Journal of Korean Dental Science

Korean Academy of Dental Science (대한치의학회)
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Periosteum-attached Autogenous Block Bone Graft with Simultaneous Implant Placement on the Anterior Maxilla: A Case Report

  • Seung-Hyun Park (Department of Periodontology, Research Institute for Periodontal Regeneration, Yonsei University College of Dentistry) ;
  • Jongseung Kim (Department of Periodontology, Research Institute for Periodontal Regeneration, Yonsei University College of Dentistry) ;
  • Ui-Won Jung (Department of Periodontology, Research Institute for Periodontal Regeneration, Yonsei University College of Dentistry) ;
  • Jae-Kook Cha (Department of Periodontology, Research Institute for Periodontal Regeneration, Yonsei University College of Dentistry)
  • Received : 2024.03.21
  • Accepted : 2024.05.16
  • Published : 2024.06.30
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Abstract

This case report presents the long-term radiographic outcomes of a novel approach for simultaneous lateral augmentation and implant surgery. A 60-year-old male patient who required tooth extraction of the maxillary central and lateral incisors due to trauma visited the clinic. After tooth extraction, severe horizontal and vertical deficiencies occurred owing to atrophy of the alveolar ridge, and a simultaneous guided bone regeneration (GBR) procedure was planned along with the installation of two implants. In the present case, a modification of the conventional 'sandwich technique' was used by placing the mixture of autogenous bone chips and xenografts at the outermost layer to maximize the osteogenic potential at the coronal part of augmentation while applying solely xenografts at the inner layer. To enhance volumetric stability, an autogenous block of periosteum harvested from the maxillary tuberosity was incorporated between the two layers. Cone-beam computed tomography was performed at baseline and 3 years after the surgery to compare radiographic outcomes. Dehiscence after fixture installation was successfully observed at the re-entry of the surgery site. Three years after the surgery, average horizontal bone gains of 6.11 mm and 4.12 mm were observed in the maxillary central and lateral incisor areas, respectively. Healthy peri-implant mucosa and well maintained marginal bone levels were observed 8 years after the surgery, meeting the criteria for implant success. The findings of this case suggest that a substantial amount of horizontal bone gain can be obtained with a layered approach using autogenous bone materials and xenografts, highlighting the advantages of incorporating autogenous blocks into the simultaneous GBR procedure.

Keywords

Acknowledgement

This research was supported by the Bio & Medical Technology Development Program of the National Research Foundation (NRF)& funded by the Korean government (MSIT) (No. 2022M3A9F3016364).

References

  1. Wang HL, Misch C, Neiva RF. "Sandwich" bone augmentation technique: rationale and report of pilot cases. Int J Periodontics Restorative Dent. 2004;24:232-45.
  2. Fu JH, Wang HL. The sandwich bone augmentation technique. Clin Adv Periodontics. 2012;2:172-7.
  3. 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.
  4. Wen SC, Fu JH, Wang HL. Effect of Deproteinized Bovine Bone Mineral at Implant Dehiscence Defects Grafted by the Sandwich Bone Augmentation Technique. Int J Periodontics Restorative Dent. 2018;38:79-85.
  5. Davies JE. Understanding peri-implant endosseous healing. J Dent Educ. 2003;67:932-49.
  6. Lee IK, Lim HC, Lee JS, Hong JY, Choi SH, Jung UW. Layered approach with autogenous bone and bone substitute for ridge augmentation on implant dehiscence defects in dogs. Clin Oral Implants Res. 2016;27:622-8.
  7. Seibert JS. Reconstruction of deformed, partially edentulous ridges, using full thickness onlay grafts. Part II. Prosthetic/periodontal interrelationships. Compend Contin Educ Dent. 1983;4:549-62.
  8. Benic GI, Hammerle CHF. Horizontal bone augmentation by means of guided bone regeneration. Periodontol 2000. 2014;66:13-40.
  9. Chen ST, Darby IB, Adams GG, Reynolds EC. A prospective clinical study of bone augmentation techniques at immediate implants. Clin Oral Implants Res. 2005;16:176-84.
  10. Kang YH, Kim HM, Byun JH, Kim UK, Sung IY, Cho YC, Park BW. Stability of simultaneously placed dental implants with autologous bone grafts harvested from the iliac crest or intraoral jaw bone. BMC Oral Health. 2015;15:172.
  11. Zufia J, Abella Sans F. Applications of maxillary tuberosity block autograft. J Esthet Restor Dent. 2022;34:1015-28.
  12. da Rosa JCM, Sotto-Maior BS, Pertile de Oliveira Rosa AC, Violin Dias Pereira LA. Clinical, Tomographic, and Histologic Evaluation of an Autogenous Bone Graft Harvested from the Maxillary Tuberosity for Guided Bone Regeneration: Case Report with a 4-Year Follow-up. Int J Periodontics Restorative Dent. 2021;41:e183-90.
  13. Younes R, Khairallah CM. The "One Piece" Autologous Tuberosity Graft: A Contemporary Concept in Ridge Preservation. Case Rep Dent. 2020;2020:3945076.
  14. Park KD, Hong H, Jung S, Kook MS, Oh HK, Park H. Effect of periosteum attached to autogenous iliac block bone graft on bone resorption in rabbits. J Craniofac Surg. 2015;26:642-6.
  15. Lin Z, Fateh A, Salem DM, Intini G. Periosteum: biology and applications in craniofacial bone regeneration. J Dent Res. 2014;93:109-16.
  16. Yang JW, Park HJ, Yoo KH, Chung K, Jung S, Oh HK, Kim HS, Kook MS. 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.
  17. Kim HJ, Kim HM, Lee JY. Additional use of autogenous periosteal barrier membrane combined with regenerative therapy in the interproximal intrabony defects: case series. J Dent Rehabil Appl Sci. 2017;33:230-7.
  18. Saimbi CS, Gautam A, Khan MA, Nandlal. Periosteum as a barrier membrane in the treatment of intrabony defect: A new technique. J Indian Soc Periodontol. 2014;18:331-5.
  19. Heberer S, Ruhe B, Krekeler L, Schink T, Nelson JJ, Nelson K. A prospective randomized split-mouth study comparing iliac onlay grafts in atrophied edentulous patients: covered with periosteum or a bioresorbable membrane. Clin Oral Implants Res. 2009;20:319-26.
  20. Chiapasco M, Autelitano L, Rabbiosi D, Zaniboni M. The role of pericranium grafts in the reduction of postoperative dehiscences and bone resorption after reconstruction of severely deficient edentulous ridges with autogenous onlay bone grafts. Clin Oral Implants Res. 2013;24:679-87.
  21. Chappuis V, Rahman L, Buser R, Janner SFM, Belser UC, Buser D. Effectiveness of Contour Augmentation with Guided Bone Regeneration: 10-Year Results. J Dent Res. 2018;97:266-74.
  22. Chappuis V, Cavusoglu Y, Buser D, von Arx T. Lateral Ridge Augmentation Using Autogenous Block Grafts and Guided Bone Regeneration: A 10-Year Prospective Case Series Study. Clin Implant Dent Relat Res. 2017;19:85-96.