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ePaper created 2018-04-05, 09:17:31 | version 1.38.0
Table 4a Healing process. Total number of defect regions: n = 115. Table 4b Postoperative complications. Total number of defect regions: n = 115. I n d i v i d u a l i z e d t i t a n i u m s c a f f o l d s Table 4a Healing Distribution in % (number of cases) No healing complications Exposure of scaffold Infection of surgical area Loosening of scaffold Loosening of scaffold and infection of surgical area Exposure of scaffold and infection of surgical area Infection of surgical area and regrafting Not specified 71.3 13.0 6.1 5.2 1.7 0.9 0.9 0.9 (82) (15) (7) (6) (2) (1) (1) (1) Table 4b Parameter Distribution in % (number of cases) Loss of the grafted volume Intervening layer of fibrous tissue between bone graft and scaffold Overgrowth of iCTS by bone No Partially Not specified Yes No Not specified Yes No Not specified 60.0 39.1 0.9 40.0 20.9 39.1 21.7 34.8 43.5 (69) (45) (1) (46) (24) (45) (25) (40) (50) Discussion Prediction and improvement of factors influenc- ing the healing process and treatment outcome are of great importance in implant dentistry.14 In the present study, the application of an iCTS with DBBM and autogenous bone was found to result in sufficient grafted volumes and satis- factory clinical outcome. Prevalence of dehis- cence was not affected by the demographic or surgical parameters analyzed. The presence of dehiscence did not influence the augmentation volume or implant insertion. In the present study, an iCTS, together with a mixture of DBBM and autogenous bone, was mainly used (in 92.2% of defects) for complex alveolar bone augmentation. Typical complica- tions, including infections and dehiscence, were easily treated. Dehiscence did not affect the final outcome, since augmented volumes were not affected and implant insertion was possible in all of the cases. These results are in line with previous studies showing similar effectiveness of iCTSs in the healing process9 that is compa- rable with that of custom-made titanium scaf- folds.4, 11 Application of an iCTS, together with a mixture of DBBM and autogenous bone, was previously shown to result in sufficient aug- mented volume and good clinical outcome.11 Although 7 out of 21 cases showed exposure after 5–12 weeks, grafting was successful in all of the cases and implant survival was 100% after mean follow-up of 12 months.11 No negative impact of dehiscence on the clinical outcome was found. Another study compared custom-made titanium devices with conventional titanium scaffolds for alveolar bone augmentation in 26 patients.9 In this study, mucosal rupture was observed less frequently with the use of custom-made tita- nium scaffolds (in 1 patient, 7.7%) in comparison with application of the conventional titanium devices (in 3 patients, 23.1%), but the difference was not statistically significant. However, the operation time was significantly shorter and the number of retaining screws used significantly fewer in the custom-made group than in the commercial titanium device group. Taken together, application of custom-made titanium scaffolds is associated with fewer complications and shorter operation time. Different factors have been shown to have an impact on the success of dental procedures. To the best of our knowledge, the association of wound dehiscence with various demographic and surgical parameters was investigated for the first time in our retrospective analysis. Important influencing factors, including age, sex, smoking, periodontitis, gingival morpho- type, surgical access, membrane coverage and regio iCTS, were taken into account. However, Journal of Oral Science & Rehabilitation Volume 4 | Issue 1/2018 43