EVALUATION OF "TENT-POLE" GRAFTING TECHNIQUE FOR RECONSTRUCTION OF MANDIBULAR RIDGE VERTICAL DEFECTS (CLINICAL AND RADIOGRAPHIC STUDY)

Document Type : Original Article

Authors

1 Oral and maxillofacial surgery ,Alexandria university,Egypt.

2 Professor of Oral and Maxillofacial Surgery, Department of Oral and Maxillofacial Surgery Faculty of Dentistry, Alexandria University, Egypt.

3 Assistant professor of Oral and Maxillofacial Surgery, Department of Oral and Maxillofacial Surgery Faculty of Dentistry, Alexandria University, Egypt.

Abstract

regeneration after loss of the adequate bone height. Numerous techniques have been mentioned for reconstruction of the atrophic mandibular ridge. Tenting of the soft tissue matrix allow maintaining space for the graft material for vertical ridge augmentation.
OBJECTIVES: The aim of this study is to evaluate clinically and radiographically the efficiency of "Tent- Pole" grafting using titanium mini-screws with guided bone regeneration for augmentation of mandibular ridge vertical defects.
MATERIALS AND METHODS: Twelve patients with posterior mandibular defects were treated with guided bone regeneration around titanium screws that tent out the soft tissue matrix with an age range of 43 and 60 years. They were of both sexes (4 males and 8 females). Osteosynthesis mini-screws were fixed on the alveolar ridge with an average of 2-3 mm of their length exposed, alloplastic material surrounded the screws completely and a resorbable membrane is used for the guided bone regeneration.
RESULTS: The mean bone height value after six months was found to be statistically significant with the mean bone height value preoperatively and immediate post operative (p < 0.001). Also, there was statistically significant difference in the mean bone density between the six months post operative and immediate post operative values (p < 0.001).
CONCLUSION: From the results of this study, the screw tent -pole grafting technique with guided bone regeneration is a technique of high reliability in restoring mandibular vertical bone loss.

Keywords

Main Subjects

References

1. Carlsson L, Röstlund T, Albrektsson B, Albrektsson T, Brånemark PI. Osseointegration of titanium implants. Acta Orthop Scand. 1986;57:285-9.
2. Chiapasco M, Zaniboni M, Boisco M. Augmentation procedures for the rehabilitation of deficient edentulous ridges with oral implants. Clin Oral Implants Res. 2006;17:136-59.
3. Rocchietta I, Fontana F, Simion M. Clinical outcomes of vertical bone augmentation to enable dental implant placement: a systematic review. J Clin Periodontol. 2008;35:203-15.
4. Draenert FG, Huetzen D, Neff A, Mueller WE. Vertical bone augmentation procedures: Basics and techniques in dental implantology. J Biomed Mater Res A. 2013; 102:1605-13.
5. Le B, Rohrer MD, Prasad HS. Screw “tent-pole” grafting technique for reconstruction of large vertical alveolar ridge defects using human mineralized allograft for implant site preparation. J Oral Maxillofac Surg. 2010;68:428-35.
6. Gomes KU, Carlini JL, Biron C, Rapoport A, Dedivitis RA. Use of allogeneic bone graft in maxillary reconstruction for installation of dental implants. J Oral Maxillofac Surg.2008;66:2335-8.
7. Gerike W, Bienengräber V, Henkel KO, Bayerlein T, Proff P, Gedrange T, et al. The manufacture of synthetic non-sintered and degradable bone grafting substitutes. Folia Morphol (Warsz). 2006;65:54-5.
8. Shivashankar VY, Johns DA, Vidyanath S, Sam G. Combination of platelet rich fibrin, hydroxyapatite and PRF membrane in the management of large inflammatory periapical lesion. J Conserv Dent. 2013;16:261-4.
9. Del Corso M, Toffler M, Dohan Ehrenfest DM. Use of an autologous leukocyte and platelet-rich fibrin (L-PRF) membrane in post-avulsion sites: an overview of Choukroun’s PRF. J Implant Adv Clin Dent. 2010;1:27-35.
10. Simion M, Trisi P, Piattelli A. Vertical ridge augmentation using a membrane technique associated with osseointegrated implants. Int J Periodontics Restorative Dent. 1994;14:496-511.
11. Lindfors LT, Tervonen EA, Sándor GK, Ylikontiola LP. Guided bone regeneration using a titanium-reinforced ePTFE membrane and particulate autogenous bone: the effect of smoking and membrane exposure. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2010;109:825-30.
12. Abd El Raouf M, Kobayashi MF, AbdEl-Aal ABM, Zhang Y, Miron RJ. Novel Bioabsorbable Bovine Derived Atelo-Collagen Type I Membrane: characterization into Host Tissues. Periodon Prosthodon. 2017;3:1-6.
13.Kirkpatrick LA, Feeney BC. A simple guide to IBM SPSS: for version 20.0. 12th ed. USA. Wadsworth cengage learning; 2012 .
14. Porter JA, Von Fraunhofer JA. Success or failure of dental implants? A literature review with treatment considerations. Gen Dent. 2005;53:423-32; quiz 433, 446.
15. Good M, Stiller C, Zauszniewski JA, Anderson GC, Stanton-Hicks M, Grass JA. Sensation and distress of pain scales: reliability, validity, and sensitivity. J Nurs Meas.2001;9:219-38.
16. Seidel HM BJ, Dains JE, Benedict GW. Heart and blood vessels. In: Schrefer S (ed). Mosby’s Guide to Physical
Examination. 3P
rd
P ed. St. Louis: Mosby; 1995.
17. Tan WL, Wong TL, Wong MC, Lang NP. A systematic review of post-extractional alveolar hard and soft tissue dimensional changes in humans. Clin Oral Implants Res. 2012;23:1-21.
18. Levin L, Schwartz-Arad D. The Effect of Cigarette Smoking on Dental Implants and Related Surgery. Implant Dent. 2005;14:357-61.
19. D’Souza D. Residual Ridge Resorption – Revisited. In: Virdi M (ed). Oral Health Care - Prosthodontics, Periodontology, Biology, Research and Systemic Conditions. Intech; 2012. P. 953-78. Available at: https://www.intechopen.com
20. Cassetta M, Sofan AA, Altieri F, Barbato E. Evaluation of alveolar cortical bone thickness and density for orthodontic mini-implant placement. J Clin Exp Dent. 2013;5:e245-52.
21. Bornstein MM, Scarfe WC, Vaughn VM, Jacobs R. Cone beam computed tomography in implant dentistry: a systematic review focusing on guidelines, indications, and radiation dose risks. Int J Oral Maxillofac Implants. 2014;29:55-77 .
22. Pedroso LA, Garcia RR, Leles JL, Leles CR, Silva MA. Impact of cone-beam computed tomography on implant planning and on prediction of implant size. Braz Oral Res. 2014;28:46-53.
23. Chasioti E, Sayed M, Drew H. Novel techniques with the aid of a staged CBCT guided surgical protocol. Case Rep Dent 2015;2015:439706.
24. Le B, Burstein J, Sedghizadeh PP. Cortical tenting grafting technique in the severely atrophic alveolar ridge for implant site preparation. Implant Dent. 2008;17:40-50.
25. Louis PJ, Gutta R, Said-Al-Naief N, Bartolucci AA. Reconstruction of the maxilla and mandible with particulate bone graft and titanium mesh for implant placement. J Oral Maxillofac Surg. 2008;66:235-45.
26. Marx RE, Shellenberger T, Wimsatt J, Correa P. Severely resorbed mandible: Predictable reconstruction with soft tissue matrix expansion (tent pole) grafts. J Oral Maxillofac Surg. 2002;60:878-88.
27. Akoush YH, Hakam MM, Al farmawy MI. Evaluation of “Tent Pole” grafting technique for vertical alveolar ridge augmentation with the use of rhBMP-2. M.Sc. Thesis. Faculty of Dentistry, Cairo University. 2014.
28. Hoexter DL. Bone regeneration graft materials. J Oral Implantol. 2002;28:290-4 .
29. Dietze S, Bayerlein T, Proff P, Hoffmann A, Gedrange T. The ultrastructure and processing properties of Straumann Bone Ceramic® and NanoBone®. Folia Morphol (Warsz). 2006;65:63-5.
30. Eldibany RM, Shokry MM.The effect of Nanobone® in combination with platelet rich fibrin on bone regeneration following enucleation of large mandibular cysts. Tanta Dent J. 2014;11:100-8.
31. Al Rayess AM, El Dibany MM, Melek LN. Clinical and radiographic study of healing of mandibular fractures using plasma rich fibrin membrane with miniplate fixation. Alex Dent J. 2018;43:41-7.
32. Dohle E, El Bagdadi K, Sader R, Choukroun J, James Kirkpatrick C, Ghanaati S. Platelet-rich fibrin-based matrices to improve angiogenesis in an in vitro co-culture model for bone tissue engineering. J Tissue Eng Regen Med. 2018;12:598-610.
33. Dahlin C, Gottlow J, Linde A, Nyman S. Healing of maxillary and mandibular bone defects using a membrane technique. An experimental study in monkeys. Scand J Plast Reconstr Surg Hand Surg. 1990;24:13-9.
34. Urban IA, Nagursky H, Lozada JL. Hori-zontal ridge augmentation with a re-sorbable membrane and particulated autogenous bone with or without anor-ganic bovine bone-derived mineral: A prospective case series in 22 patients. Int J Oral Maxillofac Implants. 2011;26:404-14.
35. Simion M, Fontana F, Rasperini G, Maiorana C. Vertical ridge augmentation by expanded-polytetrafluoroethylene membrane and a combination of intraoral autogenous bone graft and deproteinized anorganic bovine bone (BioOss). Clin Oral Implants Res. 2007;18:620-9.
36. Yang JW, Park HJ, Yoo KH, Chung K, Jung S, Oh HK, et al. A comparison study between periosteum and resorbable collagen membrane on iliac block bone graft resorption in the rabbit calvarium. Head Face Med 2014;10:15.
37. Schmid J, Wallkamm B, Hämmerle CH, Gogolewski S, Lang NP. The significance of angiogenesis in guided bone regeneration. A case report of a rabbit experiment. Clin Oral Implants Res.1997;8:244-8.
38. Delloye C, Simon P, Nyssen-Behets C, Banse X, Bresler F, Schmitt D. Perforations of cortical bone allografts improve their incorporation. Clin Orthop Relat Res. 2002;396:240-7.
39. Slotte C, Lundgren D. Impact of cortical perforations of contiguous donor bone in a guided bone augmentation procedure: an experimental study in the rabbit skull. Clin Implant Dent Relat Res. 2002;4:1-10.
40. Barbosa DZ, de Assis WF, Shirato FB, Moura CC, Silva CJ, Dechichi P. Autogenous bone graft with or without perforation of the receptor bed: histologic study in rabbit calvaria. Int J Oral Maxillofac Implants. 2009;24:463-8.
Alexandria Dental Journal
Volume 46, Issue 1
A (Oral and maxillofacial surgery, oral medicine, periodontology, oral radiology, oral pathology, oral biology)
April 2021
Pages 29-35

Files

Share

How to cite

Statistics