Evaluation of a Novel Horizontal Ridge Augmentation Technique in Dentistry
Condition: Bone Augmentation; Bone Loss, Alveolar
MeSH terms: Alveolar Bone Loss
Study type: Interventional

Summary: 
      This case series aimed to assess the efficacy of a novel horizontal ridge augmentation
      modality using histomorphometry and Raman spectroscopy. Combinations of "sticky bone" and
      tenting screws without autologous bone were used as augmentative materials.
    

Detailed description: 
      This case series aimed to evaluate the efficacy of the horizontal augmentation technique
      using the tenting screw technique with "sticky bone." The main aim was to determine whether
      this method provides similar results to the gold standard GBR or autologous onlay block
      grafts. In addition, the validity of neglecting autologous graft and its possible
      substitution with growth factor concentrate were examined. The novelty of this study is that
      no human histological examination of the described procedure has been conducted previously.
      It is hypothesized that the "stick bone" containing autologous platelet concentrate can
      substitute the use of particulate autologous bone graft in these type of procedures. In this
      prospective case series study five patients were enrolled and treated with the same type of
      bone augmentation in order to increase the alveolar ridge in the horizontal dimension with
      the previously mentioned technique. After 5 months of healing a second reentry surgery was
      performed in order to harvest the bone core for biopsy, to asses the chemical compound
      composition by Raman spectroscopy in vivo and to place the dental implants at the same time.
      Newly formed tissues were evaluated clinically during reentry, radiologically by CBCT
      acquisition, qualitatively and quantitatively by histological processing and
      physicochemically by means of Raman spectroscopy.
    

Intervention name(s): Horizontal bone augmentation
Intervention type(s): Procedure
Intervention description(s): After taking six 9 mL tubes of blood from the patient, advanced (A-PRF) and liquid (S-PRF) PRFs were prepared. A-PRF was chopped, added to the xenogeneic bone substitute (THE Graft; Purgo Biologics Inc.), and then impregnated with the liquid S-PRF, which enabled the particulate bone substitute to become moldable and turned into a block ("sticky bone"). After local anesthesia, a midcrestal incision was made with one vertical releasing incision at the flap's mesial end. After full-thickness flap elevation, a periosteal releasing incision was made at the flap's apical portion. The alveolar bone was decorticalized on the buccal aspect with surgical burs. Next, the prepared "bonded" graft matrix was adapted to the ridge. Then, tenting screws (Pro-fix; Osteogenics) were placed to maintain the periosteum in an elevated and tension-free position The bone augmentation material was covered with A-PRF membranes. Finally, tension-free wound closure was performed.
Intervention model: Single Group Assignment
Intervention model description: All subjects undergo the same type of horizontal bone augmentation using "sticky bone" (combination of xenograft and autologous platelet rich concentrate) and tenting screws.
Masking: None (Open Label)
Primary purpose: Treatment
Keywords: platelet concentrate; horizontal bone augmentation; "sticky bone"; Histology; Raman spectroscopy