Objectives: This study was conducted to assess the ability of self-inflating tissue expander to produce proper amount and quality of mucosa prior to bone grafting and implants insertion and degree of bone graft survival in severely atrophied alveolar ridges.
Material and Methods: All patients included in this study were referred to the Department of Oral and Maxillofacial Surgery, Faculty of Oral & dental Medicine, Cairo University for rehabilitation with dental implants. Inclusion criteria comprised: Missing mandibular premolar or molar area with a buccal osseous and soft tissue defect. The adjacent teeth had to be uncompromised with healthy gingival conditions. The exclusion criteria were patients who did not need bone grafting before implant placement. There were 10 patients (6 men and 4 women), with a mean age of 32 years (range, 18-60 years), who fulfilled the inclusion criteria and were consecutively included in the study. All patients were healthy and had no systemic contraindications to implant placement. They received standard treatment planning and diagnosis and gave signed informed consent. All 10 patients had an osmotic soft tissue expander implanted in the area with osseous and soft tissue defect, prior to bone grafting using bovine bone graft. Linear and volumetric measurements of the bone grafts were recorded immediately following bone graft and 6 months post grafting using cone beam CT scans.
Results: 10 sites in 10 patients were treated with soft tissue expansion using self inflating hydrogels. Complications of soft tissue expansion were only perforation (two sites), and no infection was noted. Primary wound closure was easily attained during bone augmentation procedure with no incidence of graft exposure, infection, or loss. It also allowed for good vertical bone height gain for implant placement. Volumetric measurements showed that an average mean of 1.36 cm3 mandibular ridge augmentation was established immediately Post bone grafting and 1.19 cm3 6 months after bone grafting. These measurements concluded that only 15.7% bone resorption occurred 6 months after bone grafting indicating good survival of the xenogenic bone graft.
Conclusion: The use of Osmed self-inflating tissue expander prior to bone augmentation and implants insertion allowed sufficient amount of mucosa that can cover the grafts and implants without tension or compromise to the periosteum and ensued minimal bone graft resorption in severely atrophied alveolar ridges.