Bone quality at the implant site after reconstruction of a local defect of the maxillary anterior ridge with chin bone or deproteinised cancellous bovine bone

Abstract

The purpose of this study was to investigate the quality of bone at grafted implant sites in the anterior maxilla. Grafting of these sites was necessary because of insufficient bone volume in a buccopalatinal direction (width at the top of the crest 1-3mm). Reconstruction was performed with chin bone (N=5), chin bone and a resorbable Bio-Gide GBR membrane (N=5) or Bio-Oss spongiosa granules in combination with a Bio-Gide GBR membrane (N=5). Biopsies were taken prior to implantation, i.e. 3 months after grafting with chin bone, and 6 months after grafting with Bio-Oss. Evaluation was done by assessing the histological and histomorphometric characteristics of full-length biopsies taken from the actual implant site. Both areas with non-vital bone and areas with apposition of bone and remodelling phenomena were observed in the chin bone group at the time of placement of the implants. Similar results were observed at implant sites reconstructed with a chin bone graft covered by a membrane. In the chin bone group without and with a GBR membrane, the mean total bone volume (TBV) was 55.2+/-6.8% and 57.7+/-11.5%, respectively; the marrow connective tissue volume (MCTV) was 44.8+/-6.8% and 42.3+/-11.5%, respectively. Remnants of the resorbable GBR membrane were not detected. In the Bio-Oss((R)) group, at implant placement some newly formed bone was observed in the connective tissue surrounding the Bio-Oss((R)) particles (mean TBV (newly formed bone) 17.6+/-14.5%), but most particles were surrounded by connective tissue. No convincing signs of remodelling were observed (mean remaining Bio-Oss volume 40.5+/-9.3%; mean MCTV 41.9+/-13.1%). No implants were lost during follow up (12 months). At the time of placement of the implants the grafting material (either chin bone or Bio-Oss is still not fully replaced by new vital bone. In case of Bio-Oss, most of the grafting material is even still present. Despite these differences, the 1-year clinical results were very good and comparable between the various grafting techniques applied.

Hydroxyapatite crystallinity does not affect the repair of critical size bone defects

“…The experimental groups did not show greater bone formation than the control group, and the results are similar to previous studies in humans 14,20,22,26,29 (Table 2). It is worthwhile to mention that in the current literature, synthetic and natural hydroxyapatite promoted similar levels of new bone.…”

Comparison of procedures for immediate reconstruction of large osseous defects resulting from removal of a single tooth to prepare for insertion of an endosseous implant after healing

“…Bio-Oss 1 also significantly reduces resorption of buccal bone in a horizontal direction 4 . Conflicting results have been reported regarding the long-term behaviour of Bio-Oss 1 (whether it will be resorbed or maintained), but at least up to 6 months after grafting the material will still be present 17 .…”

To Graft or Not to Graft? Evidence-Based Guide to Decision Making in Oral Bone Graft Surgery

“…No significant differences (LoE-2) regarding implant survival, marginal gingiva and bone levels as well as implant esthetics (Meijndert et al, 2007) could be found between onlay block grafts vs. guided bone regeneration. Bone biopsies at implant placement revealed no differences in total bone volume and marrow connective tissue volume (Meijndert et al, 2005). No controlled study on alveolar ridge expansion in anterior maxillary sites could be identified.…”