Tenting Screw Technique for Horizontal Alveolar Bone Augmentation in the Anterior Maxilla: A 1- to 5-Year Retrospective Study

Abstract

Objectives: To evaluate the 1- to 5-year outcomes of dental implants placed with the tenting screw (TS) technique and to compare their clinical efficacy with conventional guided bone regeneration (GBR). Methods: This retrospective study involved implants placed with TS or conventional GBR technique. Horizontal and volumetric bone gains were evaluated by reconstructing cone-beam computed tomography (CBCT) data. Complications, biological parameters, esthetic scores, and patients' satisfaction were recorded. Results: A total of 75 implants in 42 patients (20 defect sites in TS group and 22 in GBR group) were included in this study. With a 1- to 5-year follow-up, no implants failed, resulting in a 100% implant survival rate. After healing periods, the TS group demonstrated horizontal bone gains of 2.85 ± 1.42 mm, 3.37 ± 1.79 mm, and 3.27 ± 1.68 mm at 1, 3, and 5 mm below the implant shoulder, significantly exceeding the GBR group (p = 0.009, p = 0.002, p = 0.002, respectively). Consistently, three-dimensional volumetric bone resorption rates for the TS and GBR groups after healing periods were 16.5% and 29.3% (p < 0.001), increasing to 36.7% and 50.7% after follow-up periods (p < 0.001). The overall PPDs in the TS group were significantly smaller than those in the GBR group (2.50 (2.25, 2.50) mm vs. 2.50 (2.25, 2.75) mm, p = 0.038). No other significant differences were observed in terms of peri-implant soft tissue health, esthetics, and patients' satisfaction. Conclusions: Considering the superior bone augmentation outcomes and comparable peri-implant soft tissue health, esthetics, and patient satisfaction to the conventional GBR technique, the tenting screw technique emerges as a reliable treatment option for reconstructing atrophic alveolar ridges in the anterior maxilla.