Aumento óseo horizontal utilizando técnica "Tent Pole" en mandíbula posterior / Horizontal augmentation using "Tent Pole" technique in posterior mandible

Los aumentos óseos previo a la instalación de implantes son cada vez mas utilizados y el diseño de nuevas estrategias para disminuir la morbilidad deben ser considerados. El objetivo de esta investigación fue definir el aumento óseo generado con la técnica "tent pole" en sector de mandíbula posterior. Se diseño un estudio longitudinal, prospectivo para estudiar la técnica. Se incluyeron sujetos con ancho óseo no mayor a 4 mm en el sector posterior y con altura no menor a 9 mm desde el margen superior del conducto alveolar inferior. Se realizaron cirugías bajo anestesia local realizando un acceso quirúrgico; se instalaron de 2 a 4 tornillos de osteosíntesis manteniendo 4 mm del tornillo extraóseo para luego reconstruir con biomaterial alógeno y L-PRF en conjunto con una membrana biológica absorbible; después de 4 meses se realizaron las re entradas estableciendo con tomografía computadorizada de haz cónico las ganancias óseas generadas. Fueron operados 14 sujetos con 27 sitios quirúrgicos; en todos los casos se pudo realizar la instalación de implantes a los 4 meses. En la evaluación inicial, el ancho óseo observado estaba entre 1,2 y 4,0 mm (promedio de 2,95 ± 0,75 mm); después de 4 meses de realizado el aumento horizontal el ancho observado fue de 3,79 y 10,05 mm (promedio de 7,15 mm ± 1,87 mm), confirmando una ganancia ósea promedio de 4,2 ± 1,26 mm. La diferencia obtenida fue significativa (p< 0,05). Se puede concluir que la técnica "tent pole" aplicada en esta investigación es predecible en el aumento óseo y aplicable para la rehabilitación sobre implante.

Bone augmentation prior to implant placement, is among strategies that should be considered to reduce morbidity rates in these procedures. The objective of this research was to define bone augmentation generator using the "tent pole " technique in the posterior jaw. A longitudinal, prospective study was designed, and subjects were included with ridge width no greater than 4 mm, height no less than 9 mm from the upper margin of the inferior alveolar canal. Surgeries were performed under local anesthesia for surgical approach; 2 to 4 osteosynthesis screws over ridge with 4 mm of the extra osseous screws were installed and were then regenerated, using allogeneic biomaterial and L-PRF together with an absorbable biological membrane. Re-entry was performed after four months and cone beam computed tomography analysis was used to confirm bone gain. Fourteen subjects were operated with 27 surgical sites; in all the cases, implant installation was possible at 4 months. In the initial evaluation, bone width observed was between 1.2 and 4.0 mm (average of 2.95 ± 0.75 mm); after 4 months of the horizontal increase, width was recorded at 3.79 and 10.05 mm (average of 7.15 mm ± 1.87 mm), confirming an average bone increase of 4.2 ± 1.26 mm. The difference obtained was significant (p <0.05). It can be concluded that the "tent pole" technique applied in this analysis is predictable in bone augmentation and applicable for implant rehabilitation.

Application of the tent bone augmentation technique in dental implants / 口腔疾病防治

@#Tent bone augmentation technology, including the tenting screw technique, autogenous cortical bone tenting technique and implant tent-pole technique, has recently been considered as a type of bone augmentation method to solve serious alveolar bone deficiency. The tenting screw technique is simple to perform and widely used in clinical practice; it can effectively increase bone in both horizontal and vertical directions in local bone defect areas with fewer complications than other techniques. The autogenous cortical bone tenting technique is mainly used for bone augmentation in large bone defect areas. The operation is relatively simple, but it needs to be combined with partial autogenous bone grafting, with high technical sensitivity and complications. The implant tent-pole technique is the most complex method and is mainly used for bone augmentation in severe alveolar ridge absorption areas of the mandible. The maximum vertical bone augmentation height can be obtained by combining this method with autogenous bone grafting, and the number of postoperative complications is relatively high. This article reviews recent research on the application of this technique to repair various alveolar bone defects in order to provide reference for clinical implant treatment.

Colocación de ipplantes de oseointegración en mndíbulas con reabsorción severaa utilizando la técnica "tent pole": serie de casos / Osseointegrate iimplants placeent in severly resorbed mandibles using the "teent pole" technique: case series / Colocação de implantes osseointegação in jaws com técnica de absorção intensa uttilizando "tent pole": series case

La rehabilitación protésica mandibular implanto-soportada actualmente es una excelente opción de tratamiento para pacientes edéntulos, ya que brinda adecuada estabilidad y mejor acceso para la higiene. La reabsorción del reborde alveolar mandibular ocurre en sentido vertical y horizontal. Muchos de estos pacientes presentan alturas alveolares que oscilan entre los 3 mm y 8 mm, aumentando el brazo de palanca de la prótesis con respecto al soporte mandibular. La opción de aumentar el reborde alveolar en altura y grosor mediante la técnica "Tent Pole", evita futuras complicaciones como fracturas patológicas que sin duda complicarían el manejo. Utilizando este método no solo se logra un aumento de grosor y altura alveolar, sino que también evita la contaminación de los injertos que ocurre a través del abordaje intraoral (1-4). A continuación, presentamos una serie de tres casos utilizando esta técnica.

Mandibular rehabilitation with implant-supported prostheses is now an excellent treatment option for edentulous patients because it provides increased stability and improved oral hygiene. Mandibular alveolar resorption occurs in vertical and horizontal vectors. There are patients presenting mandibular alveolar heights between 3 and 8 mm which unfavorably increases the prosthetic level arm. The option to increase the alveolar height and thickness before implant placement avoids complications like pathological fractures which compromises the results. By using the "Tent Pole" technique the surgeon achieves an increase of alveolar width and height, and by the way preventing contamination of the grafts through communication with the oral cavity, (1-4). We present a series of three cases using this technique.

Reabilitação mandibular implanto-suportada próteses atualmente é uma excelente opção de tratamento para pacientes desdentados totais, uma vez que proporciona uma boa estabilidade e um melhor acesso para a higiene. O rebordo alveolar mandibular reabsorção ocorre verticalmente e horizontalmente. Muitos destes pacientes têm alturas alveolares que variam de 3 a 8 mm, aumentando o braço de alavanca da prótese em relação ao suporte inferior. A opção de aumentar a altura e espessura do rebordo alveolar utilizando a técnica de "pau da barraca", evitar complicações futuras, como fraturas patológicas certamente complicar a gestão. Usando este método, não só alcança um aumento da espessura e altura alveolar, mas também evita a contaminação dos enxertos, que ocorre através da via intra-oral (1-4). Aqui estão uma série de três casos, utilizando esta técnica.