Usage of Osteoconductive Graft Materials During Immediate Implant Placement Procedures - Paper Example

6 pages
1600 words
George Washington University
Type of paper: 
Literature review
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Usage of Osteoconductive Graft Materials During Immediate Implant Placement Procedures: A Literature Review

AbstractDifferent studies have evaluated the clinical outcome associated with the use of bone grafting during immediate implant placement. The outcomes have shown diverse interrelation in line with stability, gap management, graft materials, regeneration, augmentation, and treatment efficiency. Such a scenario calls for a systemic assessment of the publication to determine the clinical implication and recommend the best practice. Therefore, this paper is a systematic review of the studies examining the usage of osteoconductive graft materials in immediate implant placement to determine the usefulness of the process. A total of 20 studies were comparatively evaluated and clinical recommendations drawn from the outcomes of these papers.

IntroductionThe traditional process of implant placement was carried out after a period of six to eight months after extracting a tooth. Such a process was followed by an average of 3-6 months osteointegration procedures for full recovery. Worth pointing out is that the following such a prolonged procedure-based treatment resulted in extended treatment periods and patient discomfort, which called for the need for an alternative approach to enhance patient experiences. Therefore, the shortcomings such as cost implication, patient discomfort, and increased medical recommendations have encouraged the research in this area where the introduction of immediate implants has been part of the current considerations in bone grafting (Sheikh, Sima, & Glogauer, 2015). Immediate implants have been associated with reduced bone loss during extraction as well as encouraging optimal soft tissue rejuvenation. Moreover, immediate implants have been linked to increased patient comfort, reduced multiple surgical processes, and short prognostic periods after extraction. It is essential to note that the use of osteoconductive graft materials in immediate implant placement has been examined through evidence-based analysis to determine the implication of such an approach. The diverse perspectives have impacted healthcare practice in line with the need for efficiency in bone grafting process. This paper is a systematic review of the studies examining the usage of osteoconductive graft materials in immediate implant placement to determine the usefulness of the process.

Background of the StudyOverview of Bone GraftingThe change witnessed regarding the use of biomaterials in medical research has led to the establishment of new and advanced surgical approaches in dental implants. Worth noting is that the success of dental implants depends on the level of osseointegration in healthy bones. After tooth loss, the size of the bone is reduced, which can be traced to periodontitis and trauma. An average of about 1.5 2 mm of the bone is lost vertically while about 40-50% is lost horizontally (Sheikh, Sima, & Glogauer, 2015). Such a case is evident first 3-6 months after extraction, which calls for the need of implant placement in dental surgery. Therefore, several bone grafting techniques have been developed to enhance implants placement in resorbed alveolar bones. Natural and synthetic graft materials have been presented and approved for this dental process. The use of animal alternatives has been associated with cases of failure, especially in vertical augmentation. Such cases have been linked to soft tissue enucleation or the shrinking of the graft. On the other hand, possible infection, exposure of the graft material, and granulation within the tissue have also impacted the success of the grafting process based on clinical evidence (Sheikh, Sima, & Glogauer, 2015). Moreover, other limitations such as the insufficient vascularization, inadequate bone callus formation, and mismatched bone resorption have been part of the factors encouraging evidence-based clinical research to enhance the current knowledge.

Several principles have characterized the procedure of bone grafting and implant placement in dental surgery. The anatomical bone regeneration structure depends on the bio-mechanism of osteoblasts and osteoclasts, which are the building units of the bone structure. Although they work cumulatively, they emanate from different embryonic lineage. Worth noting is that osteoblasts are needed for osteoclast development and differentiation. On the other hand, the space factor and maintenance is critical on bone grafting. The high rate of soft tissue growth and overlap, slow resorption rate of the graft, and the pattern of bone loss are critical factors that impact space maintenance. Therefore, several artificial methods such as tenting screws and titanium meshes are used to enhance stability and mechanical support (Sheikh, Sima, & Glogauer, 2015). Moreover, osteogenesis and osteoconduction are principles that define the grafting procedures and methods to enhance the success of implant placement. Osteoconduction is a bone graft function that allows ingrowth of the capillaries a well as the osteoprogenitor cells to increase the recovery process. On the other hand, in bone grafting osteoinductors influence the differentiation of new osteoblasts into mature ones to enhance regeneration process (Sheikh, Sima, & Glogauer, 2015). Based on this factors associated with bone grafting as a preliminary process of implant placement, several study outcomes have revealed different perspectives, preferences, and recommendation in line with bone grafting material and process as well as implant placement in dental surgery.

Overview of Implant PlacementThe use of a dental implant is a clinical intervention that has been used over the years as an excellent option for replacement or reconstruction of a defect tooth. Surgical guidelines regarding dental implants have focused on three primary objectives. The dental implants can only be used whenever the practitioners have carried out a comprehensive examination of the specific case as well as an accurate diagnosis. Such preliminary processes allow for appropriate implant recommendations. On the other hand, the implants recommended for clinical practice have been ascertained to be both biological and restorative driven. Moreover, the aspect of ridge reconstruction forms part of the considerations to be undertaken before implants. Worth pointing out is that the goal of implant-based reconstruction is to rejuvenate the aesthetics and functionality. However, the success of the entire process depends on the nature of decision undertaken from diagnosis to prognosis. Therefore, the sequence of therapy is established based on the defined goals, which depends on the recommended evidence-based bone grafting procedures. The inclusion of a comprehensive planning process has been used to enhance the patient outcome, treatment period, and reduction of the bone grafting complexities after the process.

Over the years, several approaches have been used when dealing with implants during bone grafting. The initial method, called the late approach, involved an implant placement after an average of 7 months after an extraction process. The process is followed by an osteointegration process that takes between three to six months. The use of this method is associated with a high cost of treatment as well as prevalent cases of patient discomfort. Moreover, clinical evidence also indicates increased number surgical interventions. Therefore, the need to improve the healthcare practice led to the establishment of the early approach. In this case, the practitioners carry out the implant placement after two to 8 weeks. The approach has been associated with the decreased infection risks since the soft tissue is allowed to achieve a significant degree of healing. Furthermore, the immediate implant placement alternative has been adopted across the globe. The method has been credited with a high rate of efficiency since the amount of bone loss during the extraction process can be reduced while enhancing the aesthetics of the soft tissue. Therefore, the current clinical research has focused on the efficacy of the use of immediate implants in line with the need for improved patient experience and treatment efficiency.

Justification of the StudyThe need for reduces negative implications after bone grafting has been the concern of practitioners. While there is a need for shortening the period of treatment, other dimensions such as the disadvantages associated with the proposed alternative remains a crucial concern to be included in the clinical decisions. For example, the need for appropriate treatment process led to the introduction of the standard procedure where practitioners waited for two to eight weeks before implant placement was carried out (Fairbairn & Leventis, 2015). Such decisions were based on the need for soft tissue healing and reduced risk of infections. On the other hand, the proposition of immediate implants has been linked to improved patients experiences, which is considered a move towards the elimination of the shortcomings associated with extended treatment periods during bone grafting.

Furthermore, the studies conducted regarding the use of osteoconductive graft materials in immediate implant placement have indicated varied results. Since the evidence presented regarding this approach is inconclusive, there is a need for a systematic review of the published studies to determine the correlation of evidence as well as the deviation (Fairbairn & Leventis, 2015). Such a move will present the baseline for conclusions as well as clinical considerations regarding whether the use of bone grafting during immediate implants placement is efficient or not. Therefore, this study was founded on the need for a review of the evidence-based analysis to determine the current position and healthcare insights based on the usefulness of bone grafting during immediate implant placement.

Study ObjectivesThe previous sections of this paper have pointed out how the use of immediate implants in bone grafting is a current clinical practice. The existing literature indicates different outcome from the population samples included in the evidence-based analysis. The need for a comparative assessment of the publications regarding this subject is one of the critical knowledge achievement in medicine. The study, therefore, was designed to carry out a systematic review of the literature to present the diversity in results and offer the baseline for clinical decisions regarding the usefulness of bone grafting during immediate implant placement. The paper focused on the study population as well as the assessment criteria that informed the conclusions made in the selected studies. Based on the assessment outcome, the paper drew clinical recommendations regarding the usage of osteoconductive graft materials in immediate implant pl...

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