Dynamic Navigation-Assisted Palatal Bone Ring Harvesting for Simultaneous Ridge Augmentation and Implant Placement in the Anterior Esthetic Zone: A Prospective Cohort Study.

Conventional intraoral donor sites for bone augmentation exhibit inherent limitations. This study investigates the maxillary palate as a novel donor site for simultaneous bone augmentation and implant placement in the anterior aesthetic zone, while assessing the feasibility of dynamic navigation-guided palatal bone ring grafting. Twelve patients with maxillary anterior tooth loss（Class 4-5 ridge defects）were included in the study and divided into the palatal bone ring group (group A, n=6) and orthotopic or chin bone ring group (group B, n=6). Bone ring grafting with simultaneous implant placement were completed under the guidance of dynamic navigation. Cone-beam computed tomography (CBCT) was performed to evaluate the vertical and horizontal bone augmentation around the implants and the surgical accuracy of the 2 groups. The healing of the donor sites, the volume and the cortical bone/cancellous bone ratio of the bone ring were compared between the 2 groups. The results showed that there was no significant difference in vertical bone augmentation (4.97±1.30 mm versus 4.83±2.71 mm, P=0.91), labial bone width (1.85±0.64 mm versus 1.91±0.37 mm, P=0.87) and palatal bone width (1.63±0.57 mm versus 1.40±0.66 mm, P=0.53) between the 2 groups after 6 months. No significant differences were observed in surgical accuracy, donor-site healing, or bone ring characteristics (all P>0.05). The study showed that obtaining a palatal bone ring under dynamic navigation guidance is accurate, safe and effective, and its bone augmentation effect is comparable to that of the common donor site.