Autogenous Bone Block Graft Research Articles

Application of autogenous block bone graft in the reconstruction of severe alveolar crest defect

Patients with severe alveolar ridge defects cannot be directly implanted and repaired, which seriously affects their quality of life. Onlay bone grafting is the main solution for severe alveolar ridge bone defect reconstruction, among which autogenous block bone grafting is the most widely used and is also the focus of clinical research on bone tissue reconstruction. This article expounds the characteristics and basic principles of autogenous bone block grafting, and comprehensively analyzes the selection of autogenous bone donor site, the principles of surgical operation, and the progress of bone graft techniques. In order to help surgeons make correct clinical decisions, increase the predictability of surgical effects, and improve the level of clinical diagnosis and treatment.

Case Report: Autogenous bone block grafting in esthetic zone for implant supported prosthetic rehabilitation

Background: Dental implants provide a novel method of successful treatment and have been a highly predictable surgical procedure for replacing single or multiple teeth. Maxillary anterior single-tooth replacement is often the most difficult procedure in all of implant dentistry. The highly esthetic zone of the premaxilla often requires both hard (bone and teeth) and soft tissue restoration. Therefore, augmentation of alveolar ridge defect becomes more important in terms of providing sufficient bone volume for the placement of implants and for aesthetic considerations. The aim of this case report was to bring forward the novel technique of combining ridge augmentation using autogenous bone block graft for anterior implant placement using piezoelectric apparatus. Case description: In this case report, a 27-year-old male patient presented to the department of periodontics with a chief complaint of poor aesthetics owing to missing tooth in the upper-front region (11) due to trauma that occurred 3 years back. The patient was diagnosed with an alveolar bone wall defect with 11 region. The authors brought forward the novel technique of combining ridge augmentation using autogenous bone block graft for anterior implant placement using piezoelectric apparatus in order to treat the patient. The follow-up was done at 6- and 9-months post-op respectively. Conclusion: In spite of all the technical difficulties that the surgical and restoring clinician may face, the anterior single-tooth implant is the ideal modality of choice to replace a missing anterior maxillary tooth. Clinical significance: Unique surgical and prosthetic concepts were implemented in this case for successful results.

Reconstruction of the Atrophic Ridge with Staged approaches with the Autogenous Bone Block and Dental Implant: Case Reports and Literature Review

<p>Dental implant is a common choice for rehabilitation of edentulous areas in modern dentistry. However, alveolar bone destruction due to severe periodontitis, trauma, or other pathological conditions may compromise implant placement in an idea position. Ridge augmentation with autogenous bone blocks can be used to reconstruct the deficiency of the alveolar bone. This article reviewed about the relevant literatures and reported two cases of severe ridge atro¬phy using staged approaches with ridge augmentation using autogenous bone block grafting and implant placement for reconstruction. Case 1 showed alveolar bone destruction caused by severe periodontitis at left maxillary region, which was augmented with the autogenous bone block harvested from mandibular symphysis in combination with FDBA and collagen membrane. Case 2 presented alveolar ridge deficiency after tooth extraction due to severe periodontitis. Ridge augmentation was performed using autogenous bone block harvested from the mandibular ramus along with FDBA and collagen membrane. Both cases showed increased bone volume after ridge augmentation. Implants were successful and presented stable bone level for a follow up period at least one year after implant surgery. The literature review and case reports suggest that with appropriate case selection, careful treatment, and regular maintenance, using autogenous block bone grafts harvested from the mandibular symphysis or ramus for ridge augmentation and implant placement can achieve predictable outcomes.</p> <p> </p>

Efficacy of autogenous tooth block for lateral ridge augmentation compared with autogenous bone block: A systematic review and meta-analysis.

Autogenous tooth block (ATB) has been used as an alternative material for bone regeneration, but its efficacy compared with autogenous bone block (ABB) remains uncertain. The aim of this systematic review was to investigate and compare the clinical and histological performance of ATB and ABB grafts in lateral alveolar ridge augmentation (LARA). Electronic retrieval of MEDLINE, Embase, Cochrane Library (CENTRAL), Scopus, Web of Science, China national knowledge infrastructure, Wanfang data, SinoMed, and manual searching until July 2023 were used to identify controlled clinical trials employing ATB grafts in LARA. The identified reports included at least one of the following outcome variables: ridge width gain, graft resorption, postoperative complications, histology, and histomorphometry. Weighted or mean differences (MD), relative risk, and corresponding 95% confidence intervals (CI) were calculated. Descriptive analysis was applied to the qualitative statistics. The protocol followed the preferred reporting items for systematic reviews and meta-analyses statement and was prospectively registered in PROSPERO (CRD42023399611). Four controlled clinical trials with 77 participants each using ATB and ABB grafts were included. Meta-analysis indicated that ATB grafts resulted in greater bone width (MD = 1.31, 95% CI [0.92, 1.71], P < .00001) and less graft resorption (MD = -0.71, 95% CI [-1.22, -0.21], P = .005) than ABB grafts on LARA. There was no statistical difference in postoperative complications between ATB and ABB grafts (relative risk = 0.81, 95% CI [0.32, 2.04], P = .66). Furthermore, the ATB grafts exhibited positive replacement resorption with alveolar bone for favorable signs of new bone activity on histology and histomorphometry. Within the limitations of this study, ATB grafts could serve as an alternative material for ABB to support LARA. Further research with a longer follow-up period is required to verify these findings.

Comparison of Guided Bone Regeneration with Periosteal Pocket Flap Technique Versus Autogenous Bone Block Graft for Horizontal Bone Augmentation: A Clinical Trial Study

The aim of this study was to assess changes in the horizontal dimension of the alveolar ridge when the autogenous bone block (ABB) or periosteal pocket flap (PPF) techniques were performed prior to implant placement. This randomized trial study was conducted on 25 patients in need of horizontal bone augmentation, who were randomly divided into two groups as follows: 13 patients underwent ridge augmentation using ABB, allograft, and a collagen membrane, while the remaining 12 underwent horizontal bone augmentation via the PPF technique. For all patients, radiographic examinations via CBCT were performed both before and 26 weeks after the operation. Following the surgery, dimensional changes in the ridge width were measured both within and between the two groups in the three regions of 0, 3, and 5 mm from the top of the alveolar crest. A total of 11 patients in the ABB group and 12 patients in the PPF group successfully completed the study. Statistical analysis showed that the increase in alveolar ridge width in each group was significant, but not significantly different between the two groups at any of the measured spots (0 mm from the crest, P = .25; 3 mm, P = .38; and 5 mm, P = .73). However, more postoperative complications were observed with the ABB technique. According to the results of the present study, there was no statistically significant difference between the PPF and ABB techniques in terms of horizontal bone gain.

Horizontal Alveolar Ridge Augmentation with Xenogenic Block Grafts Compared with Autogenous Bone Block Grafts for Implant-retained Rehabilitation: a Systematic Review and Meta-Analysis.

The objective of the present systematic review and meta-analysis was to test the 0-hypothesis of no difference in implant treatment outcome after horizontal alveolar ridge augmentation with xenogenic block compared with autogenous bone block. A literature search was conducted using PubMed, Embase and Cochrane Library databases in combination with a hand-search of relevant journals until 25th of January 2022. Comparative and non-comparative studies evaluating horizontal alveolar ridge augmentations with xenogenic blocks were included. Quality and risk of bias were evaluated by Cochrane Collaboration's revised tool and Newcastle-Ottawa scale. Meta-analysis revealed no statistically significant difference in implant survival rate after more than 6 months of functional implant loading (P = 0.71), no difference in alveolar ridge width (P = 0.07) or gain of alveolar ridge width at re-entry (P = 0.13). Non-comparative studies revealed moderate to high short-term implant survival rate and gain in alveolar ridge width, however, complications including dehiscences, graft exposure and graft failure were observed in several studies. No significant difference could be identified in short-term implant treatment outcome following horizontal alveolar ridge augmentation using xenogenic block compared with autogenous bone block with the limited data available. A high incidence of healing complications and implant failures necessitates further investigation, as well as long-term results on implant survival rate.

Predictable Rehabilitation of Bone Deficiencies: Hygiene, Functional and Aesthetic Perspectives.

The aim of this article is to describe a method for correcting bone deficiencies which may compromise aesthetic, functional or oral hygiene maintenance of implant supported restorations. The generic causes of these deficiencies are mentioned. The use of autogenous block bone grafts is described alongside methods for managing the hard and soft tissues at both the recipient and donor sites. The biomechanical advantage conferred with the use of grafts in reducing the crown:implant ratio is emphasised. The sources of intraoral bone grafts are identified and the risks of damage to adjacent anatomical structures and their avoidance are addressed.The principles of healing are briefly described with an emphasis on the increasing predictability of contact healing, as opposed to gap healing.The impact and inherent risks associated with the supplementary use of membranes for containment is also addressed.Clinical cases have been used to illustrate procedures and outcomes. Previously published data is referenced.

Maxillary Anterior Implant-supported Restorations with Allogeneic Block-bone Graft: A Report of Two Clinical Cases

Prosthetic rehabilitation of a severely atrophic anterior maxilla is challenging. To achieve aesthetic and functional outcomes with anterior implant-supported restorations, horizontal or vertical bone augmentation should be performed prior to implant placement. Autogenous block-bone grafting is the gold standard for onlay graft techniques; however, it is associated with problems, such as patient discomfort due to additional surgery at the intra- or extra-oral donor site. Therefore, the allogeneic block-bone graft, which is relatively less traumatic and safer, is used for convenience, and the high success rate in previous studies has proven the reliability of this technique. Herein, we report two cases in which allogeneic block-bone was successfully grafted in single and long-span defects in the maxillary anterior region, with satisfactory aesthetic and functional outcomes that were stable at regular follow-ups after surgery.

Implant Placement Using the Bone Ring Technique With and Without Membrane Placement: A Preclinical 12-Month Study in Dogs.

The bone ring technique is applied for vertical augmentation, in which the dental implant and autogenous block bone graft are simultaneously inserted. We investigated the healing of bone around implants placed simultaneously using the bone ring technique with and without membrane placement after a 12-month healing period. Vertical bone defects were created on both sides of the mandible of Beagle dogs. Implants were inserted into the defects through bone rings and fixed with membrane screws as healing caps. The augmented sites on one side of the mandible were covered with a collagen membrane. Samples were harvested 12 months after implantation and assessed histologically and by microcomputed tomography analysis. All implants remained throughout the healing period; however, except for 1 implant, they showed lost caps and/or exposure to the oral cavity. The implants had contact with newly formed bone despite frequent bone resorption. The surrounding bone appeared mature. The medians of bone volume and percentages of total bone area and bone-to-implant contact within the bone ring were slightly higher in the group with membrane placement than in that without membrane placement. Nevertheless, none of the evaluated parameters were significantly affected by the membrane placement. In the present model, soft tissue complication was frequent, and the membrane application did not reveal the effect at 12 months after implant placement using the bone ring technique. Sustained osseointegration and maturation of surrounding bone were observed in both groups after a 12-month healing period.

Patient-centered outcome measures comparing the autogenous and allogenic bone blocks in the augmentation of deficient alveolar ridges: A pilot study.

The aim of the present study was to evaluate and compare the patient-reported experience and outcome measures (PREMS and PROMS) and three-dimensional augmentation efficacy of the autogenous and allogenic bone block grafts in deficient alveolar ridges through cone beam computed tomography (CBCT). Twenty patients were equally divided into Groups I and II treated with autogenous and allogenic bone block grafts for ridge augmentation, respectively. The radiographic parameters including the apico-coronal defect height (DH) as well as buccolingual defect depth (DD) and mesiodistal defect width (DW) at apical, middle, and cervical zone were measured using CBCT at baseline, 6 months and 1 year. The PREMS and PROMS were evaluated using Visual analogue scale (VAS) scale and questionnaire method. The mean DH, apical DD and DW, middle and cervical zone DW were significantly different between two study groups (P < 0.05). The mean apical 11.6 ± 1.91 and middle zone 9.43 ± 0.89 DD were significantly higher (in Group I as compared to Group II, with P values 0.016 and 0.004, respectively). The mean bone gains in apico-coronal DH and mesio-distal DW dimension in the apical and middle zone was significantly higher in Group I (P < 0.0001). The comparison of PROM revealed better patient satisfaction in Group II as depicted by significantly higher VAS score (P < 0.0001). Superior bone gain and reduced graft resorption was observed in Group I when compared to Group II. On the contrary, better PROMs and PREMs were obtained with the allogenic bone block augmentation.

Vertical augmentation of a severely atrophied posterior mandibular alveolar ridge for a dental implant using a patient-specific 3D printed PCL/BGS7 scaffold: A technical note

Vertical bone augmentation for dental implants in the posterior mandibular region with significant bone resorption is challenging. For this purpose, methods such as block bone grafting with screw fixation, particulate bone grafting with titanium mesh or barrier membrane, and distraction osteogenesis have been used, and autogenous block bone grafting is considered the gold standard. However, the autogenous block bone grafting has the following disadvantages: bone harvesting is challenging, and block bone contouring according to the recipient site is time-consuming and laborious. Therefore, in this study, we report the use of particulate bone with a polycaprolactone/bioactive glass-7 scaffold, designed, and three-dimensionally printed preoperatively, to resolve the above-mentioned challenges.

Lateral Alveolar Ridge Augmentation with Autogenous Tooth Block Graft Compared with Autogenous Bone Block Graft: a Systematic Review.

ABSTRACTObjectivesThe objective of the present systematic review was to evaluate the current knowledge of implant treatment outcome following lateral alveolar ridge augmentation with autogenous tooth block graft compared with autogenous bone block graft prior to implant placement.Material and MethodsMEDLINE (PubMed), Embase and Cochrane Library search in combination with hand-search of relevant journals was conducted including human studies published in English through December 20, 2021. Comparative and non-comparative studies assessing lateral alveolar ridge augmentation with autogenous tooth block graft were included. Quality and risk-of-bias assessment were evaluated by Cochrane risk of bias tool, Newcastle-Ottawa Scale and GRADE system.ResultsOne comparative study characterized by low grade and two non-comparative studies fulfilled the inclusion criteria. No significant difference in short-term implant survival, health status of the peri-implant tissue or frequency of complications between the two treatment modalities was observed. Postoperative dimensional changes of the alveolar ridge width were significant diminished with tooth block compared with bone block (P = 0.0029). Consequently, the gain in alveolar ridge width was significantly higher with tooth block, after 26 weeks (P = 0.014). However, a higher frequency of short-term peri-implant mucositis was observed with tooth block.ConclusionsLateral alveolar ridge augmentation with tooth block seems to be a suitable alternative to bone block. However, results of the present systematic review are based on short-term studies involving small patient samples. Further long-term randomized controlled trials are therefore needed before definite conclusions can be provided about the beneficial use of tooth block compared with bone block.

Changes of alveolar ridge dimension after autogeneous mandibular bone augmentation with split bone block technique

Objectives: the aim of study is to evaluate the changes of alveolar rigde dimension after split bone block technique with autogenous bone block graft from mandible on CBCT. Methods: A case series study on 10 patients who had alveolar ridge defects (≥4 mm). The patients treated by means of split bone block technique with autogenous bone from mandible, followed by delay implant placement. Scan data from dental waxed-up model and preoperative and postoperative CBCT data were superimposed and then used to measure the changes of alveolar dimension. Results: Preoperatively, the mean alveolar dimension was 2,46±0,83 mm in width and 9,38±1,48 mm in height. After 4 months, the mean alveolar dimension increased to 7,68 ±1,35 mm in width and 12,60±1,83 mm in height. The mean dimension gained 5,22±1,59 mm horizontally and 3,21±1,26 mm vertically. Conclusion: This study results suggest that split bone block technique with autogenous bone block from mandible is effective in increasing the three-dimension alveolar ridge with more 4mm defect.

Prerequisite for Successful Implant Placement with a Comparative Study on Novel Bone Ring Technique: A Review

Implant placement is getting space day by day. However, in every case, we never get the ideal condition of alveolar bone for implant placement. Alveolar bone loss is seen due to periodontitis, tooth loss, tooth extraction, and periapical infection, etc.&#x0D; Resorption of alveolar bone varies from person to person and side to side. It has been noted that the size of the residual ridge shrinks more quickly within the first six months.&#x0D; There is new demand for reconstruction of the alveolar ridge for implant placement. Various techniques are available for increasing the ridge height and width by using bone graft, membrane, etc., one of these is the vertical ring procedure.&#x0D; Bone ring technique (BRT) has been described as a one-stage approach to restore vertical ridge height defects, in which an autogenous or allogeneic bone block graft is used and the implant is placed simultaneously.&#x0D; This review aims to focus on the importance of the implant placement, consequences of complete edentulism, the problem with removable partial denture (RPD) placement, as a result of bone loss in fully edentulism patients, and the use of vertical ring technique for the implant placement.

A Modified Zygomatic Implant Placement Technique: A Prospective Study up to 6-year Follow-up

PurposeThis study proposed a new modified technique for zygomatic implant placement and evaluated the up-to-6-year survival rate of endosseous zygomatic implants of the technique and its effects in preventing related complications, such as peri-implantitis, sinusitis, and implant failure. Materials and methodsThis study included 28 patients (15 females, 13 males; mean age: 53.4 years) with a severely atrophic edentulous maxilla (class VI maxillary atrophy, according to the Cawood and Howell classification) combined with a flat buccal sinus wall (zygoma anatomy-guided approach class 0 or 1, according to Aparicio) who received zygomatic implants using the modified technique. There are 3 key points regarding this technique: 1) the zygomatic implant was placed toward the buccal wall of the maxillary sinus, resulting in the implant head being near or on the alveolar crest and allowing less bulky prostheses to facilitate oral hygiene and to prevent soft-tissue infection; 2) autogenous bone block graft material was utilized to reinforce the buccal wall and increase the stability of the implant head; and 3) sinus grafting was performed using a mixture of autogenous particulate bone, bone graft material and platelet-rich fibrin, which created maximum bone coverage around the implant head to consolidate along with the implant. All implant surgeries were carried out under general anesthesia. Implant-supported provisional prostheses were delivered immediately, except in 7 cases in which the zygomatic implant did not achieve initial stability (< 35 N/cm). All patients were scheduled for regular follow-ups every 3 months. Definitive prostheses were provided 6 months after the surgery. ResultsOf the 28 patients treated, a total of 82 zygomatic implants were installed, in conjunction with 52 conventional implants. All of the implants exhibited good osseointegration; in particular, bone coverage was observed around the implant head and the entire length of the implant. Two patients presented complications. One patient exhibited a soft-tissue infection with pus discharge after 1 month of wearing the provisional prosthesis. The other patient exhibited implantitis 4 years after implant placement. Both patients showed buccal bone resorption but no oroantral fistulas, and the sinus membrane remained intact, with no sinusitis. Overall, the survival rate of both the zygomatic and standard implants was 100%. The zygomatic-implant-supported prostheses improved both functional and esthetic aspects for the patients. No cases of sinusitis or soft-tissue inflammation were reported. The mean follow-up period was 35.7 months (range, 0-72 months). ConclusionThis study illustrates that zygomatic implant placement with the new modified technique with the implant head on or near the alveolar bone, onlay bone block augmentation, and extended simultaneous sinus grafting is a successful and important treatment option when rehabilitating the atrophic maxilla. This modified technique yields a high long-term success rate and prevents complications such as peri-implantitis, sinusitis, and implant failure.Intraoral and radiographic images illustrating the procedure A, B, Intraoral images before and after six-month implant placement. C, D, E, F, Intraoral images showed the four zygomatic implants were placed toward the buccal wall of the maxillary sinus resulting in the implant heads were near or on the alveolar crest. Autogenous block bone graft was utilized to reinforce the buccal wall and to increase the stability of the implant head, extended sinus graft was performed to create an maximum bone coverage around implant head to consolidate along the implant. G, H, I, J, K, Radiographic study of the secondary phase of implant placement six months later with bar connecting the four zygomatic implants. G, Orthopantomographic view. H, I, J, K, CT slices showed the osseous integration surrounding all four zygomatic implants.

Lateral Alveolar Ridge Augmentation with an Autogenous Bone Block Graft Alone with or without Barrier Membrane Coverage: a Systematic Review and Meta-Analysis.

ABSTRACTObjectivesTo test the hypothesis of no difference in implant treatment outcome following lateral alveolar ridge augmentation with autogenous bone block graft with or without barrier membrane coverage.Material and MethodsPubMed (MEDLINE), Embase and Cochrane library search in combination with a hand-search of relevant journals was conducted. Human studies published in English until the 8th of February 2021 were included. Randomised controlled trials with an observation period longer than three months were included. Survival of implants and suprastructures were considered as primary outcomes measures, whereas peri-implant marginal bone loss, dimensional changes of the alveolar ridge, bone regeneration, patient-reported outcome measures, biological and mechanical complications were secondary outcome measures, as evaluated by descriptive statistics and meta-analysis including 95% confidence interval (CI). ResultsElectronic search and hand-searching resulted in 411 entries. Five randomised controlled trials characterised by low or high risk of bias fulfilled inclusion criteria. No statistically significant difference between the two treatment modalities was observed in any of the outcome measures. However, barrier membrane coverage was associated with a non-significant gain in alveolar ridge width of 0.5 mm (95% CI = -0.1 to 1.1) and diminished resorption of -0.9 mm (95% CI = -2.4 to 0.7) compared with no barrier membrane coverage.ConclusionsComparable implant treatment outcomes were revealed following lateral alveolar ridge augmentation with autogenous bone block graft alone with or without barrier membrane coverage. However, postoperative dimensional changes of the augmented seems to be diminished with the use of barrier membrane coverage as evaluated by two-dimensional linear measurements.

Clinical and Histologic Evaluation of Using Block Xenograft Combined With Leukocyte-Platelet Rich Fibrin (L-PRF) Versus Intraoral Autogenous Bone Block Graft With L-PRF in Treating Localized Ridge Defects: A Randomized Clinical Trial

Background: Augmentation of vertical bone defects remains the corner stone in periodontal tissue engineering. The amount and quality of alveolar bone available in all dimensions affects the success of dental implants for restoration of edentulous areas. Adequate and healthy bone supports the degree of osseointegration which in turn affects the long-term success of oral implants. The primary aim of the study was to histologically evaluate autogenous block grafts versus synthetic block grafts for the treatment of atrophic vertical and horizontal bony defects (Siebert Class III) in the anterior esthetic zone of the mouth. The secondary aim was to clinically and radiographically evaluate the outcomes of the procedure. Methods: This was a randomized controlled clinical study with a statistically determined sample size of 10 patients per group and a total of 20 patients in both groups. Patients with vertical and horizontal bone loss were enrolled from the Department of Oral Medicine, Periodontology, and Oral Diagnosis of Ain Shams University and Misr International University. Bone augmentation procedures were performed using two techniques: autogenous bone block graft and xenograft bone block graft both with leukocyte-platelet rich fibrin (L-PRF). Results: Both autogenous and xenograft blocks in conjunction with L-PRF had a significant effect on vertical bone augmentation in cases of atrophic ridges in the esthetic region. Conclusion: Both autogenous and xenograft bone blocks in conjunction with L-PRF have a significant effect on vertical bone augmentation in cases of atrophic ridges in the esthetic region.

Tooth shell technique: A proof of concept with the use of autogenous dentin block grafts.

Autogenous bone block graft is considered the gold standard for lateral bony defects. Dentin has been identified to be a suitable autogenous bone graft material due to its structural and chemical similarities to the alveolar bone. This proof of concept study describes the clinical application of the tooth shell technique in 24 sites with 27 implants of 22 patients. A tooth shell was fixed laterally to the defect with microscrews. Distance between the shell and the residual bone was filled with particulate remnants of the tooth root. Implant was inserted simultaneously. Cone beam computed tomography was done after implant insertion (T1) and 3months later at time of implant exposure (T2). Target parameters were biological complications and the resorption of hard tissue graft. Even though a graft exposure occurred in one case (4.5% on patient-level), all implants showed enough implant stability and were able to be loaded. At T2, the evaluation of the X-rays showed no case with hard tissue loss at the mesial or distal implant shoulder. All implants were completely osseointegrated. The tooth shell technique showed promising results for the reconstruction of lateral alveolar crest defects. It may be considered to serve as an alternative material to avoid bone harvesting procedures.

Comparison of Autogenous Block Bone Graft and Screw Tent-Pole Techniques for Vertical Bone Augmentation in the Posterior Mandible: A Split-Mouth Randomized Controlled Study

Aim: To evaluate the effect on vertical bone augmentation of the screw tent-pole technique using particulate allograft in combination with injectable platelet-rich fibrin, and to compare this with autogenous block bone graft. Materials and Methods: This split-mouth randomized controlled study involved patients with bilateral partial edentulism and vertical bone loss in the posterior mandible. In each patient, the control side was treated with autogenous block bone graft harvested from the mandibular ramus and, on the test side, the screw tent-pole technique was employed, using particulate allograft in combination with injectable platelet-rich fibrin. All augmented sites were covered by leukocyte and platelet-rich fibrin membrane. The primary outcome variable of this study was the radiographic changes to bone height 6 months after augmentation. The secondary outcome variables were the percentage of newly formed bone and the implant survival rate. The data were analyzed with a significance level of α = 0.05. Results: Of the 13 patients included, a total of 11 patients (7 females, 4 males; mean age 50.92) completed the study. The mean values of vertical bone gain were 1.72 ± 0.78 mm for the test group and 2.83 ± 0.89 mm for the control group, which constitutes a significant difference ( P = .008). The percentage of newly formed bone was 18.08% ± 2.17% for the test group and 14.26% ± 1.76% for the control group. The difference between the groups was statistically significant ( P &lt; .001). The implant survival rates were 100% for both study groups. Conclusions: Based on the study results, screw tent-pole can be considered a feasible technique for bone augmentation. Further randomized studies will be necessary to fully evaluate vertical bone augmentation using the screw tent-pole technique, with different graft materials and with larger samples.

Ridge augmentation of Class III ridge defect using piezosurgery with autogenous chin graft followed by implant placement: A 6 months follow-up interventional study

Background: Tooth loss occurs due to periodontal disease, extensive dental caries, and fracture of teeth after a dento-alveolar trauma, cyst and tumours of odontogenic and non-odontogenic origin. Following loss of teeth, alveolar ridge resorption becomes an unwanted but unavoidable consequence. In order to restore the lost bone and replace the teeth with implants, ridge augmentation procedures are done. The present study aimed at restoring the class III ridge defect using piezosurgery with autogenous block bone graft procured from mandibular symphysis region. Materials and methods: A total number of 10 healthy patients with Class III ridge defect in maxillary anterior teeth region were enrolled for the study. The donor and defect sites were pre-surgically analysed using Cone-Beam Computed Tomography (CBCT), preclinical models and ridge mapping.The implant site width and height were assessed intra-operatively during the surgery and at re-entry after 6 months. The autogenous block bone grafts were procured from mandibular chin region using piezo-electric device and placed at the recipient site. At the 6 months re-evaluation, both clinical and radiographic parameters were assessed using CBCT of the recipient site. Implants were placed at two-stages and followed-up up to 6 months. Results: Clinical measurements showed that the mean horizontal bone gain and vertical bone gain was noted to be 3.21±0.24 mm and 2.18±0.32 mm respectively, by the end of 6 months follow-up. No major complications were presented at the recipient as well as donor sites. Piezoelectric surgery provided clean, bloodless field during the procedure and minimal post-operative discomfort to the patients. Conclusion: The results of the present study suggests that, class III ridge defects can be successfully augmented using piezo-surgery using autogenous bone grafting from the mandibular symphysis region. Also, delayed implant placement may provide satisfactory functional and aesthetic outcomes on the long term. Keywords: Ridge augmentation; chin graft; Piezosurgery; dental implants