PATIENT-CENTERED VERTICAL RIDGE AUGMENTATION USING THE TENT POLE CONCEPT

Background:Vertical ridge augmentation remains one of the most challenging procedures in implant dentistry because severe alveolar defects frequently require complex regenerative approaches, multiple surgical interventions, and prolonged treatment periods before definitive prosthetic rehabilitation. Maintaining a stable regenerative space during healing is considered a critical factor for successful three-dimensional bone reconstruction. Case Presentation:This report presents the clinical application of the Tent Pole System, which combines implantsupported tenting abutments (SANTA®) and a wide-head tenting screw (SBB®) to maintain regenerative space during simultaneous implant placement and vertical ridge augmentation. A patient with severe posterior maxillary alveolar ridge deficiency associated with extensive horizontal and vertical bone loss underwent simultaneous implant placement, sinus augmentation, and three-dimensional ridge reconstruction. The regenerative procedure incorporated concentrated growth factor (CGF), StickyBone™, and a collagen membrane. Implant-supported tenting abutments were used in implant sites, while a wide-head tenting screw was applied in an implant-free pontic region to provide continuous space maintenance throughout the defect. Clinical, radiographic, and prosthetic outcomes were evaluated during follow-up. Results:The Tent Pole System allowed reconstruction of the deficient alveolar ridge with stable maintenance of the augmented volume. Early provisional rehabilitation was achieved, followed by definitive prosthetic restoration with satisfactory functional and esthetic outcomes. At two-year follow-up, stable peri-implant hard and soft tissues were observed without biological or prosthetic complications. Soft tissue enhancement was successfully achieved using a minimally invasive sutureless free gingival graft technique. Conclusion:The Tent Pole System represents a promising approach for managing severe vertical ridge defects by integrating implant-supported and implant-free space-maintaining devices within a simplified regenerative protocol. Although the presented clinical outcomes are encouraging, further prospective controlled studies with larger patient populations and longer follow-up are required to validate its predictability and long-term effectiveness.