Implant Bone Rings. One-Stage Three-Dimensional Bone Transplant Technique: A Case Report
A variety of techniques and materials has been used to provide the structural base of bone and soft tissue support for dental implants. Alveolar bone augmentation techniques include different surgical approaches such as guided bone regeneration, onlay grafting, interpositional grafting, distraction osteogenesis, ridge splitting, and socket preservation. In the case presented, a technique was used to augment the alveolar bone three-dimensionally with autologous “bone rings” and immediate implant placement in a 1-stage procedure following teeth extraction. Bone rings (circular osteotomies) were outlined at the symphysis area using trephine burs, and a central osteotomy for implant placement was done before its removal. The rings were then removed and sculptured to fit the extraction socket; this was followed by screwing the implant through the ring, gaining its primary stability from the prepared basal bone.Abstract

Figure 1 . Bone rings outlined in the symphysis with the central osteotomies corresponding to the diameter for implants to be placed. Figure 2. Bone rings after removal from the symphysis. Figure 3. Three dimensional augmentation using “bone rings” with simultaneous implant placement. Figure 4. Diagrammatic representation of the “bone ring” technique.

Figure 5 . Preoperative panoramic radiograph (left) showing marked bone resorption around maxillary incisors. Periapical radiograph (right) showing preoperative crestal bone level. Figure 6. Postoperative (6 months) panoramic radiograph (left) showing the increased crestal bone height gained by the “bone rings” around the implant (yellow arrows). Note the sites of the bone rings harvested from the symphysis (white arrows). Periapical radiograph (right), showing bone surrounding the cervical part of the implants (arrows). Note the integration of the bone rings with the crestal bone and the cervical part of the implants.

Figure 7 . Probe denoting facial bone level aspect after periodontal depth measurement. Figure 8. Abutment placement. Figure 9. Final restoration.
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