Horizontal and vertical reconstruction of the severely resorbed maxillary jaw using subantral augmentation and a novel tenting technique with bone from the lateral buccal wall.

Abstract

The aim of this study was to evaluate the effect of using the lateral wall bone in sinus lifting two-dimensional reconstruction on bone augmentation. Ten patients affected by class V or VI maxillary atrophy with less than 3 mm of residual horizontal ridge were selected. Using a piezo-ultrasonic surgery tip bony lateral wall was cut. To expose native bone to the bone graft, multiple perforations, made through the cortical plate of the recipient site with a round bur. Once the bony buccal wall was adjusted it was fixed away from the ridge with two 1.5 x 13 mm bone fixation screws. Deficiencies created between the bony buccal wall and the ridge was filled with a mineralized cortical bone. A pericardium membrane was then placed on the graft. A biopsy for histologic evaluation was made. The data analysis in bone volume changes reported significant differences between the anterior and posterior locations before and after grafting (p < 0.05). The biopsy shows mature cancellous bone with predominantly lamellar structure. The use of the lateral wall bone in sinus lift surgery showed significant increase in bone volume.