A Histological Assessment of Bone Augmentation of a Knife-Edge Alveolar Ridge by the Umbrella-Screw Tent Technique Using a Xenograft Compound with Polynucleotide-Hyaluronic Acid—A Case Report

Lubauer J, Puišys A, Sader R, Rathe F, Schlee M (2026)

Publication Type: Journal article

Publication year: 2026

Journal

Applied Sciences MDPI

Book Volume: 16

Article Number: 2290

Journal Issue: 5

DOI: 10.3390/app16052290

Abstract

Objectives: Horizontal ridge augmentation remains a clinical challenge due to limitations in terms of spatial maintenance, graft stability and predictability of new bone formation. The umbrella-screw tent technique provides mechanical stability for particulate grafts, while adjuvants such as hyaluronic acid (HA) and polynucleotides (PN) may enhance biological remodeling. Evidence for this compound in implant-related bone augmentation is still scarce. Material and methods: In a single patient with a knife-edge alveolar ridge, augmentation was performed in regions 34 to 36 using the umbrella-screw tent technique. The defect was grafted with deproteinized bovine bone mineral (DBBM) mixed with hyaluronic acid (HA) and polynucleotides (PN), supplemented with platelet-rich fibrin (PFR) and covered with a resorbable collagen membrane. After six months, two implants were installed, and a biopsy was obtained by trepanation for histological and histomorphometric analysis. Results: Healing occurred without compromise, with no signs of infection or graft exposure. Horizontal bone gain averaged 4.5 mm, corresponding to a relative Target Performance Index (TPI-h) of 75%. Histomorphometric analysis revealed a total mineralized fraction of 76.4%, consisting of 36.1% newly formed bone and 40.3% residual DBBM particles. The xenogeneic granules were completely integrated into mature bone, with no signs of inflammation or foreign body reaction. Conclusion: The case report illustrates that the combination of DBBM with HA and PN, stabilized by the umbrella-screw tent technique, can lead to significant new bone formation and favorable graft integration. Although limited by its single-case design, the case report provides preliminary insights into the synergistic potential of HA and PN as biological enhancers in bone augmentation, warranting further controlled studies.

Authors with CRIS profile

Julia Lubauer Department of Operative Dentistry and Periodontology

Involved external institutions

Goethe-Universität Frankfurt am Main DE Germany (DE) Danube Private University (DPU) AT Austria (AT)

How to cite

APA:

Lubauer, J., Puišys, A., Sader, R., Rathe, F., & Schlee, M. (2026). A Histological Assessment of Bone Augmentation of a Knife-Edge Alveolar Ridge by the Umbrella-Screw Tent Technique Using a Xenograft Compound with Polynucleotide-Hyaluronic Acid—A Case Report. Applied Sciences, 16(5). https://doi.org/10.3390/app16052290

MLA:

Lubauer, Julia, et al. "A Histological Assessment of Bone Augmentation of a Knife-Edge Alveolar Ridge by the Umbrella-Screw Tent Technique Using a Xenograft Compound with Polynucleotide-Hyaluronic Acid—A Case Report." Applied Sciences 16.5 (2026).

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