Int J Stomatol ›› 2022, Vol. 49 ›› Issue (5): 497-505.doi: 10.7518/gjkq.2022084

• Expert Forum •     Next Articles

Combined treatment strategy of oral implantology and endodontic microsurgery for bone augmentation and en-dodontic diseases in aesthetic area (part 1): application basis and indications

Man Yi1,Huang Dingming2()   

  1. 1.State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Dept. of Implantology, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
    2.State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Dept. of Cariology and Endodontics, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
  • Received:2022-04-01 Revised:2022-06-16 Online:2022-09-01 Published:2022-09-16
  • Contact: Dingming Huang E-mail:dingminghuang@163.com
  • Supported by:
    Key Research and Development Project of the Science and Technology Department of Si-chuan Province(2021YFS0030);Exploration and Research and Development Project of West China Hospital of Stomatology, Sichuan University(LCYJ2019-19)

Abstract:

In the clinical practice of dental implants, the implant-related surgery in areas with proximity to a periapical lesion of adjacent teeth was relatively particular but not uncommon. Chronic apical periodontitis of adjacent teeth could become a potential source of infection in bone augmentation surgery and cause early surgery failure/or extend to the apical area of the implant and cause retrograde peri-implantitis. Unlike the traditional treatment modality, a novel digital treatment modality involves the performance of implant-related surgery in conjunction with endodontic microsurgery of the adjacent tooth during one process to control the potential risk originating from apical periodontitis, completely remo-ving the infection from the apex of adjacent teeth and establishing sufficient apical sealing. This combined surgery aimed to eliminate the potential source of infection of adjacent teeth during implant-related surgery. Meanwhile, the autologous bone retained in the apical surgery could avoid a second operating area for bone harvesting in bone augmentation surgery, significantly improving the efficiency of surgery and thus further reducing patient trauma and saving medical costs. This article discussed the application basis and clinical indications of this novel combined treatment strategy.

Key words: dental implant, guided bone regeneration, endodontic microsurgery, guided tissue regeneration, retrograde peri-implantitis

CLC Number: 

  • R 78

TrendMD: 

Fig 1

The examples of implant-related surgery in areas with proximity to a periapical lesion of adjacent teeth"

Fig 2

Periapical infection from adjacent teeth leads to retrograde peri-implantitis"

Fig 3

The application of magnifying equipment, ultrasonic instruments in the dental implant and endodontics"

Fig 4

Digital design and realization of combined surgical strategy in simultaneous bone augmentation during implant placement"

Fig 5

Digital design and realization of combined surgical strategy staged bone augmentation"

1 Penarrocha-Diago M, Maestre-Ferrín L, Penarrocha-Oltra D, et al. Inflammatory implant periapical lesion prior to osseointegration: a case series study[J]. Int J Oral Maxillofac Implants, 2013, 28(1): 158-162.
2 Mohamed JB, Alam MN, Singh G, et al. The mana-gement of retrograde peri-implantitis: a case report[J]. J Clin Diagn Res, 2012, 6(9): 1600-1602.
3 Lefever D, van Assche N, Temmerman A, et al. Ae-tiology, microbiology and therapy of periapical lesions around oral implants: a retrospective analysis[J]. J Clin Periodontol, 2013, 40(3): 296-302.
4 Jakovljevic A, Nikolic N, Jacimovic J, et al. Prevalence of apical periodontitis and conventional nonsurgical root canal treatment in general adult population: an updated systematic review and meta-analysis of cross-sectional studies published between 2012 and 2020[J]. J Endod, 2020, 46(10): 1371-1386.e8.
5 Moy PK, Aghaloo T. Risk factors in bone augmentation procedures[J]. Periodontol 2000, 2019, 81(1): 76-90.
6 Dammaschke T, Steven D, Kaup M, et al. Long-term survival of root-canal-treated teeth: a retrospective study over 10 years[J]. J Endod, 2003, 29(10): 638-643.
7 Danesh N, Ljunggren AC, Wolf E, et al. Development of criteria for investigation of periapical tissue from root-filled teeth[J]. Acta Odontol Scand, 2019, 77(4): 269-274.
8 Zhou W, Zheng QH, Tan XL, et al. Comparison of mineral trioxide aggregate and iRoot BP plus root repair material as root-end filling materials in en-dodontic microsurgery: a prospective randomized controlled study[J]. J Endod, 2017, 43(1): 1-6.
9 Moraschini V, Poubel LA, Ferreira VF, et al. Evaluation of survival and success rates of dental implants reported in longitudinal studies with a follow-up period of at least 10 years: a systematic review[J]. Int J Oral Maxillofac Surg, 2015, 44(3): 377-388.
10 McAllister BS, Masters D, Meffert RM. Treatment of implants demonstrating periapical radiolucencies[J]. Pract Periodontics Aesthet Dent, 1992, 4(9): 37-41.
11 Green TL, Walton RE, Taylor JK, et al. Radiogra-phic and histologic periapical findings of root canal treated teeth in cadaver[J]. Oral Surg Oral Med Oral Pathol Oral Radiol Endod, 1997, 83(6): 707-711.
12 Rowe AH, Binnie WH. Correlation between radiological and histological inflammatory changes following root canal treatment[J]. J Br Endod Soc, 1974, 7(2): 57-63.
13 Seltzer S. Long-term radiographic and histological observations of endodontically treated teeth[J]. J Endod, 1999, 25(12): 818-822.
14 Schwarz F, Derks J, Monje A, et al. Peri-implantitis[J]. J Periodontol, 2018, 89(): S267-S290.
15 Sarmast ND, Wang HH, Soldatos NK, et al. A novel treatment decision tree and literature review of retrograde peri-implantitis[J]. J Periodontol, 2016, 87(12): 1458-1467.
16 Ramanauskaite A, Juodzbalys G, Tözüm TF. Apical/retrograde periimplantitis/implant periapical lesion: etiology, risk factors, and treatment options: a syste-matic review[J]. Implant Dent, 2016, 25(5): 684-697.
17 Marshall G, Canullo L, Logan RM, et al. Histopa-thological and microbiological findings associated with retrograde peri-implantitis of extra-radicular en-dodontic origin: a systematic and critical review[J]. Int J Oral Maxillofac Surg, 2019, 48(11): 1475-1484.
18 di Murro B, Papi P, di Murro C, et al. Correlation between endodontic pulpal/periapical disease and retrograde peri-implantitis: a case series[J]. Aust Endod J, 2021, 47(2): 358-364.
19 Zhou W, Han C, Li DH, et al. Endodontic treatment of teeth induces retrograde peri-implantitis[J]. Clin Oral Implants Res, 2009, 20(12): 1326-1332.
20 Fernandez de Grado G, Keller L, Idoux-Gillet Y, et al. Bone substitutes: a review of their characteristics, clinical use, and perspectives for large bone defects management[J]. J Tissue Eng, 2018, 9: 204173-1418776819.
21 Antoun H, Sitbon JM, Martinez H, et al. A prospective randomized study comparing two techniques of bone augmentation: onlay graft alone or associated with a membrane[J]. Clin Oral Implants Res, 2001, 12(6): 632-639.
22 Meijndert CM, Raghoebar GM, Meijndert L, et al. Single implants in the aesthetic region preceded by local ridge augmentation; a 10-year randomized controlled trial[J]. Clin Oral Implants Res, 2017, 28(4): 388-395.
23 Sbordone L, Toti P, Menchini-Fabris G, et al. Implant survival in maxillary and mandibular osseous onlay grafts and native bone: a 3-year clinical and computerized tomographic follow-up[J]. Int J Oral Maxillofac Implants, 2009, 24(4): 695-703.
24 Setzer FC, Shah SB, Kohli MR, et al. Outcome of endodontic surgery: a meta-analysis of the literature: part 1: comparison of traditional root-end surgery and endodontic microsurgery[J]. J Endod, 2010, 36(11): 1757-1765.
25 Friedman S. Outcome of endodontic surgery: a meta-analysis of the literature-part 1: comparison of traditional root-end surgery and endodontic microsurgery[J]. J Endod, 2011, 37(5): 577-580.
26 Kim D, Kim S, Song MJ, et al. Outcome of endo-dontic micro-resurgery: a retrospective study based on propensity score-matched survival analysis[J]. J Endod, 2018, 44(11): 1632-1640.
27 Huang SY, Chen NN, Yu VSH, et al. Long-term success and survival of endodontic microsurgery[J]. J Endod, 2020, 46(2): 149-157.e4.
28 Conejo J, Atria PJ, Schweitzer D, et al. Digital implant planning and surgical guides: tools for clinical success[J]. Compend Contin Educ Dent, 2021, 42(7): 400-401.
29 Michelinakis G, Apostolakis D, Kamposiora P, et al. The direct digital workflow in fixed implant pros-thodontics: a narrative review[J]. BMC Oral Health, 2021, 21(1): 37.
30 Buser D, Sennerby L, de Bruyn H. Modern implant dentistry based on osseointegration: 50 years of pro-gress, current trends and open questions[J]. Perio-dontol 2000, 2017, 73(1): 7-21.
31 Hawkins TK, Wealleans JA, Pratt AM, et al. Targe-ted endodontic microsurgery and endodontic microsurgery: a surgical simulation comparison[J]. Int Endod J, 2020, 53(5): 715-722.
32 Ray JJ, Giacomino CM, Wealleans JA, et al. Targe-ted endodontic microsurgery: digital workflow options[J]. J Endod, 2020, 46(6): 863-871.
33 Dianat O, Gupta S, Price JB, et al. Guided endodontic access in a maxillary molar using a dynamic na-vigation system[J]. J Endod, 2021, 47(4): 658-662.
34 Joda T, Zarone F, Ferrari M. The complete digital workflow in fixed prosthodontics: a systematic review[J]. BMC Oral Health, 2017, 17(1): 124.
35 Stanley M, Paz AG, Miguel I, et al. Fully digital workflow, integrating dental scan, smile design and CAD-CAM: case report[J]. BMC Oral Health, 2018, 18(1): 134.
36 Blatz MB, Conejo J. The current state of chairside digital dentistry and materials[J]. Dent Clin North Am, 2019, 63(2): 175-197.
37 Coachman C, Sesma N, Blatz MB. The complete digital workflow in interdisciplinary dentistry[J]. Int J Esthet Dent, 2021, 16(1): 34-49.
38 Wakimoto M, Matsumura T, Ueno T, et al. Bone quality and quantity of the anterior maxillary trabe-cular bone in dental implant sites[J]. Clin Oral Implants Res, 2012, 23(11): 1314-1319.
39 Ribeiro CG, Bittencourt TC, Ferreira CF, et al. An alternative approach for augmenting the anterior maxilla using autogenous free gingival bone graft for implant retained prosthesis[J]. J Oral Implantol, 2014, 40(2): 183-187.
40 Chen ST, Buser D. Esthetic outcomes following immediate and early implant placement in the anterior maxilla: a systematic review[J]. Int J Oral Maxillofac Implants, 2014, 29(): 186-215.
41 Cha HS, Kim JW, Hwang JH, et al. Frequency of bone graft in implant surgery[J]. Maxillofac Plast Reconstr Surg, 2016, 38(1): 19.
42 Wang J, Luo YL, Tan XL, et al. Horizontal bone augmentation of the edentulous area with simulta-neous endodontic microsurgery of the adjacent too-th: a digitally-driven multidisciplinary case report with a 1-year follow-up[J]. Int J Oral Implantol (Berl), 2021, 14(4): 435-451.
43 Daubert D, Black RM, Chrepa V, et al. Endodontic peri-implant defects: a new disease entity[J]. J Endod, 2020, 46(3): 444-448.
[1] Wang Yue,Wen Bing,Deng Mengting,Li Jianping. Research advances of low-level laser therapy on peri-implant tissue healing [J]. Int J Stomatol, 2021, 48(6): 725-730.
[2] Zhu Xuanzhi,Zhao Lei. Research progress on the relationship between hypothyroidism and periodontitis [J]. Int J Stomatol, 2021, 48(4): 380-384.
[3] Zhao Wenjun,Chen Yu. Research progress on periodontal functional gradient membrane for guided tissue/bone regeneration [J]. Int J Stomatol, 2021, 48(4): 391-397.
[4] Feng Lu,Meng Wenxia. Research progress on the problems of dental implant treatment in patients with common oral mucosal disease [J]. Int J Stomatol, 2021, 48(2): 147-155.
[5] Wang Jia,Li Wenxia,Yin Lihua. Restoration strategy of dental implant for impacted teeth in the edentulous area [J]. Int J Stomatol, 2021, 48(1): 77-81.
[6] Wang Shiqi,Chang Yaqin,Chen Bin,Tan Baochun,Ni Yanhong. Comparison of clinical outcomes between using bone graft alone and the combination of bone graft with membrane for periodontal regeneration therapy: a systematic review and Meta-analysis [J]. Int J Stomatol, 2020, 47(6): 644-651.
[7] Wu Jielin,Gao Ying. Application progress on free soft-tissue grafts harvested from palatal mucosa [J]. Int J Stomatol, 2020, 47(6): 686-692.
[8] Ma Kai,Li Hao,Zhao Hongmei,Wang Yongliang,Liu Jie,Bai Na. Effects of inorganic bovine bone treated with low temperature argon-oxygen plasma on the adhesion, proliferation, and differentiation of MC3T3-E1 cells [J]. Int J Stomatol, 2020, 47(3): 278-285.
[9] Xiao Yuhan,Yu Haiyang. Interproximal open contacts between implant restorations and adjacent teeth [J]. Int J Stomatol, 2020, 47(2): 202-205.
[10] Yu Wanqi,Zhou Yanmin,Zhao Jinghui. Research status of new materials in dental implants [J]. Int J Stomatol, 2019, 46(4): 488-496.
[11] Meijie Wang,Xin Tan,Yuwei Zhao,Haiyang Yu. Influences of immediat implant or traditional implant on postoperative pain [J]. Int J Stomatol, 2019, 46(3): 292-296.
[12] Qiyue Chen,Guangbao Song. Research progress on proximal contact loss between implant-supported fixed prostheses and adjacent natural teeth [J]. Int J Stomatol, 2019, 46(3): 356-360.
[13] Kun Cao,Jiafeng Li,Yuhua Sun,Qiang Bao,Qiuning Lu,Wei Tang. Evaluating of the submandibular fossa by cone beam CT [J]. Inter J Stomatol, 2019, 46(2): 209-212.
[14] Pengfei Zhao,Qi Wang. Research progress on the etiology and therapy of bone defect during dental implantation under diabetic condition [J]. Inter J Stomatol, 2019, 46(2): 244-248.
[15] Lin Xiang,Huilu Chen,Ying Yuan,Qin Zhang,Na Xin,Ping. Gong. Research progress on calcitonin gene-related peptide on peripheral nerve, vascular regeneration and osseointegra-tion around implants [J]. Inter J Stomatol, 2018, 45(5): 509-515.
Viewed
Full text


Abstract

Cited

  Shared   
  Discussed   
[1] . [J]. Foreign Med Sci: Stomatol, 1999, 26(06): .
[2] . [J]. Foreign Med Sci: Stomatol, 1999, 26(06): .
[3] . [J]. Foreign Med Sci: Stomatol, 1999, 26(05): .
[4] . [J]. Foreign Med Sci: Stomatol, 1999, 26(04): .
[5] . [J]. Foreign Med Sci: Stomatol, 1999, 26(04): .
[6] . [J]. Foreign Med Sci: Stomatol, 1999, 26(04): .
[7] . [J]. Foreign Med Sci: Stomatol, 2004, 31(02): 146 -148 .
[8] . [J]. Foreign Med Sci: Stomatol, 2005, 32(06): 461 -462 .
[9] . [J]. Foreign Med Sci: Stomatol, 2004, 31(02): 138 -140 .
[10] . [J]. Foreign Med Sci: Stomatol, 1999, 26(05): .