Horizontal Bone Augmentation in the Posterior Atrophic Mandible and Dental Implant Stability Using the Tenting Screw Technique

Abstract

The aim of this study was to analyze horizontal bone augmentation using the tenting screw technique in the posterior mandible. Included subjects had a 3-mm bone width and 9-mm bone height, measured by CBCT. After the surgical approach, two to four screws were inserted, leaving 4 mm of extraosseous space; reconstruction was achieved using allogeneic biomaterial and leukocyte- and platelet-rich fibrin together with an absorbable membrane. After 4 months, a new CBCT scan was obtained to compare the bone gain and implant placement. Early and secondary stability were measured by the implant stability quotient (ISQ); prosthetic load was performed 16 weeks later. Student t test was used to compare bone gains and implant stability, with significance set at P < .05. Fourteen subjects and 27 surgical sites initially exhibited a mean bone width of 2.95 ± 0.75 mm. Four months after augmentation, the bone width was 7.15 ± 1.87 mm, confirming a significant bone gain (4.2 ± 1.26 mm). Twenty-seven implants were placed with a minimum insertion torque of 35 Ncm; the primary stability was 69.3 ± 7.16 ISQ, and the secondary stability was 75.9 ± 3.29 ISQ (P > .05). It may be concluded that the tenting screw technique is predictable in terms of bone gain and that it facilitates implant stability.