Marta Krasny

Evaluation of treatment outcomes and clinical indications for antibiotic prophylaxis in patients undergoing implantation procedures.

PURPOSE The use of antibiotic therapy during implantation to reduce the risk of an early implant failure is widely discussed among clinicists. However, half an hour after the procedure a quarter of patients show bacteremia which could decrease the efficacy of the surgery. Implant failure is associated with destruction of bone tissue within the alveolar process and may lead to an alternative but compromised treatment plan. The aim of the study was to evaluate the influence of perioperative antibiotic protection on success of implantation. MATERIAL AND METHODS The retrospective study involved 1915 patients (females: 57.3%, males: 42.7%) with no systemic or local diseases, who required antibiotic therapy during surgical procedures. Group 1 comprised 203 patients with diagnosed vertical or horizontal bone atrophy within the alveolar ridge requiring reconstruction procedure before implantation. Group 2 included 1712 patients who did not need any surgical procedures before implantation. All the subjects took three types of antibiotics twice a day for 7 days. The data were statistically analyzed. RESULTS A total number of 3309 implants were placed. Implantation efficacy in group 1 amounted to 98.53% and in group 2 it was 99.24%. Complications occurred most commonly after administration of cephalosporin which proved to be statistically significant for the patients who underwent augmentation with a bone block before the implant procedure (p 0.0209). CONCLUSIONS Perioperative use of antibiotic therapy beneficially influences tissue healing, provides safety and success of the surgical procedure, as well as translates into high efficacy of implantation (99.52%).

Global maxillary ridge augmentation with frozen radiation-sterilised bone blocks followed by implant placement: a case report

AbstractDue to atrophy of the tissue within the alveolar ridge, implantation must sometimes be preceded by bone regeneration. The use of allogeneic material allows the surgeon to prepare grafts of any shape and amount; therefore it is a good alternative to autograft reconstruction in patients with extensive atrophy of the alveolar ridge. The patient with maxillary anodontia showed insufficient width of the ridge along its entire length, which prevented implantation. Therefore, alveolar ridge reconstruction was planned. Four frozen, radiation-sterilised bone blocks processed in the Tissue Bank in Warsaw were used for reconstruction of the alveolar ridge. The blocks were grafted to the area of molars, premolars and lateral incisors bilaterally. Three months after surgery a normal union of transplants with the recipient site was achieved. Six implants were embedded and following the 6-month integration period a permanent prosthetic restoration was successfully performed. During a 38-month follow-up none of the implants were lost and the aesthetic or functional condition of the prosthetic restoration did not deteriorate. Frozen allogeneic radiation-sterilised bone blocks constitute good, efficient and safe material used in reconstruction of the alveolar ridge in extensive bone atrophy. This is only one of possible grafting materials for reconstruction of extremely atrophic alveolar ridge.

Preparation of allogeneic bone for alveolar ridge augmentation

Implant treatment is safe and predictable with sufficient amount and quality of bone tissue. In case of severely reduced bone tissue after a tooth was lost, augmentation of such tissue is necessary before implant embedment. Retrospective evaluation covered 380 alveolar ridge reconstructions. The study material consisted of human grafts prepared by the Department of Transplantology and Central Tissue Bank, Medical University of Warsaw. Presentation of laboratory procedures in the context of physical parameters of frozen, radiation sterilised, allogeneic corticocancellous material was presented. The preparation process makes it possible to obtain two types of bone material: granules and blocks. Women underwent 164 procedures with the use of bone granules and 61 augmentations with bone blocks. In case of men 122 packages of granules were used as well as 33 bone blocks. Based on the results an evaluation of usability of available allogeneic grafts was performed with reference to planned alveolar ridge augmentation procedures, which they were used for. 1.The opportunity to prepare allogeneic material of different textures allowed selection to meet augmentation requirements while providing biological safety.2.Allogeneic granules should be used in multi-wall defects, such as a double, closed sinus lift and post-extraction socket augmentation.3.Owing to their superior mechanical parameters, bone blocks were successfully used in extending the width and height of the alveolar ridge and in open sinus lifts with one-wall or two-wall defects and adequate location of the lamellar bone in a graft prevented substantial graft resorption.