The objective was to analyze bone resorption patterns in posterior mandibles and the dimensions of their corresponding digital bone grafts. This could allow the fabrication of bone grafts with standardized dimensions that can be applied in the majority of clinical cases. Cone beam computed tomography scans (n = 120) were analyzed to evaluate the frequency of Cawood and Howell (C&H) classes. The most frequent class needing bone augmentation was virtually regenerated using specific software. Dimensions of the grafts were calculated. Class V was the most frequent atrophic class needing augmentation in posterior mandibles (20.4%). Severe atrophic stages were more frequent in females (adjusted P value = 0.001), in older people (adjusted P value = 0.31) and in the right mandible (adjusted P value = 0.03). After virtual regeneration of Class V cases (n = 36), 3 clusters based on the number of missing teeth were evident. The mean length of the grafts was 20 mm when 2 teeth were missing (reference), 23.9 mm in the case of 3 missing teeth (P < 0.001) and 29.6 mm for 4 missing teeth (P < 0.001). Height and width were comparable across the 3 clusters (P-values = 0.39–0.93). The mean graft volume was 1,469 mm3 in the case of 2 missing teeth (reference), 1,814 mm3 for 3 missing teeth (P = 0.001) and 2,177 mm3 for 4 missing teeth (P < 0.001). These volumes corresponded to those of soft-tissue expanders, suggesting the possibility of a 2-step augmentation protocol: soft-tissue expansion, followed by regeneration with prefabricated grafts of the corresponding volume. Class V was the most frequent resorption pattern requiring augmentation in posterior mandibles. Virtual regeneration revealed 3 clusters of grafts, differing only in length based on the number of missing teeth. A 2-step augmentation protocol is proposed using soft-tissue expanders and prefabricated grafts with corresponding volumes. This protocol might be more applicable in the right mandible, females and older patients.
KeywordsMandible; alveolar bone grafting; bone graft; cone beam computed tomography; soft-tissue expansion.
The Council of European Dentists (CED) has expressed great concern about the pressures that both the liberal profession and its patients are facing. Purely market-driven dental chains put patient safety at risk through mismanagement and mistreatment of patients and employees. While advertising by dentists is tightly regulated, dental chains are able to take a more aggressive approach. Therefore, national legislators have a responsibility to put patients first and ensure that they receive the oral care they deserve.
COLOGNE, Germany: The world’s largest showcase for dentistry and dental technology is set to open on 12 March and will run until 16 March. In 170,000 m² of expanded show space, the 38th International Dental Show (IDS) will feature some 2,260 vendors—and the list is growing—from more than 60 countries, including international market leaders in dental medicine, technology, communication and organisation—the professional trade fair will have it all. No other event in the dental industry presents the extensive range of products and services that IDS does.