Citation Information :
Johar AO. Ridge Augmentation with Autogenous Bone Graft and Expanded Polytetrafluoroethylene Membrane using Tenting Screw: A Randomized Controlled Clinical Trial. J Contemp Dent Pract 2019; 20 (4):409-416.
Background: The study aims to compare non-tenting screw and tenting with a reinforced expanded polytetrafluoroethylene (ePTFE) membrane in horizontal ridge augmentation using an autogenous bone graft.
Material and methods: A randomized controlled clinical trial was conducted between 150 patients needing dental implants. The participants were randomly divided into three study groups; group 1: ridge augmentation using non-resorbable ePTFE membrane only, group2: ridge augmentation using an ePTFE and tenting screw with bone graft Bio-Oss mixed with autogenous bone particles and group 3 (control): ridge augmentation with a bone block. The initial measurement was done at the bone crest at the exact implant site and 10 mm apical to the bone crest. Repeat measurements were recorded after 6 months of healing. Statistical analysis was performed by paired sample t-test and two-way analysis of variance (ANOVA). Statistical significance was considered at p <0.05.
Results: There was a significant gain in the bone in all the three groups postsurgery. Group 3 recorded higher reading at the crest and apical sites when compared to groups 1 and 2 at 6 months (late measurements). The difference in the percentage gain was statistically significant after adjusting for age as well as the initial measurement. The highest gain was seen in group 3 followed by groups 2 and 1.
Conclusion: The membrane with tenting screw group and block bone groups had a significantly higher increase in measurement when compared to the membrane only group. Tenting screw with Bio-Oss can be used in patients with autogenous bone at the donor site.
Clinical significance: Tenting screws in combination with membranes can be used to overcome the limitations posed by the use of membranes alone. It is also a useful method for a patient not consenting for block graft for any medical reason.
Elsalanty ME, Genecov DG. Bone grafts in craniofacial surgery. Craniomaxillofac Trauma Reconstr 2009;2(3):125.
Rogers GF, Greene AK. Autogenous bone graft: basic science and clinical implications. J Craniofac Surg 2012;23(1):323–327.
Liu J, Kerns DG. Suppl 1: Mechanisms of Guided Bone Regeneration: A Review. Open Dent J 2014;8:56.
Simon BI, Chiang TF, Drew HJ. Alternative to the gold standard for alveolar ridge augmentation: Tenting screw technology. Quintessence Int 20101;41(5).
Hitti RA, Kerns DG. Guided bone regeneration in the oral cavity: a review. Open Pathol J 2011;5:33–45.
Gottlow J, Nyman S, Karring T, et al. New attachment formation as the result of controlled tissue regeneration. J Clin Periodontol 1984;11(8):494–503.
Aurer A, cJorgiæ-Srdjak K. Membranes for periodontal regeneration. Acta Stomatol Croat 2005;39:107–112.
Urban IA, Jovanovic SA, Lozada JL. Vertical ridge augmentation using guided bone regeneration (GBR) in three clinical scenarios prior to implant placement: a retrospective study of 35 patients 12 to 72 months after loading. Int J Oral Maxillofac Implants 2009;24(3):502– 510.
Roccuzzo M, Ramieri G, Spada MC, et al. Vertical alveolar ridge augmentation by means of a titanium mesh and autogenous bone grafts. Clin Oral Implants Res 2004;15(1):73–81.
Chasioti E, Chiang TF, Drew HJ. Maintaining space in localized ridge augmentation using guided bone regeneration with tenting screw technology. Quintessence Int 2013;44(10):763–771.
Mueller SM, Glowacki J. Age-related decline in the osteogenic potential of human bone marrow cells cultured in three-dimensional collagen sponges. J Cell Biochem 2001;82(4):583–590.
Pinho MN, Roriz VL, Novaes AB Jr, et al. Titanium membranes in prevention of alveolar collapse after tooth extraction. Implant Dent 2006;15(1):53–61.
Aimetti M, Romano F, Griga FB, et al. Clinical and histologic healing of human extraction sockets filled with calcium sulfate. Int J Oral Maxillofac Implants. 2009;24(5):902–909.
Peng CC, Pan WL, Pan YH, et al. Deformed Ridge Reconstruction Combining Tenting Screws and Guided Bone Regeneration before Implant Surgery-A Case Report. Taiwan J Oral Maxillofac Surg 2012;23(4):321–333.
Khraisat A, Abu-Hammad O, Dar-Odeh N, et al. Abutment screw loosening and bending resistance of external hexagon implant system after lateral cyclic loading. Clin Implant Dent Relat Res 2004;6(3):157–164.
Hämmerle CH, Jung RE. Bone augmentation by means of barrier membranes. Periodontol 2000 2003;33:36–53.
Becmeur F, Geiss S, Laustriat S, et al. History of Teflon Eur Urol 1990;17(4):299–300.
Blanco J, Alonso A, Sanz M. Long-term results and survival rate of implants treated with guided bone regeneration: a 5-year case series prospective study. Clin Oral Implants Res 2005;16(3): 294–301
Kao PC, Huang MS, Shiau YY. Vertical ridge augmentation with a titanium reinforced ePTFE membrane and tenting screws: A Case Report. J Prosthod Implantol 2012;1(1):12–18
Chiapasco M, Zaniboni M, Boisco M. Augmentation procedures for the rehabilitation of deficient edentulous ridges with oral implants. Clin Oral Implants Res 2006;17(suppl 2):136–159.
Simon B, Von Hagen S, Deasy M, et al. Changes in alveolar bone height and width following ridge augmentation using bone graft and membranes. J Periodontol 2000;71:1774–1791.
Doblin J, Salkin L, Mellado J, et al. A histologic evaluation of localized ridge augmentation utilizing DFDBA in combination with e-PTFE membranes and stainless steel pins in humans. Int J Periodontics Restorative Dent 1996;16:120–129.
Mengel R, Flores-de-Jacoby L. Implants in regenerated bone in patients treated for generalized aggressive periodontitis: A prospective longitudinal study. Int J Periodontics Restorative Dent 2005;25: 331–341.
Taylor G. Intra-oral autogenous bone grafting for dental implant site preparation. Dental Bulletin. 2010 Mar;15(3):12–14.
Idrontino G, Valente NA. Intraoral and extraoral autologous bone block graft techniques: A review of the recent literature. Int J Contemp Dent Med Rev 2016