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MINERVA STOMATOLOGICA

A Journal on Dentistry and Maxillofacial Surgery


Official Journal of the Italian Society of Odontostomatology and Maxillofacial Surgery
Indexed/Abstracted in: CAB, EMBASE, Index to Dental Literature, PubMed/MEDLINE, Scopus, Emerging Sources Citation Index


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Minerva Stomatologica 2017 Jul 04

DOI: 10.23736/S0026-4970.17.04006-7

Copyright © 2017 EDIZIONI MINERVA MEDICA

language: English

Alveolar splitting with piezosurgery, bone bank grafts and Nobelactive implants as an alternative to major bone grafting for maxillary reconstruction

Massimo ALBANESE 1, Giulia RICCIARDI 1, Dario DONADELLO 1, Alessandra LUCCHESE 2, 3, Federico GELPI 1, Alessandro ZANGANI 1, Daniele DE SANTIS 1, Alessandro RIZZINI 1, Alberto ROSSETTO 1, Dario BERTOSSI 1

1 Section of Oral and Maxillofacial Surgery, Department of Surgical Sciences, Dentistry, Gynecology and Pediatrics, University of Verona, Verona, Italy; 2 Department of Orthodontics, Vita Salute San Raffaele University, Milan, Italy; 3 Unit of Dentistry, Division of Orthodontics, Research Area in Dentofacial Orthopedics and Orthodontics, IRCCS San Raffaele Scientific Institute, Milan, Italy


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BACKGROUND: Piezo-surgery represents a novel alternative technique. The Piezo-surgery is well tolerated and permits a large number of applications in decribed literature. The principle of piezo-surgery consists into inducing micro-vibrations to a metallic insert with a particular custom. The aim of this article is to study and to evaluate the use of Nobelactive implants in combination with piezosurgical split-crest technique in severe atrophy of the upper maxilla. This approach allows avoiding the use of onlay grafts, due to rise the trasversal width of the crestal bone, which could have more complications and uncertain prognosis. This technique allows reducing timing of implant insertion because it is not necessary to wait the graft's healing.
METHODS: 10 patients (age 45-58) are selected, presenting from class 4 to 5 by Cawood and Howell of jaws. Those underwent piezosurgical split-crest technique and simultaneous implants surgery and bone grafts. Pre-operative x-ray evaluation included standard x- panoramic and CT Dental-scan. Standard chemoprophylaxis was administered to each patient. The piezosurgical split-crest procedure was combined with tissue bank fresh frozen chips and double-layer collagen membrane to improve the thickness of alveolar bone and simultaneous implant surgery. Every patient received simultaneously from 3 to 6 implants which diameter was 4.3 mm and lengt 10-11.5 mm. Healing abutments have been applied at 5 months from the first procedure.
RESULTS: Patients were clinically monitored and marginal bone changes were calculated using periapical radiographs, which were taken with O-ring technique at placement and upon subsequent appointments and a 1-mm measurement grid for marginal bone remodeling, again at baseline and thereafter 3 months within loading. Cumulative implant survival was 97,8% (n = 45). Mean marginal bone resorption (SD) was 1.19 (1.01) mm for the early loading group after 1 year. The use of Nobelactive implants seem to reduce peak stress in both cortical and trabecular bone.
CONCLUSIONS: The use of Nobelactive implants was revealed ideal in patients presenting jaw atrophy. The tapered designs show an ability to dissipate the interfacial stresses of bone, therefore improving the stability and the osteointegration if used in association to split crest made with piezosurgical device.


KEY WORDS: Piezosurgery - Split-crest technique - Nobelactive implants - Implant survival

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Publication History

Manuscript first published online: July 04, 2017
Manuscript accepted: June 24, 2017
Manuscript revised: June 13, 2017
Manuscript received: August 02, 2016

Cite this article as

Albanese M, Ricciardi G, Donadello D, Lucchese A, Gelpi F, Zangani A, et al. Alveolar splitting with piezosurgery, bone bank grafts and Nobelactive implants as an alternative to major bone grafting for maxillary reconstruction. Minerva Stomatol 2017 Jul 04. DOI: 10.23736/S0026-4970.17.04006-7

Corresponding author e-mail

dario.bertossi@univr.it