J Periodontal Implant Sci.  2018 Jun;48(3):193-200. 10.5051/jpis.2018.48.3.193.

Guided bone regeneration using K-incision technique

• Cho YD
• Ku Y

• KMID: 2414932
• DOI: http://doi.org/10.5051/jpis.2018.48.3.193

Abstract

PURPOSE
The present study describes 3 patients with chronic periodontitis and consequent vertical resorption of the alveolar ridge who were treated using implant-based restoration with guided bone regeneration (GBR).
METHODS
After extraction of a periodontally compromised tooth, vertical bone augmentation using a K-incision was performed at the healed, low-level alveolar ridge.
RESULTS
The partial-split K-incision enabled soft tissue elongation without any change in buccal vestibular depth, and provided sufficient keratinized gingival tissue during GBR.
CONCLUSIONS
Within the limits of this study, the present case series demonstrated that the novel K-incision technique was effective for GBR and allowed normal implant-based restoration and maintenance of a healthy periodontal condition. However, further long-term follow-up and a large-scale randomized clinical investigation should be performed to evaluate the feasibility of this technique.

Keyword

Alveolar bone loss; Bone regeneration; Dental Implant; Guided tissue regeneration

MeSH Terms

Alveolar Bone Loss
Alveolar Process
Bone Regeneration*
Chronic Periodontitis
Dental Implants
Follow-Up Studies
Guided Tissue Regeneration
Humans
Tooth
Dental Implants

Figure

• 

  Figure 1 The terms ‘hypsodont’ and ‘brachydont.’ (A-C) ‘Hypsodont’ describes a tooth with large crowns. A schematic drawing of a hypsodont-like implant-based restoration is shown (marked with an arrow), as well as a clinical photo (marked with asterisks). (D-F) The term ‘brachydont’ refers to low-crowned teeth. A schematic drawing of a brachydont-like implant-based restoration is shown (marked with an arrow), as well as a clinical photo (marked with asterisks).M: molar, P: premolar.

• 

  Figure 2 Schematic illustration of the K-incision. (A) Alveolar ridge showing a vertical bone defect. (B) A K-incision is performed using a Kirkland knife to split the gingiva into 2 parts. (C) After elevation of the gingival flap, decortication is performed to promote osteogenesis. (D) The microscrews are used as tent poles, and bovine bone mineral and membrane are applied. The divided gingival flap is then sutured. (E) After a 4-month healing period, the alveolar ridge shows vertically recovered bone with sufficient keratinized gingival tissue and an unchanged mucogingival junction level; the ridge is ready to receive an implant.

• 

  Figure 3 Case 1. (A) A periapical radiograph showing alveolar bone resorption around the teeth (#2 and #3). (B) An occlusal view of the tooth extraction site (teeth #2 and #3) after a 2-month healing period. (C) The microscrews were used as tent poles during guided bone regeneration. (D) The soft tissue extended by the K-incision is marked with a black tetragon. (E, F) A clinical photo (E) and radiograph (F) show the stable implant restoration with sufficient keratinized gingival tissue and alveolar bone over a 5-year periodic-recall follow-up period; no specific complications were observed.

• 

  Figure 4 Case 2. (A) A periapical radiograph showing alveolar bone resorption around tooth #3. (B) Guided bone regeneration with microscrews in the vertically resorbed alveolar ridge. (C) Flap re-opening to remove the microscrews and to place the implant. (D) Sufficient keratinized gingiva around the implant. (E) A radiograph and (F) clinical photo showing the stable implant-based restoration over the 3-year periodic-recall follow-up period.

• 

  Figure 5 Case 3. (A) Occlusal view and (B) radiograph showing alveolar bone resorption around tooth #14 after a 3-month healing period. (C) The microscrews were used as tent poles, (D) inorganic bovine bone mineral particles and a titanium-reinforced membrane were applied, and (E) the flap was sutured with no tension. (F, G) The surgical site healed well, with proper alveolar bone width and height. (H) The dental implant was placed in the correct position. (I) A radiograph showing stable implant-based restoration over a 2-year periodic-recall follow-up.

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