From the Guidelines
Vertical periodontal bone preparation involves creating a cavity with walls that are perpendicular to the bone surface, whereas horizontal periodontal bone preparation involves creating a cavity with walls that are more parallel to the bone surface. The main difference between these two approaches lies in their application and the amount of bone structure preserved. According to the most recent evidence 1, the choice between vertical and horizontal bone preparation depends on various factors, including the height of the subantral bony ridge, the presence of any medical contraindications for intraoral surgery, and the type of edentulism. In the context of maxillary sinus floor augmentation, horizontal bone preparation is often preferred as it allows for a more conservative approach, preserving more natural bone structure 1. This approach is particularly useful when using dedicated software and sinus surgical guides to facilitate the antrostomy procedure. Some key considerations for periodontal bone preparation include:
- The height of the subantral bony ridge, which determines the need for maxillary sinus floor augmentation
- The presence of any medical contraindications for intraoral surgery
- The type of edentulism and tooth anatomy, which may affect the placement of tilted implants
- The need for structural support and the choice of restorative material. Overall, understanding the differences between vertical and horizontal periodontal bone preparation is crucial for selecting the most appropriate approach for each clinical situation, balancing the need for restoration longevity with preservation of healthy bone structure.
From the Research
Vertical and Horizontal Periodontal Bone Preparation
The main difference between vertical and horizontal periodontal bone preparation lies in their approach and application:
- Vertical preparation involves a reduction to zero of the emergence anatomy, creating a new finish area, and immediate temporization, allowing the gingiva to adapt to the restoration 2.
- Horizontal preparation, on the other hand, is not explicitly discussed in the provided studies, but it can be inferred that it involves a different approach to tooth preparation, possibly with a defined margin or a chamfer type finishing line 3, 4.
Key Characteristics of Vertical Preparation
Some key characteristics of vertical preparation include:
- The use of the Biologically Oriented Preparation Technique (BOPT) 3, 5, 2.
- The creation of a new anatomic crown with a prosthetic emergence profile 6.
- The ability to modify the gingival tissue structure in thickness and height during preparation 5.
- The use of a vertical preparation protocol for veneers, which differs from the established protocol for full coverage crowns 2.
Comparison with Horizontal Preparation
While the provided studies do not directly compare vertical and horizontal periodontal bone preparation, they do discuss the advantages and applications of vertical preparation:
- Vertical preparation allows for a simpler and faster preparation impression taking, temporary crowns' relining, and creating the crowns' profiles up to the final prosthetic restoration 3.
- Vertical preparation enables the accurate transmission of information about the gingival tissue to the laboratory technician 5.
- Digital impression with an intraoral scanner seems to be a viable alternative to perform zirconia FPD in the BOPT technique 6.