On the Feasibility of Utilizing Allogeneic Bone Blocks for Atrophic Maxillary Augmentation

Abstract

Purpose. This systematic review was aimed at assessing the feasibility by means of survival rate, histologic analysis, and causes of failure of allogeneic block grafts for augmenting the atrophic maxilla. Material and Methods. A literature search was conducted by one reviewer in several databases. Articles were included in this systematic review if they were human clinical trials in which outcomes of allogeneic bone block grafts were studied by means of survival rate. In addition other factors were extracted in order to assess their influence upon graft failure. Results. Fifteen articles fulfilled the inclusion criteria and subsequently were analyzed in this systematic review. A total of 361 block grafts could be followed 4 to 9 months after the surgery, of which 9 (2.4%) failed within 1 month to 2 months after the surgery. Additionally, a weighed mean 4.79 mm (95% CI: 4.51–5.08) horizontal bone gain was computed from 119 grafted sites in 5 studies. Regarding implant cumulative survival rate, the weighed mean was 96.9% (95% CI: 92.8–98.7%), computed from 228 implants over a mean follow-up period of 23.9 months. Histologic analysis showed that allogeneic block grafts behave differently in the early stages of healing when compared to autogenous block grafts. Conclusion. Atrophied maxillary reconstruction with allogeneic bone block grafts represents a reliable option as shown by low block graft failure rate, minimal resorption, and high implant survival rate.

Short implants versus bone grafting and standard-length implants placement: a systematic review

“…For that reason, different ridge preservation and bone-regenerative techniques have been developed in order to increase the bony space in which an implant could be inserted, including sinus floor elevation and coronal bone regeneration. It has been proven that these techniques are predictable [9][10][11]. However, these techniques imply a higher economic cost for both the patient and the dentist, need a high degree of surgical expertise and require more surgical time and appointments.…”

Vertical bone augmentation in a single‐tooth gap with an allogenic bone ring: Clinical considerations

“…These results highlight the benefits of the applied technique in comparison to conventional two‐stage block augmentations: less invasiveness, shorter time to teeth and, therefore, higher patient satisfaction. Further advantages of FDBA compared to ABG include the avoidance of a second surgical site and donor site morbidity, less pain for the patient and reduced surgical time . However, further studies involving more cases are necessary to verify the reliability and validity of this technique.…”

“…Therefore, reliable alternatives with different biomaterials are increasingly demanded and used. Freeze‐dried bone allograft (FDBA) represent a promising option on account of low block graft failure rate, minimal resorption, and high implant survival rates . Especially in complex defect situations with severe bone loss, where granular bone substitutes would fail to maintain proper stability, solid forms of FDBA represent the most promising approach to circumvent the requirement for bone harvesting.…”

Treatment of a bilaterally severely resorbed posterior mandible due to early tooth loss by Guided Bone Regeneration using customized allogeneic bone blocks: A case report with 24 months follow‐up data

“…Allografts can be categorized into fresh frozen bone, freeze‐dried bone allografts (FDBA), and demineralized bone (DFDBA) . Especially, FDBA are found to be well tolerated and do not only present low block graft failure rates, but also show minimal resorptions and high implant survival rates . Altogether, the application of allogeneic bone blocks is recently becoming a popular alternative to conventional augmentation procedures.…”

“…Despite the finding of organic tissue remnants in allogeneic grafts, current studies could not detect clinical consequences after the use of allografts examined by accredited purifications techniques and patient screenings . Allografts do not only convince because of their well tolerated applicability and low block graft failure rates, but are also presenting minimal resorptions and high implant survival rates . However, there still is a lack of literature concerning the use of allografts for alveolar ridge reconstruction and the long‐time experiences.…”