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VOLUME 25 , ISSUE 6 ( June, 2024 ) > List of Articles

ORIGINAL RESEARCH

Comparison of Khoury's Bone Shell Technique vs Titanium-reinforced Polytetrafluoroethylene Membrane for 3D-bone Augmentation in Atrophic Posterior Mandible: A Randomized Clinical Trial

Ahmed ES Shaker, Ahmed S Salem, Shaimaa AA El-Farag, Fakhreldin H Abdel-Rahman, Mohamed H El-Kenawy

Keywords : Bone grafting, Guided bone regeneration, Horizontal bone augmentation, Vertical bone augmentation

Citation Information : Shaker AE, Salem AS, El-Farag SA, Abdel-Rahman FH, El-Kenawy MH. Comparison of Khoury's Bone Shell Technique vs Titanium-reinforced Polytetrafluoroethylene Membrane for 3D-bone Augmentation in Atrophic Posterior Mandible: A Randomized Clinical Trial. J Contemp Dent Pract 2024; 25 (6):518-526.

DOI: 10.5005/jp-journals-10024-3704

License: CC BY-NC 4.0

Published Online: 23-09-2024

Copyright Statement:  Copyright © 2024; The Author(s).


Abstract

Aim: This study was designed to compare between the use of Khoury's bone shell technique vs titanium-reinforced PTFE membrane for 3D-ridge augmentation of atrophic posterior mandible. Materials and methods: Sixteen patients were equally and randomly assigned to either the Khoury or PTFE group. In Khoury group, a mandibular bone block was harvested, split and then fixed to augment the mandibular defect using osteosynthesis screws. In PTFE group, augmentation was achieved using Titanium-reinforced PTFE membranes fixed with bone tacks/screws. A mixture of autogenous and xenogenic graft material at a 1:1 ratio was used in both groups. Vertical and horizontal bone gain were obtained using cone-beam computed tomography (CBCT). Preoperative dimensions were compared with the final dimensions obtained 6 months postoperatively. Results: No significant complications or neurosensory dysfunction were encountered. A solitary patient in the Khoury group experienced limited wound dehiscence, which was treated conservatively. For both groups, there were no significant differences between preoperative and postoperative vertical (p = 0.849 and 0.569) and horizontal (p = 0.778 and 0.367) dimensions. Conclusion: No significant differences exist between the augmentation dimension which can be obtained using either Khoury of Ti-PTFE membranes. Clinical significance: Both approaches are delicate and necessitate surgical expertise and experience. Both techniques can be used to achieve predictable augmentation results with a low rate of complications.

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  1. Fontana F, Maschera E, Rocchietta I, et al. Clinical classification of complications in guided bone regeneration procedures by means of a nonresorbable membrane. Int J Periodontics Restorative Dent 2011;31(3):265–273. PMID: 21556383.
  2. Rocchietta I, Fontana F, Simion M. Clinical outcomes of vertical bone augmentation to enable dental implant placement: A systematic review. J Clin Periodontol 2008;35(8 Suppl):203–215. DOI: 10.1111/j.1600-051X.2008.01271.x.
  3. Tinti C, Parma-Benfenati S. Vertical ridge augmentation: Surgical protocol and retrospective evaluation of 48 consecutively inserted implants. Int J Periodontics Restor Dent 1998;18(5):434–443. PMID: 10093520.
  4. Froum SJ, Rosenberg ES, Elian N, et al. Distraction osteogenesis for ridge augmentation: Prevention and treatment of complications. Thirty case reports. Int J Periodontics Restor Dent 2008;28(4):337–345. PMID: 18717372.
  5. Chiapasco M, Brusati R, Ronchi P. Le Fort I osteotomy with interpositional bone grafts and delayed oral implants for the rehabilitation of extremely atrophied maxillae: A 1–9-year clinical follow-up study on humans. Clin Oral Implants Res 2007;18(1):74–85. DOI: 10.1111/j.1600-0501.2006.01287.x.
  6. Chiapasco M, Zaniboni M, Rimondini L. Autogenous onlay bone grafts vs. alveolar distraction osteogenesis for the correction of vertically deficient edentulous ridges: A 2–4-year prospective study on humans. Clin Oral Implants Res 2007;18(4):432–440. DOI: 10.1111/j.1600-0501.2007.01351.x.
  7. Donos N, Mardas N, Chadha V. Clinical outcomes of implants following lateral bone augmentation: Systematic assessment of available options (barrier membranes, bone grafts, split osteotomy). J Clin Periodontol 2008;35(8 Suppl):173–202. DOI: 10.1111/j.1600-051X.2008.01269.x.
  8. Hämmerle CH, Jung RE. Bone augmentation by means of barrier membranes. Periodontol 2000 2003;33(1):36–53. DOI: 10.1046/j.0906-6713.2003.03304.x.
  9. Drake R, Vogl AW, Mitchell AW. Gray's anatomy for students E-book: Elsevier Health Sciences; 2009.
  10. Misch CM, Basma H, Misch-Haring MA, et al. An updated decision tree for vertical bone augmentation. Int J Periodontics Restor Dent 2021;41(1):11–21. DOI: 10.11607/prd.4996.
  11. Retzepi M, Donos N. Guided bone regeneration: Biological principle and therapeutic applications. Clin Oral Implants Res 2010;21(6):567–576. DOI: 10.1111/j.1600-0501.2010.01922.x.
  12. Gottlow J. Guided tissue regeneration using bioresorbable and non-resorbable devices: Initial healing and long-term results. J Periodontol 1993;64(11 Suppl):1157–1165. DOI: 10.1902/jop.1993.64.11s.1157.
  13. Simion M, Baldoni M, Rassi P, et al. A comparative study of the effectiveness of e-PTFE membranes with and without early exposure during the healing period. Int J Periodontics Restor Dent 1994;14(2):166–180. PMID: 7928132.
  14. Sittitavornwong S, Ashley D, Denson D, et al. Integrity of human mandibular angle after block graft harvest from mandibular body. Int J Oral Maxillofac Implants 2019;34(3):692–697. DOI: 10.11607/jomi.6903.
  15. Khoury F, Hanser T. Mandibular bone block harvesting from the retromolar region: A 10-year prospective clinical study. Int J Oral Maxillofac Implants 2015;30(3):688–697. DOI: 10.11607/jomi.4117.
  16. Khoury F, Hanser T. 3D vertical alveolar crest augmentation in the posterior mandible using the tunnel technique: A 10-year clinical study. Int J Oral Implantol (Berl) 2022;15(2):111–126. PMID: 35546722.
  17. Khoury F, Hidajat H. Extensive autogenous bone augmentation and implantation in patients under bisphosphonate treatment: A 15-case series. Int J Periodontics Restorative Dent 2016;36(1):9–18. DOI: 10.11607/prd.2608.
  18. Khoury F, Hanser T. Three-dimensional vertical alveolar ridge augmentation in the posterior maxilla: A 10-year clinical study. Int J Oral Maxillofac Implants 2019;34(2):471–480. DOI: 10.11607/jomi. 6869.
  19. Clifford D, Haggerty CJ. Pre-Prosthetic surgery. In: Haggerty CJ, Laughlin RM eds: Atlas of operative oral and maxillofacial surgery. 2nd ed. John Wiley & Sons, Inc; 2023. pp. 28–36.
  20. Al-Nawas B, Schiegnitz E. Augmentation procedures using bone substitute materials or autogenous bone - A systematic review and meta-analysis. Eur J Oral Implantol 2014;7(Suppl 2):S219–S234. PMID: 24977257.
  21. Tolstunov L. Surgical restorative decision algorithm for edentulous condition in implant dentistry with emphasis on bone augmentation. J Oral Implantol 2019;45(5):421–424. DOI: 10.1563/aaid-joi-D-18-00315.
  22. Tolstunov L. Surgical algorithm for alveolar bone augmentation in implant dentistry. Oral Maxillofac Surg Clin North Am 2019;31(2):155–161. DOI: 10.1016/j.coms.2019.01.001.
  23. Tolstunov L, Hamrick JFE, Broumand V, et al. Bone augmentation techniques for horizontal and vertical alveolar ridge deficiency in oral implantology. Oral Maxillofac Surg Clin North Am 2019;31(2):163–191. DOI: 10.1016/j.coms.2019.01.005.
  24. Urban IA, Montero E, Monje A, et al. Effectiveness of vertical ridge augmentation interventions: A systematic review and meta-analysis. J Clin Periodontol 2019;46(Suppl 21):319–339. DOI: 10.1111/jcpe. 13061.
  25. Cucchi A, Vignudelli E, Napolitano A, et al. Evaluation of complication rates and vertical bone gain after guided bone regeneration with non-resorbable membranes versus titanium meshes and resorbable membranes. A randomized clinical trial. Clin Implant Dent Relat Res 2017;19(5):821–832. DOI: 10.1111/cid.12520.
  26. Todisco M. Early loading of implants in vertically augmented bone with non-resorbable membranes and deproteinised anorganic bovine bone. An uncontrolled prospective cohort study. Eur J Oral Implantol 2010;3(1):47–58. PMID: 20467598.
  27. Ronda M, Rebaudi A, Torelli L, et al. Expanded vs. dense polytetrafluoroethylene membranes in vertical ridge augmentation around dental implants: A prospective randomized controlled clinical trial. Clin Oral Implants Res 2014;25(7):859–866. DOI: 10.1111/clr. 12157.
  28. Windisch P, Orban K, Salvi GE, et al. Vertical-guided bone regeneration with a titanium-reinforced d-PTFE membrane utilizing a novel split-thickness flap design: A prospective case series. Clin Oral Investig 2021;25(5):2969–2980. DOI: 10.1007/s00784-020-03617-6.
  29. Tunkel J, de Stavola L, Kloss-Brandstatter A. Alveolar ridge augmentation using the shell technique with allogeneic and autogenous bone plates in a split-mouth design-A retrospective case report from five patients. Clin Case Rep 2021;9(2):947–959. DOI: 10.1002/ccr3.3626.
  30. Proussaefs P, Lozada J. The use of intraorally harvested autogenous block grafts for vertical alveolar ridge augmentation: A human study. Int J Periodontics Restorative Dent 2005;25(4):351–363. PMID: 16089043.
  31. Sanchez-Sanchez J, Pickert FN, Sanchez-Labrador L, et al. Horizontal ridge augmentation: A comparison between Khoury and Urban technique. Biology (Basel) 2021;10(8):749. DOI: 10.3390/biology10080749.
  32. Vallecillo-Rivas M, Reyes-Botella C, Vallecillo C, et al. Comparison of implant stability between regenerated and non-regenerated bone. A prospective cohort study. J Clin Med 2021;10(15):3220. DOI: 10.3390/jcm10153220.
  33. Deli G, Petrone V, De Risi V, et al. Longitudinal implant stability measurements based on resonance frequency analysis after placement in healed or regenerated bone. J Oral Implantol 2014;40(4):438–447. DOI: 10.1563/AAID-JOI-D-12-00014.
  34. Sennerby L, Meredith N. Implant stability measurements using resonance frequency analysis: Biological and biomechanical aspects and clinical implications. Periodontol 2000 2008;47(1):51–66. DOI: 10.1111/j.1600-0757.2008.00267.x.
  35. Proussaefs P, Lozada J, Kleinman A, et al. The use of ramus autogenous block grafts for vertical alveolar ridge augmentation and implant placement: A pilot study. Int J Oral Maxillofac Implants 2002;17(2):238–248. PMID: 11958407.
  36. Urban I, Traxler H, Romero-Bustillos M, et al. Effectiveness of two different lingual flap advancing techniques for vertical bone augmentation in the posterior mandible: A comparative, split-mouth cadaver study. Int J Periodontics Restorative Dent 2018;38(1):35–40. DOI: 10.11607/prd.3227.
  37. Urban IA, Saleh MHA, Ravida A, et al. Vertical bone augmentation utilizing a titanium-reinforced PTFE mesh: A multi-variate analysis of influencing factors. Clin Oral Implants Res 2021;32(7):828–839. DOI: 10.1111/clr.13755.
  38. Jepsen S, Schwarz F, Cordaro L, et al. Regeneration of alveolar ridge defects. Consensus report of group 4 of the 15th European Workshop on Periodontology on Bone Regeneration. J Clin Periodontol 2019;46(S21):277–286. DOI: 10.1111/jcpe.13121.
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