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This study compares the accuracy of osteotomies positions using patient specific guides for onlay bone shells harvested from the chin then the graft positioning for 3D upper anterior ridge augmentation using patient-specific tooth-supported guide versus free hand technique
In this study the tooth-supported stereolithographic guiding template is proposed to allow accurate onlay grafting of labial and palatal mono-cortical shells simultaneously after harvesting using computer-designed patient-specific surgical osteotomy guide. This customized osteotomy guide should provide accurate harvesting of autogenous bone blocks from chin area which also provides suitable contour with the anterior ridge area. This computer assisted surgery is supposed to help in decreasing the operation time, thus decreasing the devascularization time to the bone graft. Thus, it helps for increased accuracy to increase three-dimensional bone gain and decrease morbidity of donor site while gaining the maximum available bone volume. Tooth-supported graft placement guide provides reproducible and convenient design without the need of high surgical skills as well.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Tooth-supported Patient-specific Surgical Guide | Experimental | In this study computer-designed patient-specific surgical osteotomy guide provides accurate harvesting of autogenous bone blocks from chin area.Then, graft placement will be done using patient-specific tooth-supported guide in upper anterior deficient ridge and fixation using 2 micro screws labially and one through and through for the palatal shell. |
|
| Free hand technique | Active Comparator | The cortical bone harvested from chin area without surgical guide, then the non-guided mono-cortical bone block grafting will be fixed on the ridge labially using 2 micro screws and one through and through for the palatal shell. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| 3D ridge augmentation using tooth-supported patient-specific guide | Procedure | In this study computer-designed patient-specific surgical osteotomy guide should provide accurate harvesting of autogenous bone blocks from chin area.Then, graft placement will be done using patient-specific tooth-supported guide in upper anterior deficient ridge and fixation using 2 micro screws labially and one through and through for the palatal shell. |
| Measure | Description | Time Frame |
|---|---|---|
| Alveolar ridge width bone gain | measures will be obtained from CT scan in millimetres | 4 months |
| Measure | Description | Time Frame |
|---|---|---|
| Alveolar ridge vertical bone gain | measures will be obtained from CT scan in millimetres | 4 months |
| Measure | Description | Time Frame |
|---|---|---|
| Accuracy of the Computer-assisted guide in the study group | measures will be obtained from CT scan in millimetres | immediate post-operative |
Inclusion Criteria:
• Anterior maxilla with horizontal deficient alveolar ridge that is from 2 to 4 mm measured from the crest of the alveolar ridge buccolingually, combined with vertical deficiency.
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Wesam Sami, Bachelor | Cairo University | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Faculty of Dentistry | Cairo | 12311 | Egypt |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 35218647 | Background | Aloy-Prosper A, Carramolino-Cuellar E, Penarrocha-Oltra D, Soto-Penaloza D, Penarrocha-Diago M. Intraoral onlay block bone grafts versus cortical tenting technique on alveolar ridge augmentations: a systematic review. Med Oral Patol Oral Cir Bucal. 2022 Mar 1;27(2):e181-e190. doi: 10.4317/medoral.25169. | |
| 32045687 | Background |
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| ID | Term |
|---|---|
| D016301 | Alveolar Bone Loss |
| ID | Term |
|---|---|
| D001862 | Bone Resorption |
| D001847 | Bone Diseases |
| D009140 | Musculoskeletal Diseases |
| D055093 | Periodontal Atrophy |
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| Cansiz E, Haq J, Manisali M, Cakarer S, Gultekin BA. Long-term evaluation of three-dimensional volumetric changes of augmented severely atrophic maxilla by anterior iliac crest bone grafting. J Stomatol Oral Maxillofac Surg. 2020 Dec;121(6):665-671. doi: 10.1016/j.jormas.2019.11.004. Epub 2020 Feb 8. |
| 19885450 | Background | Chen ST, Beagle J, Jensen SS, Chiapasco M, Darby I. Consensus statements and recommended clinical procedures regarding surgical techniques. Int J Oral Maxillofac Implants. 2009;24 Suppl:272-8. No abstract available. |
| 27977816 | Background | De Stavola L, Fincato A, Bressan E, Gobbato L. Results of Computer-Guided Bone Block Harvesting from the Mandible: A Case Series. Int J Periodontics Restorative Dent. 2017 Jan/Feb;37(1):e111-e119. doi: 10.11607/prd.2721. |
| 34682757 | Background | Naishlos S, Zenziper E, Zelikman H, Nissan J, Mizrahi S, Chaushu G, Matalon S, Chaushu L. Esthetic Assessment Succeeding Anterior Atrophic Maxilla Augmentation with Cancellous Bone-Block Allograft and Late Restoration Loading. J Clin Med. 2021 Oct 9;10(20):4635. doi: 10.3390/jcm10204635. |
| D010510 |
| Periodontal Diseases |
| D009059 | Mouth Diseases |
| D009057 | Stomatognathic Diseases |