Vertical bone augmentation
Successful placement of implants requires sufficient alveolar ridge height. Conventional approaches to increase the ridge height include autogenous bone block grafting, interpositional bone grafting, and form-stable membranes.
Augmentation with bone blocks
Autogenous bone blocks are the material of choice to compensate insufficient bone height. Resorption, however, can result in functional and aesthetic complications.
Contouring the bone block with slow resorbing Geistlich Bio-Oss® bone substitute and covering the augmented area with a Geistlich Bio-Gide® collagen barrier reduces graft shrinkage. The volume of the augmented ridge remains stable1.
Vertical resorption of the alveolar ridge is visible.
A mixture of autogenous particulated bone and Geistlich Bio-Oss® is used to cover the bone blocks and to cover steps between the margins of the grafts and the recipient bed. This procedure will simplify the contouring of the graft.
The grafts (blocks and particulated bone + Geistlich Bio-Oss®) are covered with a resorbable collagen membrane (Geistlich Bio-Gide®) in order to stabilise the particulated graft and to reduce the risk of bone resorption.
Augmentation with form-stable membranes
Currently, a form-stable membrane is required for large vertical ridge augmentation in the absence of a bone block. Synthetic titanium-reinforced membranes are often used, but with the risk of premature exposure and bacterial infection2,3. The additional use of Geistlich Bio-Gide® favours soft-tissue healing and minimises wound dehiscences4.
The space below the form-stable titanium-reinforced membrane can be filled with a mixture of autogenous bone chips and Geistlich Bio-Oss® granules. This facilitates an optimal balance of bone formation – induced by bone chips – and volume preservation through slow resorption rate of Geistlich Bio-Oss®5.
Vertically atrophied posterior ridge.
The particulated graft consisting of Geistlich Bio-Oss® and autogenous bone is placed around the tenting screws and over the atrophic mandible.
The titanium-reinforced e-PTFE membrane is shaped to adapt to the defect filled with Geistlich Bio-Oss® and autogenous bone chips.
References:
- Chiapasco M, et al.: Clin Oral Implants Res 2013; 23(9): 1012-21.
- Zitzmann N, et al.: Int J Oral Maxillofac Implants 1997; 12(6): 844-52.
- Schneider D, et al.: Clin Oral Implants Res 2013; Feb 25. [Epub ahead of print].
- Tal H, et al.: Clin Oral Implants Res 2008; 19(3): 295-302.
- Simion M, et al.: Clin Oral Implants Res 2007; 18(5): 620-29.