Alveolar Bone Grafting Techniques in Dental Implant Preparation, An Issue of Oral and Maxillofacial Surgery Clinics

Peter Waite

Description

The latest in bone grafting for dental implant preparation! Articles include general principles of bone grafting, genetic and transcriptional control of bone formation, bone graft harvesting from distant sites, bone graft harvesting from regional sites, osteoperiosteal flaps and local osteotomies, allogeneic bone, titanium mesh in alveolar bone grafting, alveolar distraction osteogenesis, soft tissue considerations and gingival grafting, dental implants following reconstruction with free tissue transfer, and more!

Sujets

• Oral Surgery
• Medical
• Médecine
• Dentistry

Informations

• Publié par: Saunders
• Date de parution: 28 août 2010
• Nombre de lectures: 0
• EAN13: 9781455700493
• Langue: English
• Poids de l'ouvrage: 2 Mo

Extrait

Alveolar Bone Grafting Techniques for Dental Implant Preparation , Vol. 22, No. 3, August 2010
ISSN: 1042-3699
doi: 10.1016/S1042-3699(10)00076-2

Contributors List
Oral and Maxillofacial Surgery Clinics of North America
Alveolar Bone Grafting Techniques for Dental Implant Preparation
Guest Editor: Peter D. Waite, MPH, DDS, MD
Department of Oral and Maxillofacial Surgery, University of Alabama School of Dentistry, University of Alabama at Birmingham, 419 School of Dentistry Building, 1530 3rd Avenue South, Birmingham, AL 35294-0007, USA
Consulting Editor: Richard H. Haug, DDS
ISSN  1042-3699
Volume 22 • Number 3 • August 2010

Alveolar Bone Grafting Techniques for Dental Implant Preparation , Vol. 22, No. 3, August 2010
ISSN: 1042-3699
doi: 10.1016/S1042-3699(10)00077-4

Contents
Cover
Contributors List
Forthcoming Issues
Preface
Genetic and Transcriptional Control of Bone Formation
Principles of Bone Grafting
Bone Graft Harvesting From Distant Sites: Concepts and Techniques
Bone Graft Harvesting from Regional Sites
Osteoperiosteal Flaps and Local Osteotomies for Alveolar Reconstruction
Bone Materials Available for Alveolar Grafting
Vertical Ridge Augmentation Using Titanium Mesh
Alveolar Distraction Osteogenesis for Dental Implant Preparation: An Update
Soft Tissue Considerations in Implant Site Development
Dental Implants After Reconstruction with Free Tissue Transfer
Retrieval and Analysis of Explanted and In Situ Implants Including Bone Grafts
Index
Alveolar Bone Grafting Techniques for Dental Implant Preparation , Vol. 22, No. 3, August 2010
ISSN: 1042-3699
doi: 10.1016/S1042-3699(10)00078-6

Forthcoming Issues
Alveolar Bone Grafting Techniques for Dental Implant Preparation , Vol. 22, No. 3, August 2010
ISSN: 1042-3699
doi: 10.1016/j.coms.2010.06.004

Preface
Alveolar Bone Grafting Techniques for Dental Implant Preparation

Peter D. Waite, MPH, DDS, MD
Department of Oral and Maxillofacial Surgery, University of Alabama School of Dentistry, University of Alabama at Birmingham, 419 School of Dentistry Building, 1530 3rd Avenue South, Birmingham, AL 35294-0007, USA
E-mail address: [e-mail]

Peter D. Waite, MPH, DDS, MD Guest Editor
Bone grafting for implant site preparation has become a new surgical technique niche similar to what preprosthetic surgery was for removable dentures. Preprosthetic surgery is almost a lost art, but the surgical techniques necessary for alveolar reconstruction or implant site preparation have become much more complex and variable. The surgical art of ridge reconstruction in preparation for dental implants in many ways has become more important and complex than the simple placement of dental implants. The final prosthetic result depends on creating the correct alveolar arch morphology, alignment, and symmetry. Oral and maxillofacial surgeons (OMSs) are best trained to address this unique surgical niche.
Bone grafting techniques are not new for the OMS, and therefore basic principles used in alveolar cleft grafting and jaw reconstruction after trauma and oncologic defects are valuable clinical applications. However, bone grafting for implant patients are quite different in many ways. Such patients often expect minimal morbidity, outpatient clinic procedures, and reasonable private financing. The amount of bone required is much less, but the stability and predictability much higher. We now know that just getting an implant in bone is not adequate if the biologic width and soft tissue is insufficient. Cosmetic reconstruction begins with the correct alveolar bone height and contour. The role of the OMS in the dental implant team will become more important as the public comes to expect natural cosmetic, long-term stability. Much of what we do is pragmatic, and dogma changes from year to year, or speaker to speaker.
The purpose of this issue is to lay out a logical approach to alveolar reconstruction and bone grafting for implant preparation. This begins with the basic science of bone biochemistry and physiology. In recent years, we have come to understand bone at a much deeper level. Understanding the human genome has unlocked some of the secrets that regulate bone deposition and resorption. Although the first article may be partially incomprehensible for the surgeon, it is important to know that bone products are developing with sound scientific structure. Bone is a much more dynamic matrix with multiple regulating factors than previously thought. It is exciting to discuss clinical problems with our basic science colleagues and share in the translational research. Basic science understanding does change the surgeon's behavior. The principles of bone grafting are applicable for the simple socket graft, sandwich graft, or the sinus lift. We must establish minimally invasive office-based procedures that yield predictable outcomes. Bone must be harvested by predictable surgical techniques, whether from local or distant sites. The OMSs are trained to harvest the best bone indicated, and therefore choice is not limited to just allogenic bone (bottle bone). New procedures such as ridge splitting, distraction osteogenesis, and titanium mesh are examples of this new surgical niche that are built on the solid surgical principles of the past. No bone graft or surgical procedure will be successful without adequate vasculature and soft tissue protection. We learn most from our failures, and the article on explantation gives us valuable information on the biomaterials of implants.
I hope our specialty finds this issue to be a valuable contribution to the clinical practice of preimplant surgery. I have learned a great deal by editing the articles, and it has already changed my surgical approach and techniques. I want to thank each of the authors who worked so hard over and beyond their normal duties to make this issue possible.
Alveolar Bone Grafting Techniques for Dental Implant Preparation , Vol. 22, No. 3, August 2010
ISSN: 1042-3699
doi: 10.1016/j.coms.2010.05.001

Genetic and Transcriptional Control of Bone Formation

Amjad Javed, MSc, PhD a , * , Haiyan Chen, PhD a , Farah Y. Ghori, MD b
a Department of Oral and Maxillofacial Surgery, School of Dentistry, University of Alabama at Birmingham, Birmingham, AL, USA
b Institute of Oral Health Research, School of Dentistry, University of Alabama at Birmingham, SDB 713, 1530 3rd Avenue South, Birmingham, AL 35294-0007, USA
* Corresponding author. Institute of Oral Health Research, University of Alabama at Birmingham, SDB 714, 1530 3rd Avenue South, Birmingham, AL 35294-0007.
E-mail address: [e-mail]

Abstract
An exquisite interplay of developmental cues, transcription factors, and coregulatory and signaling proteins support formation of skeletal elements of the jaw during embryogenesis and dynamic remodeling of alveolar bone in postnatal life. These molecules promote initial condensation of the mesenchyme, commitment of the mesenchymal progenitor to osteogenic lineage cells, and differentiation of committed osteoblasts to mature osteocytes within mineralized bone. Parallel regulatory networks promote formation of the functional osteoclast from mononuclear cells to support continuous bone remodeling within the alveolar bone. With an ever expanding list of new regulatory factors, the complexities of the molecular mechanisms that control gene expression in skeletal cells are being further appreciated. This article examines the multifunctional roles of prominent nuclear proteins, cytokines, hormones, and paracrine factors that control osteogenesis.

Keywords
• Bone development • Skeletal remodeling • Osteoblast • Molecular signaling
Skeletogenesis in mammals requires coordinated activities of multiple cell types and is formed by two distinct developmental processes.
1. Endochondral ossification: Most skeletal elements in the body, including all long bones, are derived by this process. Sequential maturation and degradation of a chondrocyte-produced cartilaginous template is a prerequisite for osteoblast recruitment. The second step in endochondral ossification is the eventual replacement of cartilage matrix with mineralized matrix synthesized by osteoblasts.
2. Intramembranous ossification: Craniofacial skeletal elements are primarily derived through this process whereby cells in condensed mesenchyme directly differentiate into mineralizing osteoblasts.

Developmental origin of alveolar bone
During embryonic development, blocks of condensed mesenchyme are modeled into precisely shaped cartilaginous elements. 1 In humans, this process of skeletal patterning is completed within the first trimester of pregnancy (ninth week after conception). Subsequently, the skeletal tissue template undergoes a dramatic increase in size and ossification but with a relatively small change in the basic shape of bones. In mammals, the mandibular and maxillary bones develop from the first branchial arch during embryonic skeletal patterning. 2 The alveolar bone and processes in the maxilla and mandible are formed by intramembranous ossification. However, cellular components of the craniofacial skeleton are unique and include cranial neural crest-derived ectomesenchyme. 3, 4 The mandibular and maxillary alveolar process houses and supports the dentition. Tooth development initiates as a local thickening of oral epithelium that subsequently grows into the underlying neural crest-derived mesenchyme of the first branchial arch. 5, 6 Tooth development procee