Clinical and radiographic outcomes of horizontal auto-augmentation of the anterior mandible using a single-site surgical technique prior to delayed implant placement: a case series

Abstract

Insufficient bone width is a common obstacle when placing dental implants. Numerous methods have been devised to enhance bone thickness. Autogenous bone is considered the benchmark material owing to its superior properties. The split bone block technique showed favorable results in bone gain, although donor site morbidity and the need for a second surgical site were major concerns. The study aimed to assess bone augmentation in the anterior mandible, using the symphysis as both the donor and recipient site, while the original technique required two surgeries. This prospective, single-center, formal consecutive case series study focused on outcomes and involved 11 patients, each having a bone width of less than 4 mm in the anterior mandibular area. Patients underwent a procedure for horizontal ridge augmentation, with implants being placed after a four-month interval. The study assessed the healing of the surgical site, reported complications, and measured pain levels using a visual analogue scale. It evaluated bone gain in width, primary stability, secondary stability of implants, short-term implant success, and augmented bone stability. The current study revealed postoperative swelling occurred in 45.5% of patients, while hematoma and flap dehiscence were each observed twice. Visual Analog Scale pain scores decreased over two weeks (P < 0.001). Mean radiographic bone width increased from (3.27 ± 0.80 mm) preoperatively to (5.88 ± 0.82 mm) at 4 months (P < 0.001). Furthermore, mean implant stability quotient scores improved from 72.80 (3.94) to 88.90 (2.10) (P < 0.001). The short-term implant success was 90.9%, and the mean linear augmented bone stability was 88.41% ± 6.24% (median: 90.57%), with individual values ranging from a minimum of 74.39% to a maximum of 94.57%. The findings of this preliminary case series suggest that the auto-augmentation technique from the mandibular symphysis is a technically feasible protocol for horizontal ridge augmentation. By confining the surgery to a single localized window, it achieves adequate bone gain while minimizing donor-site trauma and optimizing patient recovery profiles. The trial was registered on 12/09/2024 at clinicaltrials.gov (ID: NCT06727591).