Comparison of alveolar ridge splitting and autogenous onlay bone grafting to enable implant placement in patients with atrophic jaw bones

Abstract

Objective:To compare alveolar ridge splitting (ARS) and autogenous onlay bone grafting (AOBG) in atrophic jaw bones.Methods:Forty patients were included in this retrospective, parallel-group study conducted at the Istanbul Medipol University School of Dentistry, Istanbul, Turkey, between 2012-2015. The initial bone thickness was measured by cone beam computed tomography (CBCT). Patients were allocated into ARS (n=17) and AOGB (n=23) groups on the basis of ridge thickness and shape. Follow-up CBCT measurements to assess horizontal bone were repeated 4 to 6 months post augmentation. The diameters of the implants were recorded. Implant bone resorption was measured at one year post implant placement on panoramic radiography. Surgical complications and implant survival were evaluated.Results:The final bone width in the AOBG group was significantly higher than that in the ARS group (p=0.029). Forty-four implants were inserted in the AOGB group, whereas 33 implants were inserted in the ARS group. There was no significant difference regarding implant diameter (p=0.920). Implant survival rate was 93.9% in the ARS group and 93.1% in the AOGB group. Peri-implant bone resorption at one year was higher in the AOBG group than in the ARS group (p=0.032). There were minor surgical complications, including bad split and wound dehiscence.Conclusion:The incidence of peri-implant bone resorption for the AOGB technique was higher than that for the ARS technique, but their implant survival rates were similar.

Clinical and histological sequelae of surgical complications in horizontal guided bone regeneration: a systematic review and proposal for management

“…Out of the 23 studies (Table 1), there were 11 randomised controlled clinical trials [21-24, 26, 29-32, 36, 37, 39], one prospective cohort study [34,40], three retrospective cohort studies [18,20,33], and eight case series [16,17,19,25,27,28,35,38,[41][42][43], of which two research groups independently published two follow-up papers on the same study cohort [21,22,27,28], and they have been collectively grouped under one study name for this analysis. The follow-up period after ridge augmentation or implant placement was reported in all studies except two [16,35], and it ranged from 3.1 months to 10 years.…”

“…Two studies nursed wound dehiscence sites by recalling patients once a week for 4 weeks for professional local disinfectant application, and once a month thereafter until complete resolution [21,22]. Two studies reported management of wound dehiscences with exposed graft materials by removing the sequestered bone [16] and treating the site with a combination of an antimicrobial mouth rinse and systemic antibiotics [16,20]. Two studies reported uneventful and spontaneous healing of dehisced sites [17,24].…”

Autogenous Bone Graft Healing in Alveolar Bone Splitting Technique: Histological Study

“…The benefit of additional defect walls was clearly demonstrated by Cortellini et al who found that bone defect fill improved proportionally to the number of residual defect walls (20). The main advantage of this technique is a predictable amount of bone gain; rapid vascularization, leading to improved bone healing; and the expanded defect heals in a similar manner to an extraction socket (21)(22)(23). Grafting between the fractured cortical lamellae is better integrated and opening of marrow space improves vascularization and healing (24).…”

Implant survival rate in calvarial bone grafts: A retrospective clinical study with 10 year follow‐up

“…1 Tooth loss represents a serious and disabling condition, requiring an appropriate therapeutic intervention to obtain complete recovery that meets patient expectations. 3 Reconstructive preimplant surgery represents a valid therapeutic option 3 to restore proper alveolar morphology and create ideal conditions for an adequate implant-prosthetic rehabilitation. 2 In cases of severe jaw atrophy, the poor quality and quantity of bone tissue may compromise osseointegration of the fixture, especially in the posterior region of the jaw.…”

“…In such cases, more complex rehabilitation strategies are required. 3 Reconstructive preimplant surgery represents a valid therapeutic option 3 to restore proper alveolar morphology and create ideal conditions for an adequate implant-prosthetic rehabilitation. 4,5 Calvarial autogenous bone is considered the gold standard treatment for its excellent osteogenic, osteoconductive, and osteoinductive properties and its resistance to bone resorption.…”