IADR Abstract Archives

Three-Dimensional Ridge Alterations Following Stepwise Surgical Treatment of Extraction Defects

Objectives: To present morphological and volumetric hard tissue alterations following stepwise surgical rehabilitation of advanced extraction defects with the application of a cone-beam computed tomography (CBCT) image segmentation and volumetric subtraction analysis.
Methods: 7 surgical sites of 7 partially edentulous patients were treated using a staged approach for surgical rehabilitation. Stage 1: tunneled guided bone regeneration (GBR) approach for alveolar ridge preservation (ARP). Stage 2: vertical and/or horizontal GBR applying a split thickness flap design 6 months following ARP, Stage 3: dental implant placement 6-9 months following GBR. CBCT scans were taken at three timepoints: (i) at baseline, (ii) prior to GBR, (iii) prior to implant placement. CBCT scans were imported into an open-source radiographic image processing software (3D Slicer). Datasets were reconstructed and three-dimensional virtual models were acquired utilizing a semi-automatic image segmentation method. Superimposition of all three CBCT scans and subsequent volumetric subtraction of reconstructed 3D models were performed to validate volumetric and 3D morphological changes that occurred at each stage of the process (Figure).
Results: Change of hard tissue volume following ARP averaged at 0.61 cm3 ± 0.09 cm3 and 0.67 cm3 ± 0.16 cm3 following GBR (Table). After ARP, the horizontal dimension of the alveolar ridge was maintained and even increased in some cases. Hard tissue formation was visible on denudated root surfaces, in cases where adjacent teeth were involved. After GBR, vertical dimension of the edentulous ridge was restored to ensure prosthetically driven implant placement.
Conclusions: The Digital reconstruction of CBCT datasets and subsequent 3D subtraction analysis may provide a better understanding of the healing mechanisms that occurred during the staged rehabilitation of advanced extraction defects.

2021 Continental European and Scandinavian Divisions Meeting (Brussels, Belgium, Hybrid)
Brussels, Belgium, Hybrid
2021
0122
Oral & Maxillofacial Surgery Research
  • Palkovics, Daniel  ( Semmelweis University , Budapest , Hungary )
  • Pinter, Csaba  ( Empresa de Base Tecnológica Internacional de Canarias , Las Palmas de Gran Canaria , Spain )
  • Gergely, Zsofia  ( Wident Private Practise , Budapest , Hungary )
  • Szasz, Elod  ( Wident Private Practise , Budapest , Hungary )
  • Molnar, Balint  ( Semmelweis University , Budapest , Hungary )
  • Windisch, Peter  ( Semmelweis University , Budapest , Hungary ;  Wident Private Practise , Budapest , Hungary )
  • NONE
    Oral Session VIRTUAL
    Oral & maxillofacial surgery
    PatientHard tissue gain after ARP (cm3)Hard tissue gain after GBR (cm3)∑ hard tissue gain (cm3)
    10.670.691.36
    20.560.541.10
    30.710.931.64
    40.480.521.00
    50.500.511.01
    60.730.811.54
    70.590.661.25
    0.61 ± 0.090.67 ± 0.16