Piezosurgery group
postoperative pain
COLD
During the use of the piezosurgery device (Mectron s.p.a., Carasco, Italy), a saline solution stored at 4 °C was used to increase the cooling effect, and 1-minute breaks were given for the handpiece to cool down for more than 5 min. The sound of the cut was used as acoustic feedback to ensure that the handpiece and tips were not pressed down too much, thus affecting the cutting efficiency and temperature of the bone. The device was used in boosted mode with high-frequency vibration for optimum bone-cutting capacity. Laser markings on the tips were used to control the depth of the incision. Superior, anterior body and external oblique incisions were made with OT-12, while the inferior ramus cut was made using OT8-L or OT8-R tips, depending on the studied quadrant (Mectron s.p.a., Carasco, Italy). The same tip was used up to 3 times if it was not broken before (Fig. After the osteotomies were completed in both groups, the block graft was carefully separated from the donor site and stored in 0.9% saline solution. The bone obtained was used for horizontal augmentation of the bone defect in the mandible and maxilla.A full-thickness flap with a unilateral vertical incision accompanied by a sulcular incision at the recipient site was removed, and the bone defect was exposed. The length of the screw was decided using a caliper to measure the width of the recipient site. Fixing the graft to the recipient site was performed with one or two 1.6 mm microscrews. Any sharp edges were smoothed using a round bur. Maximum bone-to-bone contact between the harvested and native bone was attempted. No decortication was performed, and no membrane was applied. A periosteal-releasing incision was made for tension-free closure of the graft in the recipient site (Fig. All patients were prescribed paracetamol for postoperative pain control and antibiotics for seven days, starting one day before surgery and administered every 12 h. A cold compress for 48 h was recommended. Sutures were removed after ten days.The flap design for the second surgery at 4 months (re-entry surgery) was similar to that of the first surgery, but the releasing incision in the vestibule was shorter. Screws fixing the bone block were removed, and dental implants (Straumann AG, Basel, Switzerland or Megagen, Seoul, South Korea) were placed according to the patient’s preference and the standard surgical protocol.