Clinical evaluation of soft tissue dimension increase by use of osmotic expanders in guided bone regeneration procedures

Abstract

Introduction: The success of hard tissue regeneration techniques in the pre-implantation phase is correlated with the primary healing of the surgical wound. For this reason, the essential moment in the implementation of this procedure is the passivation of the flaps and their sufficient mobilization. Aim: The study aimed to obtain an increase in the soft tissue volume using surgical expanders and then proceed with guided bone regeneration techniques. Case presentation: Two patients presented for implant procedures with clinically and radiologically confirmed diagnoses of bone tissue atrophy and fibrous scars on soft tissues which were to be healed in the phase of pre-implantation preparation. Osmed® expander, which was used in the procedure, consists of a hydrogel, a copolymer of methyl methacrylate and N-vinylpyrrolidone, and is contained in a cylindrical perforated silicone sheath. The final soft tissue expansion after 4 weeks was increased in volume by about 38%. Conclusion: The technique of increasing the volume of soft tissue with the use of an expander enabled the increase of soft tissues in a separate surgical procedure, freeing the surgeon from the relaxation of the flap during the phase of implanting the artificial bone, and thus excluding possible disturbing factors that interfere with the primary healing of the wound during that surgical procedure.