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Flap tunneling technique in ridge augmentation with autologous bone graft- report of 2 cases and review of the literature
EAO Online Library. Paschalidi P.
Oct 9, 2018; 232747
Polytimi Paschalidi
Polytimi Paschalidi
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Vertical and horizontal augmentation of the alveolar ridge is necessary in cases of extensive resorption to achieve implant placement. Several surgical techniques have been used to increase bone height and width, including autologous onlay block bone grafts. However, this approach is frequently associated with complications, such as wound dehiscence that negatively affect the outcome of the augmentation. The flap tunnel technique for bone block augmentation has been extensively described in the literature as a safer, minimally invasive procedure. Advantages include a shorter healing period for soft tissue, prevention of graft exposure and minor postoperative complications, compared with conventional techniques.The aim of this poster is to present 2 cases of ridge augmentation with autologous block grafts via the tunnel technique, along with a brief review of the literature.The first case reported is associated with a horizontal ridge defect that was treated with an autologous bone block, originating from the external oblique ridge of the mandible. The tunnel approach was used for both cases, involving 2 vertical incisions through which a mucoperiostal flap was raised. The graft was placed through the incisions of the tunnel flap and fixed to the recipient site by use of microscrews. The second case concerns a vertical defect in the right premolar mandibular area. A bone block graft was taken from the symphysis and fixated through the tunnel flap in a crestal position of the bone defect with microscrews. In both cases, the sites were revisited 10-16 weeks post-operatively, when the screws were removed and the implants were placed without any complications.Flap design, and specifically the tunnel approach for the ridge reconstruction procedures presents numerous advantages. Maintaining tissue attachment preserves the esthetic borders of restorations especially in the anterior maxilla. It is an atraumatic approach which allows excellent access to the recipient area and minimizes complications, such as wound dehiscence and exposure of the grafting materials that may jeopardize the outcome of the procedure.
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