Abstract
Purpose: Autogenous bone was still considered as the gold standard in bone augmentations prior to implants insertion at the atrophic ridges. However if large bone grafts are needed to augment multiple edentulous atrophic segments, extraoral donor sites may be mandatory. The aim of this report is to introduce the Fares Wedge Technique, as a new bone augmentation method that can augment multiple edentulous ridges with intraoral cortical bone grafts. Methods: This report includes patients with moderate to severe ridge atrophy in different regions of the both jaws who were treated over 6-years period (2009-215) with wedge Technique (WT). Patients received panorex immediately after the surgery, and they were examined clinically and radiographically (periapical) every 2 weeks. At 4 months, computed tomography was performed to evaluate the bone gain. Reentry was performed after 4 to 5 months to evaluate the new bone volume and quality and to insert implants. At this stage specimens for histologic examination were also obtained. Results: 39 augmentation sites in 22 patients (15 women, 7 men: mean age 47 years) were followed 12 to 52 months. The healing process was uneventful, with minimal morbidity. The success rate was 95%, and the bone gain average was 3 - 6 mm vertically and 3 - 9 mm horizontally. In two patients the graft was partially exposed and treated with shaving and rounding the exposed wedges, but the augmentations were saved. In one case the majority of the bone graft was lost. At 38 sites the patients had successfully received 114 implants. Conclusions: wedge technique can augment multiple segments of atrophic ridges with small amount of autogenic graft. The bone volume that achieved was satisfying, especially that the majority of the augmented areas were at posterior mandibular defects.
Highlights
Alveolar bone loss is a result of teeth extractions, periodontal disease, trauma, pathologic conditions, failed implants, and failed bone expansion procedures may provide poor bone quality in height, width, angulation and impaired intermaxillary relationships
Autogenous bone was still considered as the gold standard in bone augmentations prior to implants insertion at the atrophic ridges
If large bone grafts are needed to augment multiple edentulous atrophic segments, extraoral donor sites may be mandatory
Summary
Alveolar bone loss is a result of teeth extractions, periodontal disease, trauma, pathologic conditions, failed implants, and failed bone expansion procedures may provide poor bone quality in height, width, angulation and impaired intermaxillary relationships. Ridge augmentation may be considered in such cases to enhance placement of dental implants at a proper prosthetic position. Several augmentation methods and materials have been successfully used but much controversy still exists [1]-[10]. Common extra donor sites such as the iliac crest, rib, tibia, and calvarium are commonly used and provide large quantities of bone. The main disadvantages of extraoral donor sites are: the need for hospitalization, general anesthesia, prolonged healing time, co-morbidities, and visible scars [11]-[17]
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