Variety of Surgical Guides and Protocols for Bone Reduction Prior to Implant Placement: A Narrative Review

Eitan Mijiritsky, Hadar Ben Zaken, Maayan Shacham, Ihsan Caglar Cinar, Cem Tore, Katalin Nagy and Scott D. Ganz
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Eitan Mijiritsky: Department of Otolaryngology, Head and Neck and Maxillofacial Surgery, Tel-Aviv Sourasky Medical Center, Sackler Faculty of Medicine, Tel Aviv 6139001, Israel
Hadar Ben Zaken: Department of Periodontology, Hadassah Faculty of Dental Medicine, Hebrew University, Jerusalem 91905, Israel
Maayan Shacham: School of Social Work, Ariel University, Ariel 40700, Israel
Ihsan Caglar Cinar: Department of Oral Implantology, Faculty of Dentistry, Istanbul University, Istanbul 34093, Turkey
Cem Tore: Department of Oral Implantology, Faculty of Dentistry, Istanbul University, Istanbul 34093, Turkey
Katalin Nagy: Department of Oral Surgery, Faculty of Dentistry, University of Szeged, Tisza L. krt 64, 6720 Szeged, Hungary
Scott D. Ganz: Department of Restorative Dentistry Rutgers, The State University of New Jersey, Newark, NJ 07103, USA

IJERPH, 2021, vol. 18, issue 5, 1-16

Abstract: Edentulism and terminal dentition are still considered significant problems in the dental field, posing a great challenge for surgical and restorative solutions especially with immediate loading protocols. When the implant placement is planned immediately after extraction with irregular bone topography or there is an un-leveled alveolar ridge topography for any other reason, bone reduction may be required to level the alveolar crest in order to create the desired bone architecture allowing for sufficient bone width for implant placement and to insure adequate inter-arch restorative space. Bone reduction protocols exist in analog and digitally planned methodologies, with or without surgical guides to achieve the desired bone level based upon the desired position of the implants with regard to the restorative outcome. The objective of this paper was to scrutinize the literature regarding the practice of bone reduction in conjunction with implant placement, and to review different types of bone reduction surgical guides. Results: The literature reveals different protocols that provide for bone reduction with a variety of bone reduction methods. The digitally-planned surgical guide based on Cone-Beam computerized tomography (CBCT) scan reconstructed data can improve accuracy, reduce surgical time, and deliver the desired bone level for the implant placement with fewer surgical and restorative complications. The clinician’s choice is based on personal experience, training, and comfort with a specific guide type. Conclusions: Bone reduction, when required, is an indispensable step in the surgical procedure to attain suitable width of bone in anticipation of implant placement ideally determined by the desired tooth position and required restorative space based on material selection for the chosen framework design, i.e., hybrid, monolithic zirconia. Additionally, bone reduction and implant placement can be accomplished in the same surgical procedure, minimizing trauma and the need for two separate interventions.

Keywords: bone reduction; bone reduction guides; alveolar ridge reduction; ostectomy; surgical techniques guided surgery (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2021
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