Evaluation of the screw tentpole technique for the repair of anterior maxilla width defects: a prospective, randomized, split-mouth study

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Abstract. The aim of this prospective study was to compare horizontal bone augmentation in the anterior maxilla associated with two types of tenting screw used in the screw tent-pole technique. Ten patients with a premaxilla width deficiency underwent grafting with protein-free xenograft bone. A split-mouth design was used, with sides allocated randomly to receive standard and wide-head tenting
screws. Implants were installed after 9 months. Patients underwent clinical, cone beam computed tomography (CBCT), and histomorphometric evaluations. The buccal aspect of the ridge was classified as flat or concave in shape. Clinical measurements showed width augmentation of 1.05 mm, 2.45 mm, and 2.70 mm for standard screws and 1.50 mm, 3.10 mm, and 3.45 mm for wide-head screws, at the ridge, 5 mm, and 10 mm, respectively. CBCT showed width augmentation of 0.74 mm, 3.88 mm, and 4.72 mm for standard screws and 0.91 mm, 4.05 mm, and 4.37 mm for wide-head screws, at the crest, 5 mm, and 10 mm, respectively.

Histomorphometric analysis showed 30.99% ± 26.43% vital bone tissue, 11.32% ± 9.68% graft residue, and 57.66% ± 21.85% connective tissue for standard screws and 32.64% ± 20.28%, 9.73% ± 5.82%, and 57.61% ± 20.15%, respectively, for wide-head screws. Flat alveolar ridges showed the lowest percentage of vital bone.

New bone formation seems to be optimized on concave ridges. There was no statistically significant difference in bone gain results between standard and widehead tenting screws.”