Clinical study on bilamina cortical grafting technique for reconstruction of severely atrophic alveolar ridges in anterior maxillae

Abstract

Objective: To evaluate the efficacy and long-term outcome of the bilaminar cortical wall building grafting technique for reconstruction of vertical and horizontal alveolar ridge defects in the esthetic zone. Methods: The retrospective study was conducted between January, 2007 and December, 2015. The sample was composed of 24 patients who received bilaminar cortical wall building augmentation in the esthetic zone in Department of Fourth Clinical Division, Peking University School of Stomatology. The 24 patients (11 female and 13 male) had age of (37.8±13.4) years (20-54 years). A bone block harvested from the lateral aspect of the mandibular ramus was bisected into two cortical laminae, which were then used to reconstruct the buccal and palatal walls of an alveolar ridge defect. The inter-laminar space was filled with particulate autogenous bone and the whole graft was covered with anorganic bone graft and collagen membrane. Bone width and vertical measurements were measured at the time of surgery and reentry surgery. Integration of the graft, implant survival rates and complications were recorded. Results: Overall, 24 patients with 35 sites who were included were followed for (7.1±1.9) years. Graft integration (24/24) and implant survival rates (35/35) were determined as 100%. The average horizontal and vertical bone gain was (6.47±2.46) and (5.01±1.12) mm with resorption rates of 9.0% and 10.9%, respectively. One patient showed soft-tissue dehiscence with peri-implant mucositis were observed 9 years after surgery. More than 1.5 mm of buccal bone plate were observed using cone beam computed tomography. Conclusions: This technique was effective and reliable for three-dimensional reconstruction of severely atrophic alveolar ridges in anterior maxillae. Autogenous graft combined with coverage by allogeneic bone graft and collagen membrane provided successful augmentation with low bone resorption.