Barbell Technique: A Novel Approach for Bidirectional Bone Augmentation: Technical Note
Horizontal bone reconstruction is a common augmentation procedure used in implant dentistry to achieve adequate 3-dimensional ridge reconstruction to permit proper dental implant positioning. However, most available techniques are focused on unidirectional bone reconstruction (grafting only on the buccal side). This study was carried out to validate an innovative device that is indicated for bidirectional bone augmentation. The study consisted of 4 patients who required bidirectional horizontal bone augmentation of the upper jaw. Two computerized tomographies were performed (T0 at baseline and T1 at 6 months postoperative examinations). Mean bone thickness in the studied sites at T0 was 2.30 ± 0.65 and mean bone thickness achieved was 9.11 ± 1.08 mm at T1, with an overall bone gain of 6.81 ± 1.33 mm. Concerning the specific gains in direction, buccal and palatal bone augmentations were 4.89 ± 0.94 and 1.92 ± 0.42 mm, respectively. Based on these results, it can be concluded that the use of this novel device allows for the achievement of bidirectional horizontal bone augmentation.
Design of the Barbell Technique devices. (a) Polyether ether ketone capsules; (b) titanium screws; (c) drill; (d) screw carrier for contra angle; (e) manual screw carrier and (f) capsule carrier.
Figure 2. Recipient bed after the surgical access and cortical perforations. Figure 3. Recipient bed exposed to allow autograft obtainment. Figure 4. Autograft and xenograft immediately before the mixture. Figure 5. Screws positioned at the recipient bed. Figure 6. Capsules fixed and membrane adapted at the palatal side.
Figure 7. Bone graft positioned at buccal and palatal sides. Figure 8. Collagen membrane covering the graft and the device. Figure 9. Immediate postoperative view. Figure 10. Site reopened after 6 months, immediately before the removal of Barbell devices (polyether ether ketone capsules [PEEK] and screws). Figure 11. Site reopened after 6 months, immediately after the removal of Barbell devices (PEEK capsules and screws).
Figure 12. Computerized tomography (CT) images at baseline (T0). Note the lack of bone thickness to allow implant placement. Figure 13. CT at 6 months postoperative (T1). Note the significant bone volume obtained.
Boxplot of bone thickness across the time points.
Contributor Notes