Lateral alveolar ridge augmentation using a synthetic nano-crystalline hydroxyapatite bone substitution material (Ostim): preliminary clinical and histological results.

Clin Oral Implants Res

Department for Oral Surgery and Dental Radiology, Campus Virchow Clinic Charité Centre 3 for Dental Medicine, Charité- Medical University Berlin, Berlin, Germany.

Published: December 2007

AI Article Synopsis

  • The study aimed to assess the tissue composition at sites augmented with a nano-crystalline hydroxyapatite (ncHA) material through clinical and histological evaluations.
  • Fourteen patients undergoing lateral ridge augmentation were treated with ncHA, and various parameters were measured, including complications and the success of bone integration over a period of 6-7 months post-surgery.
  • Results showed significant gains in alveolar ridge width, minor complications, and persistence of ncHA in biopsies, indicating effective bone filling and integration over time.

Article Abstract

Objectives: The purpose of this preliminary two-center clinical prospective study was to evaluate the tissue composition of augmented sites after the use of a nano-crystalline hydroxyapatite (ncHA) bone substitution material by clinical and histological examinations.

Material And Methods: A synthetic ncHA augmentation material was used without any additives in 14 patients requiring lateral ridge augmentation 6-7 months before (10 patients) or at implant placement (four patients). The ncHA material was covered by a titanium mesh for space maintenance. Clinical and radiographic parameters were evaluated and bone biopsy cores, obtained 6-7 months following augmentation, were assessed histologically and histomorphometrically.

Results: One patient showed gingival swelling, redness and pain at the augmentation site requiring removal of the titanium mesh 6 weeks postoperatively. In seven patients, a premature exposure of the titanium mesh without any inflammatory symptoms was noted. The width of the fixed gingival and the alveolar ridge height did not change significantly at least 6 months following augmentation (P>0.5), whereas a significant gain in alveolar ridge width (P=0.01) was noted. After a median period of prosthetic loading of 24 months, no implant was considered to be a failure. Histology revealed ncHA remnants in peripheral and central parts of biopsy cores obtained from seven patients after at least 6 months without histological symptoms of inflammation, whereas histomorphometry of bone cores revealed no significant differences of the mean percentage area of ncHA in peripheral (23.4%) and central (15.1%) parts of biopsy cores (P=0.262). The mean percentage area of bone colonizing the defect was 52.3%.

Conclusions: Small amounts of ncHA were found after at least 6 months in bone biopsies. The former defect space was filled with bone. The alveolar ridge width gain was found to be significant after lateral augmentation utilizing ncHA, providing a quantitatively and qualitatively sufficient site for primary stable implant placement.

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http://dx.doi.org/10.1111/j.1600-0501.2007.01416.xDOI Listing

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