Horizontal Bone Augmentation Using Autogenous Block Grafts and Particulate Xenograft in the Severe Atrophic Maxillary Anterior Ridges: A Cone-Beam Computerized Tomography Case Series

Abstract

The aim of the present study was to use cone-beam computerized tomography (CBCT) to assess horizontal bone augmentation using block grafts, harvested from either the iliac crest (IC) or mandibular ramus (MR) combined with particulate xenograft and a collagen membrane for in the severe maxillary anterior ridge defects (cases Class III-IV according to Cadwood and Howell's classification). Fourteen healthy partially edentulous patients requiring extensive horizontal bone reconstruction in the anterior maxilla were selected for the study. Nineteen onlay block grafts (from IC or MR) were placed. The amount of horizontal bone gain was recorded by CBCT at 3 levels (5, 7, and 11 mm from the residual ridge) and at the time of bone grafting as well as the time of implant placement (≈5 months). Both block donor sites provided enough ridge width for proper implant placement. Nonetheless, IC had significantly greater ridge width gain than MR (Student t test) (4.93 mm vs 3.23 mm). This was further confirmed by nonparametric Mann-Whitney test (P = .007). Moreover, mean pristine ridge and grafted ridge values showed a direct association (Spearman coefficient of correlation = .336). A combination of block graft, obtained from the IC or MR, combined with particulate xenograft then covered with an absorbable collagen membrane is a predictable technique for augmenting anterior maxillary horizontal ridge deficiency.

Considerations on the Use of Lumina-Porous? Biomaterial in Maxillary Sinus Floor

“…An important factor when using biomaterials in the maxillary sinus has to do with compaction [13][14]. LuminaPorous ® must fill the space neither excessively nor insufficiently.…”

Clinical considerations for optimizing results in bone grafting: part II

“…Studies such as those conducted by Block et al, 8 Maiorana et al, 16 Cosso et al 17 and Monje et al, 15 all of which assessed the importance of this type of association, are unanimous in stating that this technique leads to less bone resorption, thereby providing surgeons with more confidence.…”

“…Monje et al 15 used computed tomography scans to assess the increase in thickness of 19 block bone grafts harvested from the iliac crest or mandibular ramus, and associated with heterogeneous graft. The authors concluded that this technique is predictable and favors implant placement.…”

“…11,12 ,13 However, achieving satisfactory outcomes as a result of bone grafting or immediate implant placement remains a challenge for implantodontists, particularly in more complex cases or when unpredictable defects are involved. 8,10,[13][14][15][16][17][18][19][20] Thus, further studies are required to assist professionals in their search for better clinical results.…”

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

“…If the residual alveolar ridge is too thin to place dental implant, bone grafting is the only choice for successful dental implant rehabilitation (1,2). Anterior maxillary area is critical site for dental esthetics.…”