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Vertical Dimensional Changes Following Horizontal Alveolar Ridge Augmentation
Background: Researchers commonly distinguish horizontal alveolar ridge augmentation (HRA) procedures from those aiming to augment the vertical dimension of the edentulous ridge. However, incidental vertical changes occurring after HRA remain poorly characterized in the periodontics literature. Purpose: The objective of this study was to assess vertical dimensional changes following HRA. Materials and Methods: This study included CBCT volumes from 65 HRA sites in 57 patients. Baseline and postoperative CBCT volumes were superimposed using three-dimensional analysis software. Changes in the vertical alveolar ridge dimensional (VRD) were recorded considering a panel of patient-, site-, and procedure-related explanatory variables. Results: VRD changes ranged from -2.9 to 3.0 mm, more than half the anterior sites losing alveolar ridge height. Overall, 24 HRA sites (37 percent) lost VRD, 24 sites (37 percent) gained VRD, and 17sites (26 percent) exhibited no change in the vertical dimension of the alveolar ridge. In a two-sample test of proportions, 11 of 21 anterior sites (52 percent) and 13 of 31 posterior sites (30 percent) exhibited decrease in VRD. This difference was not statistically significant (p = 0.074). Four factors in the present study were associated with a mean reduction in VRD anterior site, maxillary site, lack of membrane fixation, and use of a resorbable barrier membrane. Conclusion: Minor alterations in the VRD following HRA may be of limited clinical consequence, particularly at posterior sites. However, loss of VRD is generally undesirable, and as such may compromise esthetics and/or limit effectiveness of personal hygiene practices. Findings of the present study suggest that variables affecting post-HRA VRD reduction are partially under the control of the clinician.
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