A Novel Approach for Horizontal Augmentation: A Split Box

Marmara University41 enrolled

Overview

The goal of this clinical study is to investigate the effectiveness of the split-box technique in systemically healthy, non-smoking, over 18 years of age, participants with narrow crests (\<5mm bone width) and adequate bone height (\>12mm). The main questions it aims to answer are: * The primary objective of the present study is to investigate the effectiveness of the split-box technique by evaluating the change in width and height of the alveolar bone. * The secondary objective is to evaluate the superiority of the split-box technique and its modifications in terms of the amount of bone gain. According to the 3D topography of the alveolar ridge of the patients before augmentation, split box or one of its modifications, reverse split box or sliding split box techniques were selected and applied. (split box was applied if the bone thickness was more than 3 mm at the top of the crest and did not increase towards the lower border at the alveolar bone, reverse split box technique was applied if the bone thickness was more than 3 mm at the top of the crest and increased towards the lower border at the alveolar bone, sliding split box was applied if the bone thickness was less than 3 mm at the top of the crest but the bone thickness increases towards the lower border at the alveolar bone.)

Study Type

OBSERVATIONAL

Enrollment

Conditions

Alveolar Bone Loss Alveolar Ridge Augmentation Augmentation, Alveolar Ridge

Interventions

Splitting of bone and fixation of bone laminae differ between the 3 groups.PROCEDURE

In split-box technique, all osteotomies were made using with piezoelectric surgery. Horizontal and vertical osteotomies were performed 1.5 mm away from adjacent teeth. Lower border osteotomy of the vestibular cortical bone was performed. A chisel osteoma was used to separate completely and mobilize the segmented bone. This separated, corticocancellous block was stabilized on the distance to the native alveolar crest with micro screws. The space between the block and the alveolar crest was filled with allograft. In reverse split box technique, differs from the split-box technique as follows: it involves reversing the separated corticocancellous bone block before fixation. In sliding split box technique, differs from the split-box technique as follows: horizontal osteotomy is performed at the level where the bone thickness reaches at least 3 mm. Separated corticocancellous bone block is slid toward the coronal of alveolar crest and fixed in line with the native alveolar bone.

Eligibility

Sex: ALLMin age: 22 YearsMax age: 73 YearsHealthy volunteers:

Medical Language ↔ Plain English

Inclusion Criteria: * To be older than 18 years of age * To be systemically healthy * To be non-smokers * Having narrow crests (\<5 mm bone width) * Having adequate bone height (\>12 mm) * Having cone-beam computed tomography scans before surgery and five months after augmentation Exclusion Criteria: * Having bone diseases, * A history of neck or head radiotherapy * Receiving steroids, bisphosphonates or chemotherapeutic drugs * Being pregnancy * Having narrow bone thickness in the crest (\<3 mm), those in whom this thickness did not increase toward the lower border of the alveolar bone * Patients with a history of infection or exposure after augmentation

Outcomes

Primary Outcomes

Horizontal changes in the alveolar bone

To determine the horizontal changes in the alveolar bone, thickness was measured at two different levels. The measurements were titled as follows: crestal width (CW) and screw level width (SLW). To measure CW, measurements were made horizontally at the highest point of the crest in pre- and post-operative tomography. To measure SLW, in the post-operative tomography, the bone thickness at the screw level was measured horizontally and recorded. In addition, the distance between the anatomical landmark (mandibular basis, mandibular foramen, lower border of nasal or sinus cavity) and the screw level was also measured and recorded. The main goal of this measurement was to provide a reference for SLW measurement on preoperative cone-beam computed tomography (CBCT), since there were no screws. After the measurements in the postoperative CBCT were made, SLW was also made in the preoperative imaging.

Time frame: 5 months

Vertical changes in the alveolar bone

To determine whether there was vertical bone loss during horizontal augmentation, the height of the alveolar ridge (ARH) was measured. To measure ARH, a line was created between the anatomical landmark and the highest point of the crest, and the length of this line was measured in the pre- and post-operative tomography.

Time frame: 5 months

Secondary Outcomes

Difference in bone thickness gain at the top of the crest (CW) between the 3 groups

In order to determine the difference between the 3 groups in terms of CW, the difference between the pre- and post-operative values of the 3 groups was determined. These values were compared between the 3 groups.

Time frame: 5 months

Difference in bone thickness gain at the top of the screw level (SLW) between the 3 groups

In order to determine the difference between the 3 groups in terms of SLW, the difference between the pre- and post-operative values of the 3 groups was determined. These values were compared between the 3 groups.

Time frame: 5 months

Difference in bone loss at alveolar ridge height (ARH) between 3 groups

In order to determine the difference between the 3 groups in terms of ARH, the difference between the pre- and post-operative values of the 3 groups was determined. These values were compared between the 3 groups.

Time frame: 5 months

A Novel Approach for Horizontal Augmentation: A Split Box

Overview

Conditions

Interventions

Eligibility

Locations (1)

Outcomes

Primary Outcomes

Secondary Outcomes