Sequential Human Histology Results of the Subperiosteal Minimally Invasive Aesthetic Ridge Augmentation Technique (SMART): A Chronologic Wound Healing Proof-of-Principle Study.

The article focuses on the histologic evaluation of bone regeneration chronology following alveolar ridge augmentation using the subperiosteal minimally invasive aesthetic ridge augmentation technique (SMART). This technique employs a tunneling method to deliver a combination of bone graft materials and recombinant human platelet-derived growth factor-BB (rhPDGF-BB) without the use of barrier membranes or bone decortication. Sequential human biopsy specimens taken at 2, 5, 9, and 14 months post-procedure demonstrated progressive new bone formation transitioning from woven to lamellar bone, with gradual resorption of xenogeneic graft material (anorganic bovine bone mineral, ABBM) and replacement by vital bone. The study provides histologic proof of principle that SMART can achieve significant vertical and horizontal ridge augmentation with reduced complications, highlighting the role of rhPDGF-BB in accelerating graft remodeling and osteogenesis from both periosteal and cortical bone sources.