Tent-pole technique for alveolar ridge width preservation with a compromised buccal plate: a prospective cohort study.

Objectives: The aim of this study was to assess the effectiveness of the tent-pole technique for alveolar ridge preservation of compromised alveolar socket following the surgical extraction of incurable single root premolars. Materials and methods: This study was conducted on 12 patients who presented to the department of oral and maxillofacial surgery and had alveolar ridge preservation using tent-pole technique between August 2021 and February 2022. The alveolar ridge width was analyzed using cone beam computed tomography scans taken preoperative and 6 months postoperative. Statistical analysis was performed to assess the alveolar ridge width at different levels. The alveolar ridge width differences between periods were assessed with paired t-test. The comparison of alveolar ridge width loss according to jaw, sex, and different levels were done with unpaired t-test. The level of significance considered was 5% (α=0.05). Results: The mean alveolar ridge width before surgery was 10.03 mm. After 6 months, the mean alveolar ridge width was 8.4 mm. The range of alveolar ridge width loss was between 0.6 and 3.22 mm with a mean of 1.63 (16.25%). There was no statistically significant difference in width loss between the maxilla and mandibular whether in males or females. Alveolar bone width loss was the greatest at W1 level (26.8%). Conclusion: According to the results of this study, the authors conclude that the tent-pole technique could preserve the alveolar bone ridge width without bone graft materials.

Evaluation of the screw tent-pole technique for the repair of anterior maxilla width defects: a prospective, randomized, split-mouth study.

The aim of this prospective study was to compare horizontal bone augmentation in the anterior maxilla associated with two types of tenting screw used in the screw tent-pole technique. Ten patients with a premaxilla width deficiency underwent grafting with protein-free xenograft bone. A split-mouth design was used, with sides allocated randomly to receive standard and wide-head tenting screws. Implants were installed after 9 months. Patients underwent clinical, cone beam computed tomography (CBCT), and histomorphometric evaluations. The buccal aspect of the ridge was classified as flat or concave in shape. Clinical measurements showed width augmentation of 1.05mm, 2.45mm, and 2.70mm for standard screws and 1.50mm, 3.10mm, and 3.45mm for wide-head screws, at the ridge, 5mm, and 10mm, respectively. CBCT showed width augmentation of 0.74mm, 3.88mm, and 4.72mm for standard screws and 0.91mm, 4.05mm, and 4.37mm for wide-head screws, at the crest, 5mm, and 10mm, respectively. Histomorphometric analysis showed 30.99% ± 26.43% vital bone tissue, 11.32% ± 9.68% graft residue, and 57.66% ± 21.85% connective tissue for standard screws and 32.64% ± 20.28%, 9.73% ± 5.82%, and 57.61% ± 20.15%, respectively, for wide-head screws. Flat alveolar ridges showed the lowest percentage of vital bone. New bone formation seems to be optimized on concave ridges. There was no statistically significant difference in bone gain results between standard and wide-head tenting screws.

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.

Técnica Tent Pole para tratamento de defeito vertical do rebordo / Technical tent for treatment of vertical defects

A técnica Tent Pole apresenta-se como uma opção viável de tratamento que proporciona a correção do defeito ósseo e a instalação simultânea dos implantes dentários. Nesse sentido, abordamos neste trabalho um caso clínico com defeito em altura, cujo manejo do mesmo ocorreu através desta técnica, reduzindo o tempo de tratamento e a morbidade ao paciente (AU).

Tent Pole is a viable treatment option that allows bone defect correction and the simultaneous installation of dental implants. So, in this paper we present a clinical case of height defect, whose management occurred through this technique, reducing treatment time and patient morbidity (AU).

Tentpole technique for bone regeneration in vertically deficient alveolar ridges: A prospective study.

PURPOSE: The purpose of the study was to qualitatively and quantitatively assess bone regeneration potential of tentpole technique using beta tricalcium phosphate bone graft in vertically deficient alveolar ridges. MATERIALS AND METHOD: This prospective study comprised of 20 patients with vertically deficient alveolar ridges, wherein thirty one implants were placed. Tenting of the soft tissue matrix was done using titanium screws and beta tricalcium phosphate synthetic bone graft was filled in the vertical defect. Clinical and radiographic assessment was done at 1, 3 and 6 months. Preoperative biochemical analysis of Osteopontin and RANKL was done and then reassesed at 3 months postoperative. Bone core collected at 6 postoperative months, while removal of screw, was analysed histologically. RESULTS: A significant gain in bone height of 2.87 ± 0.79 mm was seen at 6 months postoperative. All implants osseointegrated. Loosening of screw was seen in two patients.There was no postoperative wound dehiscence. Histologic analysis revealed new bone formation .There was no significant change in the levels of RANKL and Osteopontin at 3 months postoperative. CONCLUSION: This is a safe and effective technique for bone regeneration in vertically deficient alveolar ridges and has minimal complications. The regenerated bone has new and viable bone content and supports implant material. More studies with long term follow up are needed to assess the stability of bone after long term loading.

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.