Download PDF
Informationen aus Orthodontie & Kieferorthopädie 2014; 46(02): 71-80
DOI: 10.1055/s-0034-1382046
Originalarbeit
© Georg Thieme Verlag KG Stuttgart · New York

Augmentation des Implantatlagers durch forcierte orthodontische Extrusion[*]

Implant Site Development by Orthodontic Forced Extraction
F. Amato
1   Private Practice, Catania, Italy
,
D. Mirabella
2   Adjunct Professor, Department of Orthodontics, University of Ferrara, Italy
,
U. Macca
3   Private Practice, Siracusa, Italy
,
D. P. Tarnow
4   Clinical Professor and Director of Implant Education, Columbia University College of Dental Medicine, New York, USA
› Author Affiliations
Further Information

Publication History

Publication Date:
17 June 2014 (online)

Also available at
    Permissions and Reprints

Zusammenfassung

Ziel: Beurteilung der Reaktion von Hart- und Weichgeweben auf eine orthodontische Implantatbettaugmentation (d. h. orthodontische Extrusion), Bestimmung der Menge des neu gebildeten Gewebes und der Beziehung zur Extrusionsstrecke, Untersuchung der Gewebereaktionen bei Zähnen mit unterschiedlich starkem Verlust an parodontalem Attachment, Erkennen der Grenzen für eine OISD (orthodontic implant site development), Ermittlung der Erfolgsrate der Implantate.

Material und Methoden: An insgesamt 32 nicht erhaltungswürdigen Zähnen wurde eine OISD durchgeführt und bei 13 Patienten 27 Implantate eingesetzt. Dabei wurden die Höhe des parodontalen Attachments an den zu extrahierenden Zähnen, die Menge an augmentiertem Alveolarknochen, Veränderungen im Volumen der Weichgewebe und das Ausmaß der orthodontischen Zahnbewegung bestimmt.

Ergebnisse: Nach der OISD konnten folgende Mittelwerte bestimmt werden: orthodontische Extrusionsbewegung 6,2±1,4 mm; Knochenaugmentation 4±1,4 mm; Bewegung des Gingivarandes nach koronal 3,9±1,5 mm: Bewegung der Mukogingivalgrenze nach koronal 3,1±1,3 mm; Augmentation der befestigten Gingiva 1,8±1,1 mm; Augmentation der Gingivadicke (bukkolingual) 0,7±0,4 mm; Rezessionen 1,8±1,2 mm; Verhältnis zwischen Knochenaugmentation und orthodontischer Bewegung (Effizienz) 68,9%±17,3%; Verhältnis zwischen Gingivaaugmenta­tion und orthodontischer Bewegung (Effizienz) 65,2%±19,9% und Reduzierung der Taschentiefe 1,8±0,9 mm. Die Erfolgsrate für die Implantate betrug 96,3%.

Schlussfolgerungen: Die orthodontische Implantatbettaugmentation war ein geeignetes Verfahren zur Regeneration von Gewebe im Bereich dieser nicht erhaltungswürdigen Zähne. Seine Effizienz betrug etwa 70% bei der Regeneration von Knochengewebe und 60% bei der Regeneration von Gingiva. Der Anteil an noch vorhandenem parodontalem Attachment hatte keinen Einfluss. OISD kann eine wichtige Behandlungsoption für eine Implantatbettaugmentation bei Patienten sein, bei denen auch eine konventionelle kieferorthopädische Behandlung erforderlich ist.

Abstract

Purpose: To evaluate the soft and hard tissue response to orthodontic implant site development (OISD) (i. e., forced extraction), to measure the amount of tissue that was regenerated and its relationship to the amount of orthodontic vertical tooth movement, to evaluate the tissue response in teeth with different degrees of periodontal attachment loss, to understand the limits of OSID, and to evaluate the implant survival rate.

Materials and Methods: A total of 32 hopeless teeth were treated with OSID, and 27 implants were placed in 13 patients consecutively. The level of periodontal attachment on the teeth to be extracted, amount of augmented alveolar bone, changes in soft tissue volume, and the rate of orthodontic tooth movement were recorded.

Results: Mean values after OSID were as follows: orthodontic exclusive movement, 6.2±1.4 mm; bone augmentation, 4±1.4 mm, coronal movement of the gingival margin, 3.9±1.5 mm; coronal movement of the mucogingival junction, 2.1±1.3 mm; keratinized gingival augmentation, 1.8±1.1 mm; gingival thickness (buccolingual dimension) augmentation, 0.7±0.4 mm; recession, 1.8±1.2 mm; bone augmentation/orthodontic movement ratio (efficacy). 68.9%±17.3%; gingival augmentation/orthodontic movement ration (efficacy), 65.2%±19.9%; and pocket depth reduction, 1.8±0.9 mm. The implant survival rate was 96.3%.

Conclusions: OISD was a viable treatment for these hopeless teeth to regenerate hard and soft tissues. Its efficacy was about 70% for bone regeneration and 60% for gingival augmentation. The residual attachment level on the tooth was not a limitation. OISD might be a valuable treatment option to regenerate tissues for implant site development in patients in need of conventional orthodontic therapy.

Schlüsselwörter

Knochenaugmentation - forcierte Eruption - Gingivaaugmentation - Implantatbettaugmentation - forcierte orthodontische Extrusion - orthodontische Implantatbettaugmentation

Key words

bone augmentation - forced eruption - gingiva augmentation - implant site development - orthodontic extrusion - orthodontic implant site development (OISD)

* Dieser Artikel ist im englischen Original bereits erschienen im Int J Oral Maxillofac Implants. 2012; 27: 411–420.


 

  • Literatur

  • 1 Albrektsson T, Zarb G, Worthington P et al. The long-term efficacy of currently used dental implants: a review and proposed criteria of success. Int J Oral Maxillofac Implants 1986; 1: 11-25
    PubMedSearch in Google Scholar
  • 2 Kan JY, Rungcharassaeng K, Lozada J. Immediate placement and provisionalization of maxillary anterior single implants: 1-year prospective study. Int J Oral Maxillofac Implants 2003; 18: 31-39
    PubMedSearch in Google Scholar
  • 3 Gotfredsen K. A 5-year prospective study of single-tooth replacements supported by the Astra Tech implant: a pilot study. Clin Implant Dent Relat Res 2004; 6: 1-8
    CrossrefPubMedSearch in Google Scholar
  • 4 Henriksson H, Jemt T. Measurements of soft tissue volume in association with single-implant restorations: a 1-year comparative study after abutment connection surgery. Clin Implant Dent Relat Res 2004; 6: 181-189
    CrossrefPubMedSearch in Google Scholar
  • 5 Buser D, Martin W, Belser UC. Optimizing esthetics for implant restorations in the anterior maxilla: anatomic and surgical considerations [review]. Int J Oral Maxillofac Implants 2004; 19: 43-61
    PubMedSearch in Google Scholar
  • 6 Carlsson GE, Bergman B Hedegård Changes in contour of the maxillary alveolar process under immediate dentures. A longitudinal clinical and x-ray cephalometric study covering 5 years. Acta Odontol Scand 1967; 25: 45-75
    CrossrefPubMedSearch in Google Scholar
  • 7 Schropp L, Wenzel A, Kostopoulos L et al. 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: 313-323
    PubMedSearch in Google Scholar
  • 8 Nevins M, Camelo M, De Paoli S et al. A study of the fate of the buccal wall of extraction sockets of teeth with prominent roots. Int J Periodontics Restorative Dent 2006; 26: 19-29
    PubMedSearch in Google Scholar
  • 9 Araújo MG, Wennström JL, Lindhe J. Modeling of the buccal and lingual bone walls of fresh extraction sites following implant installation. Clin Oral Implants Res 2006; 17: 606-614
    CrossrefPubMedSearch in Google Scholar
  • 10 Botticelli D, Persson LG, Lindhe J et al. Bone tissue formation adjacent to implants placed in fresh extraction sockets: an experimental study in dogs. Clin Oral Implants Res 2006; 17: 351-358
    CrossrefPubMedSearch in Google Scholar
  • 11 Botticelli D, Berglundh T, Lindhe J. Hard tissue alterations following immediate implant placement in fresh extraction sites. J Clin Periodontol 2004; 31: 820-828
    CrossrefPubMedSearch in Google Scholar
  • 12 Wöhrle PS. Single-tooth replacement in the aesthetic zone with immediate provisionalization: fourteen consecutive case reports. Pract Periodontics Aesthet Dent 1998; 10: 1107-1114
    PubMedSearch in Google Scholar
  • 13 Malò P, Friberg B, Polizzi G et al. Immediate and early function of Brånemark System implants placed in the esthetic zone: a 1-year prospective clinical multicenter study. Clin Implant Dent Relat Res 2003; 5 (Suppl 1): 37-46
    CrossrefPubMedSearch in Google Scholar
  • 14 Esposito M, Grusovin MG, Felice P et al. Interventions for replacing missing teeth: horizontal and vertical bone augmentation techniques for dental implant treatment. Cochrane Database Syst Rev 2009; CD003607
    PubMedSearch in Google Scholar
  • 15 Aghaloo TL, Moy PK. Which hard tissue augmentation techniques are the most successful in furnishing bony support for implant placement?. Int J Oral Maxillofac Implants 2007; 22 (Suppl 1): 49-70
    PubMedSearch in Google Scholar
  • 16 Salama H, Salama M. The role of orthodontic extrusive remodeling in the enhancement of soft and hard tissue profiles prior to implant placement: a systematic approach to the management of extraction site defects. Int J Periodontics Restorative Dent 1993; 13: 312-333
    PubMedSearch in Google Scholar
  • 17 Spear FM, Kokich VG, Mathews DP. Interdisciplinary management of anterior dental esthetics. J Am Dent Assoc 2006; 137: 160-169
    CrossrefPubMedSearch in Google Scholar
  • 18 Kan JY, Rungcharassaeng K, Umezu K et al. Dimensions of peri-implant mucosa: an evaluation of maxillary anterior single implants in humans. J Periodontol 2003; 74: 557-562
    CrossrefPubMedSearch in Google Scholar
  • 19 Jemt T. Regeneration of gingival papillae after single-implant treatment. Int J Periodontics Restorative Dent 1997; 1784: 326-333
    PubMedSearch in Google Scholar
  • 20 Cardaropoli D, Cardaropoli G. Preservation of the postextraction alveolar ridge: a clinical and histologic study. Int J Periodontics Restorative Dent 2008; 28: 469-477
    PubMedSearch in Google Scholar
  • 21 Gardner DM. Platform switching as a means to achieving implant esthetics [review]. N Y State Dent J 2005; 71: 34-37
    PubMedSearch in Google Scholar
  • 22 Lazzara RJ, Porter SS. Platform switching: a new concept in implant dentistry for controlling postrestorative crestal bone levels. Int J Periodontics Restorative Dent 2006; 26: 9-17
    PubMedSearch in Google Scholar
  • 23 Touati B, Guez G, Saadoun A. Aesthetic soft tissue integration and optimized emergence profile: provisionalization and customized impression coping. Pract Periodontics Aesthet Dent 1999; 11: 305-314
    PubMedSearch in Google Scholar
  • 24 Brown IS. The effect of orthodontic therapy on certain types of periodontal defects. I. Clinical findings. J Periodontol 1973; 44: 742-756
    CrossrefPubMedSearch in Google Scholar
  • 25 Ingber IS. Forced eruption: part I. A method pf treating isolated one and two wall infrabony psseous defects – Rationale and case report. J Periodontol 1974; 45: 199-206
    CrossrefPubMedSearch in Google Scholar
  • 26 Ingber IS. Forced eruption: part II. A method of treating nonrestorable teeth – Periodontal and restorative considerations. J Periodontol 1976; 47: 203-216
    CrossrefPubMedSearch in Google Scholar
  • 27 Potashnick SR, Rosenberg ES. Forced eruption: principles in periodontics and restorative dentistry. J Prosthet Dent 1982; 48: 141-148
    CrossrefPubMedSearch in Google Scholar
  • 28 Van Venrooy JR, Yukna RA. Orthodontic extrusion of single-rooted teeth affected with advanced periodontal disease. Am J Orthod 1985; 87: 67-74
    CrossrefPubMedSearch in Google Scholar
  • 29 Ingber JS. Forced eruption: alteration of soft tissue cosmetic deformities. Int J Periodontics Restorative Dent 1989; 9: 416-425
    PubMedSearch in Google Scholar
  • 30 Kajiyama K, Murakami T, Yokota S. Gingival reactions after experimentally induced extrusion of the upper incisors in monkeys. Am J Orthod Dentofacial Orthop 1993; 104: 36-47
    CrossrefPubMedSearch in Google Scholar
  • 31 Reitan K. Clinical and histologic observation on tooth movement during and after orthodontic movement. Am J Orthod 1967; 53: 721-745
    CrossrefPubMedSearch in Google Scholar
  • 32 Mantzikos T, Shamus I. Forced eruption and implant site development: soft tissue response. Am J Orthod Dentofacial Orthop 1997; 112: 596-606
    CrossrefPubMedSearch in Google Scholar
  • 33 Celenza F. The development of forced eruption as a modality for implant site enhancement. Alpha Omegan 1997; 90: 40-43
    PubMedSearch in Google Scholar
  • 34 Spear FM, Mathews DM, Kokich VG. Interdisciplinary management of single-tooth implants. Semin Orthod 1997; 3: 45-72
    CrossrefPubMedSearch in Google Scholar
  • 35 Mantzikos T, Shamus I. Case report: forced eruption and implant site development. Angle Orthod 1998; 68: 179-186
    PubMedSearch in Google Scholar
  • 36 Mantzikos T, Shamus I. Forced eruption and implant site development: an osteophysiologic response. Am J Orthod Dentofacial Orthop 1999; 115: 583-591
    CrossrefPubMedSearch in Google Scholar
  • 37 Zuccati G., Bocchieri A. Implant site developement by orthodontic extrusion of teeth with poor prognosis. J Clin Orthod 2003; 37: 307-311
    PubMedSearch in Google Scholar
  • 38 Zachrisson BU. Alveolar bone augmentation for implants by orthodontic extrusion. World J Orthod 2003; 4: 168-173
    PubMedSearch in Google Scholar
  • 39 Nozawa T, Sugiyama T, Yamaguchi S et al. Buccal and coronal bone augmentation using forced eruption and buccal root torque: a case report. Int J Periodontics Restorative Dent 2003; 23: 585-591
    PubMedSearch in Google Scholar
  • 40 Zachrisson BU. Orthodontic tooth movement to regenerate new bone and periodontal tissue for implants. Presented at the Annual Session of the American Association of Orthodontists, Orlando, 2004
    PubMed
  • 41 Korayem M, Flores-Mir C, Nassar U et al. Implant site development by orthodontic extrusion. A systematic review. Angle Orthod 2008; 78: 752-760
    CrossrefPubMedSearch in Google Scholar
  • 42 Kan JY, Rungcharassaeng K, Lozada JL. Bilaminar subepithelial connective tissue grafts for immediate implant placement and provisionalization in the esthetic zone. J Calif Dent Assoc 2005; 33: 865-871
    PubMedSearch in Google Scholar
  • 43 Bragger U, Pasquali L, Kornman KS. Remodelling of interdental alveolar bone after periodontal flap procedures assessed by means of computer-assisted densitometric image analysis (CADIA). J Clin Periodontol 1988; 15: 558-564
    CrossrefPubMedSearch in Google Scholar
  • 44 Karring T, Nyman S, Thilander B et al. Bone regeneration in orthodontically produced alveolar bone dehiscences. J Periodontal Res 1982; 17: 309-315
    CrossrefPubMedSearch in Google Scholar