TY - JOUR
T1 - Impact of Two Flap Advancement Techniques and Periosteal Suturing on Graft Displacement During Guided Bone Regeneration
AU - Raabe, Clemens
AU - Cafferata, Emilio A.
AU - Couso-Queiruga, Emilio
AU - Chappuis, Vivianne
AU - Ramanauskaite, Ausra
AU - Schwarz, Frank
N1 - Publisher Copyright:
© 2025 The Author(s). Clinical Implant Dentistry and Related Research published by Wiley Periodicals LLC.
PY - 2025/2
Y1 - 2025/2
N2 - Objectives: This preclinical ex vivo porcine study aimed to evaluate the effects of two flap advancement techniques and periosteal suturing (PS) on graft material displacement during primary wound closure in guided bone regeneration (GBR). Secondary objectives included assessing flap advancement and the impact of soft tissue characteristics on graft displacement. Materials and Methods: Standardized two-walled horizontal bone defects were created in second premolar sites of pig hemimandibles. Sites were randomized to using either full-thickness flaps with modified periosteal releasing incisions (MPRI) or combination flaps using the mucosal detachment technique (MDT), both with and without PS. Cone-beam computed tomography was used to measure changes in graft material thickness (GMT) at seven incremental levels (L0–L6) relative to the implant platform, before and after primary wound closure. Keratinized mucosa width (KMW), flap thickness (FT), and flap advancement (FA) were also recorded. Results: Sixty-eight horizontal bone augmentation procedures were performed on 34 pig hemimandibles, divided into four groups (MDT+PS, MDT-PS, MPRI+PS, MPRI-PS). Mean overall change in GMT at L0 was −24.5% ± 14.0% for MPRI and − 23.0% ± 14.3% for MDT (p ≥ 0.085). PS reduced graft displacement (−14.2% ± 11.5%) compared with no PS (−33.2% ± 16.9%, p < 0.001). FA was 8.3 ± 1.1 mm (MPRI) and 8.3 ± 1.5 mm (MDT). The mean KMW was 6.8 ± 0.9 mm, and FT ranged from 0.8 to 1.6 mm. Conclusions: PS significantly reduced graft material displacement during primary wound closure, while flap advancement techniques and soft tissue characteristics had no impact on graft stability. Both surgical techniques provided sufficient flap advancement for primary wound closure.
AB - Objectives: This preclinical ex vivo porcine study aimed to evaluate the effects of two flap advancement techniques and periosteal suturing (PS) on graft material displacement during primary wound closure in guided bone regeneration (GBR). Secondary objectives included assessing flap advancement and the impact of soft tissue characteristics on graft displacement. Materials and Methods: Standardized two-walled horizontal bone defects were created in second premolar sites of pig hemimandibles. Sites were randomized to using either full-thickness flaps with modified periosteal releasing incisions (MPRI) or combination flaps using the mucosal detachment technique (MDT), both with and without PS. Cone-beam computed tomography was used to measure changes in graft material thickness (GMT) at seven incremental levels (L0–L6) relative to the implant platform, before and after primary wound closure. Keratinized mucosa width (KMW), flap thickness (FT), and flap advancement (FA) were also recorded. Results: Sixty-eight horizontal bone augmentation procedures were performed on 34 pig hemimandibles, divided into four groups (MDT+PS, MDT-PS, MPRI+PS, MPRI-PS). Mean overall change in GMT at L0 was −24.5% ± 14.0% for MPRI and − 23.0% ± 14.3% for MDT (p ≥ 0.085). PS reduced graft displacement (−14.2% ± 11.5%) compared with no PS (−33.2% ± 16.9%, p < 0.001). FA was 8.3 ± 1.1 mm (MPRI) and 8.3 ± 1.5 mm (MDT). The mean KMW was 6.8 ± 0.9 mm, and FT ranged from 0.8 to 1.6 mm. Conclusions: PS significantly reduced graft material displacement during primary wound closure, while flap advancement techniques and soft tissue characteristics had no impact on graft stability. Both surgical techniques provided sufficient flap advancement for primary wound closure.
KW - alveolar ridge augmentation
KW - bone substitutes
KW - cone-beam computed tomography
KW - dental implants
KW - grafts
KW - guided bone regeneration
KW - surgical flaps
UR - http://www.scopus.com/inward/record.url?scp=85215282143&partnerID=8YFLogxK
U2 - 10.1111/cid.13434
DO - 10.1111/cid.13434
M3 - Artículo
AN - SCOPUS:85215282143
SN - 1523-0899
VL - 27
JO - Clinical Implant Dentistry and Related Research
JF - Clinical Implant Dentistry and Related Research
IS - 1
M1 - e13434
ER -