Six-month stability following extensive alveolar bone augmentation by sausage technique

Resorption of alveolar bone is a common sequela of tooth loss and presents a clinical problem, especially in the esthetic zone. When ridge resorption occurs, adequate bone augmentation is essential to obtain satisfactory esthetic results. The purpose of this study was to determine the increase and retention rate of bone height or width in patients who received extensive bone augmentation and to analyze factors affecting its prognosis and stability.

This study was performed on patients who received extensive bone augmentation by sausage technique at the Department of Oral and Maxillofacial Surgery at Ewha Womans University Mok-dong Hospital from January 1, 2018, to February 28, 2022. CBCT images were taken before and 6 months after surgery to compare the amount of increase in bone height or width at the graft site. They were measured using reliable points such as adjacent implants or cephalometric landmarks, inferior alveolar nerve canals as reference points.

A total of 8 patients underwent extensive bone grafting during the given period (mean age was 53.75 years, 2 males and 6 females). Four patients received horizontal augmentation, and 4 received vertical augmentation. When divided by surgical site, 4 patients are in maxilla and 4 in mandible. The average amount of increase in bone width or bone height was 5.38 mm, and the retention rate was about 79.9% after 6 months. The retention rate of horizontal augmentation was 88.8%, which was higher than that of vertical augmentation, which was 74.5%. The maxillary area accounted for 92.2%, and the amount of bone resorption was lower than that of the mandibular area, which was 72.6%. The average stitch out period was about 2.4 weeks, and postoperative dehiscence was observed about 37.5% of the total, more frequently in the mandible (50.0%) than in the maxilla (25.0%).

In conclusion, extensive bone augmentation achieved significant horizontal or vertical bone height or width increase, and the retention rate after 6 months was also high. In addition, surgery in the maxillary region showed a more successful bone augmentation than in the mandible, with a higher maintenance rate and fewer cases of dehiscence.