Regeneration of alveolar ridge defects. Consensus report of group 4 of the 15th European Workshop on Periodontology on Bone Regeneration

Abstract

Background and Aims Bone augmentation procedures to enable dental implant placement are frequently performed. The remit of this working group was to evaluate the current evidence on the efficacy of regenerative measures for the reconstruction of alveolar ridge defects. Material and Methods The discussions were based on four systematic reviews focusing on lateral bone augmentation with implant placement at a later stage, vertical bone augmentation, reconstructive treatment of peri‐implantitis associated defects, and long‐term results of lateral window sinus augmentation procedures. Results A substantial body of evidence supports lateral bone augmentation prior to implant placement as a predictable procedure in order to gain sufficient ridge width for implant placement. Also, vertical ridge augmentation procedures were in many studies shown to be effective in treating deficient alveolar ridges to allow for dental implant placement. However, for both procedures the rate of associated complications was high. The adjunctive benefit of reconstructive measures for the treatment of peri‐implantitis‐related bone defects has only been assessed in a few RCTs. Meta‐analyses demonstrated a benefit with regard to radiographic bone gain but not for clinical outcomes. Lateral window sinus floor augmentation was shown to be a reliable procedure in the long term for the partially and fully edentulous maxilla. Conclusions The evaluated bone augmentation procedures were proven to be effective for the reconstruction of alveolar ridge defects. However, some procedures are demanding and bear a higher risk for post‐operative complications.

Surgical treatment of peri‐implantitis defects with two different xenograft granules: A randomized clinical pilot study

“…The use of composite therapeutic endpoints including information on radiographic bone levels, signs of peri‐implant soft tissue inflammation, and PPD has been published in multiple reports (Heitz‐Mayfield et al., 2014; Jepsen et al, 2019; Sanz & Chapple, 2012; Tomasi, Regidor, Ortiz‐Vigon, Regidor, Ortiz‐Vigón, & Derks, 2019). In the present study, two different versions of the composite therapeutic index were assessed based on evidence of peri‐implant tissue inflammation: (a) absolute absence of BoP and (b) allowing one site with evidence of BoP.…”

Clinical benefits of ridge preservation for implant placement compared to natural healing in maxillary teeth: A retrospective study

“…In the anterior region, the proportion of horizontal or vertical augmentation procedures was lower at ridge‐preserved sites than at naturally healed sites (62.7% vs. 75.8%, p = .016). It has been demonstrated that the GBR procedure performed either prior to or simultaneously with implant placement is a predictable technique for horizontal or vertical augmentation in the atrophic alveolar ridge (Jepsen et al, ; Naenni, Lim, Papageorgiou, & Hammerle, ; Urban, Montero, Monje, & Sanz‐Sanchez, ; Wessing, Lettner, & Zechner, ). However, extensive GBR procedures which frequently require flap mobilization further increase discomfort and surgical morbidity of patients.…”

A collagen membrane influences bone turnover marker in vivo after bone augmentation with xenogenic bone

“…For those defects in the jaws -if the bone substitute material can be stabilized properly -the clinical advantageous effect of barrier membranes could not be proven yet [17,54]. On contrary, more demanding defects have shown to bene t from GBRtechniques [55], maybe also because of the early increase platelet-derived growth factors [30] in combination with the (later) increase of bone turnover markers as found in the present study. Therefore, a critical size, full thickness defect with limited healing properties [35] was chosen.…”