Bone ring augmentation technique - advantages and disadvantages

Ugradnja dentalnih implantata danas je postala rutinski zahvat i dio radne svakodnevice doktora dentalne medicine. U samim počecima dentalne implantologije sva je pozornost bila usmjerena na postizanje oseointegracije (vezivanju) dentalnih implantata s okolnom kosti i njegove funkcionalnosti. Budući da je oseointegracija predvidiv proces, pozornost je danas usmjerena na postizanje ne samo funkcionalnih već i estetski pogodnih nadomjestaka na dentalnim implantatima. Danas se uz ugradnju dentalnih implantata sve više povezuje i pojam augmentacije, odnosno postupak dobivanja koštane mase kako bi se nadomjestio njezin nedostatak te se ostvarili zadovoljavajući estetski rezultati budućeg nadomjeska na dentalnom implantatu. Osim estetskih zahtjeva pacijentima je bitno i vrijeme trajanja terapije. Budući da pacijenti danas očekuju da budu što prije opskrbljeni i terapeutski zbrinuti, vrijeme terapije se sve više skraćuje. Sve se više pribjegava tehnikama imedijatne implantacije, odnosno ugrađivanju dentalnog implantata nakon vađenja zuba, sa ili bez augmentacije kosti. Ispitivane su i istraživane mnoge tehnike nadomještanja kosti raznim vrstama materijala za augmentaciju. U ovom će radu biti opisana tehnika koštanog prstena (engl. bone ring technique) koja omogućava istovremenu ugradnju dentalnih implantata i nadomještanje izgubljene kosti. Ovo je tehnika kojom se ispunjavaju zahtjevi skraćenja trajanja terapije te postizanja volumena kosti u sve tri dimenzije. U tehnici koštanog prstena najčešće su korišteni autologni koštani nadomjesci, najčešće uzimani s brade (simfize) i uzlaznog kraka donje čeljusti. Međutim, sve su više u upotrebi i alogeni koštani nadomjesci kojima se postižu odlični i predvidljivi rezultati u tehnici koštanog prstena.In recent years the insertion of dental implants has become a routine procedure and part of dentists’ daily duties. Initially, the biggest focus and all attention were focused on achieving osseointegration (binding) of dental implants with the surrounding bone and its functionality. Since much research showed that the osseointegration is a predictable process, the main focus was transferred to achieving not only functionally but also aesthetically appropriate replacements on dental implants. In today's dental implantology, the concept of bone augmentation is increasingly associated with dental implants and their implantation. Bone augmentation is the process of gaining bone mass in order to compensate for its deficit and achieve satisfying aesthetic results of future replacement performed on the dental implant. In addition to the aesthetic requirements, the duration of the treatment is also important to patients. Because of patients’ increasing expectations of treatment duration and the care they are provided, the treatment duration is becoming shorter and shorter. Immediate implantation techniques are being used with increasing frequency, entailing that the dental implant is implanted immediately after tooth extraction, with or without bone augmentation. Many bone replacement techniques using various types of augmentation materials have been tested and researched. This paper describes the bone ring technique, which allows the simultaneous installation of dental implants and replacement of lost bone. This is a technique that meets the requirements of shortening treatment duration and achieving satisfying bone volume in all three dimensions. In the bone ring technique, autologous bone replacements have been used most often, most frequently taken from the chin (symphysis) and the ascending arm of the lower jaw. However, allogenic bone substitutes are increasingly being used to achieve excellent and predictable results in the bone ring technique