Evaluation of wound dehiscence after vertical bone graft by using quantitative light-induced fluorescence

Wound dehiscence is a common complication following vertical bone augmentation of implant dentistry. If the implanted titanium mesh becomes exposed, the exposed titanium mesh should be removed with the contaminated grafts before a clinical graft infection develops. However, no generally accepted evaluation methods have been suggested to determine the removal timing or the extent of contaminated bone grafts to be removed. Quantitative light-induced fluorescence (QLF) technology has been used for various oral bacterial condition such as dental caries, plaque, peri-implantitis, and osteomyelitis. This paper reports two patients with wound dehiscence within the third week after vertical bone augmentation with autogenous particulate bone on the posterior maxilla. With conservative treatment, a QLF technology was applied to determine whether to remove the mesh. The exposed mesh of the first patient was removed when red-fluorescence was observed the red fluorescence by QLF. However, the other case did not show red fluorescence during the fifth week after dehiscence, and secondary healing was achieved without complications. The remaining bone grafts were well integrated into the sound cortico-cancellous complex sufficient to support the dental implant. Based on these clinical, radiological, and histological results, we discussed the rationale of QLF application on wound dehiscence after the bone graft in implant dentistry.