Comparative analysis of two biomaterials mixed with autogenous bone graft for vertical ridge augmentation: A histomorphometric study in humans

Abstract

Background The vertical increase of the alveolar ridge dimension using allograft or xenograft mixed with autogenous bone graft and covered by a nonabsorbable high‐density polytetrafluoroethylene (d‐PTFE) membrane is well documented in the literature. Purpose The aim of this study was to assess vital mineralized tissue formation in vertical ridge augmentation (VRA) procedures using autogenous bone chips mixed either with an allograft or a xenograft. Methods This prospective clinical trial recruited 16 partially edentulous patients to undergo vertical ridge augmentation in one or more sites, making up a total of 24 samples for histological evaluation. Patients were sequentially stratified into Group A (treated with a freeze‐dried bone allograft [FDBA] mixed with autogenous bone) or to Group B (treated with a bovine xenograft mixed with autogenous bone). Histological samples were analyzed according to the biomaterial used for VRA. Histological samples were obtained on the same day of membrane removal and implant placement. Results Thirty‐three implants were placed in 16 sites of regenerated bone via VRA, 13 patients with ridge augmentation in the posterior mandible, and 3 patients with VRA in the anterior maxilla. Group A (FDBA + autogenous) and Group B (xenograft + autogenous) showed a percent vital mineralized tissue (VMT) area of 67.64 ± 16.84 and 60.93 ± 18.25, respectively. A significant difference between the two biomaterials was not observed. Conclusion When mixed with autogenous bone, either allografts or xenografts may provide a successful augmentation. Either mixture could serve as reliable alternative in VRA for obtaining a high percentage of VMT.

Bioactive Scaffolds as a Promising Alternative for Enhancing Critical-Size Bone Defect Regeneration in the Craniomaxillofacial Region

“…Similarly, autologous bone chips combined with freeze-dried allografts (MinerOss) or xenografts (Zcore, porcine bone) were implanted into maxillary or mandibular severely resorbed alveolar ridges to increase BH. Interestingly, both biomaterials effectively increased the alveolar ridge height, which exhibited similar BMD nine-months postgrafting …”

“…Among the clinical studies that have compared the performance of scaffolds fabricated with different biomaterials are (a) when Bio-Oss and Lumina-Porous, two deproteinized bovine bone-based biomaterials, were used to promote the maxillary sinus floor bone growth, Bio-Oss performed better than Lumina-Porous probably due to the differences on microstructure generated on the bone by variations on the deproteinization process; (b) autologous bone mixed with allografts (MinerOss) or xenografts (Zcore, porcine bone) augmented similarly the vertical ridge in maxillary or mandibular bones nine months postimplantation …”

“…56 Among the clinical studies that have compared the performance of scaffolds fabricated with different biomaterials are (a) when Bio-Oss and Lumina-Porous, two deproteinized bovine bone-based biomaterials, were used to promote the maxillary sinus floor bone growth, Bio-Oss performed better than Lumina-Porous probably due to the differences on microstructure generated on the bone by variations on the deproteinization process; 80 (b) autologous bone mixed with allografts (MinerOss) or xenografts (Zcore, porcine bone) augmented similarly the vertical ridge in maxillary or mandibular bones nine months postimplantation. 81 In summary, biomaterials for fabricating scaffolds for CMF bone engineering applications include polymers (natural, decellularized bone matrices, and synthetic), bioceramics, metals, and composites. None of the developed biomaterials has surpassed autografts' osteogenic properties, while some showed similar bone regrowth induction as the xenografts and allografts.…”

“…Interestingly, both biomaterials effectively increased the alveolar ridge height, which exhibited similar BMD nine-months postgrafting. 81 Maxillary alveolar clefts in children were treated with autologous iliac crest bone, InFuse (rhBMP2-laden Col sponge), or mucoperiosteal grafts. Twelve months postgrafting, BV and BH were similar at defect sites treated with autografts and InFuse.…”

Complications following alveolar ridge augmentation procedures

“…Alveolar Ridge Augmentation Procedure (RAP), defined as a procedure designed to correct a deformed alveolar ridge, 2 is a broader term and often used in current literature. 14 RAP may include both soft-and hard-tissue augmentation procedures. In general, and especially in the context of dental implant therapy, these procedures require the use of multiple biomaterials, including bone graft material together with a barrier membrane.…”