Clinical implant dentistry and related research · 2024
Prefabricated CAD-CAM scaffolds for management of oro-antral communication: A case report and histological analysis.
Клинический случайСтатьяНазвание и аннотация: Перевод пока не подготовлен
Обработка статьи · этапы, ошибки и управление
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История · было → стало
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Helal Mohamed H, Ali Ahmed N, Ghoraba Sahar F, Aboushelib Moustafa N
Аннотация
INTRODUCTION: Oro-control communication is one of the complications associated with dental extraction and oral surgeries. This case report presents a minimally invasive surgical approach for bone regeneration at the site of oro-antral communication utilizing a prefabricated computer-aided design and computer-aided manufacturing (CAD-CAM) allogenic bone block.
METHODS: A 20-year-old healthy female, nonsmoker, with a badly destructed upper right first molar was referred for dental implant placement after extraction. Cone beam computerized tomography images revealed the presence of a large bone defect associated with oro-antral communication with the maxillary sinus and insufficient bone for dental implant placement. A prefabricated CAD-CAM allogenic bone scaffold was fabricated. After surgical exposure, the scaffold was secured in place and covered with a non-resorbable membrane. A dental implant was placed after 5 months, and a trephining biopsy was processed for histological evaluation.
RESULTS: Closure of the oro-antral communication was clinically observed. The average width of the alveolar bone was 12 mm, and the average height was 11 mm. Histological analysis at 5-month intervals showed thin newly formed bone trabeculae encircling remnants of graft material surrounded by osteoid tissue. The newly formed bone percentages were 32 ± 18% and 28 ± 17% volume remained after the biodegradation of the scaffold. Specific immune-histochemical staining by anti-vascular epithelial growth factor expression index value was 32.06%.
CONCLUSIONS: A prefabricated CAD-CAM scaffold was successfully used to seal a large oro-antral communication and regenerate sufficient bone to place a dental implant.
METHODS: A 20-year-old healthy female, nonsmoker, with a badly destructed upper right first molar was referred for dental implant placement after extraction. Cone beam computerized tomography images revealed the presence of a large bone defect associated with oro-antral communication with the maxillary sinus and insufficient bone for dental implant placement. A prefabricated CAD-CAM allogenic bone scaffold was fabricated. After surgical exposure, the scaffold was secured in place and covered with a non-resorbable membrane. A dental implant was placed after 5 months, and a trephining biopsy was processed for histological evaluation.
RESULTS: Closure of the oro-antral communication was clinically observed. The average width of the alveolar bone was 12 mm, and the average height was 11 mm. Histological analysis at 5-month intervals showed thin newly formed bone trabeculae encircling remnants of graft material surrounded by osteoid tissue. The newly formed bone percentages were 32 ± 18% and 28 ± 17% volume remained after the biodegradation of the scaffold. Specific immune-histochemical staining by anti-vascular epithelial growth factor expression index value was 32.06%.
CONCLUSIONS: A prefabricated CAD-CAM scaffold was successfully used to seal a large oro-antral communication and regenerate sufficient bone to place a dental implant.