Applications Of Implant Healing Abutment Supporting Vertical Bone Augment In Mandibular Posterior Area

Objective:Adequate bone volume of jaw is the basic condition of dental implantation.However,after the dentition defect in the posterior area of mandibular,due to its anatomical characteristics,most patients have the phenomenon of insufficient bone height,that is,the distance between the top of the mandibular alveolar ridge and the upper wall of the inferior alveolar neural tube is insufficient.In this case,bone augmentation surgery is often required before implantation,such as using autogenous bone graft,bone replacement material mixed with autogenous bone graft,or bone replacement material alone.The effect of these methods of bone augmentation is clear,but there are also some problems such as large surgical trauma,high cost and long treatment cycle.However,for the bone height deficiency in the mandibular posterior area in a small range,how to implant implants and augment vertical bone height at the same time on the premise of minimizing surgical trauma,so as to achieve the purpose of less trauma,low cost and short treatment period will be the focus of this study.In this study,the method of implant combined with healing abutment was used as support to carry out simultaneous vertical bone augment,so as to solve the problem of insufficient vertical bone height in a small area of mandibular posterior teeth.The effect of vertical bone augment,soft tissue around implant and crown repair on the success rate of implant were discussed,and the cases of vertical bone augment failure were analyzed,in order to provide certain clinical evidence.Materials and methods:According to the inclusion and exclusion criteria,from September 2018 to September2020,12 patients who needed mandibular posterior dental implants but lacked vertical bone height were collected from the Department of Stomatology of the Third Affiliated Hospital of Guangzhou Medical University,and underwent vertical bone augmentation surgery with implant healing abutment supporting the mandibular posterior area.The effect of vertical bone augment was approved.Peripherals soft tissue parameters were recorded during follow-up before crown restoration,and implant success rate and complications were recorded after restoration,which were imported into statistical software for analysis.Results:In this study,all 12 patients,aged 42-73 years with an average age of 55.91±11.58years,underwent vertical bone augment surgery in the mandibular posterior area with implant healing abutment support,including 7 male patients and 5 female patients.All15 implants were implanted in the 12 patients,and 3 patients received implant healing abutment augmentation for 2 consecutive dental positions,all using SLA TSIII Osstem implants(4.5*8.5mm),and the implant success rate was 93.3%.In this study,among all 15 vertical bone augment sites in the mandibular posterior dental area supported by implant healing abutment,1 patient failed to achieve vertical bone increment at 1 site(H0=0mm),the effect of vertical bone increment at 1 site was2 mm < H0≤2.5mm,the effect of vertical bone increment at 4 sites was 2.5mm < H0≤3mm,and the effect of vertical bone increment at 8 sites was 3mm < H0≤3.5mm.Vertical bone increment effect at 1 site was 3.5mm < H0≤4mm.Mean vertical bone augment: 2.9mm.The minimum and maximum m PLI of perimplant soft tissue parameters were 1,3,the mean was 1.6,and the standard deviation 0.71.The minimum value of m SBI was 0,the maximum value was 3,the mean was 0.73,and the standard deviation was 0.85.The mesial minimum and maximum values of PD were 2,5,2.73 and 0.91,respectively.The distal minimum value was 2,the maximum value was 7,the mean value was 3,the standard deviation was 1.26;The buccal minimum value was 2,the maximum value was 5,the mean was 2.8,the standard deviation was 0.83;The lingual minimum value was 2,the maximum value was 4,the mean was 2.6,and the standard deviation was 0.61.There were no clinically visible complications such as implant loosening,porcelain collapse,abutment or central screw was fractured at the 15 sites where the crown was restored.Conclusion:The vertical bone augmentation operation with implant-healing abutment supporting the mandibular posterior area has the advantages of simple operation,small trauma,obvious bone augmentation effect,and basically stable soft tissue and repair effect during short-term follow-up,which has good clinical application effect.It is worth popularizing in the case of vertical bone height in the mandibular posterior area in a smaller scope.