Bone augmentation followed by implant surgery in the edentulous mandible: A systematic review

Abstract

Long-standing loss of natural teeth in the mandible can lead to severe jaw atrophy and even mandibular fracture. There is no consensus on the best pre-prosthetic surgical treatment to reconstruct the atrophic edentulous mandible. The purpose of this review was to provide an overview of the existing literature and to give an evidence-based recommendation for bone grafting and future research. This systematic review was conducted according to the PRISMA statement. A literature search was performed in online databases Pubmed and Cochrane library for articles published between January 1980 and September 2017. The search was conducted using Medical Subject Heading terms: alveolar ridge augmentation; mouth, edentulous and mandible. Eligible articles were included according to in- and exclusion criteria and assessed on quality. Dental implant survival and bone stability were the primary outcomes. Secondary outcomes were complications. Twenty-four text articles matched the criteria and were included. Eleven articles were assessed to be of adequate quality for analysis. Graft stability seems to be higher in vertical distraction and tent-pole grafting, but as the dental implant survival is high (91.7% or higher) regardless of the procedure used for bone augmentation, this is of no clinical relevance. The survival rate of dental implants is high, regardless of the bone augmentation procedure used. High-quality clinical trials are needed to support the current evidence and guidelines on pre-implant bone grafting. Reporting of future research should include proper baseline characteristics and treatment description, as well as uniform outcome rendering.

Implant fracture failure rate and potential associated risk indicators: An up to 12‐year retrospective study of implants in 5,124 patients

“…While the statistical results may be affected by variations in criteria, the implant diameter in the posterior area should be considered in classification strategies. shown to be unrelated to implant success rates in various systematic reviews (de Groot, Oomens, Forouzanfar, & Schulten, 2018;Jung et al, 2012). However, many studies have demonstrated that vertical and horizontal augmentation allow implant placement in atrophic ridges (Clementini, Morlupi, Canullo, Agrestini, & Barlattani, 2012).…”

Trefoil System for the Treatment of Mandibular Edentulism: A Case Report with 30 Months Follow-Up

“…This kind of surgery is aimed at restoring the correct bone anatomy and allows the insertion of more implants, particularly in the molar region, thus creating a prosthesis without distal cantilever and orthopedic resin gingiva. The survival rate of dental implants is high, regardless of the bone augmentation technique chosen, but such procedures require great operator skills and a long healing period [ 5 , 6 ]. Moreover, they imply high morbidity and treatment costs, and they need strong patient compliance to achieve clinical success.…”

Sandwich osteotomy in atrophic mandibles: A retrospective study with a 2‐ to 144‐month follow‐up

“…In mandible, the compact cortical layer with single vessel for endosteal blood supply tends to limit regenerative capacity, because of a low permeability to the osteogenic elements (Marenzana & Arnett, ). In atrophic mandible, the bone healing is even complicated with comorbidity and polypharmacy among elderly people (de Groot, Oomens, Forouzanfar, & Schulten, ). Surgical techniques including guided bone regeneration with particulate bone graft, onlay block bone graft, alveolar distraction osteogenesis, and sandwich osteotomy with interposition graft were often proposed to correct the bone deficiency in mandible (Elnayef et al, ).…”