[Use of autologous free parietal periosteum in the treatment of patients with anhidrotic (hypohidrotic) ectodermal dysplasia].

OBJECTIVE

To evaluate the effectiveness of autologous free parietal periosteum combined with cranial vault bone autografts for alveolar ridge reconstruction in patients with ectodermal dysplasia.

MATERIALS AND

METHODS

Prospective single-center study; 17 patients aged 17-40 years. Two groups were formed by membrane type: autologous free periosteum (n=6) and collagen membrane (n=11). Bone augmentation was performed with fixation of parietal bone autografts; the spaces between blocks were filled with a mixture of autogenous bone chips and xenograft (70:30). Changes in bone volume were calculated relative to the total volume of the maxilla and mandible using manual slice-by-slice segmentation of MSCT scans with MPR correction (Amira 5.4.5) preoperatively, at 2-3 days, and at 6 months. Graft resorption was assessed at 6 months. Dental implant stability was measured immediately after placement and at 6 months. Statistical processing was performed in IBM SPSS.

RESULTS

Both groups demonstrated an increase in bone volume that persisted at 6 months; no between-group differences in volume were found. Graft resorption was lower with autologous free periosteum than with a collagen membrane: maxilla 18.48±1.27% vs 23.56±4.83% (p=0.025); mandible 26.22±1.74% vs 38.68±4.68% (p<0.001). Six-month implant stability was higher in the periosteum group (ISQ 86.83±2.04 vs 82.45±1.69; p<0.001). No complications of bone grafting or dental implantation were recorded.

CONCLUSION

Using autologous free parietal periosteum as a barrier membrane in cranial vault autograft reconstruction provides better graft volume preservation, lower resorption, and higher dental implant stability compared with a collagen membrane.