The Effect of Membrane Coverage on the Resorption of Autogenous Intraoral Block Grafts in Horizontal Ridge Augmentation: A Systematic Review of Literature and Meta-Analysis: Inevitability or an Iatrogenic Vulnerability?

“Horizontal Alveolar Ridge Augmentation With Autogenous Block Bone Graft a Cone Beam Computed Tomography Evaluation Case Series”

“…Regarding radiographic bone width, there was a statistically significant increase in bone width from baseline to six months, These results were in agreement with those published by (Levin et al, 2007;Mendoza-Azpur et al, 2019;Zaki et al, 2017). Regarding radiographic percentage changes in bone width from baseline to after 6 months revealed that the mean percent change in bone width was (80.78±28.26) these results were in accordance with (Zaki et al, 2017).…”

Lateral Alveolar Ridge Augmentation with an Autogenous Bone Block Graft Alone with or without Barrier Membrane Coverage: a Systematic Review and Meta-Analysis

“…Biologic and mechanical complications following LARA with or without barrier membrane coverage seems to be diminutive [54]. Mucosal dehiscence appears to be the most common complication with the two treatment modalities, which is in accordance with previous published systematic reviews [7,17,28,29]. Mucosal dehiscence and barrier membrane exposure is often associated with less bone regeneration and resorption of the augmented area, which may compromise implant placement in an optimal prosthetically position [57].…”

“…However, the use of autogenous bone block graft from extraoral or intraoral donor sites are commonly associated with an unpredictable resorption of the augmented area, which frequently necessitates additional augmentation of the alveolar ridge in conjunction with delayed implant placement [7,[11][12][13][14][15][16]. The autogenous bone block graft is therefore often covered by a non-resorbable bone substitute and shielded by a barrier membrane to stabilize the grafting material and diminish graft resorption [4,[16][17][18][19]. Various resorbable or nonresorbable membranes composed of biocompatible xenogeneic or synthetic material have previously been used in conjunction with LARA to preserve the initial dimension of augmented area and facilitates incorporation of the autogenous bone block graft [20,21].…”

“…The various types of xenogeneic or synthetic barrier membrane contain dissimilar material properties which are intended to improve bone regeneration and hamper soft tissue interference [22,23]. Nevertheless, barrier membrane coverage of the augmented area is associated with lower vascular supply to the applied grafting material, additional treatment cost, risk of infection or disease transmission as well as they can be refused by patients for religious reasons or because they are in contrast with chosen lifestyle [11][12][13]17,24,25]. Moreover, non-resorbable membranes or titanium reinforced membranes needs to be removed if they are exposed during the healing phase, which significantly compromises the principles of guided bone regeneration and patient´s perception of the surgical intervention [26,27].…”

“…Consequently, the use of barrier membrane coverage in conjunction with LARA prior to implant placement seems to be associated with pros and cons [4,7,[11][12][13]. Previous systematic reviews have demonstrated that the use of barrier membrane coverage following LARA diminishes resorption of the augmented area, whereas no significant differences was reported in alveolar width gain or incorporation of the autogenous bone block graft with or without the use of barrier membrane coverage [7,17,28,29]. However, the efficiency of barrier membrane coverage on survival of implants or suprastructures as well as patient-reported outcome measures (PROM) have never previously been assessed in a systematic review.…”