Clinical Implant Dentistry and Related Research

Bone Structure Changes in Iliac Crest Grafts Combined with Implants

Corresponding Author

Jan Willem Verhoeven MD, DDS, PhD

Associate professor, Department of Oral & Maxillofacial Surgery, Prosthodontics and Special Dental Care, University Medical Center, Utrecht, The Netherlands, and Department of Oral & Maxillofacial Surgery, Prosthodontics and Special Dental Care, Jeroen Bosch Hospital, Den Bosch, The Netherlands;

Dr. Jan Willem Verhoeven, Department of Oral & Maxillofacial Surgery, Prosthodontics and Special Dental Care, University Medical Center Utrecht, Stratenum Building, STR.4.115, P.O. Box 85.060, 3508 AB Utrecht, The Netherlands; e-mail: [email protected]Search for more papers by this author

Jan M. Ruijter PhD,

Jan M. Ruijter PhD

associate professor, Department of Anatomy and Embryology, Academic Medical Center, Amsterdam, The Netherlands;

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Ronald Koole MD, DDS, PhD,

Ronald Koole MD, DDS, PhD

professor, Department of Oral & Maxillofacial Surgery, Prosthodontics and Special Dental Care, University Medical Center, Utrecht, The Netherlands;

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Cornelis De Putter DDS, PhD,

Cornelis De Putter DDS, PhD

professor, Department of Oral & Maxillofacial Surgery, Prosthodontics and Special Dental Care, University Medical Center, Utrecht, The Netherlands;

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Marco S. Cune DDS, PhD,

Marco S. Cune DDS, PhD

associate professor, Department of Oral & Maxillofacial Surgery, Prosthodontics and Special Dental Care, St. Antonius Hospital, Nieuwegein, The Netherlands

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Jan Willem Verhoeven MD, DDS, PhD,

Corresponding Author

Jan Willem Verhoeven MD, DDS, PhD

Jan M. Ruijter PhD,

Jan M. Ruijter PhD

associate professor, Department of Anatomy and Embryology, Academic Medical Center, Amsterdam, The Netherlands;

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Ronald Koole MD, DDS, PhD,

Ronald Koole MD, DDS, PhD

professor, Department of Oral & Maxillofacial Surgery, Prosthodontics and Special Dental Care, University Medical Center, Utrecht, The Netherlands;

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Cornelis De Putter DDS, PhD,

Cornelis De Putter DDS, PhD

professor, Department of Oral & Maxillofacial Surgery, Prosthodontics and Special Dental Care, University Medical Center, Utrecht, The Netherlands;

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Marco S. Cune DDS, PhD,

Marco S. Cune DDS, PhD

associate professor, Department of Oral & Maxillofacial Surgery, Prosthodontics and Special Dental Care, St. Antonius Hospital, Nieuwegein, The Netherlands

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First published: 05 November 2010

https://doi.org/10.1111/j.1708-8208.2009.00169.x

Citations: 8

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ABSTRACT

Background: Remodeling of onlay grafts combined with implants to the mandible results in predictable changes in the graft's radiographic density. We studied the relationship between changes in radiographic density and trabecular structure during the first year after onlay grafting with simultaneous implant placement to the mandible.

Purpose: The aim of this study was to evaluate changes in bone structure after onlay grafting.

Materials and Methods: Standardized extraoral radiographs were taken regularly of 16 mandibular sides. Bone structure was measured using the Carl Zeiss Vision KS 400 3.0 imaging system. The parameters studied were trabecular area and perimeter, cavity area and perimeter, end points, branching points, skeleton length, branch angle and direction, and texture.

Results: No differences were found between measurements ventrally versus dorsally of the implant, nor close to versus away from the implant. Early cortical changes suggest partial resorption and formation of a more complex structure. In the fourth quarter after surgery, progressive resorption is seen in the graft's upper cortex. In the graft's upper spongiosa, most parameters indicate bone formation during the first postoperative year. Loading-induced structure changes could not yet be found.

Conclusion: The technique can be used to study changes in the architecture of bone grafts. Changes found in the graft's architecture are in accordance with changes in bone density.

REFERENCES

1 Neukam FW, Bothe K, Schliephake H, Schmelzeisen R, Schultze A, Wichmann M. Rekonstruktion in kombination mit implantaten im extrem atrophischen unterkiefer. Dtsch Zahnarztl Z 1993; 48: 808–810.
Google Scholar
2 Schmelzeisen R, Hessling K-H, Overbeck R, Neukam FW. Quantitative bestimmung der knochenresorption mit einem rechnergestützten normierungsprogramm von OPT-verlaufsaufnahmen. Z Zahnarztl Implantol 1991; 8: 44–48.
Google Scholar
3 Farmand M. Mandibular augmentation with split calvarial bone graft and simultaneous endosseous implants. In: 5th International Congress on Preprosthetic Surgery, Book of Abstracts, Vienna, 1993:111.
Google Scholar
4 Grätz KW, Sailer HF. Results after mandibular sandwich procedures in combination with titanium screw implants. J Craniomaxillofac Surg 1994; 22: 74–75.
Google Scholar
5 McGrath CJ, Schepers SH, Blijdorp PA, Hoppenreijs TJ, Erbe M. Simultaneous placement of endosteal implants and mandibular onlay grafting for treatment of the atrophic mandible. A preliminary report. Int J Oral Maxillofac Surg 1996; 25: 184–188.
10.1016/S0901-5027(96)80026-9
CAS PubMed Web of Science® Google Scholar
6 Vermeeren JI, Wismeijer D, Van Waas MA. One-step reconstruction of the severely resorbed mandible with onlay bone grafts and endosteal implants. A 5-year follow-up. Int J Oral Maxillofac Surg 1996; 25: 112–115.
10.1016/S0901-5027(96)80053-1
CAS PubMed Web of Science® Google Scholar
7 Verhoeven JW, Cune MS, Ruijter J. Permucosal implants combined with iliac crest onlay grafts used in extreme atrophy of the mandible: long-term results of a prospective study. Clin Oral Implants Res 2006; 17: 58–66.
10.1111/j.1600-0501.2005.01165.x
CAS PubMed Web of Science® Google Scholar
8 Verhoeven JW, Cune MS, Terlou M, Zoon MA, De Putter C. The combined use of endosteal implants and iliac crest onlay grafts in the severely atrophic mandible: a longitudinal study. Int J Oral Maxillofac Surg 1997; 26: 351–357.
10.1016/S0901-5027(97)80796-5
CAS PubMed Web of Science® Google Scholar
9 Bell RB, Blakey GH, White RP, Hillebrand DG, Molina A. Staged reconstruction of the severely atrophic mandible with autogenous bone graft and endosteal implants. J Oral Maxillofac Surg 2002; 60: 1135–1141.
10.1053/joms.2002.34986
PubMed Web of Science® Google Scholar
10 Stellingsma K. The extremely resorbed mandible: a comparative, prospective study of three treatment strategies. Thesis, State University of Groningen, Groningen, The Netherlands, 2004.
Google Scholar
11 Verhoeven JW, Ruijter J, Cune MS, Terlou M, Zoon M. Onlay grafts in combination with endosseous implants in severe mandibular atrophy: one year results of a prospective, quantitative radiological study. Clin Oral Implants Res 2000; 11: 583–594.
10.1034/j.1600-0501.2000.011006583.x
CAS PubMed Web of Science® Google Scholar
12 Carter DR. Mechanical loading history and skeletal biology. J Biomech 1987; 20: 1095–1109.
10.1016/0021-9290(87)90027-3
CAS PubMed Web of Science® Google Scholar
13 Korstjens CM. On image analysis of the radiographic trabecular bone architecture. Thesis, Free University, Amsterdam, The Netherlands,1995.
Google Scholar
14 Hansson S. The dental implant meets bone; a clash of two paradigms. Appl Osseointegration Res 2005; 5: 5–17.
Google Scholar
15 Wolff J. Das gesetz der transformation der knochen. Berlin, Germany: A. Hirschwald, 1892.
Google Scholar
16 Gruber H, Solar P, Ulm C. Anatomie und atrophiebedingte Veraenderungen der Kieferknochen. In: G Watzek, ed. Enossale implantaten in der oralen chirurgie. Berlin, Germany: Quintessenz Verlag, 1993: 37–40.
Google Scholar
17 Verhoeven JW, Ruijter J, Cune MS, Terlou M. Oblique lateral cephalometric radiographs of the mandible in implantology: usefulness and reproducibility of the technique in quantitative densitometric measurements of the mandible in vivo. Clin Oral Implants Res 2000; 11: 476–486.
10.1034/j.1600-0501.2000.011005476.x
CAS PubMed Web of Science® Google Scholar
18 Verhoeven JW, Cune MS, De Putter C. Reliability of some clinical parameters of evaluation in implant dentistry. J Oral Rehabil 2000; 27: 211–216.
10.1046/j.1365-2842.2000.00524.x
CAS PubMed Web of Science® Google Scholar
19 Verhoeven JW, Ruijter JM, Cune MS, De PC. Densitometric measurements of the mandible: accuracy and validity of intraoral versus extraoral radiographical techniques in an in vitro study. Clin Oral Implants Res 1998; 9: 333–342.
10.1034/j.1600-0501.1998.090507.x
CAS PubMed Web of Science® Google Scholar
20 White SC, Rudolph DJ. Alterations of the trabecular pattern of the jaws in patients with osteoporosis. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 1999; 88: 628–635.
10.1016/S1079-2104(99)70097-1
CAS PubMed Web of Science® Google Scholar
21 Vince DG, Dixon KJ, Cothren MR, Comhill JF. Comparison of texture analysis methods for the characterization of coronary plaques in intravascular ultrasound images. Comput Med Imaging Graph 2000; 24: 221–229.
10.1016/S0895-6111(00)00011-2
CAS PubMed Web of Science® Google Scholar
22 Showalter C, Clymer BD, Richmon B, Powell K. Three-dimensional texture analysis of cancellous bone cores evaluated at clinical CT resolutions. Osteoporos Int 2006; 17: 259–266.
10.1007/s00198-005-1994-1
PubMed Web of Science® Google Scholar
23 Ruijter JM, Thygesen HH, Schoneveld OJ, Das AT, Berkhout B, Lamers WH. Factor correction as a tool to eliminate between-session variation in replicate experiments:application to molecular biology and retrovirology. Retrovirology 2006; 3: 2–10.
10.1186/1742-4690-3-2
CAS PubMed Web of Science® Google Scholar
24 Geraets WG. Computer aided analysis of the radiographic trabecular pattern. Thesis, Free University, Amsterdam, The Netherlands, 1994.
Google Scholar
25 Kobayashi F, Ito J, Hayashi T, Maeda T. A study of volumetric visualization and quantitative evaluation of bone trabeculae in helical CT. Dentomaxillofac Radiol 2003; 32: 181–185.
10.1259/dmfr/28959099
CAS PubMed Web of Science® Google Scholar
26 Choel L, Last D, Duboeuf F, et al. Trabecular alveolar bone microarchitecture in the human mandible using high resolution magnetic resonance imaging. Dentomaxillofac Radiol 2004; 33: 177–182.
10.1259/dmfr/42933309
CAS PubMed Web of Science® Google Scholar
27 Wilding RJC, Slabbert JCG, Kathree H, Owen CP, Crombie K, Delport P. The use of fractal analysis to reveal remodelling in human alveolar bone following the placement of dental implants. Arch Oral Biol 1995; 40: 61–72.
10.1016/0003-9969(94)00138-2
CAS PubMed Web of Science® Google Scholar
28 Geraets WG, Van Der Stelt PF. Fractal properties of bone. Dentomaxillofac Radiol 2000; 29: 144–153.
10.1038/sj.dmfr.4600524
CAS PubMed Web of Science® Google Scholar
29 Jett S, Shrout MK, Mailhot JM, Potter BJ, Borke JL. An evaluation of the origin of trabecular bone patterns using visual and digital image analysis. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2004; 98: 598–604.
10.1016/j.tripleo.2004.07.020
PubMed Web of Science® Google Scholar

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Volume12, Issue4

December 2010

Pages 289-296

Bone Structure Changes in Iliac Crest Grafts Combined with Implants

ABSTRACT

REFERENCES

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References

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