Tunnel Approach for Horizontal Ridge Augmentation

Introduction: Minimally invasive procedures have been introduced to increase the horizontal ridge volume for implant placement driven by prosthetic indications. Using these clinical cases, we describe an innovative horizontal ridge augmentation approach that employs a tunnel preparation technique and grafting with xenogeneic bone, hyaluronic acid, and an acellular dermal matrix.
Procedure: Two patients were treated. A single vertical incision was made mesial to the bone defect. A dermal matrix was contoured and placed in the subperiosteal tunnel. A sticky bone graft was placed between the dermal matrix and the buccal bone plate. Primary wound closure was obtained, preserving periosteum integrity and blood supply to the flap. Optical scans were taken at baseline, five months after surgery, and two months after implant placement. Horizontal ridge thickness was measured digitally.
Results: No clinical complications were observed after the surgical procedure. The implants were successfully placed with minimal tissue damage and reduced patient morbidity. A quantitative analysis of ridge thickness, based on the superimposition of intraoral scans, showed an approximate horizontal ridge augmentation of 3.00 ± 0.15 mm at the site of the inserted implant.
Conclusions: Application of this novel horizontal ridge augmentation technique led to a considerable increase in horizontal volume, enabling implant placement with less morbidity. Further research is needed to confirm and enhance this approach.