Treatment planning in implantology Classification of osseous defects related to gingival architecture

Deformities found in the alveolar ridge can be attributed to congenital and developmental factors, tooth loss, accidents, unsuccessful endodontic treatment, trauma, advanced periodontal disease, odontogenic cysts or tumors, traumatic tooth extraction, dehiscence or fenestration, and prolonged use of a tissue-supported removable partial prosthesis or complete dentures.

According to the literature, 90% of alveolar ridge deformities are due to premature tooth loss. The residual ridge resorption has been described in the literature by several authors.

The alveolar ridge looses much of its volume in the first year after tooth extraction (25%), reaching up to 40% after three years.

Over the last 15 years, several attempts have been made to treat the alveolar ridge deficiencies in the esthetic zone: guided bone regeneration (GBR) with a barrier membrane with or without titanium reinforcement, onlay bone grafts, block bone grafts with membrane, particulated bone grafts, autogenous bone grafts from intra/extra oral sites (iliac crest, cranial vault, oral cavity), freeze dried demineralized bone allograft, and more recently the alveolar distraction osteogenesis technique.

Also, studies shown that vertical ridge augmentation has a poorer prognosis than the horizontal ridge augmentation.