Thesis (M.Sc.) - Cairo University - Faculty of Oral and Dental Medicine - Department of Oral and Maxillofacial Surgery

A clinical investigation was carried out on eight patients, presented with alveolar ridge defects in the anterior maxilla. In this study alveolar ridge augmentation was performed using recombinant human bone morphogenic protein-2 on absorbable collagen sponge (rhBMP-2/ACS).! Thorough pre-operative assessment of the patients was carried out including history taking, physical examination and radiographic examination. The preoperative volume, height width and density of the defective alveolar ridge were measured on Computed Tomographic Cone Beam scan (CBCT).! Local anesthetic solution Articaine 4% ** with vasoconstrictor epinephrine 1:100,000 was infiltrated into the operative site. A crestal incision and 2 vertical releasing incisions were performed; and a full-thickness flap was raised. The defect was completely filled with absorbable collagen sponge carrier soaked with the rhBMP-2, 2-3 sponges were used in the defect site according to the size of the alveolar ridge defect. Then pre-bent micro-system titanium mesh* 0.2 mm thick was placed to provide space for bone augmentation, and secured using 1.5 mm self-tapping titanium micro screws*. The labial flap was then approximated to the palatal flap and multiple interrupted mattress sutures were done using 3-0 polyglycolic acid (PGA) suture*** The operative procedures were similar for all patients, and the follow-up period was 6 months in the form of clinical evaluation and radiographic evaluation by CBCT scans to measure the amount of bone fill and bone density.! The immediate post-operative follow-up showed mild facial swelling, local edema and/or erythema. Post-surgery complications resolved within 1 week.No unexpected complications were observed during the post-operative follow-up period except for flap dehiscence and exposure of the titanium mesh observed in two patients at 14 days and 4 months, respectively. These patients were advised to use the Antiseptol* mouth wash until soft tissue healing was achieved. No infection or necrosis of the flap was observed in any of the cases

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