Bone Augmentation With Occlusive Barriers and Cortical Particulate Allograft in Transverse Maxillary Defects: A Pilot Study

Abstract

SUMMARY:The centripetal resorption of maxilla is a continuous process after tooth loss. For treatment of deficient bone sites, autologous bone grafts may be used, as an alternative, biomaterials can be applied which do not require intra or extraoral donor sites. The present report describes the use of occlusive barriers and cortical particulate allograft in transverse maxillary defects. This surgical approach was performed in five patients (4 females and 1 male, aged 20 to 37 years). Clinical results show that sufficient hard tissue was formed to allow implant born rehabilitation in the former insufficient bone sites. Histological evaluation revealed small amounts of newly formed bone with a predominance of collagen fibrous tissue and mature bone with very little cellular elements. Depending on the original site situation, the minimally invasive approach with occlusive barrier and cortical particulate allograft may be applied. We observed a mean of 2.3, 2.7 and 2.9 mm in bone gain for ridge, middle and apical area, respectively.

Evaluation of Bone Gain and Complication Rates after Guided Bone Regeneration with Titanium Foils: A Systematic Review

“…Three other articles were discarded, as they appear to be the same study as another two of the included papers but in earlier stages [ 20 , 21 , 23 ]. A total of 13 articles were included in the qualitative analysis [ 19 , 22 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 37 , 38 , 39 ] ( Figure 2 ). A quantitative analysis could not be performed due to the lack of information provided and the great heterogeneity of the studies, in terms of sample size, type of defect to be regenerated, time of membrane removal and filling material used.…”

“…Two of the included articles were case reports [ 28 , 30 ], seven were case series [ 19 , 22 , 25 , 26 , 29 , 31 , 39 ], three were split-mouth randomized clinical trials [ 27 , 37 , 38 ] and only one was a retrospective cohort study [ 24 ]. The studies were published between 1999 and 2020 ( Figure 3 and Table 1 ).…”

“…A wide variety of bone defects were treated: horizontal [ 25 , 28 , 29 , 30 , 39 ], horizontal and vertical [ 22 , 24 , 26 , 28 , 39 ], periodontal intrabony defects [ 27 , 37 ], post-extraction sockets [ 19 , 38 ], peri-implant defects [ 31 , 39 ] and sinus-floor augmentation [ 39 ].…”

“…The filling material was different depending on the study: blood clot [ 24 , 27 , 37 , 38 ], xenograft [ 25 , 26 , 30 ], allograft [ 22 , 29 ], β-Tricalcium phosphate [ 28 ], PRF or PRF + tricalcium phosphate + hydroxyapatite [ 19 ], autograft [ 38 ], autograft or/and hydroxyapatite [ 39 ] and autograft + xenograft [ 31 ].…”

“…The concept of using these barriers is to take advantage of the properties of the blood clot, which is why, in some studies, they are used without biomaterial filling [ 21 , 24 ]; although, in other publications, these membranes have been used in combination with PRF [ 19 ], allograft [ 20 , 22 , 23 , 29 ], xenograft [ 25 , 26 , 30 ], mixed autograft and allograft [ 31 ] or even tricalcium β-phosphate [ 28 ].…”