Self-inflating oral tissue expander for ridge augmentation in the severely atrophic mandible
A 48-year-old female patient was diagnosed with severe bone resorption after peri-implantitis and removal of her previous 3 implants for tooth loss due to periodontitis. Three new implants were planned for rehabilitation. First, she needed vertical bone augmentation and soft-tissue expansion due to severely resorbed ridge.()\nOsmed tissue expander (cylinder type, 0.15 mL) was inserted subperiosteally in the region of the lower right posterior area and fixed with 1 micro screw (Jeil self-tapping mini screw, 1.4×3 mm, Jeil Medical Corp., Seoul, Korea) under local anesthesia with lidocaine (2% Lidocaine HCL, Epinephrine Inj., Yuhan Corp., Seoul, Korea) and midazolam (Midazolam 5 mg/5 mL, Bukwang Pharmaceutical Co., Seoul, Korea) intravenous sedation.()\nThe tissue expander was left in place for 6 weeks and expanded from 0.15 mL to 0.7 mL. After bony augmentation with composite bone graft (autogenous bone [harvested from right ramal area]+xenograft [Bio-Oss; Geistlich, Wolhusen, Switzerland]), tension-free coverage of the augmented bone was achieved using the soft tissue that had been created. The tissue expander was used because of the firmness of soft tissue. Six months later, the grafted bone was very hard and intact. When implant surgery was done, insertion torque was 25 Ncm; currently, the operation site is healing following prosthetic treatment.()