Survival Rates of Dental Implants in Autogenous and Allogeneic Bone Blocks: A Systematic Review

Abstract

Background and Objectives: Preliminary studies emphasize the similar performance of autogenous bone blocks (AUBBs) and allogeneic bone blocks (ALBBs) in pre-implant surgery; however, most of these studies include limited subjects or hold a low level of evidence. The purpose of this review is to test the hypothesis of indifferent implant survival rates (ISRs) in AUBB and ALBB and determine the impact of various material-, surgery- and patient-related confounders and predictors. Materials and Methods: The national library of medicine (MEDLINE), Excerpta Medica database (EMBASE) and Cochrane Central Register of Controlled Trials (CENTRAL) were screened for studies reporting the ISRs of implants placed in AUBB and ALBB with ≥10 participants followed for ≥12 months from January 1995 to November 2021. The review was conducted in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The risk of bias was assessed via several scoring tools, dependent on the study design. Means of sub-entities were presented as violin plots. Results: An electronic data search resulted in the identification of 9233 articles, of which 100 were included in the quantitative analysis. No significant difference (p = 0.54) was found between the ISR of AUBB (96.23 ± 5.27%; range: 75% to 100%; 2195 subjects, 6861 implants) and that of ALBB (97.66 ± 2.68%; range: 90.1% to 100%; 1202 subjects, 3434 implants). The ISR in AUBB was increased in blocks from intraoral as compared to extraoral donor sites (p = 0.0003), partially edentulous as compared to totally edentulous (p = 0.0002), as well as in patients younger than 45 as compared to those older (p = 0.044), cortical as compared to cortico-cancellous blocks (p = 0.005) and in delayed implantations within three months as compared to immediate implantations (p = 0.018). The ISR of ALBB was significantly increased in processed as compared to fresh-frozen ALBB (p = 0.004), but also in horizontal as compared to vertical augmentations (p = 0.009). Conclusions: The present findings widely emphasize the feasibility of achieving similar ISRs with AUBB and ALBB applied for pre-implant bone grafting. ISRs were negatively affected in sub-entities linked to more extensive augmentation procedures such as bone donor site and dentition status. The inclusion and pooling of literature with a low level of evidence, the absence of randomized controlled clinical trials (RCTs) comparing AUBB and ALBB and the limited count of comparative studies with short follow-ups increases the risk of bias and complicates data interpretation. Consequently, further long-term comparative studies are needed.

Clinical and radiographic outcomes of customized allogeneic bone block versus autogenous bone block for ridge augmentation: 6 Month results of a randomized controlled clinical trial

“…Several studies have reported that the success rates of the blocks are in the range of 94.7%-100% (Nissan et al, 2008;Barone et al, 2009;Carinci et al, 2010;Dahlin & Johansson, 2011;Pereira et al, 2015). A recent systematic review demonstrated that the implant survival rates in allogeneic bone blocks (96.23 ± 5.27%) were similar to those of ABBs (97.66 ± 2.68%) (Donkiewicz et al, 2021). A study conducted concerning bone gain and resorption using allogeneic bone blocks by Kloss et al (2018) reported a mean HBG of 5.2 ± 1.4 mm and a mean VBG of 0.2 ± 1.2 mm.…”

Efficiency of Nanohydroxyapatite on Repairing Type II Diabetes Dental Implant-Bone Defect

“…Recent studies suggested that the autologous jaw has good biocompatibility, bone conduction, bone induction, and high safety advantages in immediate implantation, but certain complications may be induced when the autologous jaw is used for bone extraction [ 11 , 12 ]. Patients who have allogeneic bone transplants, on the other hand, are more likely to develop a rejection reaction and infection [ 13 ]. The structure of nanohydroxyapatite (n-HA) is very similar to the crystal structure of the inorganic component of human bone, and it has good biological activity, no cytotoxicity, no immunogenicity, and good degradation performance [ 14 ].…”

Specially designed and CAD/CAM manufactured allogeneic bone blocks using for augmentation of a highly atrophic maxilla show a stable base for an all-on-six treatment concept: a case report

“…However, allogeneic bone grafts show a lesser risk of infections, postoperative morbidity, and unlimited bone availability. Although the clinical data shows excellent survival rates for allogeneic bone blocks ranging from 93.7 to 100.0%, the application of the allogeneic bone blocks is assumed to be more technique-sensitive [ 24 , 25 ]. Looking at the bone gain of allogeneic bone blocks, the literature provides several studies and meta-analysis with horizontal and vertical bone gains of 4.6±1.4 mm on average.…”