Comparison of Double-Flap Incision to Periosteal Releasing Incision for Flap Advancement: A Prospective Clinical Trial

Ogata, Yumi; Griffin, Terrence J.; Ko, Alexander C; Hur, Yong

doi:10.11607/jomi.2714

Cited by 24 publications

(33 citation statements)

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“…Ogata et al used PRI with a scalpel during bone augmentation procedure, and reported that the average postoperative pain score in the first postoperative week was 37.5 mm. 5 In the same period, the mean pain score perceived by the patients in this study was 6.42 mm. Moreover, the results of this study demonstrated minimal need for NSAIDs in the postoperative period.…”

Section: Discussionmentioning

confidence: 53%

“…1,2 Tension-free primary closure of soft tissue flap is a prerequisite for successful GBR. [3][4][5] On the other hand, failure to maintain primary closure usually results in flap dehiscence and membrane exposure and may lead to reduced quantity and quality of the regenerated bone. 6 Periosteal releasing incision (PRI) is the most common method to ensure tension-free primary closure.…”

Section: Introductionmentioning

confidence: 99%

“…Facial hematoma and swelling after surgery could have a negative effect on patient's quality of life. 5 Several methods have been proposed to reduce postoperative sequelae. However, most of these techniques did not show beneficial effects.…”

Section: Introductionmentioning

confidence: 99%

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Periosteal Releasing Incision With Diode Laser in Guided Bone Regeneration Procedure: A Case Series

et al. 2016

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Introduction: Periosteal releasing incision (PRI) is nearly always essential to advance the flap sufficiently for a tension-free flap closure in bone augmentation procedures. However, hematoma, swelling, and pain are recognized as the main consequences of PRI with scalpel. The aim of this case series was to investigate the effectiveness of laser-assisted PRI in guided bone regeneration (GBR) procedure. In addition, postoperative hematoma, swelling, and pain and implant success were assessed. Methods: Seventeen patients needed GBR were included in this study. Diode laser (940 nm, 2 W, pulse interval: 1 ms, pulse length: 1 ms, contact mode, 400-μm fiber tip) was used in a contact mode to cut the periosteum to create a tension-free flap. Facial hematoma, swelling, pain, and the number of consumed nonsteroidal anti-inflammatory drugs (NSAIDs) were measured for the six postoperative days. Six months after implant loading, implant success was evaluated. Results: Minimal bleeding was encountered during the procedure. A tension-free primary closure of the flap was achieved in all cases. The clinical healing of the surgical area was uneventful. None of the patients experienced hematoma, ecchymosis, or intense swelling after surgery. The mean value of maximum pain (visual analogue scale -VAS) was 20.59 ± 12.10 mm (mild pain). Patients did not need to use NSAID after four postoperative days. All implants were successful and functional and none of them failed after 6 months of implant loading. Conclusion: This study revealed the effectiveness of laser-assisted PRI in GBR procedure. This technique was accompanied with minimal sequelae at the first postoperative week. All implants were successful and no complication was noted during the course of this study.

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Section: Discussionmentioning

confidence: 53%

Section: Introductionmentioning

confidence: 99%

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Periosteal Releasing Incision With Diode Laser in Guided Bone Regeneration Procedure: A Case Series

et al. 2016

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“…Periosteal fenestration and vertical-releasing incisions are commonly used for vertical GBR to elevate a tensionless flap [11,18,29,30]. Nevertheless, this flap design often results in complications such as swelling, bleeding, and patient discomfort, as well as flap perforation and graft exfoliation in 2.5-10% of the cases, depending on the augmentation technique [19]. One of the main causes behind these complications is probably the placement of deep periosteal incisions, which interrupts periosteal blood vessel circulation.…”

Section: Discussionmentioning

confidence: 99%

“…Apart from decreasing flap tension, the placement of incisions, which disrupt the continuity of the periosteal layer, may negatively affect periosteal blood supply. As an alternative to the classical full-thickness flap design for vertical GBR, a splitthickness flap approach was suggested by several authors, which might similarly result in a tension-free wound closure but at the same time avoiding the previously mentioned adverse events related to full-thickness flaps [19,20]. More recently, in order to additionally improve the healing and to improve the predictability of vertical augmentation procedures, our group proposed a novel minimally invasive split-thickness flap design without vertical-releasing incisions [13].…”

Section: Introductionmentioning

confidence: 99%

Vertical-guided bone regeneration with a titanium-reinforced d-PTFE membrane utilizing a novel split-thickness flap design: a prospective case series

et al. 2020

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Objectives To evaluate the feasibility of a newly proposed minimally invasive split-thickness flap design without vertical-releasing incisions for vertical bone regeneration performed in either a simultaneous or staged approach and to analyze the prevalence of adverse events during postoperative healing. Materials and methods Following preparation of a split-thickness flap and bilaminar elevation of the mucosa and underlying periosteum, the alveolar bone was exposed over the defects, vertical GBR was performed by means of a titanium-reinforced high-density polytetrafluoroethylene membrane combined with particulated autogenous bone (AP) and bovine-derived xenograft (BDX) in 1:1 ratio. At 9 months after reconstructive surgery, vertical and horizontal hard tissue gain was evaluated based on clinical and radiographic examination. Results Twenty-four vertical alveolar ridge defects in 19 patients were treated with vertical GBR. In case of 6 surgical sites, implant placement was performed at the time of the GBR (simultaneous group); in the remaining 18 surgical, sites implant placement was performed 9 months after the ridge augmentation (staged group). After uneventful healing in 23 cases, hard tissue fill was detected in each site. Direct clinical measurements confirmed vertical and horizontal hard tissue gain averaging 3.2 ± 1.9 mm and 6.5 ± 0.5 mm respectively, in the simultaneous group and 4.5 ± 2.2 mm and 8.7 ± 2.3 mm respectively, in the staged group. Additional radiographic evaluation based on CBCT data sets in the staged group revealed mean vertical and horizontal hard tissue fill of 4.2 ± 2.0 mm and 8.5 ± 2.4 mm. Radiographic volume gain was 1.1 ± 0.4 cm3. Conclusion Vertical GBR consisting of a split-thickness flap and using titanium-reinforced non-resorbable membrane in conjunction with a 1:1 mixture of AP+BDX may lead to a predictable vertical and horizontal hard tissue reconstruction. Clinical relevance The used split-thickness flap design may represent a valuable approach to increase the success rate of vertical GBR, resulting in predicable hard tissue regeneration, and favorable wound healing with low rate of membrane exposure.

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Ridge Site Preparation

2016

Clinical Cases in Implant Dentistry

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Comparison of Double-Flap Incision to Periosteal Releasing Incision for Flap Advancement: A Prospective Clinical Trial

Cited by 24 publications

References 0 publications

Periosteal Releasing Incision With Diode Laser in Guided Bone Regeneration Procedure: A Case Series

Periosteal Releasing Incision With Diode Laser in Guided Bone Regeneration Procedure: A Case Series

Vertical-guided bone regeneration with a titanium-reinforced d-PTFE membrane utilizing a novel split-thickness flap design: a prospective case series

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