IADR Abstract Archives
Piezosurgical buccal plate repositioning technique for horizontal augmentation of atrophied mandible: (A Randomized clinical trial)
Objectives: Ridge splitting technique is successfully used to increase the width of the alveolar ridge. However, in the mandible, the risk of fracture of the osteotomized segment is great. autogenous grafting is considered the gold standard for ridge augmentation. However, secondary site morbidity is a drawback. In the present study we demonstrate a novel modified alveolar ridge split technique; the buccal plate repositioning technique (BRT). The clinical success of the BRT is evaluated using different graft materials.
Methods: This randomized clinical trial included 18 patients requiring horizontal alveolar ridge augmentation. Patients were equally assigned to one of two groups; Group A was treated with the buccal plate repositioning technique and grafted with silica-calcium phosphate nanocomposite (SCPC) graft, Group B was similarly managed and grafted using freeze-dried bone allograft (FDBA). A piezosurgical four-sided osteotomy was performed, 2mm apical to the alveolar crest. The buccal plate was totally detached and refixed in a favorable horizontal position using fixing screws. The horizontal width of the reconstructed ridge was controlled by the length of the fixing screws. The remaining space between bony plates was filled with either SCPC, or DFDBA graft material, and covered with platelet rich fibrin membrane. The flap was sutured. Cone-bean computed tomography (CBCT) was performed immediately after surgery and at 6 months post-operatively.
Results: Buccal plate repositioning technique resulted in successful horizontal augmentation with a mean of (4.30 ± 0.94) for the SCPC group, (4.98 ± 1.13) for the allograft group with no statistically significant difference between groups. All augmented ridges allowed for successful implant placement with good primary stability
Conclusions: The buccal plate repositioning technique is a promising technique for horizontal alveolar ridge augmentation in deficient posterior mandible, providing an adequate volume to insert implants. It allows free movement of the buccal plate and avoids a secondary surgical site with decreased patients’ morbidity.
Methods: This randomized clinical trial included 18 patients requiring horizontal alveolar ridge augmentation. Patients were equally assigned to one of two groups; Group A was treated with the buccal plate repositioning technique and grafted with silica-calcium phosphate nanocomposite (SCPC) graft, Group B was similarly managed and grafted using freeze-dried bone allograft (FDBA). A piezosurgical four-sided osteotomy was performed, 2mm apical to the alveolar crest. The buccal plate was totally detached and refixed in a favorable horizontal position using fixing screws. The horizontal width of the reconstructed ridge was controlled by the length of the fixing screws. The remaining space between bony plates was filled with either SCPC, or DFDBA graft material, and covered with platelet rich fibrin membrane. The flap was sutured. Cone-bean computed tomography (CBCT) was performed immediately after surgery and at 6 months post-operatively.
Results: Buccal plate repositioning technique resulted in successful horizontal augmentation with a mean of (4.30 ± 0.94) for the SCPC group, (4.98 ± 1.13) for the allograft group with no statistically significant difference between groups. All augmented ridges allowed for successful implant placement with good primary stability
Conclusions: The buccal plate repositioning technique is a promising technique for horizontal alveolar ridge augmentation in deficient posterior mandible, providing an adequate volume to insert implants. It allows free movement of the buccal plate and avoids a secondary surgical site with decreased patients’ morbidity.
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