DOI:

10.37988/1811-153X_2022_1_58

Osteoplasty in oral surgery: outcomes, complications, success factors, and risks classification

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Authors

  • P.V. Polupan 1, 2, PhD in Medical Sciences, associate professor of the Maxillofacial surgery and hospital surgical dentistry Department
    ORCID: 0000-0003-0161-3784
  • A.M. Sipkin 1, PhD in Medical Sciences, head of the Maxillofacial surgery and hospital surgical dentistry Department, senior researcher
    ORCID: 0000-0001-8287-741X
  • T.N. Modina 3, PhD in Medical Sciences, full professor of the Maxillofacial dentistry Department
    ORCID: 0000-0002-2063-9464
  • 1 Moscow Regional Research Clinical Institute (MONIKI), 129110, Moscow, Russia
  • 2 Moscow Regional Dental Polyclinic, 129110, Moscow, Russia
  • 3 Pirogov National Medical & Surgical Center, 105203, Moscow, Russia

Abstract

The article discusses the results of the outcomes analysis of osteoplasty in the rehabilitation of patients with alveolar ridge atrophy and their complications. An attempt made to analyze the success factors of surgery, a systematic classification of the risks of bone grafting surgery in preparation for dental implantation proposed. The aim of work is the comparative analysis of the results (outcomes) and complications of various osteoplasties techniques for dental implantation.
Materials and methods.
The results of 84 osteoplasties for 22 men and 38 women (2017—2020) were analyzed, clinical examination and treatment of 60 patients aged 23 to 73 years with missing teeth and alveolar ridge atrophy were carried out, which were divided into 4 groups according to the type of osteoplasty: guided bone regeneration (GBR); bone block transplantation (BBT); open sinus-lifting (OSL); local bone modifying (LBM). The outcomes of bone grafting evaluated on a 4-point scale, taking into account clinical and X-ray examination, and postoperative complication evaluated.
Results.
Complications in the form of reversible non-critical vascular reactions (edema, hematoma) occurred in 35.7% of cases, however, they were most often observed in the operations of the GBR (57%) and BBT (53%). After evaluating the outcomes of bone grafting, it was found that the positive result of OSL was 89%, LBM 87%; while we noted a negative result of GBR 79%, and BBT 59%.
Conclusions.
The results of the outcomes analysis of osteoplasty in oral surgery indicate a significant percentage of unsuccessful outcomes of the GBR and BBT. In our opinion, this is due to a number of factors, the main of which are the number of available bone walls of the defect (atrophy), its volume and the state of the periosteum over osteoplasty’s area.

Key words:

alveolar ridge atrophy, bone grafting, surgery outcomes, complications

For Citation

[1]
Polupan P.V., Sipkin A.M., Modina T.N. Osteoplasty in oral surgery: outcomes, complications, success factors, and risks classification. Clinical Dentistry (Russia).  2022; 25 (1): 58—65. DOI: 10.37988/1811-153X_2022_1_58

References

  1. Clementini M., Morlupi A., Canullo L., Agrestini C., Barlattani A. Success rate of dental implants inserted in horizontal and vertical guided bone regenerated areas: a systematic review. Int J Oral Maxillofac Surg. 2012; 41 (7): 847—52. PMID: 22542079
  2. Yamada M., Egusa H. Current bone substitutes for implant dentistry. J Prosthodont Res. 2018; 62 (2): 152—161. PMID: 28927994
  3. Haugen H.J., Lyngstadaas S.P., Rossi F., Perale G. Bone grafts: which is the ideal biomaterial? J Clin Periodontol. 2019; 46 Suppl 21: 92—102. PMID: 30623986
  4. Urban I.A., Montero E., Monje A., Sanz-Sánchez I. Effectiveness of vertical ridge augmentation interventions: A systematic review and meta-analysis. J Clin Periodontol. 2019; 46 Suppl 21: 319—339. PMID: 30667522
  5. Starch-Jensen T., Deluiz D., Tinoco E.M.B. Horizontal Alveolar Ridge Augmentation with Allogeneic Bone Block Graft Compared with Autogenous Bone Block Graft: a Systematic Review. J Oral Maxillofac Res. 2020; 11 (1): e1. PMID: 32377325
  6. Schropp L., Wenzel A., Kostopoulos L., Karring T. Bone healing and soft tissue contour changes following single-tooth extraction: a clinical and radiographic 12-month prospective study. Int J Periodontics Restorative Dent. 2003; 23 (4): 313—23. PMID: 12956475
  7. Chiapasco M., Zaniboni M., Boisco M. Augmentation procedures for the rehabilitation of deficient edentulous ridges with oral implants. Clin Oral Implants Res. 2006; 17 Suppl 2: 136—59. PMID: 16968389
  8. Lomakin M.V., Filatova A.S., Soloshchanskiĭ I.I. Guided bone regeneration in the reconstruction of the alveolar bone volume for dental implantation. Russian Stomatology. 2011; 5: 15—18 (In Russ.). eLIBRARY ID: 20809979
  9. Smbatyan B.S. Bone tissue restoration in the treatment of patients using dental implants in various clinical situations: dissertation. Moscow, 2012. 174 p. (In Russ.).
  10. Bedretdinov R.M. Clinical and morphological assessment of various bone plastic surgeries before dental implantation (experimental clinical study): master’s thesis abstract. Moscow, 2016. 26 p. (In Russ.).
  11. Selsky N.E., Trokhalin A.V., Mukhamadiev D.M. Alveolar Mandible Osteoplasty with Combined Bone Transplants. Creative Surgery and Oncology. 2019; 3: 199—208 (In Russ.). eLIBRARY ID: 41342578
  12. Chuvilkina E.I. The use of prolonged antibacterial drugs of the cephalosporin group during bone plastic surgery on the alveolar process (part) of the jaws for the prevention and treatment of inflammatory complications: master’s thesis abstract. Moscow, 2016. 24 p. (In Russ.).
  13. Khachatryan L.G. Application of various methods of bone plastic surgery in vertical atrophy of jaw bone tissue in order to prepare for dental implantation. Bulletin of Dentistry and Maxillofacial surgery. 2017; 14: 4—13. (In Russ.). eLIBRARY ID: 42854873
  14. Eisenbraun O.V. Application of tunnel technique of bone grafting in patients with jaw bone atrophy: master’s thesis. Moscow, 2018. 257 p. (In Russ.).
  15. Lopez-Cedrun J.L. Implant rehabilitation of the edentulous posterior atrophic mandible: the sandwich osteotomy revisited. Int J Oral Maxillofac Implants. 2011; 26 (1): 195—202. PMID: 21365056
  16. Khoury F., Hanser T. Mandibular bone block harvesting from the retromolar region: a 10-year prospective clinical study. Int J Oral Maxillofac Implants. 2015; 30 (3): 688—97. PMID: 26009921
  17. Khoury F., Hanser T. Three-Dimensional Vertical Alveolar Ridge Augmentation in the Posterior Maxilla: A 10-year Clinical Study. Int J Oral Maxillofac Implants. 2019; 34 (2): 471—480. PMID: 30883623
  18. Kloss F.R., Offermanns V., Kloss-Brandstätter A. Comparison of allogeneic and autogenous bone grafts for augmentation of alveolar ridge defects-A 12-month retrospective radiographic evaluation. Clin Oral Implants Res. 2018; 29 (11): 1163—1175. PMID: 30303581
  19. Sipkin A.M., Modina T.N., Chenosova A.D., Tonkikh-Podolskaya O.A. Morphological assessment of the bone structure of the alveolar growth in the use of atocticosity and xenomaterial, with the addition of unstable hyaluronic acid. Clinical Dentistry (Russia). 2020; 2 (94): 67—72 (In Russ.). eLIBRARY ID: 43125607
  20. Urban I.A., Jovanovic S.A., Lozada J.L. Vertical ridge augmentation using guided bone regeneration (GBR) in three clinical scenarios prior to implant placement: a retrospective study of 35 patients 12 to 72 months after loading. Int J Oral Maxillofac Implants. 2009; 24 (3): 502—10. PMID: 19587874
  21. Choukroun J., Adda F., Schoeffler C., Vervelle A. Une opportunite´ en paro-implantologie: le PRF. Implantodontie. 2000; 42: 55—62 (In French).
  22. Badalyan V.A., Shor E.I., Elfimova N.V., Apoayn A.A., Bagirov T.M. Experience of the immediate dentoalveolar reconstruction method in the aesthetically important zone in order to preserve volume of bone and soft tissue. Clinical Dentistry (Russia). 2018; 4 (88): 26—29 (In Russ.). eLIBRARY ID: 36517610
  23. Polupan P.V. Bone grafting and dental implantation: a look at the problem. Medical Alphabet. 2014; 2 (13): 32—5. (In Russ.).
  24. Jensen O.T., Mogyoros R., Owen Z., Cottam J.R., Alterman M., Casap N. Island osteoperiosteal flap for alveolar bone reconstruction. J Oral Maxillofac Surg. 2010; 68 (3): 539—46. PMID: 20171473
  25. Felice P., Marchetti C., Piattelli A., Pellegrino G., Checchi V., Worthington H., Esposito M. Vertical ridge augmentation of the atrophic posterior mandible with interpositional block grafts: bone from the iliac crest versus bovine anorganic bone. Eur J Oral Implantol. 2008; 1 (3): 183—98. PMID: 20467621
  26. Roccuzzo A., Marchese S., Worsaae N., Jensen S.S. The sandwich osteotomy technique to treat vertical alveolar bone defects prior to implant placement: a systematic review. Clin Oral Investig. 2020; 24 (3): 1073—1089. PMID: 31927693
  27. Felice P., Pistilli R., Zucchelli G., Simion M., Karaban M., Bonifazi L., Barausse C. Decision criteria proposed for the treatment of vertical bone atrophies in the posterior mandible. Int J Periodontics Restorative Dent. 2021; 41 (1): 71—77. PMID: 33528453
  28. Summers R.B. The osteotome technique: Part 2—The ridge expansion osteotomy (REO) procedure. Compendium. 1994; 15 (4): 422, 424, 426, passim; quiz 436. PMID: 8055514
  29. Cho Y. The use of CAS-KIT in clinical cases. Dental implantology and surgery. 2014; 1 (14): 74—5. (In Russ.).
  30. Chenosova A.D. The use of unstabilized hyaluronic acid in patients with atrophy of the alveolar process of the upper jaw, the alveolar part of the lower jaw: master’s thesis abstract. Moscow, 2020. 21 p. (In Russ.).
  31. Li J., Wang H.L. Common implant-related advanced bone grafting complications: classification, etiology, and management. Implant Dent. 2008; 17 (4): 389—401. PMID: 19077576
  32. Herford A.S., Dean J.S. Complications in bone grafting. Oral Maxillofac Surg Clin North Am. 2011; 23 (3): 433—42. PMID: 21622007
  33. Bolonkin I.V. Substantiation of the use of a combined implant in patients with atrophy of the alveolar processes of the jaws (clinical and experimental study): master’s thesis. Samara, 2008. 167 p. (In Russ.).
  34. Chuvilkin V.I., Chuvilkina E.I., Tsarev V.N., Shirokov Iu.E. Preventive antibacterial treatment in oral bone augmentation procedures. Stomatology. 2013; 3: 84—87 (In Russ.). eLIBRARY ID: 19062598
  35. Malysheva N.A., Panin A.M., Vavilova T.P. Evaluation of reparative osteogenesis in reconstruction of defects and deformations of alveolar bone jaw. Dental Forum. 2012; 5: 92 (In Russ.). eLIBRARY ID: 18135923
  36. Polupan P.V., Sipkin A.M., Bondarenko E.V. Biological notes of bone grafting in oral surgery. Medical alphabet. 2021; 24: 27—33 (In Russ.). eLIBRARY ID: 46579077
  37. Kozlov V.A., Aleksandrov A.B. Free mandible autotransplantation with fibula autograft. Herald of north-western state medical university named after I.I. Mechnikov. 2013; 2: 68—73 (In Russ.). eLIBRARY ID: 20504767
  38. Dragoo M.R., Sullivan H.C. A clinical and histological evaluation of autogenous iliac bone grafts in humans. I. Wound healing 2 to 8 months. J Periodontol. 1973; 44 (10): 599—613. PMID: 4583377
  39. Moest T., Wehrhan F., Lutz R., Schmitt C.M., Neukam F.W., Schlegel K.A. Extra-oral defect augmentation using autologous, bovine and equine bone blocks: A preclinical histomorphometrical comparative study. J Craniomaxillofac Surg. 2015; 43 (4): 559—66. PMID: 25794644
  40. Troeltzsch M., Troeltzsch M., Kauffmann P., Gruber R., Brockmeyer P., Moser N., Rau A., Schliephake H. Clinical efficacy of grafting materials in alveolar ridge augmentation: A systematic review. J Craniomaxillofac Surg. 2016; 44 (10): 1618—1629. PMID: 27622971
  41. Nasr S., Slot D.E., Bahaa S., Dörfer C.E., Fawzy El-Sayed K.M. Dental implants combined with sinus augmentation: What is the merit of bone grafting? A systematic review. J Craniomaxillofac Surg. 2016; 44 (10): 1607—1617. PMID: 27622972
  42. Muzykin M.I., Iordanishvili A.K. Post-extraction regeneration of jaw bone sanogenesis model. Human ecology. 2020; 8: 40—48 (In Russ.). eLIBRARY ID: 43801072
  43. Tudor C., Bumiller L., Birkholz T., Stockmann P., Wiltfang J., Kessler P. Static and dynamic periosteal elevation: a pilot study in a pig model. Int J Oral Maxillofac Surg. 2010; 39 (9): 897—903. PMID: 20576403
  44. Dziewiecki D., van de Loo S., Gremse F., Kloss-Brandstätter A., Kloss F., Offermanns V., Yamauchi K., Kessler P., Lethaus B. Osteoneogenesis due to periosteal elevation with degradable and nondegradable devices in Göttingen Minipigs. J Craniomaxillofac Surg. 2016; 44 (3): 318—24. PMID: 26810955
  45. Ito R., Matsumiya T., Kon T., Narita N., Kubota K., Sakaki H., Ozaki T., Imaizumi T., Kobayashi W., Kimura H. Periosteum-derived cells respond to mechanical stretch and activate Wnt and BMP signaling pathways. Biomed Res. 2014; 35 (1): 69—79. PMID: 24573203
  46. Rogers G.F., Greene A.K. Autogenous bone graft: basic science and clinical implications. J Craniofac Surg. 2012; 23 (1): 323—7. PMID: 22337435

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Received

January 12, 2022

Accepted

March 2, 2022

Published on

March 1, 2022