Soft tissue expander for severely verticfal atrophied alveolar ridges

Abstract

Voluminous horizontal or vertical bone grafting can make primary tension-free wound closure difficult. To achieve tension-free wound closure at the grafted site and thus avoid dehiscence and exposure or total loss of the bone graft, extensive soft tissue mobilization is required. The objective of this study was to evaluate clinical significance and efficacy of bone augmentation and soft tissue enlargement after application of novel tissue expander and bone grafting in patients with severe vertical alveolar bone atrophy, requiring implant placement. We review three cases of soft tissue augmentation using a self-inflating tissue expander for bone graft and dental implantation. In all cases, self-inflating expander was inserted beneath the flap as a first-stage procedure and fixated into bone in both sides of the silicone using micro screws. Two to 4 weeks later, in second-stage procedures, the tissue expander was removed and guided bone regeneration technique (GBR) was carried out with titanium mesh and collagen membrane. They showed good healing without specific complications such as wound dehiscence. After periodic follow-up at 6 months, all patients showed favorable outcomes with sufficient gain of vertical height, hence, an increase in total volume, as seen in the imaging diagnostics. Within the limits of this observational clinical study, self-inflating tissue expander may help to generate additional soft tissue, and they might contribute to the overall improvement of the bone augmentation process by reducing the risk of complications related to the lack of soft tissue.