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Periosteum as a covering vascular flap in posterior mandibular augmentation: A retrospective cohort study
Arash Khojasteh1, Hannaneh Safiaghdam2, Hanieh Nokhbatolfoghahaei2
1Dental Research Center, Research Institute of Dental Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran; Department of Cranio-Maxillofacial Surgery/University Hospital, Faculty of Medicine & Health Sciences, University of Antwerp, Antwerp, Belgium.
Objective:
To analyze the impact of creating periosteal vascular flaps on the amount of bone augmentation following inlay bone grafting (IBG) and cortical autogenous tenting (CAT).
Materials And Methods:
This was a retrospective cohort study enrolling a sample cohort of patients presented to a private clinic in 2015 and 2019 for posterior mandibular ridge augmentation before dental implant placement. The predictor variables were surgical methods: CAT vs. CAT in conjunction with periosteal flap (CATP) vs. IBG vs. IBG in conjunction with periosteal flap (IBGP). The primary outcome variables were supra bundle bone (SBB) superior to the inferior alveolar canal (ΔH) and crestal width difference (ΔW) at a 4-month follow-up. Appropriate statistics were computed at 0.05 significance level.
Results:
A total of 29 cases (10 males and 19 females) with a mean age of 57.96±7.14 years were included. A total of 33 sites were augmented through CATP, 16 sites through IBGP, 33 sites through CAT, and 11 sites through IBG techniques. All patients healed uneventfully without permanent neurosensory changes, and adequate horizontal (ΔW:3.33±0.71 mm) and vertical (ΔH:5.10±2.04 mm) bone dimensions were restored that allowed implant placement. Using periosteal vascular flaps significantly increased bone augmentation in both vertical and horizontal dimensions (P < 0.01).
Conclusion:
Periosteal vascular flaps can increase the efficacy of mandibular augmentation techniques and decrease post-surgical complications.