Abstract
Simple SummaryWith the emergence of novelty regeneration techniques in the implant dentistry field, the professional may have some queries about which one to use in their daily practice. No systematic review, to date, analyzes the horizontal gains achievable with the two main procedures for bone regeneration: the Khoury technique, which uses split blocks obtained from the patient himself, or the Urban technique, which employs membranes to contain the biomaterials. Regarding this paper, the reader will be able to decide if any of these options is adequate for the indication required.Purpose. The objective of this systematic review was to evaluate and compare the clinical efficacy of horizontal alveolar ridge augmentation techniques described by Khoury and Urban. Methods. A systematic electronic search in the MEDLINE databases, SCOPUS, WOS, and the Cochrane Central Register of Controlled Trials (CENTRAL) as well as a manual search, were conducted independently by two reviewers up to July 2021. Results. Six studies met the pre-established inclusion criteria and were included in the descriptive analysis. Due to the heterogeneity found across the included studies, meta-analysis could not be performed. Horizontal bone gain was between 3.93 ± 0.9 mm and 5.02 ± 0.8 mm with the Khoury technique and between 3.9 ± 0.9 mm and 5.68 ± 1.42 mm with the Urban technique. Similar complication rates were reported in both groups: infection (7%), in the Khoury technique, and membrane exposure (3.2–13.6%), in the Urban technique, being the most frequent events. Conclusions. Both techniques were found to be effective, in terms of clinical bone gain, for horizontal alveolar ridge gain. Nevertheless, available literature is limited, and there is a lack of comparative studies to better evaluate the results.
Highlights
Tooth loss is accompanied by a series of adaptive changes, leading to dimensional alterations of the alveolar process
Monje et al [6] showed, in a recent preclinical study, that implants placed with a sufficient peri-implant buccal bone wall thickness, greater than 1.5 mm, were exposed to significantly less bone loss compared to those placed in sites exhibiting less than 1.5 mm
Due to the limited comparative information about these two techniques without combining them with other procedures or materials, this systematic review aims to evaluate and compare horizontal clinical bone gain and complications arising from the alveolar ridge augmentation techniques described originally by Khoury and Urban in the treatment of horizontal ridge deficiencies
Summary
Tooth loss is accompanied by a series of adaptive changes, leading to dimensional alterations of the alveolar process. It is mandatory to accomplish four major principles that Wang et al [13] described as PASS and allow a more predictable GBR: primary closure to facilitate a protected environment from microbiota and mechanical forces, angiogenesis to promote de novo bone formation, space to assure the different compartments and avoid the collapse of the biomaterial, and stability of the blood clot. These requirements enable better results and reduce the incidence of possible adverse effects. Due to the limited comparative information about these two techniques without combining them with other procedures or materials, this systematic review aims to evaluate and compare horizontal clinical bone gain and complications arising from the alveolar ridge augmentation techniques described originally by Khoury and Urban in the treatment of horizontal ridge deficiencies
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