Soft tissue expander for vertically atrophied alveolar ridges: Prospective, multicenter, randomized controlled trial.

Tytuł:: Soft tissue expander for vertically atrophied alveolar ridges: Prospective, multicenter, randomized controlled trial.
Autorzy:: Byun SH; Department of Oral and Maxillofacial Surgery, Dentistry, Sacred Heart Hospital, Hallym University Medical Center, Kyonggi-do, Korea.; Research Society of Gangnam Oral and Maxillofacial Surgeons, Seoul, Korea.
Kim SY; Department of Oral and Maxillofacial Surgery, Ewha Womans University Medical Center, Seoul, Korea.
Lee H; Research Society of Gangnam Oral and Maxillofacial Surgeons, Seoul, Korea.; Department of Oral and Maxillofacial Surgery, Section of Dentistry, Seoul Metropolitan Government-Seoul National University Boramae Medical Center, Seoul, Korea.
Lim HK; Research Society of Gangnam Oral and Maxillofacial Surgeons, Seoul, Korea.; Department of Oral and Maxillofacial Surgery, Korea University Medical Center, Guro Hospital, Seoul, Korea.
Kim JW; Department of Oral and Maxillofacial Surgery, Dentistry, Sacred Heart Hospital, Hallym University Medical Center, Kyonggi-do, Korea.; Research Society of Gangnam Oral and Maxillofacial Surgeons, Seoul, Korea.
Lee UL; Research Society of Gangnam Oral and Maxillofacial Surgeons, Seoul, Korea.; Department of Oral and Maxillofacial Surgery, Chung-Ang University Hospital, Seoul, Korea.
Lee JB; Department of Periodontoloy, Ewha Womans University Medical Center, Seoul, Korea.
Park SH; Department of Oral and Maxillofacial Surgery, Ewha Womans University Medical Center, Seoul, Korea.
Kim SJ; Department of Oral and Maxillofacial Surgery, Ewha Womans University Medical Center, Seoul, Korea.
Song JD; Bio R&D Center, Osstem implant Co., Ltd., Busan, Korea.
Jang IS; Bio R&D Center, Osstem implant Co., Ltd., Busan, Korea.
Kim MK; Bio R&D Center, Osstem implant Co., Ltd., Busan, Korea.
Kim JW; Research Society of Gangnam Oral and Maxillofacial Surgeons, Seoul, Korea.; Department of Oral and Maxillofacial Surgery, Ewha Womans University Medical Center, Seoul, Korea.
Źródło:: Clinical oral implants research [Clin Oral Implants Res] 2020 Jul; Vol. 31 (7), pp. 585-594. Date of Electronic Publication: 2020 Mar 15.
Typ publikacji:: Journal Article; Multicenter Study; Randomized Controlled Trial
Język:: English
Imprint Name(s):: Publication: 2009- : Copenhagen : John Wiley and Sons, Inc.
Original Publication: Copenhagen : Munksgaard, c1990-
MeSH Terms:: Alveolar Ridge Augmentation*
Tissue Expansion Devices*
Alveolar Process ; Bone Regeneration ; Bone Transplantation ; Dental Implantation, Endosseous ; Humans ; Prospective Studies ; Tissue Expansion
References:: Abrahamsson, P., Isaksson, S., Gordh, M., & Andersson, G. (2010). Onlay bone grafting of the mandible after periosteal expansion with an osmotic tissue expander: An experimental study in rabbits. Clinical Oral Implants Research, 21, 1404-1410. https://doi.org/10.1111/j.1600-0501.2010.01967.x.
Allen, M. R., Hock, J. M., & Burr, D. B. (2004). Periosteum: Biology, regulation, and response to osteoporosis therapies. Bone, 35, 1003-1012. https://doi.org/10.1016/j.bone.2004.07.014.
Argenta, L. C., & VanderKolk, C. A. (1987). Tissue expansion in craniofacial surgery. Clinics in Plastic Surgery, 14, 143-153.
Asa'ad, F., Bellucci, G., Ferrantino, L., Trisciuoglio, D., Taschieri, S., & Del Fabbro, M. (2018). Preaugmentation soft tissue expansion: A report of four pilot cases. Case Reports in Dentistry, 2018, 3162617. https://doi.org/10.1155/2018/3162617.
Austad, E. D., & Rose, G. L. (1982). A self-inflating tissue expander. Plastic and Reconstructive Surgery, 70, 588-594.
Burkhardt, R., & Lang, N. P. (2010). Role of flap tension in primary wound closure of mucoperiosteal flaps: A prospective cohort study. Clinical Oral Implants Research, 21, 50-54. https://doi.org/10.1111/j.1600-0501.2009.01829.x.
Chen, L. C., Lundgren, T., Hallstrom, H., & Cherel, F. (2008). Comparison of different methods of assessing alveolar ridge dimensions prior to dental implant placement. Journal of Periodontology, 79, 401-405. https://doi.org/10.1902/jop.2008.070021.
Cucchi, A., Vignudelli, E., Napolitano, A., Marchetti, C., & Corinaldesi, G. (2017). Evaluation of complication rates and vertical bone gain after guided bone regeneration with non-resorbable membranes versus titanium meshes and resorbable membranes. A randomized clinical trial. Clinical Implant Dentistry and Related Research, 19, 821-832. https://doi.org/10.1111/cid.12520.
Deeb, G. R., Wilson, G. H., Carrico, C. K., Zafar, U., Laskin, D. M., & Deeb, J. G. (2016). Is the tunnel technique more effective than open augmentation with a titanium-reinforced polytetrafluoroethylene membrane for horizontal ridge augmentation? Journal of Oral and Maxillofacial Surgery, 74, 1752-1756. https://doi.org/10.1016/j.joms.2016.04.031.
Elnayef, B., Monje, A., Gargallo-Albiol, J., Galindo-Moreno, P., Wang, H. L., & Hernandez-Alfaro, F. (2017). Vertical ridge augmentation in the atrophic mandible: A systematic review and meta-analysis. International Journal of Oral and Maxillofacial Implants, 32, 291-312. https://doi.org/10.11607/jomi.4861.
Fickl, S., Zuhr, O., Wachtel, H., Stappert, C. F., Stein, J. M., & Hurzeler, M. B. (2008). Dimensional changes of the alveolar ridge contour after different socket preservation techniques. Journal of Clinical Periodontology, 35, 906-913. https://doi.org/10.1111/j.1600-051X.2008.01305.x.
Jung, G.-U., Kim, J.-W., Pang, E.-K., & Kim, S.-J. (2016). Improvement of fibrosed scar tissue elongation using self-inflatable expander. Journal of Korean Dental Association, 54, 501.
Kaner, D., Zhao, H., Terheyden, H., & Friedmann, A. (2015). Improvement of microcirculation and wound healing in vertical ridge augmentation after pre-treatment with self-inflating soft tissue expanders - a randomized study in dogs. Clinical Oral Implants Research, 26, 720-724. https://doi.org/10.1111/clr.12377.
Kim, H. S., Kim, Y. K., & Yun, P. Y. (2016). Minimal invasive horizontal ridge augmentation using subperiosteal tunneling technique. Maxillofacial Plastic and Reconstructive Surgery, 38, 41. https://doi.org/10.1186/s40902-016-0087-8.
McLean, T. N., Smith, B. A., Morrison, E. C., Nasjleti, C. E., & Caffesse, R. G. (1995). Vascular changes following mucoperiosteal flap surgery: A fluorescein angiography study in dogs. Journal of Periodontology, 66, 205-210. https://doi.org/10.1902/jop.1995.66.3.205.
Mertens, C., Thiele, O., Engel, M., Seeberger, R., Hoffmann, J., & Freier, K. (2015). The use of self-inflating soft tissue expanders prior to bone augmentation of atrophied alveolar ridges. Clinical Implant Dentistry and Related Research, 17, 44-51. https://doi.org/10.1111/cid.12093.
Neumann, C. G. (1957). (1957) The expansion of an area of skin by progressive distention of a subcutaneous balloon; use of the method for securing skin for subtotal reconstruction of the ear. Plastic and Reconstructive Surgery (1946), 19, 124-130.
Nobuto, T., Imai, H., Suwa, F., Kono, T., Suga, H., Jyoshi, K., & Obayashi, K. (2003). Microvascular response in the periodontal ligament following mucoperiosteal flap surgery. Journal of Periodontology, 74, 521-528. https://doi.org/10.1902/jop.2003.74.4.521.
Park, S. H., Choi, S. K., Jang, J. H., Kim, J. W., Kim, J. Y., Kim, M. R., & Kim, S. J. (2013). Self-inflating oral tissue expander for ridge augmentation in the severely atrophic mandible. Journal of the Korean Association of Oral and Maxillofacial Surgeons, 39, 31-34. https://doi.org/10.5125/jkaoms.2013.39.1.31.
Retzepi, M., Tonetti, M., & Donos, N. (2007). Comparison of gingival blood flow during healing of simplified papilla preservation and modified Widman flap surgery: A clinical trial using laser Doppler flowmetry. Journal of Clinical Periodontology, 34, 903-911. https://doi.org/10.1111/j.1600-051X.2007.01119.x.
Rocchietta, I., Fontana, F., & Simion, M. (2008). Clinical outcomes of vertical bone augmentation to enable dental implant placement: A systematic review. Journal of Clinical Periodontology, 35, 203-215. https://doi.org/10.1111/j.1600-051X.2008.01271.x.
Tan, W. L., Wong, T. L., Wong, M. C., & Lang, N. P. (2012). A systematic review of post-extractional alveolar hard and soft tissue dimensional changes in humans. Clinical Oral Implants Reseadrch, 23(Suppl 5), 1-21. https://doi.org/10.1111/j.1600-0501.2011.02375.x.
Uijlenbroek, H. J., Liu, Y., He, J. F., Visscher, C., van Waas, M. A., & Wismeyer, D. (2011). Expanding soft tissue with Osmed tissue expanders in the goat maxilla. Clinical Oral Implants Research, 22, 121-128. https://doi.org/10.1111/j.1600-0501.2010.01972.x.
von See, C., Gellrich, N. C., Jachmann, U., Laschke, M. W., Bormann, K. H., & Rucker, M. (2010). Bone augmentation after soft-tissue expansion using hydrogel expanders: Effects on microcirculation and osseointegration. Clinical Oral Implants Research, 21, 842-847. https://doi.org/10.1111/j.1600-0501.2009.01847.x.
Wiese, K. G. (1993). Osmotically induced tissue expansion with hydrogels: A new dimension in tissue expansion? A preliminary report. Journal of Cranio-Maxillo-Facial Surgery, 21, 309-313.
Xuan, F., Lee, C. U., Son, J. S., Fang, Y., Jeong, S. M., & Choi, B. H. (2014). Vertical ridge augmentation using xenogenous bone blocks: A comparison between the flap and tunneling procedures. Journal of Oral and Maxillofacial Surgery, 72, 1660-1670. https://doi.org/10.1016/j.joms.2014.04.003.
Zeiter, D. J., Ries, W. L., Weir, T. L., Mishkin, D. J., & Sanders, J. J. (1998). The use of a soft tissue expander in an alveolar bone ridge augmentation for implant placement. The International Journal of Periodontics & Restorative Dentistry, 18, 403-409.
Grant Information:: HI17C2257 Republic of Korea Korea Health Industry Development Institute
Contributed Indexing:: Keywords: bone regeneration; clinical trial; dental implant; graft; tissue expansion
Entry Date(s):: Date Created: 20200304 Date Completed: 20200702 Latest Revision: 20200702
Update Code:: 20240105
DOI:: 10.1111/clr.13595
PMID:: 32125718
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Objectives: Conventional guided bone regeneration (GBR) limits the amount of bone graft due to limited soft tissue expansion. We hypothesize that the use of tissue expander will successfully augment soft tissue prior to bone graft, allowing for sufficient amount of grafting which will lead to a more stable and effective vertical bone graft. The authors aimed to evaluate effectiveness of the novel self-inflating tissue expander for vertical augmentation in terms of soft tissue expansion, clinical outcomes, and related complications.
Material and Methods: A prospective, multicenter, randomized controlled trial was performed on patients requiring vertical augmentation. For experimental group patients, the tissue expander was subperiosteally implanted and followed by a tunneling bone graft without full flap reflection. Control patients underwent conventional vertical GBR. Primary objectives were to evaluate the dimensional changes of soft tissue and radiographic vertical bone gain and retention. As a secondary outcome, clinical complications and thickness changes of expanded overlying tissue were assessed and analyzed.
Results: Twenty-three patients in each group were included. During a 4-week expansion, two of the experimental group showed over-expansion and one showed mucosal perforation associated with previous severe scars. The other patients showed uneventful expansion and mean tissue augmentation was 6.88 ± 1.64 mm vertically. Ultrasonographic measurements of overlying gingiva revealed no thinning after tissue expansion (p > .05). Significantly higher vertical bone gain was shown in the experimental group (5.12 ± 1.25 mm) compared with that in the control patients (4.22 ± 1.15 mm; p < .05). After a 6-month retention period, the mean vertical bone measurement of the controls had decreased to 1.90 mm (55.0% reduction), which was a significantly greater decrease than that in the experimental group (mean 3.55 mm, 30.7% reduction; p < .05).
Conclusion: Our results demonstrated the effectiveness of tissue expanders followed by tunneling bone graft for vertical augmentation; however, studies comparing the two techniques without tissue expanders are needed to elucidate the net effect of tissue expansion.
(© 2020 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)

Comment in: J Am Dent Assoc. 2020 Nov;151(11):e106. (PMID: 32917348)

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