Horizontal vascular-stalked split osteotomy (HVSO): a bone augmentation technique for the atrophic jaw- a retrospective cohort study in 29 patients.

BACKGROUND

Implant therapy in the advanced atrophic jaw remains challenging in oral and maxillofacial surgery. Hence, a plethora of different augmentation procedures to increase bone volume in the maxilla and mandible have been published. Horizontal vascular-stalked split osteotomy (HVSO) represents a safe and effective approach for the three-dimensional jaw augmentation since it combines maximum vascularization through lingual or palatinal periosteal stalking with reduced grafting morbidity.

OBJECTIVE

To analyze the efficacy of HVSO for implantation therapy in atrophic jaws by assessing vertical bone gain and implant survival rates.

MATERIALS AND

METHODS

A total of n = 29 patients (14 females, 15 males) with a mean age of 55.4 ± 10.0 years and reduced volume of the alveolar ridge were retrospectively analyzed after treatment with 34 HVSOs in the maxilla and mandible. After controlled clinical follow-up of six months after augmentation, enossal implantation of 79 implants (maxilla 45, mandible 34) was performed. A standardized two-dimensional radiological assessment with panoramic tomography (OPTG) of the augmented bone height and clinical evaluation of the implants was performed over a mean follow-up period of 2.3 years.

RESULTS

HVSO resulted in a significant increase in vertical bone height by 4.4 mm ± 2.0 mm (mean vertical gain: +59.4%) with + 101% in the maxilla and + 27.5% in the mandible directly after the procedure (T1), with both p < 0.001. After a mean observation period of 2.3 years bone height remained stable with a total gain of 41.4% (maxilla: 72.6%, mandible: 18.6%), with p < 0.001 and p = 0.001, respectively. Overall implant survival rate was 91% (maxilla: 89%; mandible: 94%).

CONCLUSION

HVSO reliably supports significantly enhanced vertical bone height with long-term stable results, thereby facilitating successful implantation in atrophic jaws with high implant survival rates observed over an extended follow-up period.

CLINICAL TRIAL NUMBER: Not applicable as the study was no clinical trial.