Preoperative buccal bone volume predicts long-term graft retention following augmentation in the esthetic zone: A retrospective case series.

Abstract

ObjectivesBuccal bone augmentation in the esthetic zone is routinely used to achieve optimal clinical outcomes. Nonetheless, long‐term data are sparse, and it is unknown how baseline buccal bone volume affects the retention of the augmented volume over time.Material and methodsThis is a long‐term follow‐up retrospective case series. After a preoperative computed tomography scan, implants were placed in the anterior maxilla following guided bone regeneration, autogenous block grafting, or both. At the follow‐up, patients received a computed tomography scan and a clinical examination. Buccal bone volume was the primary outcome. Buccal bone thickness, peri‐implant, and esthetic parameters were secondary outcomes.ResultsAfter a median follow‐up of 6.7 years (interquartile range: 4.9–9.4), 28 implants in 19 patients (median age at augmentation: 43.3 years, interquartile range: 34.4–56.7, 53% female) were followed up. Preoperative buccal bone volume at baseline (V0) showed a moderate correlation to final buccal bone volume (Vt, rs = .43) but a strong correlation to the absolute volumetric change (ΔV = Vt–V0, rs = −.80). A linear mixed model for Vt had a large intercept of 91.39 (p < .001) and a rather small slope of .11 for V0 (p = .11). Observed differences between treatments were not statistically significant in the mixed model. V0 above 105 mm3 predicted a negative volume change (ΔV < 0) with a specificity of 100% and a sensitivity of 96%.ConclusionsThe results suggest higher gains in sites with lower V0 and point to a cutoff V0 above which the augmented volume is not retained long‐term.