Preaugmentation Soft Tissue Expansion: A Report of Four Pilot Cases

Farah Asa’Ad,Massimo Del Fabbro,Silvio Taschieri,Gionata Bellucci,Luca Ferrantino,Davide Trisciuoglio

doi:10.1155/2018/3162617

Abstract

This pilot study aimed at investigating the safety and feasibility of pre-augmentation soft tissue expansion (STE). Tissue expanders of different sizes (from 240 to 1300 mm3) were implanted subperiosteally in four patients requiring vertical and/or horizontal bone augmentation, and left in situ for 20–60 days, according to the expander size. Guided bone regeneration was carried out after STE completion. Horizontal and vertical bone gains were analyzed through CBCT. Optical scanning and superimposition of cast models were used for volumetric analysis. The mean soft tissue volume increase was 483.8 ± 251.7 mm3. Horizontal bone gain averaged 3 mm in two successfully expanded sites while one case had a vertical bone gain of 8 mm. Despite promising outcomes in bone and soft tissue gain, the present technique needs improvement before being applied routinely in everyday dental practice.

Highlights

In modern dental practice, placement of endosseous implants is constantly increasing, as many patients are seeking replacement of lost teeth with this modality of treatment
Soft tissue expanders have been introduced in implant therapy, as pre-augmentation devices, to avoid the complications associated with bone-grafting procedures [6,7,8,9]. e currently used soft tissue expanders made of hydrogel, which is the same material used to fabricate contact lenses, are designed and manufactured
There is scarce clinical evidence describing soft tissue expansion (STE) prior to bone augmentation procedures: only two case series [6, 8] and one randomized controlled clinical trial [7] are available in literature. ese studies have evaluated the outcomes of bone regeneration, but neither has provided clear technical guidelines on the intraoral clinical utilization of these devices nor volumetric analysis of soft tissues

Summary

Introduction

Placement of endosseous implants is constantly increasing, as many patients are seeking replacement of lost teeth with this modality of treatment. Soft tissue expanders have been introduced in implant therapy, as pre-augmentation devices, to avoid the complications associated with bone-grafting procedures [6,7,8,9]. There is scarce clinical evidence describing soft tissue expansion (STE) prior to bone augmentation procedures: only two case series [6, 8] and one randomized controlled clinical trial [7] are available in literature. Ese studies have evaluated the outcomes of bone regeneration, but neither has provided clear technical guidelines on the intraoral clinical utilization of these devices nor volumetric analysis of soft tissues. Post-expansion changes in the profile of the attached gingiva was evaluated in one randomized controlled clinical trial [7]. e authors did not

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Conclusion