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

Abstract

Aim To evaluate the efficacy of customized allogeneic bone block (CABB) for ridge augmentation compared with autogenous bone block. Materials and Methods Patients (N = 24) in need of ridge augmentation were randomly assigned to one of two treatment modalities: CABBs (CABB group) and autogenous bone blocks (ABB group). The primary outcome of the present study was the horizontal bone gain at 1 mm below the alveolar ridge crest (HBG1). Secondary outcomes were the bone gain at other levels, bone resorption rate, ridge width, operative time, postoperative pain score, and histological results. The data obtained from the current study were analysed using a generalized linear mixed effects model, two‐sample t‐test, or a Mann–Whitney U‐test. Results Twenty‐four patients completed a 6‐month follow‐up. One patient in the CABB group exhibited block exposure. The CABB group had significantly more horizontal bone gain (HBG1) and less horizontal bone resorption (HBRR1) at 1 mm below the alveolar ridge crest when compared with those in the ABB group (HBG1: CABB group [4.29 ± 1.48 mm] and ABB group [1.12 ± 3.25 mm]; HBRR0: CABB group [42.15 ± 14.03%] and ABB group [92.52 ± 55.78%], p < .05). In addition, a longer operative time was reported in the ABB group compared with the CABB group (p < .05). The histological observation indicated a new bone formation in both groups. Conclusions The use of CABBs resulted in more horizontal bone gain and less horizontal bone resorption at 1 mm below the alveolar ridge crest at 6 months post‐surgery compared with ABBs while reducing the operative time in the treatment of ridge augmentation.

Allogeneic versus autogenous shell technique augmentation procedures: a prospective-observational clinical trial comparing surgical time and complication rates

“…In addition, the ramus of the mandible was already associated with a comparable low donor site morbidity [ 5 ]. This is to the results of others in which no donor site complications besides local swelling episodes were detected [ 8 , 35 ]. For postoperative complications using allogeneic bone block grafts, Chaushu et al reported 12.5% of soft tissue perforations, 80% of incision line opening, and 25% of block exposure.…”

“…The efficacy of processed allogeneic bone is comparable to autogenous bone transplants [ 8 , 13 , 31 – 33 ]. An advantage of the shell technique is the combination of cortical and cancellous bone, as cancellous bone alone seems more vulnerable to bone resorption [ 34 ].…”

“…An advantage of the shell technique is the combination of cortical and cancellous bone, as cancellous bone alone seems more vulnerable to bone resorption [ 34 ]. The cortical shell might be a barrier resisting external pressure [ 8 ]. Together with the sufficient bone gain and restricted implant failures reported before [ 12 ], this further proves the benefit of allogeneic shells over autogenous bone.…”

“…Wang et al compared the surgical time of customized allogeneic bone blocks with autogenous bone blocks for ridge augmentation. They found a significantly shorter operation time when using allogeneic materials (mean 8.75 vs. 78.5 min) [ 8 ]. Even so, this difference might also result from the customized blocks manufactured based on the patient’s DICOM data via computer numerical control milling processes.…”

“…When using autogenous bone blocks, most patients reported their preference for the retromolar region as the donor site [ 4 ], which has been shown to have a low donor site morbidity [ 5 ]. However, some patients experienced postoperative pain during chewing, swelling episodes, and bleeding [ 6 – 8 ]; a particular risk of infection, mucosal dehiscences, and primarily temporary neurosensory disturbances is described [ 9 , 10 ]. Allogeneic bone is a promising alternative to autogenous material for dental augmentation with clinically similar results but is readily available without any donor site morbidity [ 11 – 14 ].…”