Using a novel self-inflating hydrogel expander for intraoral gingival tissue expansion prior to bone augmentation

Abstract

The success of bony augmentation is jeopardised by inadequate perfusion and dehiscence of the soft tissue that covers the bone, and the wound should be closed primarily without tension so that vascularisation is not compromised. 1 Cordaro L. Amade D.S. Cordaro M. Clinical results of alveolar ridge augmentation with mandibular block bone grafts in partially edentulous patients prior to implant placement. Clin Oral Implants Res. 2002; 13: 103-111 Crossref PubMed Scopus (310) Google Scholar The increase in bony volume, however, sometimes makes it impossible to achieve tension-free soft-tissue coverage, particularly when a large amount of augmentation material is required, so a mucoperiosteal flap is often raised and mobilised through a periosteal incision. This, however, reduces the perfusion of the mucoperiosteal flap. 2 Esposito M. Grusovin M.G. Maghaireh H. Coulthard P. Worthington H.V. Interventions for replacing missing teeth: management of soft tissues for dental implants. Cochrane Database Syst Rev. 2007; : CD006697 PubMed Google Scholar , 3 Jivraj S. Chee W. Treatment planning of implants in the aesthetic zone. Br Dent J. 2006; 201: 77-89 Crossref PubMed Scopus (49) Google Scholar A possible solution could be soft-tissue expansion. Keeping tissue under constant tension leads to the formation of new cells and growth of tissue. 4 van Rappard J.H. Molenaar J. van Doorn K. Sonneveld G.J. Borghouts J.M. Surface-area increase in tissue expansion. Plast Reconstr Surg. 1988; 82: 833-839 Crossref PubMed Scopus (106) Google Scholar For technical reasons expanders have not yet been used intraorally routinely, but their use is now possible with miniaturised self-inflating hydrogel expanders, which need not be filled from an external source.