Immediate 3-dimensional ridge augmentation after extraction of periodontally hopeless tooth using chinblock graft

Abstract

Background The aim of the present study was to evaluate clinically and radiographically, the efficacy of immediate ridge augmentation to reconstruct the vertical and horizontal dimensions at extraction sites of periodontally hopeless tooth using an autogenous chin block graft. Material and Methods A total of 11 patients (7 male & 4 female) with localized advanced bone loss around single rooted teeth having hopeless prognosis and indicated for extraction were selected for the study. The teeth were atraumatically extracted and deficient sites were augmented using autogenous chin block graft. Parameters like clinically soft tissue height - width and also radiographic ridge height -width were measured before and 6 months after augmentation. Obtained results were tabulated and analysed statistically. Results After 6 months of immediate ridge augmentation, the mean gain in radiographic vertical height and horizontal width was 7.64 + 1.47 mm (P = 0.005) and 5.28 + 0.46 mm (P = 0.007) respectively which was found to be statistically significant (P < 0.05). Mean change of width gain of 0.40mm and height loss of 0.40mm of soft tissue parameters, from the baseline till completion of the study at 6 months was observed. Conclusions The present study showed predictable immediate ridge augmentation with autogenous chin block graft at periodontally compromised extraction site. It can provide adequate hard and soft tissue foundation for perfect 3-Dimensional prosthetic positioning of implant in severely deficient ridges. Key words:Immediate ridge augmentation, periondontally hopeless tooth, autogenous chin graft, dental implant.

Injerto autólogo en bloque de mentón, una alternativa para reconstruir rebordes alveolares atróficos en implantología

“…Se inicia preparando la zona receptora, se aborda mediante una incisión supracrestal con descargas laterales, levantamiento de colgajo mucoperióstico a espesor total, seguido de una corticotomía en la tabla vestibular 6,18,20,21 hasta generar un sangrado (Figura 1A), lo que garantizará una rápida angiogénesis y migración de las células potenciales osteogénicas desde el compartimento endosteal. 20 Luego, en la zona donadora con un abordaje vestibular mandibular 22 se realiza una primera incisión en la mucosa labial a 45 o , 4,11,23 sin incluir el músculo mentoniano, en extensión deberá ser aproximadamente de canino a canino, sin embargo, dependerá de la cantidad de milímetros que se requieran para corregir el defecto óseo; posteriormente, se realiza una segunda incisión a espesor total modificando la angulación del bisturí a 90 o con respecto al periostio de la sínfisis y parasínfisis, en donde se incidirá en el músculo mentoniano y el periostio 4,11,14,23 para lograr la exposición de la zona donadora.…”

“…6 Se han reportado resultados favorables, menor morbilidad y una mayor protección al injerto en bloque de mentón cuando se acompaña de una regeneración ósea guiada (ROG), por lo que es recomendable cubrirlo con hueso particulado y membranas, bien sean reabsorbibles o no reabsorbibles, y así aumentar las probabilidades de éxito. 8,11,12,[14][15][16][17][18]20 Finalmente, es de suma importancia que se realice la síntesis de los tejidos blandos en la zona receptora liberando el periostio en la base del colgajo para permitir el cierre libre de tensión 22,24 y de esta forma minimizar el riego de dehiscencias, se recomienda sutura Nylon 5/0 que por ser monofilamento tiene menos acúmulo de biofilm que pueda comprometer el injerto. En la zona donadora se debe suturar en dos planos, el plano muscular del mentoniano con sutura absorbible ácido poliglicólico 3/0 22,24 y el plano mucoso con Nylon 5/0.…”

Localized Ridge Augmentation with Mandibular Block Autograft and Guided Bone Regeneration: A Case Report

“…In a study conducted by Maiorana et al 2005, showed use of bovine bone particles (Bio-Oss) with block grafts, help lessen the degree of bone resorption almost up to 9.3% in the test group while 18.3% in the control group. 17 In contrast, Khoshhal S 2016 carried out a case of mandibular ridge augmentation using chin graft procured using trephine drills. FDBA 70% infused with DFDBA 30% was used with chin graft [18].…”

Unicystic Ameloblastoma: Rehabilitation With Chin Graft Harvested and Implant-Supported Fixed Prosthesis

“…The chin-harvested en bloc graft offers biological and immunological advantages in comparison with xenografts, allografts or alloplastic materials as it has viable cells (for osteogenesis), bone morphogenetic protein (for osteoinduction), and a bone matrix (osteoconduction) (19)(20)(21). The chin offers additional advantages as a donor site due to its accessibility, ease of harvesting (even under local anesthesia), minimal morbidity, and an absence of visible scarring (22). Its main complicationincisor and mental nerve damage -can be reduced to 14% of cases by using the harvesting technique described by Pommer et al (23) in 2008, which maintains an 8 mm safety margin from the incisor roots apex and the graft harvest site and 5 mm between the site and the mandibular base and mentonian foramen respectively.…”