapatite-coated implants were placed. Autogenous bone from the lateral access window that had been removed en bloc was particulated and placed around the implants. Because vertical alveolar ridge augmentation had been performed, the coronal portion of the implant was not exposed after transposition of the IAN. It is suggested that vertical ridge augmentation may be considered prior to transposition of the IAN in situations where minimal bone height exists above the IAN canal. However, long-term clinical investigations are recommended.

Alveolar Ridge Augmentation↗