Island Osteoperiosteal Flap for Alveolar Bone Reconstruction

The bone growing concept: A call for a paradigm shift in bone reconstruction

Alveolar bone reconstruction has significantly evolved over the years. The transition from bone transfer techniques to bone regeneration methods aimed to reduce morbidity, increase the available reservoir of bone, and enhance volumetric outcomes. However, current bone regeneration techniques are prolonged and yield suboptimal biological results. This is primarily because the process relies heavily on bone substitutes that lack osteoinductive or osteogenic properties, with the supply of cells and growth factors entirely dependent on endogenous sources. This article calls for a new paradigm shift, proposing a biological approach for more controlled bone growth by the incorporation of exogenous cells and growth factors into a bone-growing process, thereby enhancing biological outcomes over time. Additionally, it presents a biomorphometric clinical algorithm to tailor treatment protocols for various types of bone loss.

Lateral osteoperiosteal flap versus lateral pedicle flap in the treatment of class III gingival recession: A single-center, open-label trial

AIMS

The aim of this study was to compare outcomes of lateral osteoperiosteal flap (OPF) and lateral pedicle flap (LPF) in the treatment of Miller's Class III gingival recession.

MATERIALS AND METHODS

Twenty-two anterior maxillary and mandibular sites from 16 participants requiring mucogingival surgery for Miller's Class III gingival recession were included in the study. Eleven sites each were assigned to two groups. OPF: sites treated with lateral OPF and LPF: sites treated with LPF. Recession depth (RD) and bone level (BL) were the primary outcome variables, and probing pocket depth, clinical attachment level (CAL), and keratinized tissue width (KTW) were the secondary variables. All the variables were recorded at baseline (on the day of surgery), 3 months, and 6 months postsurgery.

RESULTS

OPF and LPF resulted in similar reduction in RD at the end of the study period (P ≤ 0.001). There was no statistically significant difference in RD between OPF and LPF at 6 months (P = 0.862). OPF-treated sites showed greater gain in BL at 3 months (P = 0.0004) and 6 months (P = 0.0002). No significant differences were seen between OPF and LPF in measures of PD, CAL, and KTW.

CONCLUSION

Data from this 6-month trial seem to suggest that OPF can be used as an alternative procedure for treating Miller's class III recessions with adjacent edentulous sites or wide interproximal spaces. Long-term effects of OPF on the stability of root coverage outcomes are an exciting direction for future research.

Bone Augmentation Techniques for Horizontal and Vertical Alveolar Ridge Deficiency in Oral Implantology

Bone deficiency is the major obstacle in implant dentistry. Guided bone regeneration (GBR) with particulate bone and barrier membranes has been the primary surgical technique used to regenerate alveolar bone for dental implant therapy. This procedure has been used in implant dentistry for more than 30 years and continues to be developed and refined for more predictable surgical outcomes. This article reviews GBR and alternative ride expansion procedures and reviews the use of various particulate graft materials. Alveolar distraction osteogenesis, used as an augmentation technique, is also presented.

Bone grafting the mandible

Many bone grafting techniques have been used to reconstruct the partially dentate and edentulous mandible. This article discusses the various bone grafting techniques to reconstruct mandibular defects. Also included are issues such as whether autogenous bone is necessary for reconstruction of the mandibular ridge and the importance of membranes.

Orthognathic and osteoperiosteal flap augmentation strategies for maxillary dental implant reconstruction

In this article, five variations in orthognathic surgery procedures used to gain bone mass for implants are discussed: Le Fort I downgrafting, Le Fort I distraction, sub-Le Fort I interpositional sandwich grafting, segmental sandwich grafting, and the island osteoperiosteal flap approach.

Bone grafting the mandible

Many bone grafting techniques have been used to reconstruct the partially dentate and edentulous mandible. This article discusses the various bone grafting techniques to reconstruct mandibular defects. Also included are issues such as whether autogenous bone is necessary for reconstruction of the mandibular ridge and the importance of membranes.