TITLE:
The Use of Cortical Bone Wedges from the Mandibular Ramus “Wedge Technique”: For 3-Dimensional Bone Augmentation of the Atrophic Ridges. Technique Presentation and Report of Case Series
AUTHORS:
Fares Kablan
KEYWORDS:
Bone Augmentation, Autogenic Bone Grafts, Allogenic Bone Substitute, Donor Site, Space Maintenance
JOURNAL NAME:
Open Journal of Stomatology,
Vol.8 No.6,
June
29,
2018
ABSTRACT: Purpose: Autogenous bone was still considered as the gold
standard in bone augmentations prior to implants insertion at the atrophic ridges.
However if large bone grafts are needed to augment multiple edentulous atrophic
segments, extraoral donor sites may be mandatory. The aim of this report is to
introduce the Fares Wedge Technique, as a new bone augmentation method that can
augment multiple edentulous ridges with intraoral cortical bone grafts. Methods: This report includes
patients with moderate to severe ridge atrophy in different regions of the both
jaws who were treated over 6-years
period (2009-215) with wedge Technique (WT). Patients received panorex immediately after the surgery, and they were examined clinically and
radiographically (periapical) every 2 weeks. At 4 months, computed tomography
was performed to evaluate the bone gain. Reentry was performed after 4 to 5
months to evaluate the new bone volume and quality and to
insert implants. At this stage specimens for histologic examination were also
obtained. Results: 39
augmentation sites in 22 patients (15 women, 7 men: mean age 47 years)
were followed 12 to 52 months. The healing process was uneventful, with minimal
morbidity. The success rate was 95%, and the bone gain average was 3 - 6
mm vertically and 3 - 9
mm horizontally. In two patients the graft was partially exposed and treated
with shaving and rounding the exposed wedges, but the augmentations were saved.
In one case the majority of the bone graft was lost. At 38 sites the patients
had successfully received 114 implants. Conclusions:
wedge technique can augment multiple segments of atrophic ridges with small amount
of autogenic graft. The bone volume that achieved was satisfying, especially
that the majority of the augmented areas were at posterior mandibular defects.