Lateral Alveolar Ridge Augmentation with an Autogenous Bone Block Graft Alone with or without Barrier Membrane Coverage: a Systematic Review and Meta-Analysis

Abstract

Objectives: To test the hypothesis of no difference in implant treatment outcome following lateral alveolar ridge augmentation with autogenous bone block graft with or without barrier membrane coverage. Material and Methods: PubMed (MEDLINE), Embase and Cochrane library search in combination with a hand-search of relevant journals was conducted. Human studies published in English until the 8 th of February 2021 were included. Randomised controlled trials with an observation period longer than three months were included. Survival of implants and suprastructures were considered as primary outcomes measures, whereas peri-implant marginal bone loss, dimensional changes of the alveolar ridge, bone regeneration, patient-reported outcome measures, biological and mechanical complications were secondary outcome measures, as evaluated by descriptive statistics and meta-analysis including 95% confidence interval (CI). Results: Electronic search and hand-searching resulted in 411 entries. Five randomised controlled trials characterised by low or high risk of bias fulfilled inclusion criteria. No statistically significant difference between the two treatment modalities was observed in any of the outcome measures. However, barrier membrane coverage was associated with a non-significant gain in alveolar ridge width of 0.5 mm (95% CI = -0.1 to 1.1) and diminished resorption of -0.9 mm (95% CI = -2.4 to 0.7) compared with no barrier membrane coverage. Conclusions: Comparable implant treatment outcomes were revealed following lateral alveolar ridge augmentation with autogenous bone block graft alone with or without barrier membrane coverage. However, postoperative dimensional changes of the augmented seems to be diminished with the use of barrier membrane coverage as evaluated by two-dimensional linear measurements.

A Comparison of Guided Bone Regeneration vs. the Shell Technique Using Xenogeneic Bone Blocks in Horizontal Bone Defects: A Randomized Clinical Trial

“…In cases when neither less invasive alternatives, such as narrow or short implants, nor removable prostheses were possible or accepted by a patient, several augmentation techniques have been widely documented: among these, many authors have indicated the use of autogenous bone blocks as the gold standard since they have good osteogenetic, osteoinductive, and osteoconductive properties. Nevertheless, the harvesting procedure may imply postoperative complications as well as limited availability and a higher degree of resorption compared to other grafts [18,20,21].…”

“…Furthermore, according to a recent systematic review, postoperative dimensional changes in the augmented bone seem to diminish with the use of barrier membrane coverage [18].…”

Clinical and Biological Validation of an Allogeneous Cancellous Bone Block for Alveolar Maxillary Ridge Reconstruction: A Case Series

“…Regarding the latter aspect, block grafting was considered in the reported cases due to the advanced defect dimensions and the potential advantage of block grafts of remaining more stable and robust against graft displacement upon wound closure and healing. There is a lack of evidence supporting the use of barrier membranes with bone block grafting [41,42].…”

Localized Ridge Augmentation with Mandibular Block Autograft and Guided Bone Regeneration: A Case Report

“…Fortunately, none of the complications were reported by the patient in the present case. Interestingly, the combination of chin graft with particulate bone grafts covered by a collagen membrane has yielded gain in bone dimensions in the present case and as a result [21][22][23].…”