Piezosurgical Buccal Plate Repositioning Technique: A Modified Surgical Approach for the Horizontal Augmentation of Atrophied Mandibles.

PURPOSE: To demonstrate a modified surgical approach for horizontal ridge augmentation that allows for safe manipulation and predictable management of the buccal plate and avoids creation of a secondary surgical site.

MATERIALS AND

METHODS

This pilot randomized controlled clinical trial included 24 patients who required horizontal alveolar ridge augmentation. Patients were assigned to one of the three groups: Group A was treated with the buccal plate repositioning (BPR) technique and grafted with silica calcium phosphate nanocomposite (SCPC) graft, group B was similarly managed and grafted using demineralized freeze-dried bone allograft (DFDBA), and group C was augmented using mandibular ramus autogenous bone block graft (ABBG). The primary outcome was the coronal crest width, which was measured at 6 months using CBCT.

RESULTS

The BPR technique resulted in horizontal augmentation with a mean of 4.30 ± 0.94 mm for group A, showing no significant difference from either group B (4.98 ± 1.13 mm) or group C (3.68 ± 0.27 mm). All augmented ridges allowed for successful implant placement with good primary stability.

CONCLUSIONS

The BPR technique resulted in horizontal bone gain in extremely narrow alveolar ridges. It allowed for implant placement in a vascular cancellous bed protected by intact cortical plate. Different types of bone grafts, whether alloplast or allograft, resulted in successful augmentation comparable to that gained from autogenous block grafting.