Cortical Bone Repositioning Technique for Horizontal Alveolar Bone Augmentation: A Case Series

Int J Periodontics Restorative Dent. 2018 September/October;38(5):691–697. doi: 10.11607/prd.2839. Epub 2018 Mar 7.

Abstract

The objective of this study was to present a novel procedure for cortical bone repositioning (CBR) that maintains a secure space under the periosteum by replacement of the lateral cortex via fixation, employing titanium screws. Seven systemically healthy patients presenting with horizontal alveolar bone defects in radiographs and CT images were enrolled for CBR technique for horizontal alveolar bone augmentation. A lateral cortical bone block was cut in the defects and freed from the original bony surface. A screw was inserted into the block, and the block was placed laterally to allow fixation. The block was checked for adequate stability, and the flap was closed after creation of periosteal releasing incisions to ensure tension-free closure. There were no complications, and 16 implants were placed uneventfully. Preoperative bone width in the defect area was 3.28 mm; the postoperative 4-month bone width in the same area was 6.46 mm. The mean implant stability quotient (ISQ) at placement was 68. At the secondary operation for changing to a healing abutment, the mean ISQ was 72. All patients were functionally and esthetically rehabilitated with implant-supported dentures. CBR technique is a simple procedure without the use of any biomaterials or devices. The main advantage of this technique in comparison to autogenous grafts is the lack of donor site issues. This technique has the possibility of inducing the patient's regenerative ability for bone healing.

MeSH terms

  • Adult
  • Alveolar Bone Loss / diagnostic imaging
  • Alveolar Bone Loss / surgery*
  • Alveolar Process / diagnostic imaging
  • Alveolar Process / surgery
  • Alveolar Ridge Augmentation / methods*
  • Cone-Beam Computed Tomography
  • Cortical Bone / transplantation*
  • Crowns
  • Dental Implantation, Endosseous / methods
  • Dental Prosthesis, Implant-Supported / methods
  • Female
  • Humans
  • Male
  • Middle Aged
  • Radiography, Dental
  • Young Adult