Abstract
Wound dehiscence is the most frequent complication after ridge augmentation and causes postoperative infection, inadequate bone healing, or graft failure. In the oral cavity, conservative treatment for dehiscence is difficult to maintain until secondary healing occurs because of its normal flora, dynamic masticatory muscle movement, and humid environment. This paper reports an effective conservative method using an oral wound dressing material with an omnivec splint and presents three wound dehiscence cases: (1) autogenous tooth bone graft material with a collagen membrane, with dehiscence occurring at postoperative 5 days. (2) Autogenous bone graft covering titanium mesh, with dehiscence occurring at postoperative three weeks. The mesh was removed after 10 weeks with histologic analysis. (3) Autogenous bone and autogenous tooth bone graft covering a titanium mesh, with dehiscence occurring at postoperative 1 week. The exposed titanium mesh was maintained for 6 months after the graft. All cases achieved secondary healing and acceptable outcomes for a dental implant by conservative treatment without infection after the dehiscence after ridge augmentation.
Highlights
The reconstruction of severe atrophy or defects on the alveolar bone resulting from a pathologic lesion is a clinically challenging indication for ridge augmentation [1]
Orascar showed a sealing effect by adhesion with the gingiva after a few minutes of application. The dehiscence of these three patients was acceptable, and secondary healing was achieved without complications, such as bacterial infection and graft failure, within four weeks of the wound dehiscence occurrence
Exposure of the titanium mesh is a complication with a high risk of bacterial infection [1,9]
Summary
The reconstruction of severe atrophy or defects on the alveolar bone resulting from a pathologic lesion is a clinically challenging indication for ridge augmentation [1]. High osteogenic potency bone substrates have been used for the severe defects, such as autogenous bone and demineralized dentin matrix with rhBMP-2 (Auto-DDM/rhBMP-2, Korea Tooth Bank, Korea) [2,3]. The common complication of the ridge augmentation is wound dehiscence, which is caused mainly by a lack of soft tissue and tension of the flap [1,4]. The earlier intervention, such as membrane removal or re-suture, can adversely affect graft stability [5]. Graft stability should be secured during the vascularization and remodeling period
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