Outcomes of alveolar segmental ‘sandwich’ osteotomy with interpositional particulate allograft for severe vertical defects in the anterior maxilla and mandible

Chan, Cindy; Mirzaians, A.A.; Le, Bach

doi:10.1016/j.ijom.2021.06.004

Cited by 4 publications

(23 citation statements)

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“…the maxillary alveolar bone vertical deficiencies, among which the principle of sandwich osteotomy technique (Inlay Bone Grafting). 9,10 The main advantage of this technique is preservation of the blood supply to the created four wall defect between the mobilized and the fixed basal segment, coupled with the possibility of immediate dental implant placement at the same surgery with subsequent decrease of the overall treatment time and cost. 11 However, the palatal tipping and rotation of the mobilized down-fractured segment was the main disadvantage of this technique that usually affects the final amount of vertical bone gain.…”

Section: Resultsmentioning

confidence: 99%

“…Several reconstructive techniques have been introduced to reestablish the maxillary alveolar bone vertical deficiencies, among which the principle of sandwich osteotomy technique (Inlay Bone Grafting) 9,10 . The main advantage of this technique is preservation of the blood supply to the created four wall defect between the mobilized and the fixed basal segment, coupled with the possibility of immediate dental implant placement at the same surgery with subsequent decrease of the overall treatment time and cost 11 .…”

Section: Discussionmentioning

confidence: 99%

“…[3][4][5][6][7][8] Sandwich osteotomy technique (Inlay bone grafting) has been used previously with promising results to vertically augment the deficient anterior maxilla by placing one horizontal and two vertical full-thickness osteotomies aiming to down fracture a bony segment in a vertical dimension. 9,10 This technique allows for simultaneous implant placement reducing the overall time till the final restoration. 11 Moreover, it can be used with different bone substitutes without donor site morbidity.…”

Section: Introductionmentioning

confidence: 99%

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Maxillary vertical alveolar ridge augmentation using computer‐guided sandwich osteotomy technique with simultaneous implant placement versus conventional technique: A pilot study

Nazzal

Al‐Dubai

Mounir

et al. 2021

Clin Implant Dent Rel Res

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Background: Sandwich osteotomy technique (Inlay bone grafting) is considered as a highly reliable procedure for vertical bone augmentation in the maxillary anterior esthetic zone. The aim of this study was to compare vertical bone gain and palatal tipping using computer-guided inlay technique versus the conventional technique.Material and methods: This was a randomized clinical trial including 12 patients who were randomly divided into two groups: sandwich osteotomy with simultaneous implant placement at the anterior maxillary esthetic zone (six patients) using patient-specific guides (PSGs) in the study group versus conventional technique (six patients). In the control group, free-hand sandwich osteotomy was done, while in the study group all the procedures were performed with two sequential PSGs with cutting slits, guiding holes, and implant sleeves. Radiographic assessment included measurements of linear changes in the vertical dimensions of the labial plate of bone and palatal tipping on cross-sectional cuts of cone-beam computed tomography using special software.Results: All the procedures were uneventful except one case of the study group showed a cracked bony segment that did not affect the final outcome. Radiographic results showed comparable bone gain in both groups with no statistical significance difference (study group 4.4 mm, control group 3.9 mm). To the contrary, the computer-guided approach significantly reduced the palatal tipping to 0.4 mm compared to 2.1 mm in the conventional group, and there was a statistically significant difference between the two groups (p-value <0.001). Conclusion:Sandwich osteotomy using PSGs appears to be efficient and showed promising results regarding improving the palatal tipping compared to the freehand technique.

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Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Maxillary vertical alveolar ridge augmentation using computer‐guided sandwich osteotomy technique with simultaneous implant placement versus conventional technique: A pilot study

Nazzal

Al‐Dubai

Mounir

et al. 2021

Clin Implant Dent Rel Res

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“…Many advantages for the sandwich technique make it standout when compared to other techniques for vertical ridge augmentation, and multiple contemporary studies have documented its success in preparing the alveolar ridge for placement of implant. 11,13,[16][17][18]24 The main benefits of the technique include the high vascularity of the graft bed, which makes it osteoinductive and enhances graft incorporation as the graft is in direct contact with the marrow of the surrounding bone. 15 Other benefits of the sandwich osteotomy include very few incidences of wound dehiscence, graft exposure, graft resorption, or infection.…”

Section: Discussionmentioning

confidence: 99%

“…13,14 Furthermore, it has the benefits of fewer incidences of wound dehiscence and graft exposure, less disturbance to the osteogenic crestal periosteum, and the created graft bed is highly vascular, which increases graft incorporation with the recipient site. 15,16 Several reports exist in the literature that debate the maximum achievable height of vertical augmentation that will not put the transported bone segment under excessive pulling force by the tough palatal tissues, leading to segment palatal rotation, deficient buccal contour, and significant loss in the amount of vertical augmentation. 11,12,[17][18][19][20] Briefly, vertical bone augmentation in the maxillary esthetic zone remains a major challenge.…”

Section: Introductionmentioning

confidence: 99%

Maxillary vertical alveolar ridge augmentation using sandwich osteotomy technique with simultaneous versus delayed implant placement: A proof of principle randomized clinical trial

Al‐Dubai

Mounir

Ali

et al. 2022

Clin Implant Dent Rel Res

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Background The sandwich osteotomy technique usually requires high surgical skills and prolonged intraoperative time and had some technical drawbacks with a subsequent deficient amount of vertical bone gain. The aim of this study was to evaluate the final vertical bone gain using sandwich osteotomy with simultaneous versus delayed implant placement in the anterior maxilla. Material and methods This study included 16 patients having multiple missing maxillary anterior teeth with a vertically deficient alveolar ridge. Patients were randomly assigned into two equal groups. Both groups were treated using sandwich osteotomy with interpositional particulate bovine bone graft. In the study group (8 patients, 17 implants), the transport mobilized bone segment was fixed in position using simultaneous implant placement. Whereas in the control group (8 patients, 18 implants), micro‐plates and screws were used, followed by a second‐stage surgery for plates removal and delayed implant placement. Radiographic assessment included 4 months postoperative mean of vertical gain in alveolar ridge height, taken from cross‐sectional cuts of cone beam CT. Results The mean vertical bone gain in the study group was 4.04 ± 0.59 mm compared to 3.86 ± 0.52 mm in the control group with no statistically significant difference (p = 0.518). The mean value of bone gain percentage in the study group was 33.02% compared to 31.75% in the control group, with no statistically significant difference (p = 0.656). Conclusion The sandwich osteotomy technique with simultaneous implant placement is a reliable method for vertical ridge augmentation that eliminates the need for a secondary surgery.

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Bone Tissue Engineering (BTE) of the Craniofacial Skeleton, Part I: Evolution and Optimization of 3D-Printed Scaffolds for Repair of Defects

Nayak,

Slavin,

Bergamo

et al. 2023

Journal of Craniofacial Surgery

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Bone tissue regeneration is a complex process that proceeds along the well-established wound healing pathway of hemostasis, inflammation, proliferation, and remodeling. Recently, tissue engineering efforts have focused on the application of biological and technological principles for the development of soft and hard tissue substitutes. Aim is directed towards boosting pathways of the healing process to restore form and function of tissue deficits. Continued development of synthetic scaffolds, cell therapies, and signaling biomolecules seeks to minimize the need for autografting. Despite being the current gold standard treatment, it is limited by donor sites’ size and shape, as well as donor site morbidity. Since the advent of computer-aided design/computer-aided manufacturing (CAD/CAM) and additive manufacturing (AM) techniques (3D printing), bioengineering has expanded markedly while continuing to present innovative approaches to oral and craniofacial skeletal reconstruction. Prime examples include customizable, high-strength, load bearing, bioactive ceramic scaffolds. Porous macro- and micro-architecture along with the surface topography of 3D printed scaffolds favors osteoconduction and vascular in-growth, as well as the incorporation of stem and/or other osteoprogenitor cells and growth factors. This includes platelet concentrates (PCs), bone morphogenetic proteins (BMPs), and some pharmacological agents, such as dipyridamole (DIPY), an adenosine A2A receptor indirect agonist that enhances osteogenic and osteoinductive capacity, thus improving bone formation. This two-part review commences by presenting current biological and engineering principles of bone regeneration utilized to produce 3D-printed ceramic scaffolds with the goal to create a viable alternative to autografts for craniofacial skeleton reconstruction. Part II comprehensively examines recent preclinical data to elucidate the potential clinical translation of such 3D-printed ceramic scaffolds.

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Outcomes of alveolar segmental ‘sandwich’ osteotomy with interpositional particulate allograft for severe vertical defects in the anterior maxilla and mandible

Cited by 4 publications

References 50 publications

Maxillary vertical alveolar ridge augmentation using computer‐guided sandwich osteotomy technique with simultaneous implant placement versus conventional technique: A pilot study

Maxillary vertical alveolar ridge augmentation using computer‐guided sandwich osteotomy technique with simultaneous implant placement versus conventional technique: A pilot study

Maxillary vertical alveolar ridge augmentation using sandwich osteotomy technique with simultaneous versus delayed implant placement: A proof of principle randomized clinical trial

Bone Tissue Engineering (BTE) of the Craniofacial Skeleton, Part I: Evolution and Optimization of 3D-Printed Scaffolds for Repair of Defects

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