Geometry of TEG.
\r\n\tunidentifiable by traditional imaging techniques. It has a wide range of applications including remote sensing, industry sorting, food analysis, bio-medical imaging, etc. However, in contrast to RGB images from which information can be intuitively extracted, hyperspectral data is only useful with proper processing and analysis. This emphasizes the importance of using advanced signal processing, image processing and machine learning techniques for such a purpose. Classical hyperspectral image analysis tasks include target detection, classification, and spectral unmixing. This book firstly intends to provide a comprehensive overview of recent state-of-the-art of these three tasks. Thereafter, considering the prosperous study in deep-learning based image and data analysis, this book also aims to collect the very recent results of hyperspectral data analysis that benefit from deep neural networks. Finally, practical applications will be included to show how these analytics are useful in promoting real industry, medical, biological development.
",isbn:"978-1-78985-110-6",printIsbn:"978-1-78985-109-0",doi:null,price:0,slug:null,numberOfPages:0,isOpenForSubmission:!0,hash:"02b920d9c266e28152227280ff18ebbe",bookSignature:"Dr. Jie Chen",publishedDate:null,coverURL:"https://cdn.intechopen.com/books/images_new/8223.jpg",keywords:"Hyperspectral Unmxing, Endmember Extraction, Abundance Estimation, Hyperspectral Classification, Spatial-spectral Classification, Hyperspectral Detection, Target Detection, Spectral Signature, Spatial Information, Deep Learning, Deep Neural Networks, Hyperspectral analysis, Hyperspectral Applications",numberOfDownloads:null,numberOfWosCitations:0,numberOfCrossrefCitations:0,numberOfDimensionsCitations:null,numberOfTotalCitations:null,isAvailableForWebshopOrdering:!0,dateEndFirstStepPublish:"February 14th 2019",dateEndSecondStepPublish:"March 7th 2019",dateEndThirdStepPublish:"May 6th 2019",dateEndFourthStepPublish:"July 25th 2019",dateEndFifthStepPublish:"September 23rd 2019",remainingDaysToSecondStep:"11 days",secondStepPassed:!1,currentStepOfPublishingProcess:2,editedByType:null,editors:[{id:"218017",title:"Dr.",name:"Jie",middleName:null,surname:"Chen",slug:"jie-chen",fullName:"Jie Chen",profilePictureURL:"https://mts.intechopen.com/storage/users/218017/images/system/218017.png",biography:"He is currently a Professor at the Northwestern Polytechnical University (NPU),\nConcurrently, he is also the Vice Director of the Center of Intelligent Acoustics and\nImmersive Communications in NPU. His research interests include adaptive signal\nprocessing and distributed optimization with applications to hyperspectral image analysis, acoustic signal processing, and bioinformatics. Dr. Chen has been recognized\nwith the “Thousand Talents Plan (Youth Program)” Award in China. He serves as\nDistinguished Lecture of Asia-Pacific Signal and Information Processing Association\n(APSIPA), and he was the Technical Co-Chair of IWAENC’16 .",institutionString:"Northwestern Polytechnical University",position:null,outsideEditionCount:0,totalCites:0,totalAuthoredChapters:"2",totalChapterViews:"0",totalEditedBooks:"0",institution:null}],coeditorOne:null,coeditorTwo:null,coeditorThree:null,coeditorFour:null,coeditorFive:null,topics:[{id:"9",title:"Computer and Information Science",slug:"computer-and-information-science"}],chapters:null,productType:{id:"1",title:"Edited Volume",chapterContentType:"chapter",authoredCaption:"Edited by"},personalPublishingAssistant:{id:"288104",firstName:"Ivana",lastName:"Spajic",middleName:null,title:"Ms.",imageUrl:"//cdnintech.com/web/frontend/www/assets/author.svg",email:"ivana.s@intechopen.com",biography:"As an Author Service Manager my responsibilities include monitoring and facilitating all publishing activities for authors and editors. From chapter submission and review, to approval and revision, copyediting and design, until final publication, I work closely with authors and editors to ensure a simple and easy publishing process. I maintain constant and effective communication with authors, editors and reviewers, which allows for a level of personal support that enables contributors to fully commit and concentrate on the chapters they are writing, editing, or reviewing. I assist authors in the preparation of their full chapter submissions and track important deadlines and ensure they are met. I help to coordinate internal processes such as linguistic review, and monitor the technical aspects of the process. As an ASM I am also involved in the acquisition of editors. Whether that be identifying an exceptional author and proposing an editorship collaboration, or contacting researchers who would like the opportunity to work with IntechOpen, I establish and help manage author and editor acquisition and contact."}},relatedBooks:[{type:"book",id:"9220",title:"Self Organizing Maps Alternatives",subtitle:null,isOpenForSubmission:!0,hash:"03bd3a6aeeddd83a8547aa9d2b00e94d",slug:null,bookSignature:"",coverURL:"https://cdn.intechopen.com/books/images_new/9220.jpg",editedByType:null,editors:null,productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"9228",title:"Game Theory in Communication Networks",subtitle:null,isOpenForSubmission:!0,hash:"8b08c0b6f4551f40871d7ef503c634ee",slug:null,bookSignature:"",coverURL:"https://cdn.intechopen.com/books/images_new/9228.jpg",editedByType:null,editors:null,productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"9236",title:"Cheminformatics and its Applications",subtitle:null,isOpenForSubmission:!0,hash:"22387852abf96ae511a741a735738494",slug:null,bookSignature:"",coverURL:"https://cdn.intechopen.com/books/images_new/9236.jpg",editedByType:null,editors:null,productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"7351",title:"Eye Tracking and New Trends",subtitle:null,isOpenForSubmission:!1,hash:"2f3c00ae8b1f64fe65ab236df85ce9a0",slug:null,bookSignature:"Dr. Francisco Lopez-Orozco",coverURL:"https://cdn.intechopen.com/books/images_new/7351.jpg",editedByType:null,editors:[{id:"232939",title:"Dr.",name:"Francisco",surname:"Lopez-Orozco",slug:"francisco-lopez-orozco",fullName:"Francisco Lopez-Orozco"}],productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"7367",title:"Watermarking Techniques and Applications",subtitle:null,isOpenForSubmission:!0,hash:"a92da74e033b9b383bc350ba8c41540f",slug:null,bookSignature:"",coverURL:"https://cdn.intechopen.com/books/images_new/7367.jpg",editedByType:null,editors:null,productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}},{type:"book",id:"7407",title:"3D Reconstruction and Visualization - 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Pareto-optimal and Related Principles",subtitle:null,isOpenForSubmission:!0,hash:"05baea741edde509bab2259dad7f6384",slug:null,bookSignature:"Prof. Nodari Vakhania and Dr. Frank Werner",coverURL:"https://cdn.intechopen.com/books/images_new/8521.jpg",editedByType:null,editors:[{id:"202585",title:"Prof.",name:"Nodari",surname:"Vakhania",slug:"nodari-vakhania",fullName:"Nodari Vakhania"}],productType:{id:"1",chapterContentType:"chapter",authoredCaption:"Edited by"}}]},chapter:{item:{type:"chapter",id:"52858",title:"Modeling of a Thermoelectric Generator Device",doi:"10.5772/65741",slug:"modeling-of-a-thermoelectric-generator-device",body:'Increase in greenhouse gases emissions in the atmosphere due to burning of fossil fuels for the production of electricity and heat energy has motivated the development of alternative efficient and clean‐energy‐generation systems including that for the recovery of waste heat into electrical power. Numerous power‐generation systems, such as solar panels, wind turbines, and geothermal power plants, which utilize renewable energies, have been designed to reduce dependency on fossil fuels, thus reducing greenhouse gases emissions. However, such power‐generation systems require high maintenance and are often expensive as compared to thermoelectric generator devices (TEGs). Thermoelectric generator device (TEG) is a device that directly converts heat into electricity. Essentially, TEG is thermoelectric module (TEM), which consists of thermopiles, that is, a set of thermocouples built by legs of p‐ and n‐type semiconductors, which are connected electrically in series and thermally in parallel [1, 2]. Thermocouples built by legs of p‐ and n‐type semiconductors are sandwiched between two ceramic plates, which are to be held at two different temperatures to realize generation regime. Temperature gradient induced between top and bottom ceramic plates originates voltage on TEG poles due to Seebeck effect in thermocouples built by legs of p‐ and n‐type semiconductors.
Employing waste heat as heat source for TEGs is cost‐effective due to waste heat being free of charge and already available. About 70% of the world energy production is known to be wasted into atmosphere through heat dissipation, which is one of significant contributions in global warming [3]. Therefore, the utilization of waste heat by converting into electricity using TEGs can contribute to energy savings and preservation of the environment as well. Thermoelectric device can also operate in reverse mode as thermoelectric cooler (TEC) and produce reverse temperature gradient between top and bottom ceramic plates due to Peltier effect, if electrical bias is applied. Depending on operation mode, applying bias voltage to thermoelectric module (TEM) and hence initiating flow of electrical current result in the production of temperature difference between top and bottom plates and TEM acts as thermoelectric cooler (TEC) and vice versa; the placement of TEM in temperature gradient results in the occurrence of voltage on TEM poles and TEM acts as heat pump with the function of thermoelectric generator (TEG) [4].
Thermoelectric devices possess various advantages compared to other power‐generation systems [5]. TEGs are branded attractive power‐generation systems, because they are silent solid‐state devices with no moving parts, environmental friendly, scalable from small to giant heat sources, and highly reliable. They also have extended lifetime and ability to utilize low‐grade thermal energy to generate electrical energy.
Seebeck effect describes the induction of voltage, when junctions of two different conducting materials are maintained at different temperatures as shown in Figure 1. Seebeck effect increases in magnitude, when Seebeck coefficient of conducting materials and/or temperature difference between their connections increases. Voltage induced through Seebeck effect is defined as below:
where
Seebeck effect.
Peltier effect describes heat dissipation or absorption at the connection of two conducting materials, when current flows through the junction as shown in Figure 2. Depending on the direction of current flow, heat is either absorbed or dissipated at connection.
Peltier effect.
Thomson effect describes the dissipation or absorption of heat, when electric current passes through a circuit composed of a single material, which has temperature variation along its length, as shown in Figure 3.
Thomson effect.
where
Joule‐heating effect defines heat dissipated by material with nonzero electrical resistance in the presence of electrical current, as shown in Figure 4,
Joule heating.
TEGs are composed of numerous legs (slabs) made of p‐ and n‐type semiconductors forming thermocouples, all connected electrically in series and thermally in parallel. Semiconductor legs are connected to each other through conductive copper tabs, and they are sandwiched between two ceramic plates, which conduct heat, but behave as insulators to electrical current. Schematic diagram of three‐dimensional (3‐D) multielement thermoelectric generator is shown in Figure 5.
3‐D schematic of multielement TEG.
Waste heat from various sources, such as automobile engines exhaust, industry and infrastructure‐heating activities, geothermal, and others, can be supplied to top ceramic plate of TEGs. As shown in Figure 5, heat flows through ceramic plate and copper‐conductive tabs before reaching the top surface of p‐ and n‐type legs made of proper semiconductors, which is defined as the hot side of TEG. Heat flows through both semiconductor\'s legs and then again through copper‐conductive tabs and bottom ceramic plate. Through heat sink, the bottom ceramic plate is maintained at significantly lower temperature than top ceramic in order to produce high‐temperature gradient, which will lead to high‐power output. Allowed temperature applied on top and bottom ceramic plates depends on materials of p‐ and n‐type legs. Also, p‐ and n‐type materials are designed to possess low thermal conductivity in order to restrict, as much as possible, heat flow through semiconductors and maintain temperature difference between hot and cold sides of TEG.
Pictorial distribution of temperature along legs of TEG at conditional difference of temperature
Temperature gradient within TEG.
After temperature gradient has been induced between hot and cold sides of TEG, voltage occurred on TEG‐positive and ‐negative poles due to Seebeck effect, as depicted in Figure 7.
Voltage distribution within TEG.
Voltage generated in TEG due to Seebeck effect induces the movement of charge carriers within p‐and n‐type semiconductor legs and, hence, electrical current in electrical circuit including load resistor
Current density within TEG.
Establishing one‐dimensional (1‐D) representation of TEG is helpful in determining analytical expressions of heat absorbed and heat rejected, as the power output of TEG is defined as the difference between heat absorbed and heat rejected. Figure 9 represents 1‐D schematic of TEG with heat source and heat sink, respectively, applied on top and bottom sides of TEG.
1‐D schematic of multielement TEG.
Electrical resistance network of TEG is shown in Figure 10. P‐type and n‐type semiconductor legs are connected to each other electrically in series through copper‐conductive tabs.
Electrical network resistance.
Thermal resistance of TEG is shown in Figure 11 and it assists in determining heat transfer rate through ceramic plates, copper strips, and p‐ and n‐type semiconductor legs. The number of thermocouples is N.
Thermal resistance network.
Thermoelectric materials of TEG legs, p‐ and n‐type semiconductors, are characterized by parameter called the figure of merit Z, which measures the ability of thermoelectric materials to convert heat into electrical power. The figure of merit is expressed as follows:
where
In order to obtain maximum figure of merit, when designing TEG, the geometry of semiconductor legs and properties of thermoelectric materials need to satisfy the following equation [1, 11]:
where
To reduce manufacturing costs, p‐ and n‐type semiconductor legs are fabricated with the same geometry, that is,
In order to obtain expressions describing TEG performance, thermocouple built by legs of p‐ and n‐type semiconductors is extracted from Figure 9 and represented in Figure 12. Figure 12 represents heat transfer within single thermocouple. The length and cross‐sectional area of both p‐ and n‐type semiconductor legs are equal and symbolize as L and A, respectively. The junction of thermocouple is fixed at thermal conducting and electrical‐insulating ceramic plate.
Heat transfer within TEG thermocouple.
Employing the conservation of energy and assuming one‐dimensional steady‐state condition, the energy equation of differential control volume inside of p‐type semiconductor leg can be expressed as follows:
Using Taylor expansion:
Fourier\'s law of conduction for one‐dimensional heat conduction states:
Substituting Eq. (9) into Eq. (8):
Provided that thermoelectric properties are temperature independent,
Integrating Eq. (11):
where
Considering Peltier effect happening at the hot junction of p‐type leg:
where
Employing the same procedure with the same boundary conditions to derive heat flow through n‐type leg leads to the expression of
where
We use the same method to derive expression for heat rejected at the cold junction of p‐type and n‐type legs. Consequently, the following expression is obtained:
TEG is characterized by numerous performance expressions, including heat absorbed on the hot side, heat rejected on the cold side, power output, voltage induced, and current flowing in the electrical circuit with load resistor. Defining symbols below from Eqs. (24) and (25):
Expressions of heat flow through the hot and cold junctions for N semiconductor thermocouples can therefore be expressed as follows:
As stated previously, the power generated by TEG is defined as the difference between heat absorbed at the hot junction and heat rejected at the cold junction:
Optimal current generated in TEG is obtained by first deriving Eq. (31) with respect to current as follows:
Eq. (32) is equated to zero to determine the following expression of optimal current:
Generally speaking, voltage, current, and output power induced in TEG consisting of set of thermocouples similar to the one represented in Figure 9 are, respectively, defined as:
where
In actual TEG, two thermoelectric materials are used, that is, p‐ and n‐type semiconductors. The maximum efficiency provided by TEG is expressed as follows:
where
Numerical example is adopted in order to optimize and analyze effects of heat transfer governing equations on output power, efficiency, and induced voltage of TEG.
In numerical analysis, the following geometry is adopted (Table 1).
The following thermoelectric properties are adopted (Table 2).
Number of pairs (N) | Cross‐sectional area (A) | Length (L) |
---|---|---|
10 | 2.5×2.5×10-6 m2 | 2×10-3 m |
Geometry of TEG.
Thermoelectric properties.
All obtained performance curves are computed at the hot‐side temperature up to
By fixing the cold side at temperature
One can observe that the power as a function of current behaves as a parabola with optimum power value at specific current. Figure 13 shows the existence of maximal current value, which corresponds to optimum power. Any current higher or lower than the maximum current value generates power output less than optimum power. Also, as temperature at the hot side increases, then power produced increases as well.
TEG output power as a function of electrical current.
Efficiency curves shown in Figure 14 behave as parabola as well, with specific current value maximizing efficiency for each temperature difference. In real devices, TEGs are always operated at an optimal current. One thing to note is that the efficiency of TEG is still low compared to other energy‐conversion techniques. A lot of effort has been made to enhance efficiency [13, 14]. Given that heat sources are plenty and free, TEGs could be promising solutions, when they are employed to harvest waste heat from industry activities and central‐heating systems.
Efficiency as a function of current.
Employing various temperature differences, while maintaining the cold‐side temperature at 373 K, voltage induced as a function of current behaves as shown in Figure 15.
Voltage as a function of current (I‐V dependences of TEG).
One can observe from Figure 15 that voltage induced for each temperature difference is decreasing and the linear function of output electrical current. Slopes of I–V dependences are the same.
While still maintaining the cold side at a temperature of 373 K and replacing current in output power equation (Eq. (31)) by optimal current expression (Eq. (33)), power expression becomes a function of temperature at the hot side, and Figure 16 shows the behavior of output power as a function of the hot‐side temperature.
Power as a function of hot‐side temperature.
Output power as a function of hot‐side temperature behaves as nonlinear curve increasing as the hot‐side temperature increases.
The efficiency of TEG as a function of hot‐side temperature is shown in Figure 17.
Efficiency of TEG as a function of hot‐side temperature.
Figure 18 depicts variations of output power as a function of external load resistance. Eq. (35) is used to obtain dependences shown in Figure 18.
Output power as a function of external load resistance.
Optimal output power occurs when load resistance equates to internal electrical resistance of the total number of p‐ and n‐type semiconductor legs.
ZT value is modified figure of merit, where T represents averaged temperature between the hot‐side and cold‐side temperatures. For each temperature difference, efficiency increases as ZT value increases. Therefore, employing thermoelectric materials possessing high ZT values leads to great TEG efficiency (Figure 19).
Efficiency as a function of ZT value.
In this chapter, the basics of thermoelectric generator devices are covered including phenomena that guide their operation. State‐of‐the‐art modeling efforts are summarized. The presented modeling is crucial for comprehensive understanding of heat to electric energy conversion in TEGs. Simulation results are very useful in predicting the maximum ratings of TEGs during operation under different ambient conditions.
This work was funded by the startup fund from Virginia Polytechnic Institute and State University.
Esthetic rehabilitation in cases of tissue loss in anterior areas represents a major challenge in dentistry with respect to the treatment planning when the choice of therapeutic options is aimed at maintaining the tissue long-term [1]. The developed surgical recommendations require long-term treatment with possible undesirable complications in the tissue architecture [2, 3, 4, 5, 6].
These cases can also be successfully treated using immediate dentoalveolar restoration (IDR), a previously described one-stage technique [1, 7] that allows dental extraction, implantation, and provisionalization to occur during the same procedure as the flapless bone reconstruction using a corticocancellous bone graft harvested from the maxillary tuberosity [8, 9, 10, 11]. The IDR technique, in addition to having lower overall cost and treatment time, has been shown clinically and tomographically to be effective regarding bone and soft tissue stability [9].
According to the IDR protocol for total loss of the buccal bone wall, the corticocancellous is shaped to the defect size and inserted between the implant and the remaining buccal soft tissue without opening the flap [1, 7, 9, 11]. Then, particulate bone is compacted until it completely fills the gaps between the main graft and the implant surface [7, 8, 9]. The provisional restoration is made at the same time. The proper anatomical contour of the prosthetic emergence profile is mandatory to guide the soft tissue healing [9, 10, 11].
The key factors that may explain the positive results obtained with immediate and flapless implant insertion and provisionalization using autogenous bone grafts in the esthetic zone are as follows: the flapless procedure may preserve the blood supply of the facial lamella, the sole use of autogenous bone without any bone substitutes and without membranes may prevent resorption due to foreign body reactions, and the placement of the implants along with the palatal cortical border of the extraction socket may increase primary stability and avoid any crossing of the bony envelope [12].
The advantages of IDR include the following: the harvest of maxillary tuberosity is easily performed; the malleability of bone fragment allows adequate adaptation to the receptor region; and the corticocancellous acts as a biological membrane, thereby promoting effective bone and gingival healing [13]. Furthermore, the trabecular nature of grafts harvested from the maxillary tuberosity contributes to the increased revascularization capacity and the release of growth factors to the receptor site [13, 14]. The immediate provisional restoration contributes to tissue healing acceleration and formatting the ideal gingival prosthetic emergence profile [11, 15].
The position of the implant in IDR, as in any other technique, should be considered one of the main reasons to obtain stability of hard and soft tissues. The protocol used for selecting the diameter and position of implants placed in esthetic zones uses the buccopalatal distance from the socket opening as a reference [16]. Regardless of the tooth to be replaced, a gap of approximately 3 mm between the buccal implant surface and the outer buccal bone wall is expected. After gap filling, peri-implant tissue remains stable using this surgical protocol, which has yielded satisfactory as well as predictable esthetic outcomes in a prospective case series [17].
The most challenging stages of the IDR technical application concern the implant primary stability in compromised alveolar sockets to allow immediate provisional fabrication and bone reconstruction in a single procedure [7, 9, 17]. In this context, using the counterclockwise rotation of site preparation would increase implant stability in favor of its IDR execution. The osseodensification allows bone autograft by compaction throughout the depth of drilling laterally and at the deepest part of the perforation [18, 19]. This nonextraction technique utilizes a designed bur that promotes the application of controlled bone plastic deformation due to the rolling and sliding contact of the bur along the inner surface of the osteotomy [20].
A 63-year-old female presented with the right lateral incisor fractured with abscess, fistula, severe bone loss, and low soft tissue quality (Figure 1).
Clinical evaluation showing very poor quality soft tissue due to the fracture and infection in the right lateral incisor.
The periapical radiograph and cone beam computed tomography (CBCT) images confirmed the loss of the buccal wall in the right lateral incisor (Figure 2).
(A and B) Through the X-ray, it is possible to notice the bone available beyond the root apex of the damaged tooth. The CBCT image shows the loss of the buccal bone wall.
The gingival architecture showed a very thin periodontal biotype. Intraoral examination with dental probing confirmed that the buccal bone wall had been lost in the right lateral incisor (Figure 3).
(A and B) The probe depth showed approximately 11 mm in height of the buccal aspect. It is possible to notice the periodontal probe underneath the gingival tissue due to the thinness of the soft tissue.
Considering the esthetic and functional demands, the treatment plan consisted of following the IDR technique using the corticocancellous graft protocol. Antibiotic therapy was prescribed 5 days prior and 7 days after surgery due to the contamination of the affected area. The steps included a minimally invasive dental extraction (Figure 4), curettage and cleaning of the socket, evaluation of the extension of the bone defects (Figure 5), and site preparation using the osseodensification concept (Densah burs kit, Versah, USA) due to the presence of very soft bone in the anterior area (Figure 6). Burs were used in a noncutting action in a counterclockwise (CCW) rotation at 1100 rpm to prepare the immediate implant site trajectory. Installation of the immediate implant placement 3 mm from the gingival margin apically (V3 implant—MIS, Israel) in the correct 3D position (Figure 7) achieved primary stability, leaving a gap approximately 3 mm at the buccal aspect, construction of a screwed provisional restoration with an ideal emergence profile (Figure 8), and reconstruction of the socket bone defects using corticocancellous graft harvested from the maxillary tuberosity (Figure 9) with chisels (IDR chisels kit, Schwert, Germany) were performed to restore the bone defects (Figure 10). The residual gaps were filled with particulate cancellous bone harvested from the same donor area (Figure 11), maintaining the reconstructed bone wall and the surrounding soft tissue. The graft was placed at a biological distance of 2 mm from the bone graft apically to the gingival margin and 3 mm in thickness (Figure 12).
(A–C) The damaged tooth was extracted applying minimally invasive procedures, favoring preservation of the remaining bone walls. A careful curettage of the socket was performed to completely remove the granulation tissue and remains of periodontal tissue.
(A–C) The extension of the bone defect at the buccal aspect in the corono-apical and mesio-distal directions was measured. The thickness of soft tissue was measured using a caliper. A very thin periodontal biotype was confirmed.
(A–C) The site was prepared using the osseodensification concept densifying bone laterally while also increasing the bone volume.
(A and B) The implant (V3—MIS, Israel) was anchored at the palatal wall in the 3D position favoring the construction of the screwed provisional crown. A total of 50 Ncm of primary stability was obtained. The 3D positioning of the implant allowed a gap of 3 mm at the buccal aspect.
(A–F) A screwed provisional restoration was manufactured with an adequate emergence profile to allow space of correct accommodation of the tissues.
(A–F) Prior to surgery, it was evaluated clinically the donor area of the bone graft and through CBCT scans to assess the bone availability of the maxillary tuberosity. The corticocancellous graft and particulate bone were harvested from maxillary tuberosity using IDR chisels (IDR kit, Schwert, Germany).
(A–C) The graft was reshaped according to the defect configuration. The corticocancellous graft was inserted and stabilized by juxtaposition into the receptor site.
(A and B) Particulate bone was compacted to fully fill the gaps between the marrow portion of the corticocancellous graft and the implant.
(A and B) 3 mm in thickness of the bone was reconstructed and confirmed through the periodontal probe.
The screwed provisional restoration was placed in position immediately and was adjusted out of occlusion (Figure 13). The immediate periapical radiograph showed the bone entirely reconstructed (Figure 14). A week after the surgery, the soft tissue had improved healing (Figure 15).
(A–D) A screwed provisional crown out of occlusion was inserted over the implant. It is possible to observe the correct 3D position of the implant.
The immediate X-ray showing the bone entirely reconstructed.
Soft tissue healed 1 week after the procedure.
Three months after the surgery, the soft tissue showed the maintenance of volume and papillae positioning (Figures 16 and 17). The definitive restoration was accomplished after 4 months (Figure 18).
(A–D) Soft tissue was stable in volume and with relevant thickness after 3 months. The anatomical contour of the provisional restoration allowed the correct accommodation of the soft tissue.
(A–C) Maintenance of the anatomical contour of soft tissue can be observed.
(A–D) Screwed porcelain crown insertion with ideal emergence profile. A periapical X-ray showing bone stability all around the implant.
Clinical evaluation after 2 years showed stability of the soft tissue volume regarding gingival margin and papillae (Figure 19) and the CBCT image showed the buccal wall completely restored with relevant thickness in the right lateral incisor (Figure 20).
(A–C) Clinical follow-up after 2 years showing the stability of soft tissue regarding gingival margin and papillae.
(A–C) BCT image after 2 years highlights the stability of the buccal wall, in terms of thickness and height.
Different surgical alternatives for bone augmentation in postextraction compromised sockets have been described. However, some of these techniques require longer periods for rehabilitation and are usually costly [3, 4, 5, 6]. As an alternative, the IDR technique using maxillary tuberosity grafts presents significant gains in esthetic results and in treatment time, recovery of the alveolar bone defect at the same surgical implant installation and immediate provisionalization without opening the flap and keeping the gingival architecture in the same position [8]. As previously described, if the soft tissue and periosteum remains attached to the buccal bone, the bone supply will be maintained, allowing rapid graft revascularization [13, 14].
Bone density at the buccal, palatal, and basal cortical maxillary tuberosity is lower, compared to other maxillary and mandibular bones [13, 17, 21]. Due to the small thickness of its cortical bone, maxillary tuberosity grafts are easily shaped and its cortical structure can act as a biological barrier, stabilizing the soft tissue and the particulate bone graft around the implant [7, 9]. The total porosity and porous volume indicate that the corticocancellous structure can act as a scaffold structure for cellular and vascular growth [10, 11, 15]. The maxillary tuberosity is a source of osteoprogenitor cells and growth factors [14]. Taken together, the cortical and the cancellous bone from the maxillary tuberosity can be considered as an ideal structure for bone regeneration since it is a natural scaffold filled with osteoblastic cells and growth factors [7, 9, 10, 11].
The structural and biological characteristics of the graft removed from the tuberosity and its proper manipulation and adaptation to the recipient site can be identified as one of the reasons for the success of the IDR technique, as it has been shown in studies monitoring long-term results [1, 14, 17].
Osseodensification was utilized in the postextraction site preparation in this case to preserve any remaining apical bone and to produce an intimate osteotomy for the implant. This compaction grafting increased implant primary stability and allowed for the higher insertion torque due to the spring-back phenomenon [18, 20].
Histological evidence has demonstrated that the compacted, autologous bone immediately in contact with the implant will not only enhance the primary stability due to the physical interlocking between the bone and the device but also facilitate osseointegration due to osteoblasts nucleating on the instrumented bone near the implant [19]. This enhanced implant stability allowed the author to predictably restore this case immediately postextraction for the IDR procedure.
The IDR allowed dental extraction of the compromised alveolar socket as well as implantation and provisionalization in the same procedure as the flapless bone reconstruction using a corticocancellous bone graft harvested from the maxillary tuberosity.
The clinical case showed adequate implant rehabilitation in the freshly compromised tooth with severe alveolar bone defect and the infected site, which strengthened the clinical outcome of the IDR technique using the osseodensification concept. When properly indicated and performed, the IDR technique exhibits a high success rate.
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