Effect of postoperative steroids on clinical outcomes and radiographic findings of horizontal alveolar ridge augmentation: A retrospective study.

Abstract

The purpose of the study was to investigate if the prescription of oral postoperative steroids has an effect on clinical outcomes of horizontal ridge augmentation including implant placement and characteristics of the grafted bone. A retrospective chart review of 73 horizontal ridge augmentation cases was completed to assess the clinical outcomes, 53 of those cases were further assessed radiographically. Information was gathered regarding surgical technique, grafting materials, postoperative healing, medications used postoperatively, bone growth, and density changes as quantified on a cone-beam computed tomography (CBCT) scan. Statistical analysis was completed to identify whether the use of postoperative oral steroids altered outcomes. Steroids were used postoperatively following various horizontal ridge augmentation procedures. The use of tenting screws and resorbable membranes with a combination of osseous allograft and xenograft was used in 73 cases, 53 of which had preoperative and postoperative CBCT scans. Graft exposure occurred in five of the cases (9%), with the majority (n=4) among those with postoperative steroids, but this was not statistically significant (P-value=0.6510). Use of steroids was also not significantly associated with the number of courses of antibiotics (P-value>0.05), but it was significantly associated with increased number of postoperative visits (P-value<0.05). Among the subset for radiographic analysis (n=53), there were significant clinical and radiographic dimensional changes in alveolar ridge width with an average horizontal bone gain of 3.6mm. There were no statistically significant differences found in radiographic linear bone gain or clinical outcomes with the addition of steroids. A marginally statistically significant in the density of grafted bone was found with the addition of steroids (P-value>0.05). The prescription of postoperative steroids did not make a significant difference in clinical outcomes, success of implant placement or on radiographic assessment of grafted sites following horizontal alveolar ridge augmentation.