Effectiveness of Lateral Bone Augmentation on the Alveolar Crest Dimension

Abstract

Lateral ridge augmentation procedures are aimed to reconstruct deficient alveolar ridges or to build up peri-implant dehiscence and fenestrations. The objective of this systematic review was to assess the efficacy of these interventions by analyzing data from 40 clinical studies evaluating bone augmentation through either the staged or the simultaneous approach. The PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-analyses) guideline for systematic reviews was used. The primary outcomes were the changes at reentry, in the ridge width, and in the vertical and horizontal dimensions of the peri-implant defect, measured in millimeters, in the staged and simultaneous approaches, respectively. The results of the meta-analysis showed, for the simultaneous approach, a statistically significant defect height reduction when all treatments were analyzed together (weighted mean difference [WMD] = -4.28 mm; 95% confidence interval: [CI] -4.88, -3.69; P < 0.01). The intervention combining bone replacement grafts with barrier membranes was associated with superior outcomes The most frequently used intervention was the combination of xenograft and bioabsorbable membrane. Similarly, for the staged approach, there was a statistically significant horizontal gain when all treatment groups were combined (WMD = 3.90 mm; 95% CI: 3.52, 4.28; P < 0.001). The most frequently used intervention was the use of autogenous bone blocks. Both treatment strategies led to high survival and success rates (>95%) for the implants placed on the regenerated sites. Nonexposed sites gained significantly more in the simultaneous and staged approaches (WMD = 1.1 and 3.1 mm).

Histomorphometric and immunohistochemical evaluation of collagen containing xenogeneic bone blocks used for lateral bone augmentation in staged implant placement

“…Among the grafting materials, particulated xenogeneic materials have been extensively studied in both experimental and clinical studies and when combined with porcine-derived natural collagen membranes have resulted in predictable clinical and histological outcomes [2]. This combined treatment has shown to be safe and efficacious in horizontal ridge augmentations resulting in regenerated bone with similar implant survival rates when compared to implants placed in pristine bone and demonstrating a low degree of morbidity and a low rate of post-operative complications [3, 4]. However, in clinical situations with severe bone resorption of the alveolar process, which results in non-self-containing bone defects, the use of particulate bone replacement grafts with its inherent weak volumetric stability may limit the predictability of the regenerative therapy [5, 6].…”

“…However, in clinical situations with severe bone resorption of the alveolar process, which results in non-self-containing bone defects, the use of particulate bone replacement grafts with its inherent weak volumetric stability may limit the predictability of the regenerative therapy [5, 6]. In these cases, dental implants are usually placed staged to the lateral bone augmentation procedure and autogenous bone blocks have been the state of the art procedure, resulting in superior results in mean horizontal bone gains when compared with guided bone regeneration with particulate bone grafts [4, 7, 8]. The use of bone blocks, however, has been associated with increased surgical time, morbidity [9, 10], and a higher frequency of post-operative complications [11, 12].…”

Bone defect rehabilitation using lyophilized bone preshaped on a stereolithographic model

“…(2015) reported that the use of a barrier membrane over the graft resulted in better results when compared with the graft alone. [7] In this case report, the use of barrier membrane may have contributed to the success of treatment.…”

“…The autogenous graft is considered the gold-standard for rehabilitation of bone defects,[17] due to its osteogenic properties. [3] However, the main disadvantages of autogenous bone are the need for a second surgical procedure that causes the patient morbidity and discomfort.…”

Clinical and Translational Research

“…As of this writing, this month's clinical research supplement will be our final one, as we will now embark to collaborate with the new JDR Clinical & Translational Research editorial team on the publication of cutting-edge science in the area. In our final clinical research supplement, you will find some exciting advances in big data (DeRouen 2015), clinical bone augmentation strategies (Sanz et al 2015), cardiometabolic diseases (Janket et al 2015), and 3-dimensional printing (Obregon et al 2015), to name just a few.…”