A Pilot Study Showing Application of Palatal Bone Harvesting Under Dynamic Navigation Guidance in Oral Implantology

Summary

The protocol introduces a novel surgical method for palatal ring bone block harvesting using dynamic navigation guidance, addressing the challenge of insufficient bone volume in typical intraoral grafting areas and offering a viable solution for effective bone augmentation in implant dentistry.

Abstract

In cases of insufficient bone volume in the implant area, bone augmentation surgery is often required to ensure an adequate amount of bone around the implant. In autologous bone grafting procedures, some patients face insufficient bone volume at conventional intraoral bone harvesting sites. Due to the high difficulty associated with completing palatal osteotomies freehand, fewer palatal lateral osteotomies have been reported, and palatal bone blocks are not routinely used in bone augmentation procedures. With the development of digitally guided implant technology, palatal bone harvesting has become feasible. In this paper, we will present a method of obtaining a circumferential bone block of the palate for implant surgical application through dynamic navigation guidance. A total of three patients had undergone this procedure to obtain circumferential palatal bone blocks and completed bone augmentation surgery. The bone augmentation results in the implanted area have been favorable, and there has been some bone recovery at the harvesting site. This is a safe and effective way to obtain intraoral bone blocks.

Introduction

In recent years, with the advancement of implant technology, more and more patients with tooth loss are choosing dental implants for restorative treatment^1,2. One of the keys to implant success is adequate bone volume in the alveolar ridge. Patients often experience varying degrees of alveolar bone resorption after tooth extraction. According to previous studies, the alveolar ridge width decreases by 5-7 mm, and the alveolar ridge height decreases by 2-4.5 mm within 12 months after tooth extraction³. Therefore, bone augmentation is a very important part of oral imp....

Protocol

The study was approved by the Ethics Committee of West China Stomatological Hospital of Sichuan University (No. WCHSIRB-D-2021-209-R1), and all participants volunteered to participate in this clinical trial and signed an informed consent form. All patients were admitted to the Department of Implantology at West China Stomatological Hospital, Sichuan University, China, presenting with dental defects characterized by horizontal or vertical bone defects and expressing a desire for implants.

Discussion

Block bone grafting is commonly used clinically to enhance bone volume in areas with bone defects. Grafted bone blocks can be categorized into three types based on their source: allogeneic, xenogeneic, and autogenous bone blocks. Allogeneic bone blocks are easier to obtain and relatively inexpensive, but their effectiveness in vertical bone augmentation is limited¹². Allogeneic bone can yield better osteogenic results but is more costly and carries risks such as rejection reactions and ethical con.......

Materials

Name	Company	Catalog Number	Comments
3D Bone Graft Set	Zepf	47.500.31
3-matic software	Materialise	13
3Shape software	3Shape	1.7.27.6
Bio-Gide	Geistlich
Bio-Oss	Geistlich
Carestream 360 oral scanner	OneX	FN-11
CBCT scanner Morita 3D Accuitom	Morita	1620
Dcarer dynamic navigation	Dcarer
Dental implant dynamic navigation sys-tem software	Dcarer	3.0.7.2432
Dental tines	Zepf	17.008.01
Drufomat scan	DREVE	DV3300
GraphPad Prism 9	GraphPad	9
Mimics software	Materialise	21
PROLENE Monofilament polypropylene suture 5-0	Johnson & Johnson	W8310
Straumann Dental Implant System	Straumann	021.3312
Straumann Surgical Toolbox	Straumann	040.165
Temporary crown and bridge material automix system	Coltene	170152-202
Thermo-forming foils and plates	DREVE	20172636510