In an insightful session titled "Tell Me More About," Helena Francisco, a respected assistant professor at the University of Lisbon and a member of the EAO Education Committee, delved into the intricate world of lateral ridge augmentation. The session featured Arndt Happe, an experienced surgeon and researcher from Germany, who brought extensive knowledge in bone regeneration and implant placement to the discussion.
Autogenous Bone vs. Allograft: An Expert's Perspective Arndt Happe began the session by sharing his transition from exclusively using autogenous bone grafts, learned under the tutelage at the Curie Clinic, to incorporating allografts into his practice. This shift was motivated by the need for specialized techniques tailored to individual patient requirements. Happe’s experience with allografts began about a decade ago, showcasing a challenging case that led him to explore allograft options due to the patient's severe periodontitis and compromised bone quality.
Clinical Case Study and Outcomes Happe detailed a case where he utilized allografts in a split-mouth design to treat a patient with significant periodontal issues and a narrow ridge in the lower jaw. The allografts, processed differently by two companies, were used to augment the deficient ridge. After seven months, the follow-up results demonstrated significant bone regeneration, highlighting the effectiveness of allografts in complex cases. This outcome was further supported by long-term follow-up, showing stable bone maintenance around the implants.
Safety and Efficacy of Allografts Addressing the safety concerns associated with allografts, Happe discussed the rigorous processing protocols that reduce the risk of infection transmission and ensure biocompatibility. He referenced the extensive use of allografts in orthopedics as a testament to their safety. The discussion also covered the survival rates of implants placed in allografted areas, which were comparable to those placed in autogenously grafted bones, as evidenced by systematic reviews.
Technical Insights and Surgical Challenges Happe emphasized the technical nuances of working with allografts, such as the importance of proper rehydration and the challenges of handling brittle cancellous blocks. He stressed that successful outcomes with allografts require meticulous surgical technique and are not a shortcut for less skilled surgeons.
Histological and Long-term Perspectives The session also touched on the histological outcomes of allografts, showing signs of remodeling and new bone formation similar to autogenous grafts. Long-term stability of the grafts was discussed, with studies showing minimal shrinkage over time and excellent integration with the host tissue.
Conclusion: A Balanced View on Graft Choices Arndt Happe concluded by advocating for a balanced approach to choosing between autogenous bone and allografts, based on specific case requirements and surgeon expertise. He highlighted that while allografts offer a viable alternative with comparable outcomes, they require careful handling and are best used by experienced surgeons familiar with advanced regenerative techniques.
This session not only illuminated the complexities involved in lateral ridge augmentation but also provided a platform for in-depth discussion on the evolving preferences and practices in dental implantology, showcasing a shift towards more personalized and patient-specific approaches in regenerative treatments.