MINIMALLY INVASIVE TUNNELING TECHNIQUE FOR BONE HARVESTING

Аннотация

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Aim. The aim of our study was to evaluate the effect of the atraumatic «MicroSaw» technique and the Tunnel Technique for bone osteotomy and autogenous bone grafting from retro-molar site used for bone augmentation prior to dental implant surgery. Material and Methods. Forty free (43) partially edentulous patients with alveolar bone atrophy were enrolled in our clinical study and went through surgery. Osteotomies of the jaws were made using thin diamond saws «MiscoSaw» (Stoma, Germany), since these are the finest modern saws. The auto-grafts were obtained from the retromolar site of the lower jaw. The bone wound of the donor site was filled with a blood clot and sutured with single sutures. The bone blocks were cut into thin cortical plates. Bone augmentation in the atrophy area was made both in height and width, using thin bone plates to create the contours of bone tissue. Autogenous bone chips were placed between the plates. Soft tissue edema, pain syndrome, wound healing time were clinically evaluated after the surgery. Four months later a bone column was taken from the implant site for its histological structure analysis. The bone tissue of the autograft was examined 4 months after bone augmentation. Results and Discussion. The time of bone block grafting procedure while using the «MicroSaw» technique is significantly reduced due to high speed of diamond disk rotation. Bone cut has a negligible thickness, which minimizes bone trauma. Patients who underwent bone augmentation performed with the help of the «MicroSaw» technique noted a comfortable postoperative period and minimal postoperative edema. Patients rarely took painkillers. Postoperative wounds in the donor site healed without complications, the stitches were removed within 10.0±3.0 days, depending on bone augmentation method. There was no evidence of loss of sensitivity either of the lip or chin. No cases of hematomas or purulent inflammation were reported. The histological study of the autograft bone tissue 4 months after conventional and tunneling bone grafting indicates that the bone autograft is intimately connected with the native bone tissue and there is not border between these tissues. This phenomenon can be explained by the beneficial effect of this diamond micro-saws invasion in the bone tissue, which has a positive effect on the process of bone autograft osteoregeneration. Conclusions. The «MicroSaw» technique and Tunneling Technique have positive effect on postoperative healing of soft and bone tissue. Using Tunnel Technique and «MicroSaw» Technique reduces surgery time and makes the results more predictable.