APPLICATION OF THE SOFT TISSUE EXPANDING TECHNIQUE BEFORE GUIDED BONE REGENERATION OF AN ATROPHIC ALVEOLAR RIDGE
Received 2022-12-25; Accepted 2023-02-18; Published 2023-05-10
Keywords:alveolar bone atrophy, bone regeneration, dental implant, osseointegration, tissue expansion device
Objective: This study aimed to evaluate the effectiveness of the application of a self-inflating tissue expander before guided bone regeneration (GBR) in cases of atrophy of the alveolar ridge.
Methods: 76 patients with alveolar bone atrophy were randomly assigned to four groups depending on a treatment plan and graft material (autograft, xenograft, and combi-graft). Before GBR patients of group 4 (experimental) underwent preliminary soft tissue expansion by a hydrogel-type soft tissue expander TissueMax (Osstem, South Korea). The influence of this stage on the thickness and microcirculation parameters of the gum was studied. In addition, the authors assessed and analyzed the results of the following GBR and dental implantation with prosthetic loading: rate of bone resorption, complications, and stability of dental implants.
Results: No complications or significant changes in the thickness of the mucosa were observed after a 28-day expansion. Gradual stretching had a positive influence on the parameters of microcirculation. Enough volume of soft tissues provided suturing without tension and additional laxative vertical incisions in GBR. Less traumatization caused a more favorable course of the postoperative period. The experimental group showed significantly higher values of horizontal (4.4 ± 0.11 mm) and vertical (4.07 ± 0.3 mm) bone gain after 6 months of GBR compared to other groups (p < 0.05). The lowest values of bone resorption were also in this group. The stability of dental implants reached high values (ISQ ≥70) in a shorter period in group 4.
Conclusion: Results of the study showed the effectiveness of preliminary soft tissue expanding before GBR and its positive influence on local microcirculation. However, complex studies comparing different techniques of osteoplasty with different types of grafts should be carried out for a more complete evaluation of the effectiveness of self-inflating expanders.
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