EVALUATION OF BONE AUGMENTATION USING AUTOLOGOUS TOOTH SHELL IN THE ESTHETIC ZONE OF NARROW MAXILLA (A CLINICAL STUDY)

Abstract

INTRODUCTION: Following extraction of tooth, the alveolar bone is resorbed in different directions with variant measurements. The decrease in alveolar bone width is higher in amount than alveolar bone height resorption, and is most significant buccally. The autologous tooth shell (ATS) had been of great interest in dental research as for it's low cost and less aggressiveness than Autogenous bone (AB), also it showed similar composition to bone tissue. Furthermore, ATS proved to have osteogenic and osteoconductive characteristics as AB. MATERIALS AND METHODS: A prospective clinical trial was carried on 12 patients of both sexes between the ages of 20-45 years. Patients who were radiologically diagnosed with narrow maxillary ridge in the anterior and/or premolar area. Tooth shells were used to augment the narrow ridge, by fixing them buccally with osteosynthesis screws. Cerabone® bone granules and a resorbable collagen membrane were used. Measurement of horizontal ridge width (HRW) was done both preoperatively (HRW1) and 4 months postoperatively (HRW2) using CBCT. Participant patients were fully informed of the clinical trial and had to sign a written informed consent. RESULTS: The age of the selected sample size varied from 20 to 45 years old, with a mean of 42.08±2.19 , and there were three men and nine females. 10 cases underwent uneventful recovery showing no signs of infection while 2 cases showed dehiscence. ATS persisted and united to the narrow ridge four months after surgery. ATS was utilized in the augmentation of the narrow ridge, from a narrow ridge width HRW1 of mean value 4.46±0.51 mm to the final HRW2 of mean value 6.85±0.63mm after 4 months of surgery. The average horizontal ridge width gain HRWG was 2.40±0.41 mm. Cancellous bone density of augmented maxillary ridge showed minimal or no significant change 4 months post operatively. CONCLUSION: This study showed that autologous tooth shell improves esthetics and bone healing and bone thickness in the esthetic zone of maxilla. ATS is a potential replacement for traditional autologous bone grafts in the future.