Appositional bone graft tunneled: Technical note

Azevedo, Roberto Almeida de; Matos, Felipe Seoane; Figueiredo, Leonardo Morais Godoy

doi:10.1016/j.ijscr.2017.02.011

Cited by 3 publications

(1 citation statement)

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“…The initial electronic search identified 274 records in PubMed. However, after screening for title and abstract, only two manuscripts focused on minimally invasive approaches in vertical ridge augmentation 53–55 . Therefore, we decided to remove the term “minimal invasiveness” from the search strategy and update it from January 2018 to July 2021.…”

Section: Electronic Searchmentioning

confidence: 99%

Minimal invasiveness in vertical ridge augmentation

Urban

Montero

Sanz‐Sánchez

et al. 2023

Periodontology 2000

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Vertical ridge augmentation is one of the most challenging procedures in implant dentistry because of the advanced skills required by the operator and the fact that bone augmentation is aimed outside the bony contour, in an environment of reduced blood supply. What is more, the flap management required to ensure soft tissue closure frequently leads to associated comorbidities in terms of swelling and hematomas. For these reasons, and even if autologous onlay block grafts are still the gold standard, new techniques and biomaterials have favored the development of potentially less invasive approaches. The present work evaluates the most recent strategies in vertical ridge augmentation to reduce invasiveness and complications, including diagnostic/treatment planning considerations, surgical techniques, digital tools (eg, customized titanium meshes/membranes or bone blocks), and future trends in the field of tissue engineering and cell therapy.

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Section: Electronic Searchmentioning

confidence: 99%

Minimal invasiveness in vertical ridge augmentation

Urban

Montero

Sanz‐Sánchez

et al. 2023

Periodontology 2000

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Natural Implant Restoration in Stable Alveolar Bone (NIRISAB)—Concepts in Clinical Practice: Long-Term Follow-up on Three Cases of Ridge Reconstruction Using the Tunnel Approach With Remote Incision

Liang

2022

Journal of Oral Implantology

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Post surgical incision line failures is a common occurrence for various reasons. The damaged tissue from the incision is required to re-attach but the biological process of wound healing dictates in period of vulnerability to the site. The tissue integrity is compromised because of surgical trauma. It may he further compromised if there is opposing tension within the flap. Bacterial ingress and/or physical trauma at the incision region is always a threat. The latter ranges from food impaction, muscle pull, pressure from adjacent structures such as the tongue and even normal function such as deglutition or speech may interfere with the timely healing of the incision site. The act of suturing and the frequency of punctures to the tissue as part of the suture placement also compromises the blood supply and tissue integrity at the incision line. The act of releasing the periosteum compromises the blood supply of the overlying soft tissue and further increases the risk of incision line failure. Finally, the suturing soft tissue flaps over non-vital graft material devoid of blood supply is never ideal for soft tissue healing. Therefore, surgical success may be greatly enhanced if incisions are avoided over any graft material. Remote incision and tunnel approach to bone grafting are two fundamentally game changing principles that bares examination. The concepts are part of a larger philosophy of Natural Implant Restoration In Stable Alveolar Bone. ( NIRISAB ) that was developed since the 1970’s and first presented by Hilt Tatum. This article presents three clinical cases with ten year plus followup results of three bone grafting modalities: 1. Tunnel particulate graft, 2. Tunnel alloblock graft, 3. Tatum Vascularized Osteotomy. All three modalities utilized the philosophy of NIRISAB. Of particular emphasis in this article, is the surgical approach of tunnelling and lack of a crestal incision and a remotely placed access incision.

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