CORTICAL TENTING TECHNIQUE FOR VERTICAL AUGMENTATION OF ATROPHIC POSTERIOR PART OF THE MANDIBLE (CLINICAL TRIAL)
Hares, J., Mohamed, S., Noureldin, M. (2021). CORTICAL TENTING TECHNIQUE FOR VERTICAL AUGMENTATION OF ATROPHIC POSTERIOR PART OF THE MANDIBLE (CLINICAL TRIAL). EKB Journal Management System, 46(Issue 1), 15-22. doi: 10.21608/adjalexu.2021.144851
John K. Hares; Sherif S. Mohamed; Marwa G. Noureldin. "CORTICAL TENTING TECHNIQUE FOR VERTICAL AUGMENTATION OF ATROPHIC POSTERIOR PART OF THE MANDIBLE (CLINICAL TRIAL)". EKB Journal Management System, 46, Issue 1, 2021, 15-22. doi: 10.21608/adjalexu.2021.144851
Hares, J., Mohamed, S., Noureldin, M. (2021). 'CORTICAL TENTING TECHNIQUE FOR VERTICAL AUGMENTATION OF ATROPHIC POSTERIOR PART OF THE MANDIBLE (CLINICAL TRIAL)', EKB Journal Management System, 46(Issue 1), pp. 15-22. doi: 10.21608/adjalexu.2021.144851
Hares, J., Mohamed, S., Noureldin, M. CORTICAL TENTING TECHNIQUE FOR VERTICAL AUGMENTATION OF ATROPHIC POSTERIOR PART OF THE MANDIBLE (CLINICAL TRIAL). EKB Journal Management System, 2021; 46(Issue 1): 15-22. doi: 10.21608/adjalexu.2021.144851

CORTICAL TENTING TECHNIQUE FOR VERTICAL AUGMENTATION OF ATROPHIC POSTERIOR PART OF THE MANDIBLE (CLINICAL TRIAL)

Alexandria Dental Journal
Article 3, Volume 46, Issue 1, April 2021, Page 15-22  XML PDF (332.14 K)
Document Type: Original Article
DOI: 10.21608/adjalexu.2021.144851
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Authors
John K. Hares email 1; Sherif S. Mohamed2; Marwa G. Noureldinorcid 3
1BDS, 2014, Faculty of Dentistry, Alexandria University.
2Professor of Oral and Maxillofacial Surgery, Department of Oral and Maxillofacial Surgery Faculty of Dentistry, Alexandria University, Egypt.
3Lecturer of Oral and Maxillofacial Surgery, Department of Oral and Maxillofacial Surgery Faculty of Dentistry, Alexandria University, Egypt
Abstract
INTRODUCTION: The progressive decrease in the alveolar bone volume after tooth loss impedes the use of dental implants for rehabilitation of edentulous regions. This fact is of utmost significance in the posterior areas of mandible, where the presence of inferior alveolar nerve further complicates the proper insertion of dental implants. Considering the drawbacks of the non-reconstructive treatment options, restoring deficits of alveolar ridges by reconstructive procedures might still be more practicable, despite the invasiveness. The majority of reconstructive techniques involve a process of bone grafting and vertical ridge augmentation. Cortical tenting technique is used for vertical ridge augmentation and can achieve a good degree of success.
OBJECTIVES: To evaluate the effectiveness of cortical tenting technique in vertical ridge augmentation of atrophic posterior mandibles.
METHODS: The study was made on ten patients with atrophic posterior part of the mandible. In each one of them, the atrophic alveolar ridge will be treated with cortical tenting technique. Bone height over the mandibular canal was measured on Standardized CBCT scans taken preoperatively (base line), and 1 week and 4 months postoperatively and bone density was measured at grafted area 4 months postoperatively.
RESULTS: The average final bone gain was 4.540 mm at the end of follow up period with 1.700 mm average of graft resorption. Estimated bone density was measured also at grafted area 4 months after surgery with a mean value of 398.59 voxel value (VV).
CONCLUSION: The use of cortical block graft taken from the ramus of the mandible to augment vertical bone defect in the posterior of the mandible has significant success rates.
Keywords
Vertical augmentation; Cortical tenting; Atrophic mandible; Piezosurgery
References
1.Tallgren A. The continuing reduction of the residual alveolar ridges in complete denture wearers: a mixed-longitudinal study covering 25 years. J Prosthet Dent. 1972;27:120-32.
2.Carlsson G, Thilander H, Hedegård B. Histologic changes in the upper alveolar process after extractions with or without insertion of an immediate full denture. Acta Odontol Scand. 1967;25:21-43.
3.Atwood DA. Reduction of residual ridges: a major oral disease entity. J Prosthet Dent. 1971;26:266-79.
4.Li H, Zhou CR, Zhu MY, Tian JH, Rong JH. Preparation and characterization of homogeneous hydroxyapatite/chitosan composite scaffolds via in-situ hydration. J Biomater Nanobiotechnol. 2010;1(01):42-9.
5.Herford AS, Tandon R, Stevens TW, Stoffella E, Cicciu M. Immediate distraction osteogenesis: the sandwich technique in combination with rhBMP-2 for anterior maxillary and mandibular defects. J Craniofac Surg. 2013;24:1383-7.
6. das Neves FD, Fones D, Bernardes SR, do Prado CJ, Neto AJF. Short implants--an analysis of longitudinal studies. Int J Oral Maxillofac Implants. 2006;21:86-93.

7. Hummel SK, Wilson MA, Marker VA, Nunn ME. Quality of removable partial dentures worn by the adult US population. J Prosthet Dent. 2002;88:37-43.
8. Felice P, Cannizzaro G, Checchi V, Marchetti C, Pellegrino G, Censi P, et al. Vertical bone augmentation versus 7-mm-long implants in posterior atrophic mandibles. Results of a randomised controlled clinical trial of up to 4 months after loading. Eur J Oral Implantol. 2009;2:7-20.
9. Raviv E, Turcotte A, Harel-Raviv M. Short dental implants in reduced alveolar bone height. Quintessence Int. 2010;41:575-9.
10. Higuchi KW, Folmer T, Kultje C. Implant survival rates in partially edentulous patients: a 3-year prospective multicenter study. J Oral Maxillofac Surg. 1995;53:264-8.
11. Simion M, Jovanovic SA, Tinti C, Benfenati SP. Long-term evaluation of osseointegrated implants inserted at the time or after vertical ridge augmentation. A retrospective study on 123 implants with 1-5 year follow-up. Clin Oral Implants Res. 2001;12:35-45.
12. Merli M, Bernardelli F, Esposito M. Horizontal and vertical ridge augmentation: a novel approach using osteosynthesis microplates, bone grafts, and resorbable barriers. Int J Periodontics Restorative Dent. 2006;26:581-7.
13. Herford AS, Lu M, Akin L, Cicciù M. Evaluation of a porcine matrix with and without platelet-derived growth factor for bone graft coverage in pigs. Int J Oral Maxillofac Implants. 2012;27:1351-8.
14. Chiapasco M, Zaniboni M, Rimondini L. Autogenous onlay bone grafts vs. alveolar distraction osteogenesis for the correction of vertically deficient edentulous ridges: a 2-4-year prospective study on humans. Clin Oral Implants Res. 2007;18:432-40.
15. Park SH, Lee Kw, Oh TJ, Misch CE, Shotwell J, Wang HL. Effect of absorbable membranes on sandwich bone augmentation. Clin Oral Implants Res. 2008;19:32-41.
16. Fu JH, Oh TJ, Benavides E, Rudek I, Wang HL. A randomized clinical trial evaluating the efficacy of the sandwich bone augmentation technique in increasing buccal bone thickness during implant placement surgery: I. Clinical and radiographic parameters. Clin Oral Implants Res. 2014;25:458-67.
17. 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.
18. Khoury F, Khoury C. Mandibular bone block grafts: diagnosis, instrumentation, harvesting techniques and surgical procedures. In: Khoury F, Antoun H, Missika P, J Bessade J (eds). Bone augmentation in oral implantology. London , Chicago: Quintessence Pub; 2007.
19. Ozdemir F, Tozlu M, Germec-Cakan D. Cortical bone thickness of the alveolar process measured with cone-beam computed tomography in patients with different facial types. Am J Orthod Dentofacial Orthop. 2013;143:190-6.
20. Morad G, Khojasteh A. Cortical tenting technique versus onlay layered technique for vertical augmentation of atrophic posterior mandibles: a split-mouth pilot study. Implant Dent. 2013;22:566-71.
21. Brugnami F, Caiazzo A, Leone C. Local intraoral autologous bone harvesting for dental implant treatment: alternative sources and criteria of choice. Keio J Med. 2009;58:24-8.
22. Misch CM. Use of the mandibular ramus as a donor site for onlay bone grafting. J Oral Implantol. 2000;26:42-9.
23. Deshpande S, Deshmukh J, Deshpande S, Khatri R, Deshpande S. Vertical and horizontal ridge augmentation in anterior maxilla using autograft, xenograft and titanium mesh with simultaneous placement of endosseous implants. J Indian Soc Periodontol. 2014;18:661-5.
24. Enneking WF, Eady JL, Burchardt H. Autogenous cortical bone grafts in the reconstruction of segmental skeletal defects. J Bone Joint Surg Am. 1980;62:1039-58.
25. Hammack BL, Enneking WF. Comparative vascularization of autogenous and homogenous-bone transplants. J Bone Joint Surg Am. 1960;42-A:811-7.
26. Burchardt H. The biology of bone graft repair. Clin Orthop Relat Res. 1983;:28-42.
27. Hallman M, Thor A. Bone substitutes and growth factors as an alternative/complement to autogenous bone for grafting in implant dentistry. Periodontol 2000. 2008;47:172-92.
28. Einhorn TA, Lee CA. Bone regeneration: new findings and potential clinical applications. J Am Acad Orthop Surg. 2001;9:157-65.
29. Kim ES, Kim JJ, Park EJ. Angiogenic factor-enriched platelet-rich plasma enhances in vivo bone formation around alloplastic graft material. J Adv Prosthodont. 2010;2:7-13.
30. Khoury F KC. Mandibular bone block grafts: Diagnosis, instrumentation, harvesting technique and surgical procedures. In: Khoury F, Antoun H, Missika P, Bessade J (eds). Bone Augmentation in Oral Implantology. London, Chicago: Quintessence Pub. 2007:169-83.
31. Proussaefs P, Lozada J. The use of intraorally harvested autogenous block grafts for vertical alveolar ridge augmentation: a human study. Int J Periodontics Restorative Dent. 2005;25:351-63.
32. Novy LFS, Aguiar EG, de Arruda JAA, de Castro MAA, Moreira AN, Dos Santos EG, et al. Linear and volumetric gain after vertical bone augmentation in the posterior mandible using an autologous cortical tenting method. Int J Oral Maxillofac Surg. 2019;48:1485-91.
33. Peng W, Kim I-K, Cho H-Y, Pae S-P, Jung B-S, Cho H-W, et al. Assessment of the autogenous bone graft for sinus elevation. J Korean Assoc Oral Maxillofac Surg. 2013;39:274-82.
34. Wang X, Luo Y. Influencing factors on bone resorption after alveolar bone grafting. Zhonghua Kou Qiang Yi Xue Za Zhi 2005;40:373-5.

35. Antoun H, Sitbon JM, Martinez H, Missika P. A prospective randomized study comparing two techniques of bone augmentation: onlay graft alone or associated with a membrane. Clin Oral Implants Res. 2001;12:632-9.
36. Chenchev IL, Ivanova VV, Neychev DZ, Cholakova RB. Application of Platelet-Rich Fibrin and Injectable Platelet-Rich Fibrin in Combination of Bone Substitute Material for Alveolar Ridge Augmentation - a Case Report. Folia Med (Plovdiv). 2017;59:362-6.
37. Alkhader M, Hudieb M, Khader Y. Predictability of bone density at posterior mandibular implant sites using cone-beam computed tomography intensity values. Eur J Dent. 2017;11:311-6.
38. Zhang J, Tian Y, Liu Y, Liu Q, Zhang J, Liu J, et al. Alveolar Bone Mineral Density Measurement using CBCT Images. Neuroscience and Biomedical Engineering. 2017;5(1):44-9.
39. Schultze-Mosgau S, Keweloh M, Wiltfang J, Kessler P, Neukam F. Histomorphometric and densitometric changes in bone volume and structure after avascular bone grafting in the extremely atrophic maxilla. British Journal of Oral and Maxillofacial Surgery. 2001;39(6):439-47.
40. Cassetta M, Stefanelli LV, Pacifici A, Pacifici L, Barbato E. How accurate Is CBCT in measuring bone density? A comparative CBCT‐CT in vitro study. Clinical implant dentistry and related research. 2014;16(4):471-8.

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