The method of clinical trial optimization at oral osteoplastic surgical intervention

Objectives: The aim of this study was to evaluate the effectiveness in the bone volume preservation in the area of the periosteum during oral implantation with improved medical navigation method. Methods: We studied condition of bone segments preparations in the area of the periosteum at 30 cases after the previous implantations. The study was conducted in the Cologne University, Germany (course of prof. J. Zoeller). For medical navigation "Navigator YK" (Pat. 68641) device was used. In experimental clinical studies the selection of 20 patients after surgery in the our private dental clinic was examined. The experimental group (10 patients) included those who had operation (root implant) with constant control of the process. The control subgroup (10 patients) consisted of persons for whom we have applied the standard technique of dental implantation. To prevent uncontrolled pressure damaging load on the periosteum and bone segment loss a homogeneous layer of autogenous bone material was placed circularly on the back side of the implant platform. The rooting dental implant operation was shut down was when the compression arise and the residual layer thickness was about 0,5 mm. Results: When studying of bone segments in 22 cases (73%) in the area of the periosteum adjoining to the implant the presence of bone defect was observed. When analyzing RVG shots in 58% we observed the presence of wedge defects, which were formed gradually during three to four months. Further the process of remodeling bone structures was stabilized. The results of bone tissue densitometry in the periosteum zone close to the implant show the bone density increase on 20-30%. Clinical analysis within 3 months showed that the patients of experimental subgroup had no complaints. The gum changes and the problems with subsequent prosthetics were determined with significantly lower frequency. Upon further observation over 12 months the patients of the experimental subgroup had no complaints. After evaluating of vertical bone resorption for 2 patients of the experimental subgroup the additional bone augmentation for cosmetic reasons was done. Conclusions: Thus our study allowed us to optimize the process of surgery, to predict the influence of pathogenic factors in the process of an implantation and to offer a method of its elimination. Also the clinical symptoms were eliminated, including the later periods. Keywords: implant, implantоgingival pockets, bone augmentation, prosthetic rehabilitation, medical navigation