Abstract
Autogenous bone is still considered the gold standard in bone augmentation for implant insertion in atrophic ridges. However, augmentation of multiple edentulous atrophic segments usually necessitates the use of extraoral donor sites. This chapter introduces the Wedge Technique, as a new bone augmentation method that can augment multiple edentulous ridges with intraoral cortical bone grafts. Patients with moderate to severe ridge atrophy in different regions of the jaws were treated with the wedge technique (WT). Patients received a panoramic radiograph immediately after the surgery, and they were examined clinically and radiographically (periapical radiograph) every 2 weeks. At four months, CBCT 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. The follow-up period ranged from 30 to 120 months. The healing process was uneventful, with minimal morbidity. The success rate was 95%, the bone gain average was 3–6 mm vertically and 3–9 mm horizontally. The wedge technique can augment multiple segments of atrophic ridges with a small amount of autogenous graft. The achieved bone volume was satisfying, especially that the majority of the augmented areas were at posterior mandibular defects.
Highlights
Alveolar bone loss as a result of teeth extractions, periodontal disease, dentoalveolar trauma, pathologic conditions, failed implants, and failed bone grafting procedures may provide poor bone quality in height, width, and angulation which may result in impaired intermaxillary relationships
Autogenous bone grafts are still considered as the gold standard because of their osteogenic, osteoinductive, and osteoconductive biological activities and due to their safety and their excellent incorporation in the recipient bed
Bone augmentation with cortical bone wedges was performed in adult patients, mean age 47 years; ranging from 19 to 67 years
Summary
Alveolar bone loss as a result of teeth extractions, periodontal disease, dentoalveolar trauma, pathologic conditions, failed implants, and failed bone grafting procedures may provide poor bone quality in height, width, and angulation which may result in impaired intermaxillary relationships. Ridge augmentation is considered in such cases to enhance the insertion of dental implants with good diameter and length at a proper prosthetic position. Current Concepts in Dental Implantology - From Science to Clinical Research. Autogenous bone grafts are still considered as the gold standard because of their osteogenic, osteoinductive, and osteoconductive biological activities and due to their safety and their excellent incorporation in the recipient bed. Common extra donor sites such as iliac crest, rib, tibia, and cranium are used and provide large quantities of cortical and cancellous bone. Extraoral donor sites have several disadvantages that include the need for hospitalization and general anesthesia, prolonged healing time of donor site, concomitant morbidities, and visible scars [11–17]
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