Tissue expansion improves the outcome and predictability for alveolar bone augmentation: Prospective, multicenter, randomized controlled trial

Soo Hwan Byun; Sun Hyun Kim; Sura Cho; Ho Lee; Ho Kyung Lim; Ju Won Kim; Ui Lyong Lee; Wan Song; Sun Jong Kim; Min Kyoung Kim; Jin Woo Kim

doi:10.3390/jcm9041143

Tissue expansion improves the outcome and predictability for alveolar bone augmentation: Prospective, multicenter, randomized controlled trial

Soo Hwan Byun, Sun Hyun Kim, Sura Cho, Ho Lee, Ho Kyung Lim, Ju Won Kim, Ui Lyong Lee, Wan Song, Sun Jong Kim, Min Kyoung Kim, Jin Woo Kim

Department of Dentistry

Research output: Contribution to journal › Article › peer-review

6 Scopus citations

Abstract

Objectives: The purpose of this study was to evaluate the effectiveness of the intraoral use of subperiosteally placed self-inflating tissue expanders for subsequent bone augmentation and implant integrity. Material and methods: A prospective, multicenter, randomized controlled trial was performed on patients requiring alveolar bone graft for dental implant insertion. Patients were assigned to three groups: tissue expansion and tunneling graft (TET group), tissue expansion and conventional bone graft (TEG), and control group without tissue expansion. Dimensional changes of soft tissue and radiographic vertical bone gain, retention, and peri-implant marginal bone changes were evaluated and secondary outcomes; clinical complications and thickness changes of expanded overlying tissue were assessed. Results: Among 75 patients screened, a total of 57 patients were included in the final analysis. Most patients showed uneventful soft tissue expansion without any inflammatory sign or symptoms. Ultrasonographic measurements of overlying gingiva revealed no thinning after tissue expansion (p > 0.05). Mean soft vertical and horizontal tissue measurements at the end of its expansion were 5.62 and 6.03 mm, respectively. Significantly higher vertical bone gain was shown in the TEG (5.71 ± 1.99 mm) compared with that in the control patients (4.32 ± 0.97 mm; p < 0.05). Hard tissue retention— measured by bone resorption after 6 months—showed that control group showed higher amount of vertical (2.06 ± 1.00 mm) and horizontal bone resorption (1.69 ± 0.81 mm) compared to that of the TEG group (p < 0.05). Conclusion: The self-inflating tissue expander effectively augmented soft tissue volume and both conventional bone graft and tunneling techniques confirmed their effectiveness in bone augmentation. With greater amount of bone gain and better 6 month hard tissue integrity, the TEG group compared to the control group—without tissue expansion—showed that the combined modality of tissue expander use and guided bone regeneration (GBR) technique may improve the outcome and predictability of hard tissue augmentation.

Original language	English
Article number	1143
Journal	Journal of Clinical Medicine
Volume	9
Issue number	4
DOIs	https://doi.org/10.3390/jcm9041143
State	Published - Apr 2020

Bibliographical note

Funding Information:
We thank the bioinformatics support from Dr. Yun Liu from Fudan University, Dr. Zizhang Sheng from Columbia University and Dr. Yuanhua Liu from Institut Pasteur of Shanghai.

Funding Information:
This work was supported by the Strategic Priority Research Program [grant number XDB29030302]; the Frontier Science Key Research Project, Chinese Academy of Sciences [grant number QYZDB-SSW-SMC036]; the National Natural Science Foundation of China [grant numbers 31770960, 81602488, 81861138010]; the National Key R&D Program of China [grant number 2017YFC1311004]; and the PIFI project [grant number 2016PB076].

Publisher Copyright:
© 2020 by the authors. Licensee MDPI, Basel, Switzerland.

Keywords

Bone regeneration
Clinical trial
Dental implant
Graft
Tissue expansion

Access to Document

10.3390/jcm9041143

Cite this

@article{690aa9936f7c47118fab608fa4fa259c,

title = "Tissue expansion improves the outcome and predictability for alveolar bone augmentation: Prospective, multicenter, randomized controlled trial",

abstract = "Objectives: The purpose of this study was to evaluate the effectiveness of the intraoral use of subperiosteally placed self-inflating tissue expanders for subsequent bone augmentation and implant integrity. Material and methods: A prospective, multicenter, randomized controlled trial was performed on patients requiring alveolar bone graft for dental implant insertion. Patients were assigned to three groups: tissue expansion and tunneling graft (TET group), tissue expansion and conventional bone graft (TEG), and control group without tissue expansion. Dimensional changes of soft tissue and radiographic vertical bone gain, retention, and peri-implant marginal bone changes were evaluated and secondary outcomes; clinical complications and thickness changes of expanded overlying tissue were assessed. Results: Among 75 patients screened, a total of 57 patients were included in the final analysis. Most patients showed uneventful soft tissue expansion without any inflammatory sign or symptoms. Ultrasonographic measurements of overlying gingiva revealed no thinning after tissue expansion (p > 0.05). Mean soft vertical and horizontal tissue measurements at the end of its expansion were 5.62 and 6.03 mm, respectively. Significantly higher vertical bone gain was shown in the TEG (5.71 ± 1.99 mm) compared with that in the control patients (4.32 ± 0.97 mm; p < 0.05). Hard tissue retention— measured by bone resorption after 6 months—showed that control group showed higher amount of vertical (2.06 ± 1.00 mm) and horizontal bone resorption (1.69 ± 0.81 mm) compared to that of the TEG group (p < 0.05). Conclusion: The self-inflating tissue expander effectively augmented soft tissue volume and both conventional bone graft and tunneling techniques confirmed their effectiveness in bone augmentation. With greater amount of bone gain and better 6 month hard tissue integrity, the TEG group compared to the control group—without tissue expansion—showed that the combined modality of tissue expander use and guided bone regeneration (GBR) technique may improve the outcome and predictability of hard tissue augmentation.",

keywords = "Bone regeneration, Clinical trial, Dental implant, Graft, Tissue expansion",

author = "Byun, {Soo Hwan} and Kim, {Sun Hyun} and Sura Cho and Ho Lee and Lim, {Ho Kyung} and Kim, {Ju Won} and Lee, {Ui Lyong} and Wan Song and Kim, {Sun Jong} and Kim, {Min Kyoung} and Kim, {Jin Woo}",

note = "Funding Information: We thank the bioinformatics support from Dr. Yun Liu from Fudan University, Dr. Zizhang Sheng from Columbia University and Dr. Yuanhua Liu from Institut Pasteur of Shanghai. Funding Information: This work was supported by the Strategic Priority Research Program [grant number XDB29030302]; the Frontier Science Key Research Project, Chinese Academy of Sciences [grant number QYZDB-SSW-SMC036]; the National Natural Science Foundation of China [grant numbers 31770960, 81602488, 81861138010]; the National Key R&D Program of China [grant number 2017YFC1311004]; and the PIFI project [grant number 2016PB076]. Publisher Copyright: {\textcopyright} 2020 by the authors. Licensee MDPI, Basel, Switzerland.",

year = "2020",

month = apr,

doi = "10.3390/jcm9041143",

language = "English",

volume = "9",

journal = "Journal of Clinical Medicine",

issn = "2077-0383",

publisher = "MDPI AG",

number = "4",

}

TY - JOUR

T1 - Tissue expansion improves the outcome and predictability for alveolar bone augmentation

T2 - Prospective, multicenter, randomized controlled trial

AU - Byun, Soo Hwan

AU - Kim, Sun Hyun

AU - Cho, Sura

AU - Lee, Ho

AU - Lim, Ho Kyung

AU - Kim, Ju Won

AU - Lee, Ui Lyong

AU - Song, Wan

AU - Kim, Sun Jong

AU - Kim, Min Kyoung

AU - Kim, Jin Woo

N1 - Funding Information: We thank the bioinformatics support from Dr. Yun Liu from Fudan University, Dr. Zizhang Sheng from Columbia University and Dr. Yuanhua Liu from Institut Pasteur of Shanghai. Funding Information: This work was supported by the Strategic Priority Research Program [grant number XDB29030302]; the Frontier Science Key Research Project, Chinese Academy of Sciences [grant number QYZDB-SSW-SMC036]; the National Natural Science Foundation of China [grant numbers 31770960, 81602488, 81861138010]; the National Key R&D Program of China [grant number 2017YFC1311004]; and the PIFI project [grant number 2016PB076]. Publisher Copyright: © 2020 by the authors. Licensee MDPI, Basel, Switzerland.

PY - 2020/4

Y1 - 2020/4

N2 - Objectives: The purpose of this study was to evaluate the effectiveness of the intraoral use of subperiosteally placed self-inflating tissue expanders for subsequent bone augmentation and implant integrity. Material and methods: A prospective, multicenter, randomized controlled trial was performed on patients requiring alveolar bone graft for dental implant insertion. Patients were assigned to three groups: tissue expansion and tunneling graft (TET group), tissue expansion and conventional bone graft (TEG), and control group without tissue expansion. Dimensional changes of soft tissue and radiographic vertical bone gain, retention, and peri-implant marginal bone changes were evaluated and secondary outcomes; clinical complications and thickness changes of expanded overlying tissue were assessed. Results: Among 75 patients screened, a total of 57 patients were included in the final analysis. Most patients showed uneventful soft tissue expansion without any inflammatory sign or symptoms. Ultrasonographic measurements of overlying gingiva revealed no thinning after tissue expansion (p > 0.05). Mean soft vertical and horizontal tissue measurements at the end of its expansion were 5.62 and 6.03 mm, respectively. Significantly higher vertical bone gain was shown in the TEG (5.71 ± 1.99 mm) compared with that in the control patients (4.32 ± 0.97 mm; p < 0.05). Hard tissue retention— measured by bone resorption after 6 months—showed that control group showed higher amount of vertical (2.06 ± 1.00 mm) and horizontal bone resorption (1.69 ± 0.81 mm) compared to that of the TEG group (p < 0.05). Conclusion: The self-inflating tissue expander effectively augmented soft tissue volume and both conventional bone graft and tunneling techniques confirmed their effectiveness in bone augmentation. With greater amount of bone gain and better 6 month hard tissue integrity, the TEG group compared to the control group—without tissue expansion—showed that the combined modality of tissue expander use and guided bone regeneration (GBR) technique may improve the outcome and predictability of hard tissue augmentation.

AB - Objectives: The purpose of this study was to evaluate the effectiveness of the intraoral use of subperiosteally placed self-inflating tissue expanders for subsequent bone augmentation and implant integrity. Material and methods: A prospective, multicenter, randomized controlled trial was performed on patients requiring alveolar bone graft for dental implant insertion. Patients were assigned to three groups: tissue expansion and tunneling graft (TET group), tissue expansion and conventional bone graft (TEG), and control group without tissue expansion. Dimensional changes of soft tissue and radiographic vertical bone gain, retention, and peri-implant marginal bone changes were evaluated and secondary outcomes; clinical complications and thickness changes of expanded overlying tissue were assessed. Results: Among 75 patients screened, a total of 57 patients were included in the final analysis. Most patients showed uneventful soft tissue expansion without any inflammatory sign or symptoms. Ultrasonographic measurements of overlying gingiva revealed no thinning after tissue expansion (p > 0.05). Mean soft vertical and horizontal tissue measurements at the end of its expansion were 5.62 and 6.03 mm, respectively. Significantly higher vertical bone gain was shown in the TEG (5.71 ± 1.99 mm) compared with that in the control patients (4.32 ± 0.97 mm; p < 0.05). Hard tissue retention— measured by bone resorption after 6 months—showed that control group showed higher amount of vertical (2.06 ± 1.00 mm) and horizontal bone resorption (1.69 ± 0.81 mm) compared to that of the TEG group (p < 0.05). Conclusion: The self-inflating tissue expander effectively augmented soft tissue volume and both conventional bone graft and tunneling techniques confirmed their effectiveness in bone augmentation. With greater amount of bone gain and better 6 month hard tissue integrity, the TEG group compared to the control group—without tissue expansion—showed that the combined modality of tissue expander use and guided bone regeneration (GBR) technique may improve the outcome and predictability of hard tissue augmentation.

KW - Bone regeneration

KW - Clinical trial

KW - Dental implant

KW - Graft

KW - Tissue expansion

UR - http://www.scopus.com/inward/record.url?scp=85114273630&partnerID=8YFLogxK

U2 - 10.3390/jcm9041143

DO - 10.3390/jcm9041143

M3 - Article

AN - SCOPUS:85114273630

SN - 2077-0383

VL - 9

JO - Journal of Clinical Medicine

JF - Journal of Clinical Medicine

IS - 4

M1 - 1143

ER -

Tissue expansion improves the outcome and predictability for alveolar bone augmentation: Prospective, multicenter, randomized controlled trial

Abstract

Bibliographical note

Keywords

Access to Document

Fingerprint

Cite this