Topics covered include factors influencing bone quality; characteristics of
compromised alveolar bone; and techniques for bone assessment, bone
regeneration, and implant placement in compromised bone. The book also presents
specific considerations for placing implants in different types of compromised
bone, such as aged, underdeveloped, and irradiated bone. A useful work of
reference for implant students, practicing implant clinicians, and
implant-oriented researchers.
Contents
Preface
Contributors
1 Overview of Factors Affecting Bone Quality/Georg Watzek
2 Mechanisms of Bone Development, Remodeling, and Loss/Reinhard Gruber
3 Structure of Atrophic Alveolar Bone/Christian Ulm and Gabor Tepper
4 Perfusion of Compromised Bone and Implications for Implant Therapy/Gabor
Tepper and Christian Ulm
5 Assessment of Bone Quality: Techniques, Procedures, and Limitations/André
Gahleitner and Gabriel Monov
6 Surgical Perspectives for Compromised Bone/Georg Mailath-Pokorny
7 Experimental Approaches in Bone Regeneration/Reinhard Gruber and Gabor Fuerst
8 Implants in the Elderly/Robert Haas and Georg Watzak
9 Implants in Children and Adolescents/Thomas Bernhart and Werner Zechner
10 Implants in Irradiated Bone/Michael Weinländer and John Beumer III
11 Lasers in Implant Dentistry/Robert Haas, Orhun Dörtbudak, and Norbert Jakse
Preface
Hardly any term in implant surgery has been misused as often as compromised
bone. Most attempts to shed light on the concept have been confined to data on
changes in bone microstructure, while a comprehensive review of the cellular,
microstructural, and gross anatomic pathology and physiology; current diagnostic
tools; and treatment options is still not available. Few have attempted to go
beyond the four well-known bone quality classes defined by Lekholm and Zarb in
1985, which continue to be the basis of discussions in the literature. One
notable exception is Aging, Osteoporosis, and Dental Implants, edited by
G. Zarb, U. Lekholm, T. Albrektsson, and H. Tenenbaum (Quintessence, 2002).
Although, as the title suggests, the book is focused specifically on age-related
changes and their impact on dental implants, contributing to this work inspired
me, along with my colleagues at the University of Vienna, to review the problem
of compromised bone and its impact on dental implants in a more comprehensive
way and to condense our findings in this volume.
Previous to this effort, we had spent almost two decades studying the problem
and have contributed a great number of publications in nearly all related
fields. These laid the groundwork for the present volume inasmuch as we could
draw on numerous experimental studies conducted by our research group, both in
vitro and in vivo, to describe what reduced bone quality means and what we can
currently do to improve it. Similarly, the clinical section on therapeutic
approaches draws heavily on our large and diverse pool of case studies. This
enabled us to review in some detail what can be done to improve the quality of
the host bone intended to accommodate dental implants. We were assisted in this
exercise by our close collaboration with the Institute of Anatomy at the
University of Vienna, which provided ample material for the study of
microstructural and gross anatomic changes. The University of Vienna’s
Department of Radiology also made a significant contribution to the precise and
profound review of the diagnostic potentialities presented here. Our one
deficiency was a lack of both theoretical and practical experience with the
problem of pre-irradiated bone. This was thankfully filled by a former affiliate
of the University of Vienna in what has traditionally been a seminal cooperation
with the UCLA School of Dentistry in Los Angeles.
This book is intended to provide beginning implant students with a comprehensive
review of the current knowledge regarding the placement of implants in
compromised bone. We also hope that this volume will serve as a useful work of
reference for both practicing implant clinicians and implant-oriented
researchers and will provide all readers interested in the subject with new and
helpful information. The least we expect is that it will contribute a clear
definition of compromised bone so that, in the future, the term will be used
properly and serve as a useful rationale for planning an optimal treatment
strategy.
Edited by
Georg Watzek, MD, DMD, PhD
Head
Department of Oral Surgery
University of Vienna
Vienna, Austria
