Horizontal Ridge Augmentation Utilizing a Composite Graft of Demineralized Freeze-Dried Allograft, Mineralized Cortical Cancellous Chips, and a Biologically Degradable Thermoplastic Carrier Combined With a Resorbable Membrane: A Retrospective Evaluation of 73 Consecutively Treated Cases From Private Practices

Abstract

Ridge deficiency is an unfortunate obstacle in the field of implant dentistry. Many techniques are available to rebuild the deficient ridge. Some of these techniques are associated with significant morbidity and often require a second surgical site. With the advent of guided bone regeneration (GBR), one may now graft the deficient ridge with decreased morbidity and without a second surgical site. The purpose of this retrospective consecutive case series from 5 private practices is to report on the outcomes of a composite material of demineralized freeze-dried allograft, mineralized cortical cancellous chips, and a biologically degradable thermoplastic carrier (Regenaform RT) when combined with a resorbable membrane for GBR of lateral ridge defects in human patients. The specific aim was to quantify clinical results through direct measurement. Data were obtained from 73 consecutively treated lateral ridge augmentations performed on 67 partial and/or completely edentate patients. Clinical data (presurgical ridge width, ridge width at implant placement, and bone density at implant placement) were obtained retrospectively from 5 private practices via an exhaustive retrospective chart review, which was pooled and averaged for analysis. The average gain in horizontal ridge width was 3.5 mm (range, 3-6 mm). The density of the bone was noted to be type 2 to 3, with type 3 being the predominant finding. This retrospective case series from 5 clinical private practices suggests that the use of a composite material of demineralized freeze-dried allograft, mineralized cortical cancellous chips, and a biologically degradable thermoplastic carrier, when covered by a resorbable collagen membrane for GBR, is an effective means of horizontal ridge augmentation.

Role of Cone Beam Computed Tomography in Rehabilitation of a Traumatised Deficient Maxillary Alveolar Ridge Using Symphyseal Block Graft Placement

“…As compared to onlay grafts, particulate grafts require additional materials to ensure space maintenance and graft containment such as barrier membranes, tenting screws, and/or graft binders, while onlay grafts are self-contained and provide an inherent ability to support the soft tissue [4]. Therefore, onlay autografts are the best grafting material for ridge augmentation procedure.…”

“…Additionally, harvesting graft from extraoral sources requires general anaesthesia and hospital admission with a longer healing period which can be avoided when an intraoral site is chosen [3, 4]. Several studies have shown that intraoral autogenous grafts have a lower rate of resorption and better revascularization compared to iliac crest grafts [4]. …”

“…The surgical procedure was easily done under local anaesthesia with a short recovery period and uneventful healing at the donor site as in majority of the reported cases [4, 7]. …”

“…Gains of 4-5 mm in width and height of alveolar ridge have been reported with autogenous onlay grafts with associated implant success rates [2, 4]. Although the various case reports document the successful placement of implants following ridge augmentation with onlay allografts, the effectiveness and predictability of these procedures for ridge augmentation remain unclear.…”

An Alternative Approach for Augmenting the Anterior Maxilla Using Autogenous Free Gingival Bone Graft for Implant Retained Prosthesis

“…6,7 Because of this, several factors must be taken into consideration when choosing the donor site, including the location of the recipient bed, the quality and quantity of the required bone graft, and the potential for surgical complications. 8 Guided bone regeneration (GBR) is a procedure often employed for an implant site that presents buccal dehiscence or fenestration defects. 9 A barrier membrane is necessary for this procedure.…”