Assessment of bone quality using buccal and palatal autogenous cortical shells harvested from two different mandibular donor sites for maxillary alveolar ridge augmentation: a histomorphometric randomized clinical trial.

Abstract

This study aims to compare the quality of free autogenous bone grafts harvested from two different mandibular donor sites, used as onlay shells to augment horizontally and vertically deficient anterior maxillary alveolar ridges. Fourteen patients with edentulous and atrophic anterior maxillae are randomly allocated into two groups. Seven symphyseal chin (group I) and seven retromolar (group II) mandibular bone grafts were harvested and fashioned to construct buccal and palatal frameworks, fixed in place with mini-screws, followed by compacting the inter-positional gaps with an equal particulate mix of xenograft and autogenous cancellous particulates. Six months later, 42 core biopsies, three from each patient, 21 for each study group, were retrieved before the implants' insertion and subjected to histomorphometric bone area percent analysis. The bone area percent of the newly formed bone augmented with the chin shells was 52.53 ± 1.68% versus 47.97 ±1.83% for the retromolar grafts. The mean area percent difference between both groups was statistically significant (p = 0.0004). A higher bone quality and more volumetric stability were associated with the symphyseal cortical shells. The study was registered on www.clinicaltrials.gov (#: NCT03607006) in July 2018 by Ola Alaa El Morsy.