The Khoury Cortical Bone Grafting Technique for Severe Horizontal Bone Deficiency: A Staged Implant Rehabilitation

Oktopcu Karakoyun H., Belet M. M., Karakoyun A., Tezel A.

European Association for Osseointegration Congress, Lisbon, Portekiz, 24 - 26 Eylül 2026, (Özet Bildiri)

  • Yayın Türü: Bildiri / Özet Bildiri
  • Basıldığı Şehir: Lisbon
  • Basıldığı Ülke: Portekiz
  • Ankara Üniversitesi Adresli: Evet

Özet

İntroduction: Severe horizontal alveolar bone deficiency in the posterior mandible represents a significant surgical challenge, frequently precluding conventional implant placement. This case report presents a staged treatment protocol combining the Khoury bone grafting technique for horizontal ridge augmentation followed by implant placement, demonstrating its feasibility and predictability in a severely resorbed mandibular ridge.

Matherials and Methods: A systemically healthy female patient presented with severe horizontal bone deficiency in the posterior mandible. Preoperative CBCT revealed ridge widths as narrow as 2.0–3.5 mm at the planned implant sites, rendering standard implant placement impossible. A staged approach was therefore planned, and written informed consent was obtained prior to any intervention. Horizontal bone augmentation was performed using the Khoury technique: thin cortical bone lamellar harvested from the retromolar region were rigidly fixed to the buccal aspect of the deficient ridge with osteosynthesis screws, the intervening space was filled with xenograft material, covered with a collagen membrane, and the flap was closed primarily.

Results: No graft exposure, membrane failure, or significant postoperative morbidity was recorded during the healing phase. Six-month follow-up CBCT confirmed successful horizontal bone augmentation, with crestal ridge widths increasing from a preoperative range of 2.0–3.5 mm to 3.8–4.3 mm at site 46, 5.7 mm at site 45, and 7.6–8.1 mm at site 44. Re-entry surgery revealed well-consolidated, mature bone throughout the augmented region, providing sufficient volume for ideal three-dimensional implant positioning. Three Straumann implants (44: 3.3×10 mm, 45: 3.3×8 mm, 46: 4.1×10 mm) were placed with satisfactory primary stability at all sites. Postoperative panoramic radiography confirmed appropriate implant positioning and satisfactory crestal bone levels.

Conclusions: The Khoury cortical bone grafting technique proved to be a predictable and effective solution for severe horizontal ridge deficiency, demonstrating that significantly atrophic sites can be successfully rehabilitated through a staged augmentation approach.