Journal of Shanghai Jiao Tong University (Medical Science) ›› 2022, Vol. 42 ›› Issue (6): 768-777.doi: 10.3969/j.issn.1674-8115.2022.06.011

• Clinical research • Previous Articles    

Application of a tent-pole screw technology in reconstruction of severe alveolar bone defect: a retrospective study of 30 patients

WU Jing1(), ZHAO Zhengyi2, ZOU Duohong1(), YANG Chi1, ZHANG Zhiyuan1   

  1. 1.Department of Oral Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine; College of Stomatology, Shanghai Jiao Tong University; National Center for Stomatology; National Clinical Research Center for Oral Diseases; Shanghai Key Laboratory of Stomatology; Research Unit of Oral and Maxillofacial Regenerative Medicine, Chinese Academy of Medical Sciences, Shanghai 200011, China
    2.College of Stomatology, Anhui Medical University, Hefei, 230032, China
  • Received:2022-04-12 Accepted:2022-06-08 Online:2022-06-28 Published:2022-08-19
  • Contact: ZOU Duohong E-mail:wujingsjtu2021@163.com;zouduohongyy@163.com
  • Supported by:
    National Natural Science Foundation of China(31870969);CAMS Innovation Fund for Medical Sciences (CIFMS)(2019-I2M-5-037);Two Hundred-Talent Program of Shanghai Jiao Tong University School of Medicine(20191816)

Abstract: Objective

·To explore the effect of a tent-pole screw technology on reconstruction of severe alveolar bone defect.

Methods

·Thirty patients underwent tent-pole screw technology to reconstruct severe alveolar bone defects in the Department of Stomatology, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine from January 2018 to January 2021 were enrolled. By analyzing and reconstructing the image data of cone-beam computed tomography (CBCT) before and 8 months after operation, the effects of repairing and reconstructing the horizontal, vertical and mixed alveolar bone defects were counted. The alveolar bone volumetric parameters were evaluated by micro-computed tomography (Micro-CT), and trabecular bone number (Tb. N), trabecular bone thickness (Tb. Th), bone volume/total volume (BV/TV) and bone mineral density (BMD) were calculated to assess the maturity of regenerated bone. The regeneration of alveolar bone and remanent scaffold were calculated by analyzing histological sections.

Results

·Eight months after using the tent-pole screw, the vertical bone gain value was 4.81 (1.58, 7.66) mm, and the horizontal post-operative width was 3.96 (2.38, 5.67) mm. Additionally, the bone volume gain was 2 157.22 (776.59, 2 831.63) mm3. Micro-CT analysis of bone core, which was collected 8 months after the surgery, and Tb. N was (3.09±0.68)/mm, Tb. Th was (0.08±0.01) μm, BV/TV was (25.24±5.60)% and BMD was (0.24±0.05) g/cm3. Histological sections showed that the percentages of regenerated bone and remanent scaffold were (16.30±3.57)% and 34% (31.75%, 38.25%), respectively. These data suggested good new bone formation in targeted area. There were no complications or adverse events during surgery or post-operative healing.

Conclusions

·Based on “stability-oriented” alveolar ridge augmentation, using tent-pole screw, membrane pins and packaging structure in a standard operation procedure can achieve beneficial results for bone augmentation, while complications seldom occurre. The tent-pole screw may offer predictable and exceptional outcomes for implantation site preparation, especially for large alveolar defects, which will provide advantages to subsequent implantation and restoration.

Key words: stability-oriented, alveolar bone, bone augmentation, guided bone regeneration, tenting technique, tent screw, package structure, bone defect

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