AUGMENTATION OF THE ATROPHIC MAXILLARY ALVEOLAR RIDGE WITH HYDROXYAPATITE GRANULES IN A VICRYL (POLYGLACTIN-910) KNITTED TUBE AND SIMULTANEOUS OPEN VESTIBULOPLASTY

A modified technique for augmentation of the severely atrophic edentul ous maxillary alveolar ridge is described. The augmentation was carrie d out using a knitted polyglactin 910 mesh tube filled with porous hyd roxyapatite granules, the tube being inserted through the access achie ved by an open vestibuloplasty. The results of an in-vivo animal study showed that the absorption of the mesh was complete between 49 and 70 days. The clinical study included 11 patients in all of whom there wa s severe maxillary ridge atrophy and major prosthetic problems; follow -up was for a mean of 25 months. The procedure was without significant complication and produced a mean immediate absolute augmentation of 5 .5 mm and substantially increased vestibular depth. A gradual reductio n of ridge height was found over time. Nevertheless all patients showe d significantly increased ability to wear their dentures. The techniqu e is presented as a safe and predictable alternative to the use of bon e grafts and titanium implants in these severely atrophic cases.