Results of Vertical Bone Augmentation with Autogenous Bone Block Grafts and the Tunnel Technique: A Clinical Prospective Study of 10 Consecutively Treated Patients

Abstract

The aim of this study was to report the outcome of the management of alveolar crest vertical defects using the tunnel technique approach associated with autogenous bone blocks prior to implant placement in 10 partially dentate consecutively treated patients. Four clinical linear measurements were taken: maximal extension of the vertical defect (VD) at the time of the augmentation procedure (time 0), vertical bone graft (VBG) recorded at time 0, bone resorption at implant placement (time 1), and bone resorption during implant healing at the time of abutment connection (time 2). All patients healed uneventfully, and no complications were recorded. Both mean VD and VBG at time 0 were 6.50 ± 1.43 mm. Mean bone resorption at time 1 was 0.30 ± 0.48 mm and mean bone resorption at time 2 was 0.25 ± 0.26 mm, yielding an overall vertical bone remodeling of 0.55 ± 0.49 mm (8.4%) after 8 months. This study supports the capability of a minimally invasive approach to regenerate bone in vertical defects prior to implant placement.

Results of Computer-Guided Bone Block Harvesting from the Mandible: A Case Series

“…Following Khoury and Khoury's bone block management approach, 9,23,24 the bone block was bisected into two thinner cortical lamina and then grafted in combination with autogenous particles bone scraped from the same lamina (Fig 8). When needed, a sinus lift procedure was done in conjunction with the autogenous bone grafting procedure.…”

Evaluation of Ramus Autogenous Block Graft for Vertical Augmentation of Mandibular Posterior Alveolar Ridge

“…Rates of up to 40% for graft exposure and resorption in the mid or long term are the main drawbacks of using onlay bone grafts to treat posterior vertical mandibular defects (17)(18)(19).…”

Reconstruction of mandibular vertical defects for dental implants with autogenous bone block grafts using a tunnel approach: clinical study of 50 cases

“…10 Rates of up to 40% for graft exposure and resorption in the mid or long term are the main drawbacks of using onlay bone grafts to treat posterior vertical mandibular defects. 15 Khoury and other authors 11,15,16 have described the combination of a tunnel approach with 3D reconstruction using a bone block graft sectioned into two thinner layers (width of 1-2 mm) as a simple and effective treatment that offers very good short-term outcomes and stability over time. Cordaro et al 17 reported a 41.5% loss in bone height in the first 6 months when the chin or mandibular ramus was used as the donor site.…”

“…Also, the low incidence of graft exposure in this study is in agreement with previous reports on the use of the tunnel technique for bone augmentation. 16,21,22 The two vertical vestibular incisions offer an appropriate minimally invasive access to the defect for placing and correctly fixating the cortical laminae with microscrews. Sub-periosteal tunnelling in the posterior mandible often requires dissection of mental nerve branches, especially for extensive defects that involve the premolar area.…”

“…Recent studies have reported a mean vertical gain of 6.5 AE 1.4 mm in 10 cases of vertical augmentation (three in the mandible and seven in the maxilla) using a similar bone reconstruction technique with tunneling. 16 At 8 months (time of implant abutment connection), the mean remodelling was Reconstruction by block graft and tunnel approach 5 (1) the tunnel approach, which improves the blood supply for bone regeneration by maintaining the whole periosteum over the graft, and (2) the bone block management, in which two thin cortical bone layers (1-2 mm wide) create a space filled with particulate bone, facilitating and accelerating vascular penetration. Utilizing the technique described in the present article, it proved easy to fill the vertical gap with particulate bone, always before the final coverage with the buccal thin cortical graft.…”