Bone Regeneration After Procedure For Preservation of Alveolar Ridge With BONDBONE®

Introduction

Ridge augmentation technics are a matter of choice after tooth extraction in order to prevent the loss of bone as a result of atrophic changes that may occur in time. We can say that for the current widely used alloplastic materials based on betatricalcium phosphate and hidroxylapatite the resorbtion time is 6 - 9 - 12 months*. This fact needs to be taken in consideration, when placing an implant in an area with guided bone regeneration. The need of using a membrane to immobilize the bone graft and covering it with flap additionally increases the complexity of the procedure. In this case study we are going to demonstrate the capabilities of biphasic calcium sulphate (BONDBONE®) as a bone graft material that provides predictable results and bone regeneration on the 4th month after the usage.

Aim

To present the histopathology result of bone regeneration in a clinical case of conventional implant placing after a procedure for saving the alveolar ridge using BONDBONE®.

Methods And Materials

A 55 years old patient with present bridge constructions - #17_16_15_#14; #23_24_#25_#26; #34_35_36_#37; #44_45_46_#47 placed 5 years ago. The complaints of the patient are connected with recurring periodontic symptoms from tooth #14 (median bridge carrier from the bridge construction - #17_16_15_#14. After the removal of the bridge construction, a 2nd degree of mobility is determined as well as a periapical lesion. After an atraumatic extraction, the socket is filled in with BONDBONE®without having to cover the graft with a membrane. Free gingival autotransplant from the neighboring toothless area is mobilized. The gingiva of the extraction wound is fixed with a modified vertical mattress suture stitch and the gingiva graft is fixated with Ostitches. After 4 months is performed a mucoperiostal flap with the purpose of placing dental implants on #14, #15 and #16. Bone biopsy is taken with a trephine borer from the places of the future implants. Sample 1 is taken from the spot with BONDBONE®and Sample 2 is from patient’s own bone from spot #15. Results of the histopathology- “Fragment of spongios bone with fibrosing of the bone marrow spaces”- Military Medical Academy, department “Patomorfology, autopsy and biopsy diagnostic”.

Conclusion

The presented clinical case shows that Bond Bone can be used with predictable success in cases where the bone volume of the alveoli ridge needs to be preserved. The advantages of the material are that there is no need to use an immobilizing membrane, as well as the quick hardening of the material in the presence of oral liquids. Having in mind that so far there isn’t a similar bone graft material with histomorphology on the 4th month close to natural bone, the product will be subject of additional research.

References

Karl-Erik Kahnberg-Bone Grafting Techniques for Maxillary Implants 2005 Martin Dunitz-Implants and Restorative Dentistry 2001.

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News 28, October 2011

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Professor assistant at the Parodontology Department “ Faculty of Dental Medicine”, Medical University Sofia-Bulgaria

Fig. 1

Ro condition before the extraction of #14 (14.06.2010)Fig. 2Clinical condition before the extraction of #14

(16.06.2010)