Use of autologous free parietal periosteum in the treatment of patients with anhidrotic (hypohidrotic) ectodermal dysplasia

Objective. To evaluate the effectiveness of autologous free parietal periosteum combined with cranial vault bone autografts for alveolar ridge reconstruction in patients with ectodermal dysplasia. Materials and Methods. Prospective single-center study; 17 patients aged 17—40 years. Two groups were formed by membrane type: autologous free periosteum (n=6) and collagen membrane (n=11). Bone augmentation was performed with fixation of parietal bone autografts; the spaces between blocks were filled with a mixture of autogenous bone chips and xenograft (70:30). Changes in bone volume were calculated relative to the total volume of the maxilla and mandible using manual slice-by-slice segmentation of MSCT scans with MPR correction (Amira 5.4.5) preoperatively, at 2—3 days, and at 6 months. Graft resorption was assessed at 6 months. Dental implant stability was measured immediately after placement and at 6 months. Statistical processing was performed in IBM SPSS. Results. Both groups demonstrated an increase in bone volume that persisted at 6 months; no between-group differences in volume were found. Graft resorption was lower with autologous free periosteum than with a collagen membrane: maxilla 18.48±1.27% vs 23.56±4.83% (p=0.025); mandible 26.22±1.74% vs 38.68±4.68% (p<0.001). Six-month implant stability was higher in the periosteum group (ISQ 86.83±2.04 vs 82.45±1.69; p<0.001). No complications of bone grafting or dental implantation were recorded. Conclusion. Using autologous free parietal periosteum as a barrier membrane in cranial vault autograft reconstruction provides better graft volume preservation, lower resorption, and higher dental implant stability compared with a collagen membrane.