Horizontal ridge augmentation with guided bone regeneration using particulate xenogenic bone substitutes with or without autogenous block grafts: A randomized controlled trial

Abstract

Background: To evaluate dimensional bone alterations following horizontal ridge augmentation using guided bone regeneration (GBR) with or without autogenous block graft (ABG) for the rehabilitation of atrophic jaws with dental implants.Materials and Methods: Forty-two patients, with 42 severe horizontal bone atrophy sites in the maxilla or mandible were randomly assigned to two groups: ABG or GBR. The ABG group received a combination of ABG with particulate xenograft, covered by a collagen membrane, while the GBR group received particulate xenograft alone, covered by a collagen membrane.After 6-9 months of healing, implants were inserted. All implants were definitively restored 6 months after implant placement. Radiographic examination (cone-beam computed tomograms) was performed immediately after bone grafting procedure (T0), at 6 months (T6), and at 18 months (T18), to evaluate the amount of horizontal bone width (HBW) gain. Patient demographic information, amount of ridge width augmentation, implant survival, complications, and contributing factors were gathered and analyzed.Results: Thirty-nine patients completed the study. Both groups developed enough bone ridge width for implant placement. A total of 65 implants were placed. Implant survival rate was 100% in both groups at T18. Mean increases in HBW amounted to 5.6 ± 1.35 mm in GBR sites and 4.8 ± 0.79 mm in ABG sites at T18. There was no statistically significant difference in HBW gain obtained in the GBR group when compared to the ABG group at 6 months (P = 0.26) or 18 months (P = 0.26). However, the ABG group had a statistically significant higher prevalence of sensory disturbances (P = 0.02) and hematomas (P = 0.002) compared to the GBR group.

Clinical and histological sequelae of surgical complications in horizontal guided bone regeneration: a systematic review and proposal for management

“…While one study treated all minor wound dehiscences immediately with a PRGF membrane [31], another study treated all wound dehiscences with an initial course of systemic amoxicillin and clavulanic acid for 10 days and only proceeded to graft a dehisced site with a free gingival graft at the fifth week after surgery due to nonresolution [34]. One study reported late complications emerging only 3 to 4 months after the initial GBR, and they were treated with 0.5% chlorhexidine topical gel application, 0.12% chlorhexidine rinse, and a 1 week course of amoxicillin and clavulanic acid [29]. Minor infections such as suppuration were treated either only with systemic antibiotics [34] or with the addition of a chlorhexidine mouth rinse [16].…”

Comparison of in‐situ bone ring technique and tent‐pole technique for horizontally deficient alveolar ridge in the anterior maxilla

“…Monje et al adopted iliac crest for horizontal bone augmentation but found out the donor site morbidity might cause patients unable to move freely, which limited its application in clinic . Similarly, Mendoza‐Azpur et al reported a randomized clinical trial utilizing chin bone ring to augment the anterior site, with the limitation of secondary surgical site and occurrence of the accompanying complications such as infection and paraesthesia of chin due to the incisal nerve injury . With the rapid progress of horizontal bone augmentation, several novel techniques have arisen in the last decade to compensate for the shortcomings of causing further stress concentration by creating favorable three‐dimensional space regarding bony walls as to realize desired augmented effect.…”

“…The so‐called bone ring technique, as using a ring‐shaped autogenous bone block, has emerged recently and been documented in several medical records showing excellent outcomes for the dimensional bone augmentation . Nevertheless, most of the reports only emphasizes on the vertical augmentation and the existing proposal for horizontal bone augmentation is lack of investigation on the stability of the biomaterials and reflects drawbacks such as aggravating intraoperative pain due to the secondary surgical site and occurrence of the accompanying complications such as infection and paraesthesia of chin due to the incisal nerve injury …”

“…[22][23][24][25] Nevertheless, most of the reports only emphasizes on the vertical augmentation and the existing proposal for horizontal bone augmentation is lack of investigation on the stability of the biomaterials and reflects drawbacks such as aggravating intraoperative pain due to the secondary surgical site and occurrence of the accompanying complications such as infection and paraesthesia of chin due to the incisal nerve injury. 26,27 Consequently, in this study, we mainly compared the volume alteration and bone profile maintenance ability between in-situ bone ring and tent-pole technique for the localized bone defect in anterior area to evaluate their effects on horizontal bone augmentation.…”

Bone Augmentation Procedures in a Patient with Acromegaly

“…We used anorganic bovine-derived bone mineral because is one of the most well-documented biomaterials and we mixed it with particulate freeze-dried bone allograft [ 11 ] to replace the autologous component. We took into consideration the fact that after a healing period of 9–10 months, the combination of deproteinized bovine bone mineral (DBBM) and a collagen membrane is an effective treatment option for horizontal bone augmentation before implant placement [ 12 , 13 ].…”