Tunnel Access for Lateral Alveolar Ridge Augmentation

Study Overview
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Brief Summary
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Minimally invasive procedures with the tunnel technique have been suggested to decrease patient post-operative discomfort and morbidity in oral bone regeneration. In the ridge augmentation tunnel technique, crestal incision and the release of the connective tissue are avoided in order to enhance the blood supply of the flap. This approach preserves the blood circulation and does not damage the periosteum The purpose of this study is to evaluate the clinical outcome of a minimally invasive technique for maxillofacial horizontal bone augmentation . performed by using a collagen dermal matrix, deproteinized bovine bone and hyaluronic acid. Collagen matrix is inserted into a sub-periosteal tunnel using microsurgical instruments. Deproteinized bovine bone in a hyaluronic acid carrier are placed and inserted repeatedly into the pocket and absorbable suture is used to close the vertical incision.

Detailed Description
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Tunnel bone regeneration achieves treatment objectives using the least invasive surgical approach.The goal is to increase patient satisfaction, decrease post-operative discomfort and morbidity.Preservation of the integrity of the periosteum is a determining factor in reducing postoperative pain and improving wound vascularization. The present study value the clinical results of a subperiosteal minimally invasive ridge horizontal augmentation technique. The technique includes the use of a laparoscopic approach to deliver hyaluronic acid,xenograft and a dermal matrix into a subperiosteal pouch.

Official Title
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Tunnel Access for Ridge Augmentation Using Xenogenous Bone, Hyaluronic Acid and Acellular Dermal Matrix

Conditions
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Bone Loss, Implant Site Injury

Intervention / Treatment
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* Procedure: bone and soft tissue augmentation


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: • Patients had to be healthy according to System of the American Society of Anesthesiology (ASA) and aged 18 years or older No general medical condition representing a contraindication to implant therapy minimum 2 missing teeth in the maxilla or mandible from the canine to the second molar No periodontal disease (periodontal probing depth <4 mm) or treated periodontitis Good oral hygiene (full mouth plaque index<25%) Adequate control of inflammation (full mouth bleeding on probing<25%) Exclusion Criteria: smoking of more than 15 cigarettes a day untreated periodontal disease pregnancy or breastfeeding at date of inclusion acute infections keratinized mucosal tissue less than 2 mm.

Ages Eligible for Study
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Minimum Age: 30 Years
Maximum Age: 75 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Other
Intervention Model: Single Group Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Bone regeneration<br>Minimally invasive horizontal bone augmentation using hyaluronic acid, deproteinized bovine bone and dermal matrix. | Procedure: bone and soft tissue augmentation<br>* A vertical full-thickness incision in the mesial aspect of the defect ridge.Microsurgery instruments is subsequently use to carefully elevate the full thickness of the mucosa. Extreme caution must be exercised during these maneuvers to avoid tissue perforation and to maintain the integrity of the periosteum.An dermal matrix is place into the tunnel.A pouch is create between the bone and the membrane and the mixed bone chips and hyaluronic acid are inserted into the tunnel until the desirable ridge dimensions are obtained. Primary closure of the vertical incisions was achieved with single interrupted sutures.<br>* Other names: Bone regeneration;|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Augmented tissue volume | The edentulous ridge will be scanned with an intraoral scan 3 times. First time: Initial situation. Second time: 5 months after regeneration. Third time: After implant placement. Will be evaluate the 3 scan in a cad-cam software to evaluate the ridge three-dimensional changes. | 7 month |