Ridge augmentation using autologous concentrated growth factors enriched bone graft matrix versus guided bone regeneration using native collagen membrane in horizontally deficient maxilla: A randomized clinical trial.

Abstract

Facial resorption of maxillary alveolar ridges is a challenging situation for implant rehabilitation, which mandates a preparatory surgery of bone augmentation. Guided bone regeneration using a 1:1 mixture of autogenous particulate and anorganic bovine bone mineral (ABBM) showed reliable outcomes in treating horizontally deficient ridges. Twenty-eight patients were randomly assigned into two groups; in the control group, the 1:1 mixture of particulate autogenous bone and ABBM was covered with native collagen membrane, while in the study group, it was mixed with autologous fibrin glue (AFG) to make a sticky bone that was covered by concentrated growth factor (CGF) membrane. For each proposed implant site, the average bone width gain was calculated preoperatively, immediately after augmentation and after 6 months. Implants were placed after 6 months and the implant stability quotient (ISQ) was measured after insertion and after 6 more months. The graft consolidation period went uneventful in both groups; however, two cases in the sticky bone group showed total resorption of the graft upon re-entry. The mean horizontal bone width after 6months was 9 mm ± 0.71 in the guided bone regeneration (GBR) group which was higher than 7.9 mm ± 0.92 for the sticky bone group. The mean primary stability was higher in the GBR group; 67.19 ± 2.23 compared to 66.7± 3.22 for the sticky bone group, while the mean secondary stability was higher in the sticky bone group; 72 ± 2.15 compared to 71.7± 2.27 for the GBR group. Results of Shapiro-Wilk's for bone width data and model residuals were both statistically not significant (p> 0.05). Comparing CGF membrane versus native collagen membrane as barriers for GBR showed no statistically significant difference regarding bone gain. However, from a clinical point of view, CGF membrane is not a predictable barrier for guided bone regeneration.