The outcome of intraoral onlay block bone grafts on alveolar ridge augmentations: A systematic review

Abstract

Aim: The purpose of this study was to systematically review clinical studies examining the survival and success rates of implants placed with intraoral onlay autogenous bone grafts to answer the following question: do ridge augmentations procedures with intraoral onlay block bone grafts in conjunction with or prior to implant placement influence implant outcome when compared with a control group (guided bone regeneration, alveolar distraction, native bone or short dental implants.)? Material and Method: An electronic data banks and hand searching were used to find relevant articles on vertical and lateral augmentation procedures performed with intraoral onlay block bone grafts for dental implant therapy published up to October 2013. Publications in English, on human subjects, with a controlled study design –involving at least one group with defects treated with intraoral onlay block bone grafts, more than five patients and a minimum follow-up of 12 months after prosthetic loading were included. Two reviewers extracted the data. Results: A total of 6 studies met the inclusion criteria: 4 studies on horizontal augmentation and 2 studies on vertical augmentation. Intraoperative complications were not reported. Most common postsurgical complications included mainly mucosal dehiscences (4 studies), bone graft or membrane exposures (3 studies), complete failures of block grafts (2 studies) and neurosensory alterations (4 studies). For lateral augmentation procedures, implant survival rates ranged from 96.9% to 100%, while for vertical augmentation they ranged from 89.5% to 100%. None article studied the soft tissues healing. Conclusions: Survival and success rates of implants placed in horizontally and vertically resorbed edentulous ridges reconstructed with block bone grafts are similar to those of implants placed in native bone, in distracted sites or with guided bone regeneration. More surgical challenges and morbidity arise from vertical augmentations, thus short implants may be a feasible option. Key words:Alveolar ridge augmentation, intraoral bone grafts, onlay grafts, block grafts, dental implants.

Custom-Made Direct Metal Laser Sintering Titanium Subperiosteal Implants: A Retrospective Clinical Study on 70 Patients

“…Such surgical techniques, however, are rather complex, have a high risk of complications, and result in increased time and cost of treatment [5, 6, 10, 13, 15]. …”

“…Several surgical techniques have been proposed for bone regeneration to allow for the subsequent placement of endosseous implants; these include onlay/inlay bone grating [6, 7], guided bone regeneration (GBR) with resorbable or nonresorbable membranes [8], alveolar ridge split [9], distraction osteogenesis [10], and maxillary sinus augmentation [11, 12]. …”

“…All of these regenerative techniques, which make use of different materials (autogenous bone harvested from intraoral/extraoral sites; homologous, heterologous, or synthetic bone grafts) may restore bone volume to a level that allows the proper placement of endosseous dental implants [6–14]; however, these surgical techniques are complex and can have a rather high percentage of complications [5, 6, 10, 13, 15]. In addition, they lengthen the time of treatment and present additional costs to the patient [5, 6, 10, 13, 15].…”

Retrospective analysis of 10,000 implants from insertion up to 20 years—analysis of implantations using augmentative procedures

“…This indicates that under daily practice all these augmentation procedures may provide clinically acceptable results. Recent reviews have also reported a high implant survival of more than 90% for sinus augmentation [5, 15, 17, 21–23], lateral ridge augmentation [15, 19, 24, 25], for bone splitting [21, 26] as well as for three-dimensional augmentations using titanium mesh [27]. When augmentation procedures were compared to each other, the authors were not able to draw a clear conclusion on the superiority of a certain augmentation procedure or grafting protocol [15, 17, 21, 28].…”

A Simple Surgical Guide for Horizontal Bone Graft: A Technical Note

“…When patient had worn denture for long time in the maxilla, we can expect severe alveolar bone resorption. Predictive treatment in severely resorbed anterior maxilla is block bone graft and delayed or immediate implant installation (4).…”