Clinical efficacy of grafting materials in alveolar ridge augmentation: A systematic review

Troeltzsch, Markus; Troeltzsch, Matthias; Kauffmann, Philipp; Gruber, Rudolph; Brockmeyer, Phillipp; Moser, Norman; Rau, Andreas; Schliephake, Henning

doi:10.1016/j.jcms.2016.07.028

Cited by 162 publications

(178 citation statements)

References 141 publications

Supporting

Mentioning

142

Contrasting

Unclassified

Order By: Relevance

“…However, in clinical situations with severe bone resorption of the alveolar process, which results in non-self-containing bone defects, the use of particulate bone replacement grafts with its inherent weak volumetric stability may limit the predictability of the regenerative therapy [5, 6]. In these cases, dental implants are usually placed staged to the lateral bone augmentation procedure and autogenous bone blocks have been the state of the art procedure, resulting in superior results in mean horizontal bone gains when compared with guided bone regeneration with particulate bone grafts [4, 7, 8]. The use of bone blocks, however, has been associated with increased surgical time, morbidity [9, 10], and a higher frequency of post-operative complications [11, 12].…”

Section: Introductionmentioning

confidence: 99%

Histomorphometric and immunohistochemical evaluation of collagen containing xenogeneic bone blocks used for lateral bone augmentation in staged implant placement

et al. 2017

View full text Add to dashboard Cite

BackgroundThe osteoconductive properties of collagen containing xenogeneic bone blocks (CCXBB) remain unclear. The aim of this prospective single-arm clinical study was to assess the histological outcomes of CCXBB blocks used as bone replacement grafts for lateral bone augmentation procedures.MethodsIn 15 patients with severe horizontal alveolar ridge resorption, lateral augmentation procedures were performed using CCXBB as bone replacement grafts. Twenty-six weeks postoperatively, a re-entry procedure was performed to evaluate the bone width for adequate implant placement and two histological specimens were retrieved from each patient, one being processed for ground sectioning and the other for decalcified paraffin-included sections. In non-decalcified sections, the relative proportions occupied by bone, biomaterials, and connective tissue present in the biopsies were identified. In de-calcified sections, structures and cells positive for osteopontin (OPN), tartrate-resistant acid phosphatase activity (TRAP), osteocalcin (OSC), and alkaline phosphatase (ALP) were assessed.ResultsSoft tissue dehiscence occurred during the follow-up in 5 out of 15 patients (33.3%). The mean crest width at baseline was 2.78 mm (SD 0.57) and the mean crest width at re-entry was 6.90 mm (SD 1.22), with a mean ridge width increase of 4.12 mm (SD 1.32). Twenty-six bone biopsies were obtained from 13 patients. Histomorphometric analysis showed a mean of 26.90% (SD 12.21) of mineralized vital bone (MVB), 21.37% (SD 7.36) of residual CCXBB, 47.13% (SD 19.15) of non-mineralized tissue, and 0.92% of DBBM. The immunohistochemical analysis revealed a large number of OPN-positive cells 8.12% (SD 4.73), a lower proportion of TRAP positive multinuclear cells 5.09% (SD 4.91), OSC-positive cells 4.09% (SD 4.34), and a limited amount of ALP positive cells 1.63% (SD 2).ConclusionsCCXBB achieved significant horizontal crestal width allowing for staged implant placement in most of the patients. In light of the histological outcomes and implant failures, special attention must be placed to prevent soft tissue dehiscence when CCXBB is used in severe atrophic alveolar crests.

show abstract

Section: Introductionmentioning

confidence: 99%

Histomorphometric and immunohistochemical evaluation of collagen containing xenogeneic bone blocks used for lateral bone augmentation in staged implant placement

et al. 2017

View full text Add to dashboard Cite

show abstract

“…The meta-analysis by Troeltzsch et al indicated that bone blocks significantly enhanced horizontal augmentation in comparison to particulate materials. In terms of vertical augmentation beneficial results depended on the origin of the bone block material [17]. In this study disc-shaped collagenous scaffolds (ICBM carrier) were used fitting precisely around the coronal part of the implants.…”

Section: Discussionmentioning

confidence: 99%

“…A recent meta-analysis reviewed the use of grafting materials for alveolar ridge augmentation in combination with implant placement. Troeltzsch et al showed that in terms of vertical bone augmentation autogenous bone blocks harvested from the iliac crest and the calvarium seem to be the only ones capable of gaining larger bone volumes [17]. The main disadvantages of bone grafts are donor site morbidity, limited supply, and possible postoperative complications [18].…”

Section: Introductionmentioning

confidence: 99%

“…The main disadvantages of bone grafts are donor site morbidity, limited supply, and possible postoperative complications [18]. When it comes to quality of life after surgery, patients’ discomfort appears to be significantly higher when autogenous bone grafts (especially iliac crest grafts) are used in comparison to other augmentative techniques or materials [6, 17, 19–23]. Bone grafts often cause insufficient bone consolidation and sometimes are limited in size (e.g.…”

Section: Introductionmentioning

confidence: 99%

“…Small volume vertical defects can be augmented by particulate grafting materials. If no skeletal scaffold is available, the combination with titanium meshes seems to be most beneficial for three-dimensional stability [17]. GBR has led to promising results in the past [8, 27–29]: there is unlimited supply and no need of a donor site.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Vertical bone regeneration using rhBMP-2 and VEGF

et al. 2017

View full text Add to dashboard Cite

BackgroundSufficient vertical and lateral bone supply and a competent osteogenic healing process are prerequisities for the successful osseointegration of dental implants in the alveolar bone. Several techniques including autologous bone grafts and guided bone regeneration are applied to improve quality and quantity of bone at the implantation site. Depending on the amount of lacking bone one- or two-stage procedures are required. Vertical bone augmentation has proven to be a challenge particularly in terms of bone volume stability. This study focuses on the three dimensional vertical bone generation in a one stage procedure in vivo. Therefore, a collagenous disc-shaped scaffold (ICBM = Insoluble Collagenous Bone Matrix) containing rhBMP-2 (Bone Morphogenetic Protein-2) and/or VEGF (Vascular Endothelial Growth Factor) was applied around the coronal part of a dental implant during insertion. RhBMP-2 and VEGF released directly at the implantation site were assumed to induce the generation of new vertical bone around the implant.MethodsOne hundred eight titanium implants were inserted into the mandible and the tibia of 12 mini pigs. Four experimental groups were formed: Control group, ICBM, ICBM + BMP-2, and ICBM + BMP-2 + VEGF.After 1, 4 and 12 weeks the animals were sacrificed and bone generation was investigated histologically and histomorphometrically.ResultsAfter 12 weeks the combination of ICBM + rhBMP2 + VEGF showed significantly more bone volume density (BVD%), a higher vertical bone gain (VBG) and more vertical bone gain around the implant (PVBG) in comparison to the control group.ConclusionBy using collagenous disc-shaped matrices in combination with rhBMP-2 and VEGF vertical bone can be generated in a one stage procedure without donor site morbidity. The results of the presenting study suggest that the combination of rhBMP-2 and VEGF applied locally by using a collagenous carrier improves vertical bone generation in vivo. Further research is needed to establish whether this technique is applicable in clinical routines.

show abstract

Ridge Defects (Localised)

2018

Diseases and Conditions in Dentistry

View full text Add to dashboard Cite

Clinical efficacy of grafting materials in alveolar ridge augmentation: A systematic review

Cited by 162 publications

References 141 publications

Histomorphometric and immunohistochemical evaluation of collagen containing xenogeneic bone blocks used for lateral bone augmentation in staged implant placement

Histomorphometric and immunohistochemical evaluation of collagen containing xenogeneic bone blocks used for lateral bone augmentation in staged implant placement

Vertical bone regeneration using rhBMP-2 and VEGF

Ridge Defects (Localised)

Contact Info

Product

Resources

About