Nunes Marcelo Pereira, de Macedo Luís Guilherme Scavone, Santamaria Mauro Pedrine, Ribeiro João Carlos, Moy Peter Karyen, Pelegrine André Antonio
Proimperio Institute, São Paulo, Brazil.
Division of Implant Dentistry, São Leopoldo Mandic Dental School, Campinas, Brazil.
Case Rep Dent. 2023 Nov 9;2023:4180372. doi: 10.1155/2023/4180372. eCollection 2023.
Appositional bone augmentation is considered a challenging surgical problem to correct for the deficient alveolar ridge. To overcome this challenge, a novel concept was recently published called "Barbell Technique." This technique has been used more commonly for horizontal bone augmentation. To our knowledge, this is the first report on using the Barbell Technique for vertical bone augmentation. . This report describes and demonstrates the clinical feasibility of the use of this concept in the reconstruction of a tridimensional alveolar ridge defect in the anterior maxilla. Due to the severity of the defect, both hard and soft tissue deficiencies required augmentation. The first surgery involved a soft tissue grafting procedure while in the second surgical procedure, hard tissue augment was performed using the Barbell device to provide both vertical and horizontal support for the hard tissue graft. The donor material consisted of equal volume of xenograft and autogenous bone used to fill the defect and covered with a collagen barrier membrane. After a healing period of 9 months, the site was reopened. Bone formation clinically verified the correction of alveolar bone contour and volume permitted placement of two titanium implants after the removal of Barbell device.
This case report demonstrates successful vertical and horizontal bone augmentation of a critical size defect in the anterior maxilla, correcting both hard and soft tissue contours, and providing the tissues needed to support dental implants in the anterior maxilla.
附着性骨增量被认为是矫正牙槽嵴缺损的一项具有挑战性的外科难题。为克服这一挑战，最近发表了一种名为“杠铃技术”的新概念。该技术已更常用于水平骨增量。据我们所知，这是关于使用杠铃技术进行垂直骨增量的首篇报道。本报告描述并展示了在重建上颌前部三维牙槽嵴缺损中使用这一概念的临床可行性。由于缺损严重，硬组织和软组织均需增量。首次手术为软组织移植手术，而在第二次手术中，使用杠铃装置进行硬组织增量，为硬组织移植提供垂直和水平支撑。供体材料由等量的异种移植物和自体骨组成，用于填充缺损，并覆盖胶原屏障膜。经过9个月的愈合期后，该部位重新切开。骨形成在临床上证实了牙槽骨轮廓和体积的矫正，在移除杠铃装置后允许植入两颗钛种植体。
本病例报告展示了对上颌前部临界尺寸缺损成功进行垂直和水平骨增量，矫正了硬组织和软组织轮廓，并提供了在上颌前部支持牙种植体所需的组织。
