Autogenous Bone Block Graft Research Articles

An in vivo comparative evaluation of graft uptake between chin and ramal graft in the reconstruction of atrophic anterior maxillary edentulous ridges for implant placement

Introduction: The goal of modern dentistry is to restore the patient to normal function, esthetics, comfort, speech and health, which can be brought by caries prevention or replacing of missing teeth. Loss of teeth may be devastating for the patient, both functionally and aesthetically. Complex anatomy, functional and aesthetic demands often make reconstruction very challenging as well as the multitude of complications that can arise during or after treatment. Aim and Objectives: To evaluate the amount of bone resorption of mandibular autogenous block bone graft in reconstruction of atrophic anterior alveolar ridges. Materials and Methods: 5 patients underwent harvesting of corticocancellous bone from Mandibular ramus and 5 patients underwent harvesting of corticocancellous bone from Mandibular chin region for Reconstruction of atrophic alveolar ridge. All patients were reviewed for follow-up for 5 months to evaluate the amount of resorption and acceptance of graft. Results: In a follow up period of 5 months the mean graft resorption in ramal graft is 16.8% and mean graft resorption in symphysis graft is 18%. Conclusion: Minimally invasive approach, ease of application, volume of the graft and least postoperative morbidity are observed in ramal graft. The survival of the graft is better in ramal graft than the graft from the chin as the chin graft shows higher resorption rate. Patient compliance is favorable more towards the ramal graft than the chin graft as the immediate postoperative pain is high in symphysis region. Keywords: Graft, Reconstruction, Implant, Ramus, Symphysis.

Clinical performance of alveolar ridge augmentation with xenogeneic bone block grafts versus autogenous bone block grafts. A systematic review

IntroductionThis systematic literature review aimed to evaluate the feasibility of xenogeneic bone blocks for ridge augmentation compared with autogenous blocks by analyzing block survival rates, block resorption, subsequent implant survival rate, post-surgical complications, and histomorphometric findings. Materials and MethodsElectronic searches were conducted in the Medline (PubMed), Web of Science and Cochrane databases, complimented by a manual search in specialist journals, for relevant articles published up to March 2020. Inclusion criteria were human studies in which the outcomes of xenogeneic bone block grafts were evaluated by means of their survival rates and subsequent implant survival rates. ResultsSixteen articles fulfilled the inclusion criteria and were analyzed. 333 patients were recruited with a total of 337 xenogeneic bone blocks and 82 autogenous bone blocks, showing block failure rates of 6.82% and 6.1%, respectively. Bone gain, in both height and width, was similar among xenogeneic and autogenous bone blocks, but autogenous bone blocks suffered greater resorption. Implant survival rates were slightly lower for xenogeneic bone blocks. Histological and histomorphometric analysis observed more bone formation and less residual bone substitute with autogenous bone blocks than xenogeneic bone blocks. ConclusionsAtrophic alveolar crest reconstruction with xenogeneic bone block grafts would appear to offer a viable alternative to autogenous bone block grafts, obtaining similar block graft failure rate, fewer sensitive postoperative complications but a slightly lower implant survival rate. Further investigations generating long term data are needed to confirm the feasibility of xenogeneic bone blocks in different clinical scenarios.

Pain after mandibular ramus block harvesting and lateral ridge augmentation with and without involvement of platelet-rich fibrin: a randomized controlled trial

The purpose of this study was to evaluate pain after mandibular ramus block harvesting and lateral ridge augmentation. Autogenous bone block grafts were covered with platelet-rich fibrin (PRF) membranes (test group) or deproteinized bovine bone and a resorbable collagen membrane (control group). This study included 27 partially edentulous patients (test = 14, control = 13) with an indication for bone block augmentation before staged implant placement. Postoperative methylprednisolone (32 mg, day 1) and analgesics comprising ibuprofen (400 mg, four times daily) and paracetamol (1 g, four times daily) were prescribed for 1 week. Pain was recorded by the patient on a 100-mm visual analogue scale (VAS), hourly on the day of surgery and daily for the following 7 days. The average (mean ± standard deviation) maximum pain score over the whole observation period was similar in the test (13.6 ± 13.5) and control (21.0 ± 19.9) groups (P = 0.17). In conclusion, harvesting of a mandibular ramus block and lateral ridge augmentation, in conjunction with the pharmacological protocol described, is characterized by low postoperative pain. Adding PRF membranes to the surgical site generally resulted in slightly lower pain perception, although a statistically significant difference between the test and control groups was only identified on day 1 postoperative.

Sandwich osteotomy of the atrophic posterior mandible with interpositional autogenous bone block graft compared with bone substitute material: a systematic review and meta-analysis.

The objective of the present systematic review was to test the hypothesis that there were no differences in outcome of implant treatment after sandwich osteotomy in the atrophic posterior mandible with interpositional autogenous bone block graft, compared with bone substitute material. A MEDLINE/PubMed, Embase and Cochrane Library search in combination with hand-search of selected journals was conducted. Two short-term randomised controlled trials with a split-mouth study design and low risk of bias fulfilled the inclusion criteria. High survival rate of suprastructures and implants was disclosed with no significant difference between interpositional autogenous bone block graft compared with bone substitute material. Meta-analysis revealed patient-based implant survival risk ratio of 1.05 (95% CI: 0.88 to 1.25) and peri-implant marginal bone loss of 0.31mm (95% CI: -0.29 to 0.90) indicating no significant differences between the two treatments. High implant stability values, gain in vertical alveolar ridge height, bone formation, and few complications were reported with both treatments. Sandwich osteotomy with interpositional grafting material appears to be a predictable surgical technique for enhancement of the vertical alveolar ridge height in the atrophic posterior mandible prior to implant placement.

Quantity and Quality of Intraoral Autogenous Block Graft Donor Sites with Cone Beam Computed Tomography.

The autogenous bone block graft is regarded as the gold standard material due to reported osteoconductive, osteoinductive, and osteogenic properties. Various intraoral donor sites for autogenous block grafts are presented in the literature. The aim of this study was to radiographically evaluate the maximum dimensions, volume, and bone quality values of these sites. According to the inclusion criteria, 50 cone beam computed tomography (CBCT) images from 50 subjects were evaluated. The maximum length, width, height, and volume of autogenous regions where block grafts could be harvested were measured. Radiographic bone quality was calculated by using Hounsfield units derived from CBCT (CBCT-HU). The mean age of 50 subjects (19 men and 31 women) was 55.84 ± 15.9 years. In this study, the symphysis was the largest potential donor site (3.14 ± 1.05 cm3), while maxillary tuberosity was the smallest (0.53 ± 0.34 cm3). These results correlated with bone density values, where the symphysis retained the highest values (937.31 ± 160.59 CBCT-HU) and the maxillary tuberosity had the lowest values (360.87 ± 141.48 CBCT-HU). Intraoral bone blocks have restrictions due to surrounding vital anatomical structures. The surgeons should consider these vital structures using accurate CBCT evaluation. The volume and density of the maximal bone harvest from the symphysis was statistically higher in comparison with ramus, palatal, and maxillary tuberosity bone blocks.

Lateral ridge augmentation in the posterior part of the mandible with an autogenous bone block graft harvested from the ascending mandibular ramus. A 10-year retrospective study

PurposeThe objective of the present retrospective study was to assess the long-term implant treatment outcome and patient satisfaction after lateral ridge augmentation in the posterior mandible with autogenous bone block graft harvested from the ascending mandibular ramus. Materials and methodsSeventy-four lateral ridge augmentation procedures in the posterior mandible with an autogenous bone block graft harvested from the ascending mandibular ramus and delayed placement of 87 implants was conducted in 46 consecutive patients from 2002–2006. Records and radiographs were retrospectively analyzed. Twenty-four patients responded to a 10-years follow-up examination including 39 lateral ridge augmentation procedures and 48 implants. Survival of suprastructures and implants, peri-implant marginal bone loss, patient perception and professional evaluation of the final implant treatment was assessed after 10 years. ResultsThe 10-year survival of suprastructures and implants was 100% as all the implants and suprastructures were present with limited peri-implant marginal bone loss. The patients were highly satisfied with the esthetic and implant treatment outcome. ConclusionLateral ridge augmentation in the posterior mandible with autogenous bone block graft from the ascending mandibular ramus is characterized by high long-term implant survival rate and patient satisfaction.

颏部块状骨移植改善前牙区种植骨量不足CBCT的研究

颏部块状骨移植改善前牙区种植骨量不足CBCT的研究

Maxillary Alveolar Ridge Expansion with Split-Crest Technique Compared with Lateral Ridge Augmentation with Autogenous Bone Block Graft: a Systematic Review.

ABSTRACTObjectivesThe objective of the present systematic review was to test the hypothesis of no difference in implant treatment outcome after maxillary alveolar ridge expansion with split-crest technique compared with lateral ridge augmentation with autogenous bone block graft.Material and MethodsA MEDLINE (PubMed), Embase and Cochrane Library search in combination with a hand-search of relevant journals was conducted. Human studies published in English until 8th of February, 2018 were included.ResultsOne comparative and four noncomparative studies fulfilled the inclusion criteria. Both treatment modalities disclosed high survival rate of implants with few complications. High survival rate of prosthesis, implant stability values, limited peri-implant marginal bone loss and gain in maxillary alveolar ridge width were reported with the split-crest technique. Patient-reported outcome measure and length of patient treatment time was not assessed in any of the included studies.ConclusionsThe split-crest technique seems to be useful for horizontal augmentation of maxillary alveolar deficiencies with high survival rate of prosthesis and implants. However, further long-term randomized controlled trials with larger patient sample as well as assessment of patient-reported outcome measures and patient treatment time are needed before well-defined conclusions can be provided about the two treatment modalities.

Assessment of vertical ridge augmentation and marginal bone loss using autogenous onlay vs inlay grafting techniques with simultaneous implant placement in the anterior maxillary esthetic zone: A randomized clinical trial.

Bony reconstruction and dental rehabilitation of patients with posttraumatic anterior maxillary alveolar defects is a very complicated procedure. The aim of this study is the assessment of vertical ridge augmentation using autogenous onlay vs inlay bone grafting techniques in the anterior maxilla. Sixteen patients (40 implants) with vertically deficient anterior maxillary alveolar ridges were equally allocated into two groups; Autogenous block bone graft was harvested from the chin with simultaneous implant placement was done either onlay (control) or inlay (study). Radiographic assessment was performed preoperatively, 1 week and 6 months postoperatively. Assessment included measurements of linear changes in the vertical height on cross sectional cuts of cone beam computed tomography (CBCT) using special software. Finally, the amount of vertical gain and marginal bone loss in each group was compared to that of the other. Wound healing was uneventful for all cases except three cases of the onlay group showed wound breakdown and graft loss. The mean vertical bone gain in the control group was -0.02 mm while in the study was 3.34 mm. While the mean of the crestal bone loss of the control group was 4.77 mm and that of the study group was 1.65 mm. The final vertical bone gain was statistically significant in the study group, so the inlay bone grafting technique with immediate implant placement could be used successfully for vertical alveolar ridge augmentation in the esthetic zone.

Horizontal Alveolar Ridge Augmentation with Allogeneic Bone Block Graft Compared with Autogenous Bone Block Graft: a Systematic Review.

ABSTRACTObjectivesThe objective of the present systematic review was to test the hypothesis of no difference in implant treatment outcome after horizontal ridge augmentation with allogeneic bone block compared with autogenous bone block.Material and MethodsA MEDLINE (PubMed), Embase and Cochrane Library search in combination with a hand-search of relevant journals was conducted including human studies published in English through March 13, 2019. Comparative and non-comparative studies evaluating horizontal ridge augmentation with allogeneic bone block were included. Cochrane risk of bias tool and Newcastle-Ottawa Scale were used to evaluate risk of bias.ResultsOne comparative study with high quality and 12 non-comparative studies fulfilled the inclusion criteria. Considerable heterogeneity prevented meta-analysis from being performed. The comparative retrospective short-term study demonstrated no significant difference in implant treatment outcome between the two treatment modalities. Non-comparative long-term studies revealed high implant survival, gain in alveolar ridge width and bone regeneration with allogeneic bone block. However, non-comparative studies disclosed high incidence of complications including dehiscence, exposure of allogeneic bone block and partial or total loss of the grafts.ConclusionsThere seemed to be no difference in implant treatment outcome after horizontal ridge augmentation with allogeneic bone block compared with autogenous bone block. However, increased risk of complications was frequently reported with allogeneic bone block.

Bone Block Augmentation - A Long Term Follow-Up

Introduction Autogenous bone block grafting is used for both vertical and horizontal augmentation of the upper and lower jaw. The bone block could be provided using extraoral or intraoral donor location. Aim The aim of this study was to observe the survival rate, the marginal bone level and the bleeding on probing (BOP) for a period of 4 to 6 years of implants, inserted in autogenous bone block graft. Materials and Methods We considered advanced horizontal bone loss, where guided bone regeneration with simultaneous implant placement could not be performed and/or vertical bone loss, where vertical augmentation of the alveolar bone of more than 3 to 6 mm is required, as indications for the bone block grafting procedure. As an intraoral donor site was used the mental area. Results and Discussion The mean observation period was 4.81 years. The mean marginal bone loss was 0.442 mm, as bone resorption was established in 48% of all cases, BOP was observed in 17.7 % of the cases. No correlation was found between BOP and bone loss. The survival rate of the implants placed into bone augmented using autogenous bone block graft was 98.7 %. Conclusion For an implant placement we considered a period of 4 months after the procedure enough to provide high survival rate of the implants. The implants placed in bone augmented using autogenous bone block grafting according to our methodology demonstrated high survival rate and unstable marginal bone level.

Mandibular ridge reconstruction: A review of contemporary methods.

Reconstruction can be very problematic in the case of mandibular alveolar bone loss, which can also hinder the implant restorative treatment. The aim of the study was to present current views on reconstructing the alveolar part of mandibular bone, which allows the insertion of implants and then the placement of denture. Based on the available literature, the efficacy of various techniques of filling of mandibular bone losses was described and compared. Reconstruction with autogenous bone block graft had been used as a gold standard. Recently, other techniques have appeared that offer better functional and esthetics results. They include reconstruction with allogeneic bone block graft, osteotomy allowing immediate insertion of implants, bone distraction, guided bone regeneration using titanium mesh (Ti-mesh), new techniques using scaffolds (biphasic calcium phosphate, poly-lactide-co-glycolide/tricalcium phosphate, bioresorbable polycaprolactone), Sonic Weld Technique® (Tuttlingen, Germany) using resorbable membrane and pins with polymer lactide acid (PLA), and the tent technique. These abovementioned techniques allow solving the problem of insufficient amount of bone for prosthetic treatment.

Application of interconnected porous hydroxyapatite ceramic block for onlay block bone grafting in implant treatment: A case report.

Autogenous block bone grafting as treatment for alveolar ridge atrophy has various disadvantages, including a limited availability of sufficiently sized and shaped grafts, donor site morbidity and resorption of the grafted bone. As a result, interconnected porous hydroxyapatite ceramic (IP-CHA) materials with high porosity have been developed and used successfully in orthopedic cases. To the best of the author's knowledge, this is the first report of clinical application of an IP-CHA block for onlay grafting for implant treatment in a patient with horizontal alveolar atrophy. The present study performed onlay block grafting using an IP-CHA block to restore bone volume for implant placement in the alveolar ridge area without collecting autogenous bone. Dental X-ray findings revealed that the border of the IP-CHA block became increasingly vague over the 3-year period, whereas CT scanning revealed that the gap between the block and bone had a smooth transition, indicating that IP-CHA improved the process of integration with host bone. In follow-up examinations over a period of 5 years, the implants and superstructures had no problems. An IP-CHA block may be useful as a substitute for onlay block bone grafting in implant treatment.

Dimensional alterations following vertical ridge augmentation using collagen membrane and three types of bone grafting materials: A retrospective observational study.

Various biomaterials have been introduced for vertical ridge augmentation to replace autogenous block bone grafting. This retrospective study radiographically evaluated dimensional alterations of the vertically augmented alveolar ridge using collagen membrane and 3 types of materials: autogenous bone block, allogenous bone block, and particulated bone substitute. The electronic medical records of 32 patients who received vertical ridge augmentation using 3 types of materials were searched: 9 for autogenous bone block, 12 for allogenous bone block, and 11 for particulated bone substitutes. The vertical bone gain, progression of bone resorption, and peri-implant marginal bone loss after prosthetic loading were measured on follow-up radiographs. The alveolar ridge was vertically augmented by 5.13 ± 1.61, 4.54 ± 2.48, and 3.90 ± 0.85 mm (mean ± standard deviation) after grafting with autogenous bone block, allogenous bone block, and particulated bone substitute, respectively. The radiographic vertical height of the augmented ridge that received autogenous bone block reduced continuously during the first year but was stable thereafter. Sites that received allogenous bone block or particulated bone substitute exhibited dimensional shrinkage for up to 1.5 years postsurgery. However, the peri-implant marginal bone loss did not exceed 1 mm throughout the observational periods in all groups. The clinical findings of this study suggest that the alveolar ridge can be vertically augmented using either allogenous bone block or particulated bone substitute. However, they require a longer healing period to ensure dimensional stability compared to the autogenous bone block.

Comparison of Tunnel and Crestal Incision Techniques in Reconstruction of Localized Alveolar Defects.

The aim of this study was to compare the complication rates of recipient sites prepared using two incision techniques: crestal and tunnel. In this prospective study, patients underwent augmentation procedures (68 patients; 75 sites) by the same surgeon that were performed consecutively using the crestal incision technique (27 horizontal, 10 vertical; crestal group) or the tunnel incision technique (27 horizontal, 11 vertical; tunnel group). Autogenous bone block grafts were harvested with a piezoelectric surgical device, and the grafts were fixed at the recipient sites by two titanium screws in both groups. The authors evaluated minor exposure, transient paresthesia, major exposure, permanent paresthesia, gingival recession at adjacent teeth, surgery time, and visual analog scale pain scores. Soft tissue dehiscence and graft failure were significantly lower in patients undergoing the tunnel technique. The tunnel incision technique significantly decreased soft tissue exposure, the most common complication of augmentation procedures with autogenous onlay bone grafts. This technique should be considered an alternative to the crestal incision technique for preparation of the recipient site.

Maxilla reconstruction with autogenous bone block grafts: computed tomography evaluation and implant survival in a 5-year retrospective study

This retrospective study was performed to evaluate the bone thickness of the anterior maxillary region after reconstruction with autogenous bone blocks at 6 months and 5 years after surgery using computed tomography (CT) and to determine the implant survival rate. Eleven patients with a horizontal bone deficiency were treated with reconstructive procedures and implant placement. CT measurements were obtained before surgery (T0) and at 6 months (T1) and 5 years (T2) after surgery. The values were analysed statistically (analysis of variance and Tukey’s test; P<0.05). Implant survival was evaluated at follow-up. The mean width of the lower region of the ridge (±standard deviation, in millimetres) was 3.8±1.6 at T0, 7.0±1.6 at T1, and 6.5±1.0 at T2; the mean width of the upper region of the ridge was 5.7±2.3 at T0, 8.3±2.2 at T1, and 7.3±1.6 at T2. The mean total thickness of the ridge was 4.7mm at T0, 7.6mm at T1, and 6.9mm at T2; the average increase in horizontal thickness was 2.9mm at T1 and 2.2mm at T2. A statistically significant difference was observed in the mean width of the lower portion at T1 and T2 compared to the width at T0. The implant survival rate was 94.1%. This technique demonstrated high predictability for implant survival, with a reduction in the graft bone during the follow-up period.

Long-Term Results of Peri-implant Conditions in Periodontally Compromised Patients Following Lateral Bone Augmentation.

The aim of this retrospective study was to compare long-term (≥ 5 years) outcomes of implants placed in patients treated for chronic periodontitis versus those placed in periodontally healthy patients. In both groups, the implants were placed in alveolar ridges that were laterally augmented with autogenous bone block grafts using a split bone block technique. Two hundred ninety-two patients were screened in the course of supportive periodontal treatment examinations. Nonsmoking patients without any severe systemic diseases who had adhered to regular supportive periodontal treatment for a minimum of 5 years after undergoing autogenous lateral grafting (using the split bone block technique), implant placement, and prosthetic reconstructions were classified into two groups based on their presurgical status: periodontally healthy patients (PHP) and periodontally compromised patients (PCP). Clinical outcomes for 77 patients, 38 PHP and 39 PCP, were examined. All had been successfully treated for severe lateral atrophy and received a total of 241 endosseous implants between 2002 and 2008. At the final examination, mean bleeding on probing was 7.08% ± 7.27% in PHP and 14.49% ± 18.14% in PCP, a statistically significant difference. Significantly higher Plaque Index and more recession were associated with a narrow (< 2 mm) width of keratinized mucosa. Implants in alveolar ridges laterally augmented using a split bone block technique revealed similar clinical peri-implant conditions in both PHP and PCP. Using autogenous bone block grafts without biomaterials resulted in long-term peri-implant tissue stability.

Autogenous Tooth Bone Graft Block For Socket Preservation: A One-Stage Technique

To replace the autogenous bone block graft in socket preservation technique that has disadvantages despite gold standard such as second surgery, more healing period and cost, the author introduces the surgical technique and five-year clinical outcome of using preformed autogenous tooth bone graft block (ABTB) which was fabricated from the patient’s own extracted tooth, with simultaneous implant placement. Evaluations of the five-year clinical outcome were also performed with cone beam computed tomography (CBCT). ABTB is root dentin block composed of Type I collagen matrix with several osteoinductive non-collagenous proteins such as bone morphogenetic proteins (BMP) and dentin matrix proteins. Geometrically, alveolar bone morphology was maintained by ABTB as well as it has micropores (dentinal tubules) of 3-5 μm diameter and macropores of 0.2-0.3 mm diameter for enhancing osteoinductive and osteoconductive functions. Five year follow up with CBCT showed that alveolar bone volume and shape were maintained successfully which was repaired and restored by ABTB. This might become the effective technique for socket preservations given the well controlled long term follow up studies.

Unprotected autogenous bone block grafts in anterior maxilla: Resorption rates and clinical outcomes

Background/Aim. The use of autogenous bone grafts for augmentation of the resorbed alveolar ridge is still considered the gold standard in implant dentistry. The aim of this study was to analyze the resorption rate of autogenous bone block grafts from the retromolar region placed in the frontal segment of the upper jaw unprotected by barrier membranes, to assess the stability of implants placed into the grafted bone, as well as to monitor its changes during the healing period. Methods. The study included 18 patients with a total of 20 grafted sites. The residual alveolar ridge was measured before and after the augmentation and prior to implant placement. All implants were restored with provisional crowns within 48 hours after the placement. Implant stability was assessed using resonance frequency analysis. Results. The average period from ridge augmentation to reentry was 5.4 months (range 4?6 months). At reentry the healed alveolar ridge had a mean width of 6.1 ? 1.27 mm. The mean calculated width gain was 3.04 ? 1.22 mm. The overall surface resorption of block grafts was 0.68 ? 0.69 mm (18.85%). At the time of implant placement the mean value of implant stability quotient (ISQ) was 71.25 ? 5.77. The lowest ISQ values were noted after three weeks of healing, followed by a gradual increase until week 12. After 12 weeks implants showed significantly higher ISQ values compared to primary stability (p &lt; 0.05 Wilcoxon signed ranks test). During the 3-years followup period no cases of implant loss were recorded. Conclusion. Despite a significant resorption of bone grafts, it was possible to place implants in all the cases and to use the immediate loading protocol without affecting implant survival rate.

Influence of low-level laser therapy on the healing process of autogenous bone block grafts in the jaws of systemically nicotine-modified rats: A histomorphometric study

ObjectiveTo analyze the influence of low-level laser therapy (LLLT) on the bone healing process of autogenous bone block grafts installed in nicotine systemically modified rats. MethodsSeventy-two rats (Wistar) were randomly assigned into 4 groups (n=18). SS-BG: saline application+bone graft. SS-BG/LLLT: saline application+bone graft+LLLT. NIC-BG: nicotine application+bone graft. NIC-BG/LLLT: nicotine application+bone graft+LLLT. After 30days of application of solutions, all animals received autogenous bone block graft in the jaw, with the donation from the parietal bone’s calvarial area. Treatment with LLLT was in bed-graft interface, after accommodation of the graft. The animals in each group were sacrificed at 7, 14, and 28days after graft surgery. ResultsThe histologic analyses of NIC-BG group depicted a delay of osteogenic activity in the recipient bed-graft interface and the irradiation of tissue with LLLT provided better bone healing. The histometric analysis revealed that SS-BG/LLLT and NIC-BG/LLLT groups showed increased bone formation compared to BG-SS and NIC-BG groups, after 14days (SS-BG 24.94%±13.06% versus SS-BG/LLLT 27.53%±19.07% and NIC-BG 14.27%±2.22% versus NIC-BG/LLLT 24.37%±11.93%) and 28days (SS-BG 50.31%±2.69% versus SS-BG/LLLT 58 19%±12.32% and NIC-BG 36.89%±8.40% versus NIC-BG/LLLT 45.81%±6.03%). ConclusionNicotine harms bone formation in the bed-graft interface and LLLT action can mitigate this.