Containment and contouring (CoCoon) technique: a biologically adequate approach to less invasive autogenous preimplant augmentation of bone

Br J Oral Maxillofac Surg. 2013 Dec;51(8):880-6. doi: 10.1016/j.bjoms.2012.11.001. Epub 2012 Dec 4.

Abstract

We have analysed retrospectively whether the less invasive zygomatic buttress graft is able to meet the dimensional and biological requirements of preimplant augmentation of bone. A total of 273 patients were treated by zygomatic buttress graft, of whom 42 (12 men and 30 women) met the criteria for inclusion. Intensity of pain was judged by a visual analogue score (VAS). Complications of grafting were evaluated, and dental implants were studied on clinical and radiographic examinations. The Schneiderian membrane was perforated in 13 cases (28%). The mean (SD) postoperative VAS was 3.1 (0.9) at the donor site. The mean (SD) follow-up after implant was 17(8) months. Two grafts were lost, one from initial dehiscence and later infection, and the other from infection. The mean (SD) marginal resorption of bone graft was 0.5 (0.7) mm. No implant was lost during the observation period. The zygomatic buttress graft meets the biological and dimensional requirements of augmentation of bone before implant that allows the dental implants to survive with satisfactory prosthetic rehabilitation.

Keywords: Alveolar ridge defect; Dental implant; Maxillary augmentation; Zygomatic buttress.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Alveolar Ridge Augmentation / methods*
  • Autografts / transplantation*
  • Bone Resorption / etiology
  • Bone Transplantation / methods*
  • Dental Implants*
  • Female
  • Follow-Up Studies
  • Graft Survival
  • Humans
  • Intraoperative Complications
  • Male
  • Maxilla / surgery*
  • Maxillary Sinus / injuries
  • Middle Aged
  • Minimally Invasive Surgical Procedures / methods
  • Nasal Mucosa / injuries
  • Pain Measurement / methods
  • Pain, Postoperative / etiology
  • Retrospective Studies
  • Surgical Wound Dehiscence / etiology
  • Surgical Wound Infection / etiology
  • Transplant Donor Site / surgery*
  • Young Adult
  • Zygoma / surgery*

Substances

  • Dental Implants