Barbell Technique: A Novel Approach for Bidirectional Bone Augmentation: Clinical and Tomographic Study

Horizontal bone augmentation is a common surgical procedure used in implant therapy to achieve adequate bone volume to permit dental implant placement. However, most current techniques are focused on unidirectional bone reconstruction (grafting only on the buccal side). This study was carried out to validate a new device that will permit bidirectional bone augmentation. The study evaluated ten patients who required bidirectional horizontal bone augmentation of the upper jaw which were separated in accordance with the HAC classification published by Pelegrine et al., 2018 (HAC 3 and HAC 4). The patients classified as HAC 3 (i.e. containing remaining cancellous bone at the recipient bed) received the Barbell device with xenogeneic biomaterial and a collagen membrane, while HAC 4 patients (i.e. with no remaining cancellous bone at the recipient bed) received the Barbell device with a mixture of autogenous bone chips and xenogeneic biomaterial covered by a collagen membrane. For each patient, two CTs scans were performed (T0 at baseline and T1 at six months postoperative examinations). Mean bone thickness (T0) in the studied sites were 3.25 + 0.35 in HAC 3 and 1.98 + 0.5 in HAC 4 patients. The mean bone thickness achieved after 6 months was 7.70 + 0.89 mm and 8.62 + 0.89 in HAC 3 and 4 respectively. All grafted sites were able to receive dental implants in adequate prosthetic positions. Based on these results, the use of this novel device permits bidirectional horizontal bone augmentation.