Abstract

Objectives: To determine clinical, histological, and histomorphometrial results following ridge preservation via contour augmentation with high resistance biomaterials.

Material and Methods: A 54-year-old female was referred by her general dentist due to her crowded and periodontally hopeless maxillary right canine and premolar teeth. Two dental implants were surgically placed in palatal positions. The exposed implant surfaces were covered with a slowly-resorbable, synthetic, nanocrystalline hydroxyapatite bone substitute and overbuilding was done with porous titanium granules (PTGs) mixed with the patient’s blood. A long-lasting collagen membrane was fixed over the graft sites. Patient was recalled six months later for the second-phase surgery. At that time, a core biopsy from the augmentation site was taken.

Result: The patient’s cone beam computed tomography scan showed that hard tissue width and height increased from 8.4 and 10.6mm to 9.2 and 12.3mm, respectively. The histological sections revealed that new bone was bridging between the PTGs and neighboring particles. The new bone matrix consisted of 12.41% mineralized bone matrix and 2.82% osteoid. Concerning the osteoconductivity of PTGs, 27.0% new mineralized bone, 10.2% osteoid, and 62.8% soft tissue were found covering the titanium particles.

Conclusion: Overbuilding the ridge via contour augmentation with non-resorbable titanium granules could serve as a valid approach based on optimal clinical and biological results.

Clinical Relevance: Immediate implant placement and use of PTGs and collagen membrane all at the same time can improve clinical periodontal parameters and implant stability in the short-term.

Keywords: Guided Bone Regeneration; Contour Augmentation; Ridge preservation; Titanium Granules