Efficacy of lateral bone augmentation performed simultaneously with dental implant placement: A systematic review and meta-analysis.

Abstract

To analyse the evidence regarding the efficacy of lateral bone augmentation procedures in terms of defect resolution in cases of horizontal ridge deficiencies after implant placement. Included studies met the following inclusion criteria: randomized controlled trials (RCTs) or controlled clinical trials (CCTs), re-entry procedure to assess defect resolution, minimum of 10 patients (5 per group). Meta-analyses were performed whenever possible, including subgroup analysis based on membranes and grafting materials. Twenty-eight publications (20 short-term, 8 follow-up studies) were included. The most often used type of intervention was a xenogeneic particulated grafting material (XE) and a resorbable collagen membrane (CM). The mean defect height at baseline amounted to 5.1mm (range 2.4-7.8) and decreased to a mean of 0.9mm (range 0.2-2.2) at re-entry, and the mean defect resolution was 81.3% (range 56.4%-97.1%). Defect height reduction was not significantly different using CM+XE as control treatment compared to the combined data of the respective test groups [n=11; weighted mean difference (WMD)=-0.006mm; 95% CI, -0.61, 0.60; p=0.985]. The absence of any lateral bone augmentation was less favourable than the conjunction of a membrane and a bone grafting material (n=1; MD=-1.96mm; 95% CI, -3.48, -0.44; p=0.011). The lack of a grafting material was less favourable than the conjunction of grafting material and membrane (n=1; MD=-2.44mm; 95% CI, -4.53, -0.35; p=0.022), and the addition of a membrane compared to a grafting material alone was more favourable (n=3; WMD=0.97mm; 95% CI, 0.31, 1.64; p=0.004). Lateral bone augmentation is a successful treatment modality. For optimal defect height reduction, a barrier membrane and a grafting material should be combined.