Edentulism and terminal dentition are still considered significant problems in the dental field, posing a great challenge for surgical and restorative solutions especially with immediate loading protocols. When the implant placement is planned immediately after extraction with irregular bone topography or there is an un-leveled alveolar ridge topography for any other reason, bone reduction may be required to level the alveolar crest in order to create the desired bone architecture allowing for sufficient bone width for implant placement and to insure adequate inter-arch restorative space. Bone reduction protocols exist in analog and digitally planned methodologies, with or without surgical guides to achieve the desired bone level based upon the desired position of the implants with regard to the restorative outcome. The objective of this paper was to scrutinize the literature regarding the practice of bone reduction in conjunction with implant placement, and to review different types of bone reduction surgical guides. Results: The literature reveals different protocols that provide for bone reduction with a variety of bone reduction methods. The digitally-planned surgical guide based on Cone-Beam computerized tomography (CBCT) scan reconstructed data can improve accuracy, reduce surgical time, and deliver the desired bone level for the implant placement with fewer surgical and restorative complications. The clinician’s choice is based on personal experience, training, and comfort with a specific guide type. Conclusions: Bone reduction, when required, is an indispensable step in the surgical procedure to attain suitable width of bone in anticipation of implant placement ideally determined by the desired tooth position and required restorative space based on material selection for the chosen framework design, i.e., hybrid, monolithic zirconia. Additionally, bone reduction and implant placement can be accomplished in the same surgical procedure, minimizing trauma and the need for two separate interventions.

中文翻译：

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植入物植入前骨复位的各种外科手术指南和规程：叙事回顾

在牙科领域，牙本质病和最终牙列问题仍然被认为是重要的问题，这给外科手术和修复解决方案带来了巨大的挑战，尤其是在立即加载方案的情况下。如果在拔牙后立即计划植入物的放置，并采用不规则的骨骼形态或出于其他任何原因使牙槽形态不平整，则可能需要进行骨复位以平整牙槽level，以创建所需的骨骼结构，从而获得足够的骨骼植入物的宽度，并确保有足够的牙弓间修复空间。骨减少方案存在于模拟和数字计划的方法中，有或没有外科手术指导，可根据植入物相对于修复结果的所需位置来达到所需的骨水平。本文的目的是审查有关与植入物植入有关的骨减少实践的文献，并回顾不同类型的骨减少手术指南。结果：文献揭示了各种协议，这些协议通过各种骨骼减少方法提供了骨骼减少的方法。基于锥束计算机断层扫描（CBCT）扫描重建数据的数字化计划的手术指南可以提高准确性，减少手术时间并为植入物放置提供所需的骨水平，而减少手术和恢复并发症。临床医生的选择取决于个人的经验，培训和对特定指南类型的舒适度。结论：必要时可减少骨量，这是在外科手术过程中必不可少的步骤，以便在预期植入物放置时获得合适的骨骼宽度，理想地由所需牙齿位置和所需修复空间决定，理想选择取决于所选框架设计（即混合的整体式氧化锆）的材料。此外，可以在同一手术过程中完成骨骼的减少和植入物的放置，从而最大程度地减少了创伤并减少了两种单独干预的需要。