The most difficult of bone grafting techniques are the vertical and horizontal techniques. This video shows a way to utilize thin autogenous bone plates to create stunning bone. This is not the easiest technique but it is definitely the fastest way to grow bone and is quite predictable in the right clinician’s hands.
Khoury’s split bone block technique harvests an autograft from the buccal shelf. The bone block(s) fixed to the alveolar ridge recreate the bony envelope within which bone particulate may be packed to reconstruct the site. An implant may even be placed simultaneous to the augmentation should it be placed in the correct prosthodontically planned position and with enough residual bone to gain acceptable primary stability. An aesthetically pleasing reconstruction can be achieved should the implant osseointegrate, the bone augmentation heal to restore the ridge architecture, and possibly the soft tissue also augmented to bulk the gingival marginal seal around the restoration. 1,2,3,4
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1. Howard Gluckman, et al. Reconstruction of a single-tooth traumatic defect in the anterior maxilla using the Khoury bone plate graft. INTERNATIONAL DENTISTRY – AFRICAN EDITION VOL. 5, NO. 2
2. Khoury F, Antoun H, Missika P. Bone augmentation in oral implantology. UK:
Quintessence; 2007.
3. Levine RA, Huynh-Ba G, Cochran DL. Soft tissue augmentation procedures
for mucogingival defects in esthetic sites. Int J Oral Maxillofac Implants. 2014;29
Suppl:155-85.
4. Chen ST, Buser D. Esthetic outcomes following immediate and early implant
placement in the anterior maxilla–a systematic review. Int J Oral Maxillofac
Implants. 2014;29 Suppl:186-215
Is there an alternative for. this technique ?
Why we dont use the basal implant ?
I dont do them. And I’m not sure why it would make a difference in this case. You need bone
Hi Howard
I really like this technique which you performed masterfully. 2 questions, 1)what are you conditioning the root surfaces with? and 2) Is there any way to do this procedure without obliterating the vestibule when you release of the buccal flap?
HI Yaron. The conditioning of the root is Prefgel which is used prior to Emdogain placement. The emdogain is used to help new attachment procedure on the root that has lost bone. to answer your second question the answer is simple. It is NO. you have to get passive closure to get a successful bone augmentation. this reduction will be managed with an apically repositioned flap in the exposure process.