Intraoral Autogenous Bone Research Articles

AUTOLOGOUS BONE GRAFTS – INDICATIONS AND RESTRICTIONS

INTRODUCTION : Autologous bone grafts and especially intraoral autografts have been used with increasing success for centuries and remain in common use today. They involve the transport of bone from an intraoral donor site to a different intraoral site, in the same patient. AIM AND METHOD: The aim of this poster is to introduce the intraoral autogenous bone grafts and evaluate the indications and restrictions of these techniques. MATERIAL AND METHOD: Autografts are commonly obtained from intraoral sites such as: symphysis mandible, ramus mandible, anterior sinus wall and lateral zygomatic buttress. Autograft bone harvested from mandibular ramus is used when the requiring augmentation is less than 4mm in thickness and span a maximum of four teeth. Although this graft presents a risk of damage to the inferior alveolar nerve, it is associated with secondary complications compared to other intraoral sites. Generally, indications for bone augmentation procedures are determined by means of the following parameters: a)Presence of severe alveolar ridge atrophy rated classes IV and V according to the Cawood and Howell classification b)Residual maxillary bone less than 5 mm from the alveolar crest to the sinus floor. RESULTS: Even when major augmentation procedures with autografts had to be carried out for severely resorbed jaws, success rates exceeding 95% have been achieved. CONCLUSION: Although, autolografts occasionally have significant drawbacks, such as increased postoperative morbidity, the need of secondary surgical visit and the lack of sufficient bone mass at the donor site, it is still regarded as the gold standard in alveolar reconstruction, due to its osteoconduction, osteoinduction and osteogenesis-inducing characteristics.

Sites of autogenous bone harvesting during orthognathic surgery

Bone grafting in orthognathic surgery is used for a variety of reasons, including promoting healing, buttressing large osteotomy gaps, and prevention of skeletal relapse post-operatively. With the ever-changing landscape of available grafting materials, it is possible to overlook a rich supply of autogenous bone which is readily available during orthognathic surgery. This purpose of this paper is to outline a comprehensive list of intra-oral autogenous bone harvest sites, all of which are readily available and accessible during routine orthognathic surgery. The aim of these techniques is to aid the surgeon in maximizing stability of the surgical construct while minimizing cost and morbidity.

Patient\u2019s perception of recovery after maxillary sinus floor augmentation with autogenous bone graft compared with composite grafts: a single-blinded randomized controlled trial

BackgroundAutogenous bone graft is considered as the preferred grafting material for maxillary sinus floor augmentation (MSFA). However, harvesting of extraoral or intraoral autogenous bone graft is associated with risk of donor site morbidity and supplementary surgery. From a clinical and patient perspective, it would therefore be an advantage, if postoperative discomfort could be minimized by diminishing the need for autogenous bone graft harvesting. The objective of the present study was to test the hypothesis of no difference in patient’s perception of recovery after MSFA with autogenous bone graft from the zygomatic buttress (control) compared with 1:1 mixture of autogenous bone graft and deproteinized porcine bone mineral (DPBM) (Test I) or biphasic bone graft material (BBGM) (Test II). Sixty healthy patients were randomly allocated to either control or test groups. Oral Health-related Quality of Life (OHRQoL) was evaluated by Oral Health Impact Profile-14 (OHIP-14) at enrollment. Recovery was estimated by self-administrated questionnaires and visual analog scale assessing pain, social and working isolation, physical appearance, eating and speaking ability, diet variations, sleep impairment and discomfort after 1 week and 1 month. Descriptive statistics was expressed as mean with standard deviation (SD). Correlation between OHRQoL at enrollment and recovery were assessed by linear regression. p-value below 0.05 was considered significant.ResultsTreatment satisfaction and willingness to undergo similar surgery were high in all groups. Average numbers of days with pain and sick leave were 3.5 (SD 3.9) and 0.5 (SD 1.2), respectively, with no significant difference between groups. Moreover, no significant difference in eating and speaking ability, physical appearance, work performance and sleep impairment were seen between groups. Mean OHIP-14 score at enrollment was 9.30 (SD 9.25) (control), 9.95 (SD 7.96) (Test I) and 8.15 (SD 9.37) (Test II), with no significant differences between groups. Impaired OHRQoL, gender or age seems not to predispose for delayed recovery or increased postoperative discomfort.ConclusionsMSFA with diminutive autogenous bone graft harvesting is associated with high patient satisfaction, limited postoperative discomfort and willingness to undergo similar surgery. Presurgical OHRQoL, gender or age seems not to be associated with impaired patient’s perception of recovery.

Clinical and Histologic Evaluation of Using Block Xenograft Combined With Leukocyte-Platelet Rich Fibrin (L-PRF) Versus Intraoral Autogenous Bone Block Graft With L-PRF in Treating Localized Ridge Defects: A Randomized Clinical Trial

Background: Augmentation of vertical bone defects remains the corner stone in periodontal tissue engineering. The amount and quality of alveolar bone available in all dimensions affects the success of dental implants for restoration of edentulous areas. Adequate and healthy bone supports the degree of osseointegration which in turn affects the long-term success of oral implants. The primary aim of the study was to histologically evaluate autogenous block grafts versus synthetic block grafts for the treatment of atrophic vertical and horizontal bony defects (Siebert Class III) in the anterior esthetic zone of the mouth. The secondary aim was to clinically and radiographically evaluate the outcomes of the procedure. Methods: This was a randomized controlled clinical study with a statistically determined sample size of 10 patients per group and a total of 20 patients in both groups. Patients with vertical and horizontal bone loss were enrolled from the Department of Oral Medicine, Periodontology, and Oral Diagnosis of Ain Shams University and Misr International University. Bone augmentation procedures were performed using two techniques: autogenous bone block graft and xenograft bone block graft both with leukocyte-platelet rich fibrin (L-PRF). Results: Both autogenous and xenograft blocks in conjunction with L-PRF had a significant effect on vertical bone augmentation in cases of atrophic ridges in the esthetic region. Conclusion: Both autogenous and xenograft bone blocks in conjunction with L-PRF have a significant effect on vertical bone augmentation in cases of atrophic ridges in the esthetic region.

Anterior Mandibular Composite Graft for Regeneration of Knife-Edge Ridges in Implant Surgery: A Treatment Case Report

Implant insertion into an atrophic knife-edge ridge with non-simultaneous extraction of anterior and posterior teeth is challenging; this is why bone regeneration before implant placement is of great importance. One of the best sources for reconstruction is an intraoral autogenous bone graft. A composite bone graft is a combination of autogenic bone and mucosal flap that provides adequate blood supply and fixation compared to conventional (from the mandibular symphysis or ramus) and extraoral bone grafts.

Secondary closure of alveolar cleft with resorbable collagen membrane and a combination of intraoral autogenous bone graft and deproteinized anorganic bovine bone.

Objects:Secondary alveolar bone grafting is a method that enables an excellent oral rehabilitation of the patients having alveolar cleft. The aim of this work is to report the closure of the alveolar cleft with the use of harvested autogenous bone graft combined with deproteinized anorganic bovine bone (Bio-Oss) under local anesthesia.Settings and Sample Population:Nine patients with age range, 8–11 years were consulted for their unilateral alveolar cleft.Materials and Methods:A combination of symphyseal bone and deproteinized bovine bone mineral (DBBM) was placed into the alveolar cleft defect. Clinical and radiographical assessments were performed at 1, 3, and 6 months postoperatively.Results:The healing period was uneventful in all cases, and no complications, such as membrane exposure, infection, or harvest site morbidity, were observed. All treated defect sites exhibited excellent bone formation, with an average of 5.45 mm (range, 2–9 mm; standard deviation 1.93 mm) of augmentation achieved overall.Conclusion:The treatment of vertically deficient alveolar ridges with guided bone regeneration using a mixture of autogenous bone and DBBM and resorbable collagen membrane can be considered successful, using this technique in an out-patient office setting.

RETROSPECTIVĂ DIN LITERATURĂ PRIVIND GREFELE OSOASE AUTOGENE MAXILO-MANDIBULARE

This study is a review of the specialised literature regarding the intraoral autogenous bone grafts used in oral implantology. 382 abstracts of scientific papers, 71 full-text scientific articles and 9 specialized books, out of which 113 included in the references, were studied. The area behind the mandibular third molar, the posterior buccal area of the mandible body and the mandibular symphysis are the most frequently used sites for intraoral block bone harvesting. The mandible should be the first choice in the intraoral donor site selection for peri-implant augmentation, if the quantity of bone that is going to be harvested is considered to be enough.

Alveolar ridge augmentation with titanium mesh. A retrospective clinical study.

An adequate amount of bone all around the implant surface is essential in order to obtain long-term success of implant restoration. Several techniques have been described to augment alveolar bone volume in critical clinical situations, including guided bone regeneration, based on the use of barrier membranes to prevent ingrowth of the epithelial and gingival connective tissue cells. To achieve this goal, the use of barriers made of titanium micromesh has been advocated.A total of 13 patients were selected for alveolar ridge reconstruction treatment prior to implant placement. Each patient underwent a tridimensional bone augmentation by means of a Ti-mesh filled with intraoral autogenous bone mixed with deproteinized anorganic bovine bone in a 1:1 ratio. Implants were placed after a healing period of 6 months. Panoramic x-rays were performed after each surgical procedure and during the follow-up recalls. Software was used to measure the mesial and the distal peri-implant bone loss around each implant. The mean peri-implant bone loss was 1.743 mm on the mesial side and 1.913 mm on the distal side, from the top of the implant head to the first visible bone-implant contact, at a mean follow-up of 88 months.The use of Ti-mesh allows the regeneration of sufficient bone volume for ideal implant placement. The clinical advantages related to this technique include the possibility of correcting severe vertical atrophies associated with considerable reductions in width and the lack of major complications if soft-tissue dehiscence and mesh exposures do occur.

Risk of bacterial contamination of bone harvesting devices used for autogenous bone graft in implant surgery

BackgroundVarious instruments have been developed for collecting bone debris during intraoral autogenous bone graft procedures in implant surgery. The aim of this study was to quantitatively determine the degree of contamination in bone debris collected by different devices.MethodsTwelve patients underwent autogenous bone collection using a bone chisel, bone scraper, trephine drill, and bone filter during bone augmentation surgery as a part of implant therapy, and the total bacterial count in bone debris collected by each was determined.ResultsFollowing anaerobic incubation, bacterial colony formation was found in all of the samples. The mean colony forming units (CFU)/g in samples collected by the trephine drill was found to be significantly lower than that of samples obtained with the other devices, while those values for samples collected by the bone scraper and bone filter was significantly higher as compared to the bone chisel and trephine drill.ConclusionThe bacterial levels may still carry the infection risk. Thus prophylactic antibiotic therapy maybe indicated when using bone particles for intraoral augmentation procedures.

Stability of Implants Placed in Augmented Posterior Mandible after Alveolar Osteotomy Using Resorbable Nonceramic Hydroxyapatite or Intraoral Autogenous Bone: 12‐Month Follow‐Up

This prospective, controlled split-mouth study evaluated the stability of dental implants placed in the augmented mandibular areas with alveolar segmental "sandwich" osteotomies using nonceramic hydroxyapatite (ncHA) or autogenous bone. This study included 11 bilaterally partially edentulous mandibular patients in a split-mouth design. Alveolar augmentation osteotomies were performed bilaterally with interpositional ncHA graft (test group) or interpositional intraoral autogenous bone graft (control group). After 6 months of healing, four implants (two implants in each side) were placed in each patient. Forty-four implants were inserted and loaded after 6-month healing period. At 1-year follow-up, radiographic, prosthetic, and resonance frequency analysis parameters were assessed. Success criteria included absence of pain, sensitivity, suppuration, and implant mobility; absence of continuous peri-implant radiolucency; and distance between the implant shoulder and the first visible bone contact (DIB) < 2 mm. After a 1-year loading period, the overall implant survival rate was 95.45%, with two implant losses (one of each group). Among the surviving implants (42 out of 44), two did not fulfill the success criteria; therefore, the implant success was 90.90%. DIB was 0.71 ± 0.70 and 0.84 ± 0.72 mm for ncHA and autogenous bone grafts, respectively (p > .05). Implant stability measurements were similar between the groups during the 12-month follow-up (p > .05). Within the limits of this study, the implants placed either in sites augmented with ncHA or autogenous bone seem to represent a safe and successful procedure, at least, after 12-month follow-up.

Alveolar osteotomy associated with resorbable non‐ceramic hydroxylapatite or intra‐oral autogenous bone for height augmentation in posterior mandibular sites: a split‐mouth prospective study

The presence of the inferior alveolar nerve within the body of the mandible could jeopardize the placement of dental implants. Previous studies have shown that the interpositional osteotomy for posterior mandible ridge augmentation could be a predictable procedure. Nevertheless, there are few prospective, controlled, and randomized studies that evaluated this technique using different bone graft materials. This prospective, controlled split-mouth study evaluated, using tomographic and Resonance Frequency Analyses (RFA), implants placed in the augmented mandibular area. Alveolar augmentation osteotomies were performed bilaterally in 12 partially edentulous mandibular patients in a split-mouth design. The alveolar segmental osteotomies were assigned in two groups: test group, interpositional non-ceramic hydroxylapatite bone graft, and control group, interpositional intra-oral autogenous bone graft. After 6months healing, implants were placed. The tomographic measurements of bone gain were recorded at baseline and 6months after surgery, when the implants were placed. At 12months after osteotomy, RFA were performed for each implant. The mean of bone gain 6.5±2.4mm and 7.0±1.76mm to control and test group, respectively (P>0.05). RFA values between groups were similar at baseline and 12months follow-up (P>0.05). Alveolar osteotomies associated with sandwich interpositional bone graft, independently of bone graft, resulted in bone formation over a period of 12months.

A Comparative Volumetric Study of Symphysis Donor Defects, Unfilled or Filled with Bone Substitute

Background Intraoral autogenous bone grafts are a convenient source of bone in reconstruction of the residual ridge before dental implant placement. The aim of this study was to evaluate bone volume of symphysis donor defects filled with bone substitute compared with unfilled symphysis donor defects. The study included 26 patients who underwent either alveolar ridge reconstruction or maxillary sinus elevation. Two groups were studied: symphyseal donor defects filled with bone substitute and unfilled symphyseal donor defects. Pre- and postoperative volumetric variables were determined using computed tomography scans and the software program SimPlant® (Materialise Dental Italia, Roma, Italy). At 6 months postsurgery, the filled donor defects exhibited a significant increase in bone volume compared with unfilled donor defects (97.7% and 73.4%, respectively). At 18 months postsurgery, volume of unfilled donor defects was reevaluated with no significant increase in bone volume. Six months following block harvesting procedure, filled donor defects maintained bone volume, while unfilled donor sites generated defects that cannot achieve full regeneration; even not 18 months postblock harvesting.

Simultaneous Sinus Membrane Elevation and Dental Implant Placement Without Bone Graft: A 6‐Month Follow‐Up Study

Previous studies have shown that simultaneous elevation of the sinus mucosal lining and placement of dental implants without graft materials can be a predictable procedure. Nevertheless, few prospective, controlled, and randomized studies have evaluated this technique. The aim of this prospective, controlled, and randomized clinical study is to evaluate whether sinus membrane elevation and simultaneous placement of dental implants without autogenous bone graft can create sufficient bone support to allow implant success 6 months post-surgically. Sinus membrane elevation and simultaneous placement of dental implants were performed bilaterally in 15 patients in a split-mouth design. The sinuses were assigned to two groups: the test group, with simultaneous sinus mucosal lining elevation and placement of dental implants without graft materials; and the control group, with simultaneous sinus mucosal lining elevation and placement of dental implants with intraoral autogenous bone graft. After 6 months of healing, abutments were connected. For each implant, length of implant protrusion into the sinus, resonance frequency analysis, and bone gain were recorded at baseline and 6 months follow-up. Clinical complications were not observed, except for two postoperative fistulas and suppuration in both groups. Only one implant of the test group was lost, reaching a success rate of 96.4% and 100% for the test and control groups, respectively. After healing, radiographic new peri-implant bone was observed in both groups ranging between 8.3 ± 2.6 and 7.9 ± 3.6 mm for the control and test groups, respectively (P >0.05). Resonance frequency analysis values were lower for the control group compared to baseline (P <0.05). However, these values were similar at 6 months (P >0.05). A significant positive correlation was found between the protruded implant length/bone gain and implant survival/sinusitis (P <0.0001). Implants placed simultaneously to sinus membrane elevation without graft material resulted in bone formation over a period of 6 months.

Histologic and clinical evaluation for maxillary sinus augmentation using macroporous biphasic calcium phosphate in human

This study evaluated both the clinical and histological aspects of bone formation in maxillary sinus augmentation using MBCP as the bone-grafting material. MBCP was used as a primary bone substitute for maxillary sinus augmentation. Fifty-two patients were selected after a medical and dental examination, and were divided into the following three groups: those augmented with MBCP only; MBCP combined with irradiated cancellous bone; and MBCP combined with intraoral autogenous bone. After a healing period (average 6.78 months after surgery), bone cores were harvested for a histological evaluation and the implant fixtures were installed. These bone cores were evaluated via light microscope and implants were followed up for at least six months after loading. Four to ten months after surgery, new vital bone surrounding the MBCP particles was observed in 18 bone biopsies. Two out of the 130 implants installed were explanted due to a failure of osseointegration before the prosthetic procedure. All the remaining implants were functioning for 6 to 27 months (average 12.96 months). The cumulative survival rate of the implants was 98.46%. These results show that MBCP can be used as a grafting material for sinus floor augmentation, whether combined with other bone graft materials or not, and lead to a predictable prognosis for dental implants in the posterior maxillary area where there is insufficient vertical height for fixture installation.

Vertical ridge augmentation by expanded‐polytetrafluoroethylene membrane and a combination of intraoral autogenous bone graft and deproteinized anorganic bovine bone (Bio Oss)

To evaluate, from a histological and histomorphometrical perspective, the efficacy of a 1 : 1 mixture of deproteinized bovine bone mineral (DBBM) and autogenous bone graft associated with an expanded-polytetrafluoroethylene (e-PTFE) membrane for vertical ridge augmentation in the human. Seven patients with 10 surgical sites requiring vertical ridge augmentation of partially edentulous lower jaws were included in the study. The vertical augmentation procedure was performed combining a titanium-reinforced e-PTFE Gore-Tex membrane with a composite graft consisting of a 1 : 1 ratio of DBBM (Bio-Oss) and autogenous bone. Twenty-seven Branemark implants have been inserted. Eleven biopsies from the regenerated area were analyzed histologically and histomorphometrically. The healing period was uneventful in nine surgical sites. In one site the membrane showed an exposure after 3 months. At the abutment connection, all implants appeared stable and submerged by a hard regenerated tissue clinically similar to bone. The histological analysis showed new bone formation and ongoing remodelling of the autogenous bone and the DBBM particles. The findings from the present clinical and histological study support the use of a 1 : 1 combination of DBBM and autogenous bone chips for vertical ridge augmentation by means of guided bone regeneration techniques. The regenerated bone may lead to proper osseointegration of a dental implant inserted at the time of the regenerative procedure or after a healing period of at least 6 months. DBBM undergoes very slow resorption and substitution with new bone. Furthermore, long-term clinical studies are needed to confirm the positive effect of DBBM in enhancing the lasting stability of the vertically augmented bone.

Histologic and Histomorphometric Evaluation of Alveolar Ridge Augmentation Using Bone Grafts and Titanium Micromesh in Humans

Recently, the use of titanium micromesh for alveolar bone augmentation has drawn interest; however, only limited histologic data are available on the quality of the bone regenerated. Therefore, this study compared the use of 100% intraoral autogenous bone to a combination of intraoral autogenous bone (70%) and bovine porous bone mineral (BPBM) (30%) for alveolar ridge augmentation with titanium micromesh histologically and histomorphometrically. Twelve partially edentulous patients required alveolar bone augmentation before implant insertion because of ridge resorption. The defect sites, six in the maxilla and six in the mandible, were reconstructed with particulate autologous bone (control group, N = 6) or a mixture of autologous bone and BPBM (test group, N = 6) in combination with titanium micromesh. Core biopsies were taken from the defect sites 8 to 9 months after grafting at the time of implant insertion. Newly formed compact bone with a well-organized lamellar pattern was identified in all specimens. In the samples taken from the test group, the BPBM particles were surrounded completely by newly formed bone with no signs of resorption. The mean total bone volume was 62.38% +/- 13.02% in the control group and 52.88% +/- 11.47% in the test group. The soft tissue volume was 37.61% +/- 13.02% and 29.96% +/- 12.58%, respectively, and the residual BPBM volume was 17.15% +/- 2.72% in the test group. No statistical difference was observed in the histologic parameters evaluated, irrespective of graft type and site (P >0.05). Within the limits of this study, BPBM (30%) in combination with autogenous bone (70%) did not yield a lower percentage of new bone formed compared to autogenous bone alone in ridge augmentation with titanium micromesh.

Multitier Technique for Bone Augmentation Using Intraoral Autogenous Bone Blocks

Intraoral bone grafts are a convenient and acceptable source of autogenous bone for alveolar reconstruction due to bone origin similarity and less morbidity. In large bone defects, 1 tier might be insufficient to achieve the desired bone shape. The purpose of this article was to describe a multitier technique for reconstruction of extensive bone deficiency, using only intraoral block bone grafts for implant site augmentation. After clinical and radiographic evaluation of the recipient site, measurements were taken to determine the size of the bone deficiency. The first tier of bone graft was harvested from the mandibular ramus. After additional clinical and radiographic evaluation of the recipient site 5 months later, bone graft blocks for the second tier were harvested either from the second ramus or the mandibular symphysis. A new technique, the multitier intraoral bone block graft, for the future use of dental implants, is described. This technique can serve as an optional operation procedure for extensively atrophic alveolar bone augmentation.

O.458 Application of autologous platelet-rich plasma in preprosthetic surgery

We studied the reconstruction of the maxilla with the simultaneous placement of International Team for Implantology (ITI) implants with the combined use of a small amount of intraoral autogenous bone providing the necessary viable stem cells, and a larger amount of xenogenic bone used as a scaffold and a purely autologous platelet concentrate providing the growth factors for optimal bone formation.Ninety-seven consecutive patients, 57 females and 40 males, with severe maxillary atrophy necessitating bone grafting for implant and fixed bridge reconstruction were treated between 2001 and 2003. A total of 314 implants ITI sand-blasted large-grit acid-etched type were placed simultaneously in the anterior, posterior or both parts of the maxilla.Of all the cases, 97.8% healed uneventfully with excellent hard and soft tissues healing. Bone maturation was excellent at 3 months as seen on x-rays and CAT scans.The use of autologous platelet concentrate combined with autogenous and xenogenous grafts allowed fast soft and hard tissue healing.

Early Implant Loading in Severely Resorbed Maxilla Using Xenograft, Autograft, and Platelet-Rich Plasma in 97 Patients

We studied the reconstruction of the maxilla with the simultaneous placement of International Team for Implantology (ITI) implants with the combined use of a small amount of intraoral autogenous bone providing the necessary viable stem cells, and a larger amount of xenogenic bone used as a scaffold and a purely autologous platelet concentrate providing the growth factors for optimal bone formation. Ninety-seven consecutive patients, 57 females and 40 males, with severe maxillary atrophy necessitating bone grafting for implant and fixed bridge reconstruction were treated between 2001 and 2003. A total of 314 implants ITI sand-blasted large-grit acid-etched type were placed simultaneously in the anterior, posterior or both parts of the maxilla. Of all the cases, 97.8% healed uneventfully with excellent hard and soft tissues healing. Bone maturation was excellent at 3 months as seen on x-rays and CAT scans. The use of autologous platelet concentrate combined with autogenous and xenogenous grafts allowed fast soft and hard tissue healing.

Lateral Alveolar Ridge Augmentation With Allogenic Block Grafts: Observations From a Multicenter Prospective Clinical Trial

Statement of the Problem: The use of autogenous bone block grafts in guided bone regeneration procedures for alveolar ridge augmentation is limited by donor-site morbidity and the need for advanced bone-harvesting skills. The need for advanced bone-harvesting techniques was highlighted as a key factor. It became apparent that the success of these early techniques was dependent upon operator skill and training with flap designs, membranes and stabilization screws, as well as the ability to harvest sufficient intraoral autogenous bone. The necessary skill level and postoperative patient morbidity have limited the potential for most clinicians to incorporate horizontal and vertical ridge augmentation techniques into their clinical practices. To enable more dental clinicians to use lateral ridge augmentation as a treatment option in patients with inadequate bone volume prior to implant placement, this paper describes the use of an allogenic bone block graft as an alternative to conventional GBR and autogenous block-grafting techniques. In this study, allogenic block grafts were used for ridge augmentation prior to implant placement. Materials and Methods: Twenty seven patients with severe ridge width deficiency underwent augmentation using an allogenic corticocancellous iliac bone block graft. The mean bone block size was 11 13 5 mm. Two miniscrews were used for each block graft. In 15 patients the block graft was placed in the anterior maxilla. After rigid fixation of the graft with miniscrews, the graft site was covered with a type I collagen membrane and tension-free closure was performed. Patients received postoperative antibiotics. Implants were placed 6 months later and bone-core biopsies were taken for histological examination. Six months after implant placement, computed tomography scans and panoramic radiographs were taken. Further bone-core biopsies were taken from one patient. Method of Data Analysis: Cumulative data and histological examination of bone-core biopsies. Results: No clinical problems were encountered. The block graft became well integrated into the surrounding bone, and the augmented bone remained stable throughout the implant placement procedures. Six months after implantation, there was no bone resorption, and bonecore biopsies showed newly formed woven bone and new lamellar bone within the graft. Conclusion: Evidence demonstrates that allogenic bone block grafts in conjunction with resorbable membranes might be a viable alternative to autogenous grafts in patients with alveolar ridge deficiencies. Further study and data accumulation is required.