Lateral Ridge Augmentation Research Articles

"Xenogeneic Bone Block in Lateral Ridge Augmentation: Where Are We Now?' A Systematic Review and Meta-Analysis.

This systematic review and meta-analysis aimed to investigate the clinical outcomes of xenogeneic bone blocks (XBB) used for lateral ridge augmentation, specifically focusing on bone gain, graft survival, and implant survival. Data search was conducted in Pubmed, Embase, and ClinicalTrial.gov for randomized controlled trials (RCTs), and prospective cohort studies up to March 1, 2024. Horizontal bone gain (HBG), horizontal bone resorption (HBR), graft survival rate, and implant survival rate were analyzed. Cochrane Risk of Bias Tool 2 and Newcastle-Ottawa Scale were applied to assess the quality and risks of the included studies. Four RCTs and five prospective cohortstudies, comprised 120 graft sites and 141 implants in total were included for the meta- analysis. Non-comparative analysis resulted in a weighted mean horizontal bone gain (HBG) of 4.38 mm and horizontal bone resorption (HBR) of 0.85 mm. Comparative analysis with data from 4 RCTs that paired xenogeneic bone block (XBB) with autogenous bone block (ABB) exhibited a statistically significant greater HBG in XBB, with a mean difference of 0.72mm (95% CI=0.067 to 1.382, p=0.031, I2=28.2%). The weighted graft survival rate for XBB was 91.3% (95% CI = 76.6% to 97.1%, I2 = 58.0 %), and the weighted implant survival rate was 84.3% (95% CI = 72.6% to 91.6%, I2 = 31.6 %). Histologically, mean percentage of mineralized vital bone in XBB ranged from 11.6% to 29.8%, and the resorption rate ranged from 7.3% to 21%. The utilization of xenogeneic bone block for lateral ridge augmentation demonstrates an acceptable survival rate and yields an adequate volume of bone for subsequent implant therapy. Nonetheless, the survival rate of implants placed in ridges augmented with xenogeneic blocks is less favorable when compared to those augmented with autogenous block grafts.

Lateral Alveolar Ridge Augmentation with Autogenous Tooth Roots and Staged Implant Placement-5-Year Follow-Up Case Series.

Background/Objectives: Alveolar bone augmentation before implant placement is a safe and effective treatment option for the reconstruction of a deficient alveolar ridge. According to recent research, permanent teeth have been used as bone graft materials, with studies confirming their clinical and histological results. This study aimed to evaluate the efficacy of alveolar ridge augmentation with autogenous tooth roots and staged implant placement, and peri-implant tissue stability in augmented sites. Methods: A total of 20 augmentations with autogenous tooth roots on mandibular alveolar ridges in 15 patients were performed. After 6 months, the ridge width (RWa) and ridge width gain (RWg) were measured. Titanium dental implants were placed in grafted sites and loaded 10 weeks after placement. Clinical parameters (bleeding on probing-BOP; probing depth-PD; mucosal recession-MR; and clinical attachment level-CAL) were assessed 2 months (T1), 3 years (T2), and 5 years (T3) after implant loading. Results: The mean RWa was 6.71 ± 0.74 mm, and the RWg was 3.15 ± 0.54 mm, respectively. No statistically significant differences were observed for clinical parameters (BOP, PD, MR, and CAL) among different time points (p > 0.05). Conclusions: Autogenous tooth roots represent a viable solution for alveolar ridge augmentation and implant placement, providing a stable environment for peri implant tissues.

Multidisciplinary approach in periodontics: Planning and treatment of complex cases – Case series

The aim of this case series is to show the management of complex cases by combining different surgical procedures from different dental specialties. Addressing complex cases with an interdisciplinary approach provides the best treatment outcome. This approach helps in reducing the cost, time, and postoperative sequelae. The presented three clinical cases showed a combination of surgical procedures such as aesthetic crown lengthening, lateral ridge augmentation, apical surgery, and implant placement. They also showed that using bone grafting during the apical surgery improved the healing.

Clinical outcomes following atrophic alveolar ridge reconstruction using collagenated xenogeneic bone block or autogenous bone block: One-year follow-up of a randomized controlled clinical.

This investigation aimed to evaluate the 1-year survival of implants placed after staged lateral alveolar ridge augmentation using equine-derived collagenated xenogeneic bone blocks (CXBBs) or autogenous bone block (ABB). Fifty patients who underwent lateral augmentation in a previous trial were included. The primary outcome measure was implant survival at the 1-year follow-up, and secondary outcomes included implant success, peri-implant clinical and volumetric parameters, pink aesthetic scores (PES) and patient-reported outcome measures. Data analysis involved Fisher's exact test, the Mann-Whitney U-test and the Wilcoxon signed-rank test. In this study, no late implant failures were observed. The cumulative survival rates were 78.6% for the CXBB group and 90.9% for the ABB group, with no difference between the groups. Similarly, the success rates were 53.6% and 63.6%, respectively, showing no significant difference. Peri-implant clinical and volumetric parameters indicated the presence of healthy peri-implant tissues surrounding implants placed in both CXBB- and ABB-augmented sites. PES were 8.5 and 11.0 for implants placed in CXBB- and ABB-augmented sites, respectively. Furthermore, patient satisfaction rates were high and similar between the groups. Dental implants placed in both CXBB- and ABB-augmented ridges demonstrated no statistically significant differences in clinical, volumetric and aesthetic outcomes, along with high patient satisfaction rates.

Efficacy of autogenous tooth block for lateral ridge augmentation compared with autogenous bone block: A systematic review and meta-analysis.

Autogenous tooth block (ATB) has been used as an alternative material for bone regeneration, but its efficacy compared with autogenous bone block (ABB) remains uncertain. The aim of this systematic review was to investigate and compare the clinical and histological performance of ATB and ABB grafts in lateral alveolar ridge augmentation (LARA). Electronic retrieval of MEDLINE, Embase, Cochrane Library (CENTRAL), Scopus, Web of Science, China national knowledge infrastructure, Wanfang data, SinoMed, and manual searching until July 2023 were used to identify controlled clinical trials employing ATB grafts in LARA. The identified reports included at least one of the following outcome variables: ridge width gain, graft resorption, postoperative complications, histology, and histomorphometry. Weighted or mean differences (MD), relative risk, and corresponding 95% confidence intervals (CI) were calculated. Descriptive analysis was applied to the qualitative statistics. The protocol followed the preferred reporting items for systematic reviews and meta-analyses statement and was prospectively registered in PROSPERO (CRD42023399611). Four controlled clinical trials with 77 participants each using ATB and ABB grafts were included. Meta-analysis indicated that ATB grafts resulted in greater bone width (MD = 1.31, 95% CI [0.92, 1.71], P < .00001) and less graft resorption (MD = -0.71, 95% CI [-1.22, -0.21], P = .005) than ABB grafts on LARA. There was no statistical difference in postoperative complications between ATB and ABB grafts (relative risk = 0.81, 95% CI [0.32, 2.04], P = .66). Furthermore, the ATB grafts exhibited positive replacement resorption with alveolar bone for favorable signs of new bone activity on histology and histomorphometry. Within the limitations of this study, ATB grafts could serve as an alternative material for ABB to support LARA. Further research with a longer follow-up period is required to verify these findings.

Measuring the outcomes of lateral ridge augmentation using cone-beam computed tomography.

Lateral ridge augmentation (LRA) is a surgical technique to gain bone prior to implant placement. Performing cone-beam computed tomography (CBCT) pre- and post-surgery allows for quantitative comparison of the buccal-lingual width and the vertical height of the edentulous ridges. This study used CBCT images to evaluate the bone regeneration following surgery. A total of 30 cases from adult patients who underwent LRA and had high-quality CBCT images taken pre- and post-surgery from the same CBCT scanner were available for the retrospective study. Study data included linear measurements of the bone ridge width and height obtained from the middle of the edentulous ridge and a volumetric measurement of bone growth at the edentulous site observed on the CBCT scan. The reliability of the measurements was excellent as indicated by Intra-Class Coefficient values of 0.974 or higher. There was a significant mean bone increase from pre-surgery compared to post-surgery for both the linear and volumetric measurements. The linear bone gain ranged from 1.5 to 2.5 mm and volumetric gain from 250 to 750 mm3 . However, two patients did not gain any bone. Multivariate regression showed the strongest predictors of bone gain post-surgery were the pre-surgery bone volume and a surgical site being in the mandible. For maxillary surgical sites, particularly anterior areas, the LRA surgeries were the least successful. LRA before implant placement helped to increase bone for the majority of patients, particularly for surgical sites in the mandible. The quantitative analyses in the CBCT images showed excellent intra-examiner agreement.

Simultaneous or staged lateral ridge augmentation: A clinical guideline on the decision-making process.

Lateral ridge augmentation is a standard surgical procedure that can be performed prior to (staged) or simultaneously with implant placement. The decision between a simultaneous or staged approach involves considering multiple variables. This paper proposed a decision-making process that serves as a guideline for choosing the best treatment choice based on the available evidence and the author's clinical experience.

Ossification and Bone Regeneration in a Canine GBR Model, Part 1: Thick vs Thin Glycated Cross-Linked Collagen Devices.

Purpose: To compare glycated multilayered membranes (OV) to a commercially available thin-layer membrane (OP) in a lateral ridge augmentation model in dogs. Materials and Methods: This was designed as a three-arm study, where one negative control (empty defect) was compared to two test arms: alveolar bone defects grafted with a mixture of 90% deproteinized bovine bone mineral and 10% porcine collagen, then covered with either a thick- (OV) or thin-layered (OP) membrane. Animals were randomly divided into three groups corresponding to the final sacrifice times of 4 weeks, 12 weeks, and 24 weeks. Sections underwent microCT, histology, histopathology, and histomorphometry. Results: No statistical differences were observed for OV compared to OP regarding the percentage of mineral volume and mean mineral density, amount of bone maturation, percentage of bone graft and membrane remaining in the grafted area, alveolar ridge width measurements, membrane mineralization, or ossification. Test groups presented significantly higher values compared to the empty control for all the endpoints. Conclusions: Within its limitations, this in vivo study highlighted that multilayered thick glycated membranes can serve as effective occlusive barriers for up to 6 months.

Comparison of Marginal Bone Loss in Simultaneous Versus Delayed Implant Placement Following Horizontal Ridge Augmentation with Autogenous Lateral Ramus Bone Block.

Alveolar ridge resorption after tooth extraction may interfere with optimal dental implant placement. This study aimed to compare the marginal bone loss (MBL) and thickness of the buccal aspect of the augmented site in simultaneous versus delayed implant placement following lateral ramus horizontal ridge augmentation in the posterior mandible. This prospective cohort study was conducted on patients who required horizontal bone augmentation of the posterior mandible using lateral ramus autogenous bone graft. Patients were divided into two groups of simultaneous implant placement (group 1) and delayed implant placement (group 2). Cone-beam computed tomography (CBCT) images were obtained before augmentation, at the time of implant placement, and 10 months later (6 months after implant loading). MBL and thickness of the buccal aspect were evaluated over time. There were 18 patients in the group 1 and 16 patients in the group 2. Analysis of the CBCT scans demonstrated that the mean MBL was 1.21±0.35mm in the group 1 and 1.08±0.19mm in the group 2, with no significant difference between the two groups (p= 0.19). Thickness of the buccal aspect of the augmented site at the time of implant placement was 1.85±0.20mm in the group 1 and 2.16±0.29 mm in the group 2, with a significant difference (p< 0.001). However, data analysis regarding changes in the buccal plate thickness showed no significant difference between the two groups (p= 0.36). According to the results of this study, there was no significant difference in M-BL and post-operative changes in the thickness of the buccal aspect of the augmented sites with onlay lateral ramus bone blocks between simultaneous and delayed implant placement.

Frozen Stored Teeth: Autogenous Dentin as an Alternative Augmentation Material in Dentistry.

Tooth Shell Technique (TST) with the use of autologous dentin has proven to be a suitable method of grafting in the context of lateral ridge augmentation. This present feasibility study aimed to retrospectively evaluate the preservation by lyophilization of processed dentin. Thus, the frozen stored processed dentin matrix (FST: 19 patients with 26 implants) was re-examined with that of processed teeth used immediately after extraction (IUT: 23 patients with 32 implants). Parameters of biological complications, horizontal hard tissue loss, osseointegration, and buccal lamella integrity were used for evaluation. For complications, the observation period was 5 months. Only one graft was lost (IUT group). In the area of minor complications, without the loss of an implant or augmentation, there were two cases of wound dehiscence and one case with inflammation and suppuration (IUT: n = 3, FST: n = 0). Osseointegration and integrity of the buccal lamella were present in all implants without exception. Statistically, there was no difference between the groups studied for the mean resorption of the crestal width and the buccal lamella. Results of this study show that prepared autologous dentin preserved with a conventional freezer had no disadvantage compared to immediately use autologous dentin in terms of complications and graft resorption in the context of TST.

Clinical And Radiographic Outcomes Following Lateral Alveolar Ridge Augmentation Using Autogenous Dentin Block Graft- A clinical study

Clinical And Radiographic Outcomes Following Lateral Alveolar Ridge Augmentation Using Autogenous Dentin Block Graft- A clinical study

Autogenous bone block versus collagenated xenogeneic bone block in the reconstruction of the atrophic alveolar ridge: A non-inferiority randomized clinical trial.

To compare the efficacy of equine-derived collagenated xenogeneic bone blocks (CXBB) and autogenous bone block (ABB) for lateral alveolar ridge augmentation and two-stage implant placement. Sixty-four patients with tooth gaps up to four teeth and atrophic alveolar ridges with ≤4 mm were randomly assigned to lateral augmentation using CXBB or ABB. Lateral bone thickness (LBT) was measured 2 mm below the alveolar crest at augmentation surgery and 30 weeks later at implant placement. Implant-related outcomes, adverse events, surgery duration, pain sensation, analgesic consumption, and oral health-related quality of life were also assessed. Data were analysed using Fisher's exact, Mann-Whitney, and Wilcoxon signed-rank tests. At 30 weeks, the median change in LBT amounted to 2.90 (CXBB) and 3.00 (ABB), respectively. Secondary endpoints demonstrated similar results for CXBB and ABB in terms of possibility to place an implant, need to perform a secondary bone augmentation at implant placement and rate of complications. Early implant failure was 20% for CXBB and 10% for ABB, with no difference between the groups. Pain scores and post-operative consumption of analgesics were significantly lower in the CXBB group than in the ABB group, especially during the first days post-surgery. CXBB is non-inferior to ABB for horizontal alveolar ridge augmentation and two-stage implant placement.

Simultaneous presence of Mycoplasma salivarium and Tannerella forsythia in the implant sulcus after lateral augmentation with autogenous root grafts is associated with increased sulcus probing depth.

To characterize a potential pathogenic role of Mycoplasma salivarium and bacterial co-detection patterns on different implant augmentation types. 36 patients were non-randomly assigned to autogenous lateral alveolar ridge augmentation with either cortical autogenous bone blocks, or healthy autogenous tooth roots or non-preservable teeth. Mucosal inflammation was assessed by probing pocket depth (PD) at all sampling sites and by bleeding on probing (BOP) in a subset of sampling sites, and standardized biofilm samples were obtained from the submucosal peri-implant sulcus and sulcus of a contralateral tooth at two times (t1 after implant placement; t2 after six months). Seven bacterial species were quantified using Taqman PCR. Mucosal inflammation did not differ between augmentation groups, but peri-implant sulci showed increased abundance of M. salivarium after augmentation with autogenous tooth roots lasting for at least six months (t1 p = 0.05, t2 p = 0.011). In M. salivarium-positive samples, Tannerella forsythia was correlated with PD (R = 0.25, p = 0.035) This correlation was not observed in M. salivarium-negative samples. Compared to all other samples, PD was deeper in co-detection (i.e., simultaneous M. salivarium and T. forsythia) positive samples (p = 0.022). No association of single or co-detection of bacteria with BOP was observed. Presence of M. salivarium in peri-implant sulci varies with augmentation method and is associated with increased PD but not BOP. A potential causal role of M. salivarium in inflammation through a mechanism involving co-presence of T. forsythia requires further study.

Lateral Alveolar Ridge Augmentation with Autologous Dentin of Periodontally Compromised Teeth: A Retrospective Study.

Tooth shell technique (TST) using autologous dentine is possible with lateral ridge augmentation while avoiding a donor region. This study aimed to clarify whether the use of periodontally compromised teeth (PCT) leads to similar results compared to non-periodontally compromised teeth (NPCT). In this retrospective study, the dentin matrix of 41 patients (PCT: n = 19 with 29 implants; NPCT: n = 22, with 29 implants) was used for TST. All cases were re-examined. Outcome parameters were biological complications, horizontal hard tissue loss, osseointegration, and the integrity of the buccal lamella. Only in one case in the PCT group, a graft was lost. In three cases, minor complications were identified, including two cases of wound dehiscence and one case of inflammation with suppuration (PCT: n = 1, NPCT: n = 3). All implants, except the one with the severe complication, were osseointegrated and the integrity of the buccal bone lamella was preserved. Mean difference of the resorption of the crestal width and the buccal lamella did not differ statistically between the two groups. TST using PCT showed results comparable to those of NPCT in terms of complications and graft resorption. Processed dentin matrix from PCT can be used and applied with predictable results for bone grafting, utilizing TST.

Immediate postoperative complications after lateral ridge augmentation – a clinical comparison between bone shell technique and sticky bone

Nowadays, implant dentistry is strongly interconnected to bone augmentation procedures. Lateral ridge augmentation is often an imperative treatment stage for successful, prosthetic-driven implant placement. This study aimed to comparatively analyze the immediate postoperative complications of two horizontal bone grafting procedures: sticky bone and bone shell technique. Records of patients with lateral ridge augmentation were analyzed to identify immediate postoperative complications. The study group included 80 patients divided into 40 control (bone-shell technique – BS) and 40 tests (sticky bone –SB). More patients reported moderate and severe pain in the BS – group (11 patients – 27.5%) than in the SB group (6 patients – 15%). In the BS group, the incidence of severe and moderate trismus, neurosensory disturbances, and important hematoma was higher. There was an increased inflammatory response following the bone shell technique, while the sticky bone technique proved reduced surgical morbidity. There was no difference between the two groups in the risk of dehiscence or infection.

Lateral Alveolar Ridge Augmentation with Autogenous Tooth Block Graft Compared with Autogenous Bone Block Graft: a Systematic Review.

ABSTRACTObjectivesThe objective of the present systematic review was to evaluate the current knowledge of implant treatment outcome following lateral alveolar ridge augmentation with autogenous tooth block graft compared with autogenous bone block graft prior to implant placement.Material and MethodsMEDLINE (PubMed), Embase and Cochrane Library search in combination with hand-search of relevant journals was conducted including human studies published in English through December 20, 2021. Comparative and non-comparative studies assessing lateral alveolar ridge augmentation with autogenous tooth block graft were included. Quality and risk-of-bias assessment were evaluated by Cochrane risk of bias tool, Newcastle-Ottawa Scale and GRADE system.ResultsOne comparative study characterized by low grade and two non-comparative studies fulfilled the inclusion criteria. No significant difference in short-term implant survival, health status of the peri-implant tissue or frequency of complications between the two treatment modalities was observed. Postoperative dimensional changes of the alveolar ridge width were significant diminished with tooth block compared with bone block (P = 0.0029). Consequently, the gain in alveolar ridge width was significantly higher with tooth block, after 26 weeks (P = 0.014). However, a higher frequency of short-term peri-implant mucositis was observed with tooth block.ConclusionsLateral alveolar ridge augmentation with tooth block seems to be a suitable alternative to bone block. However, results of the present systematic review are based on short-term studies involving small patient samples. Further long-term randomized controlled trials are therefore needed before definite conclusions can be provided about the beneficial use of tooth block compared with bone block.

Lateral Ridge Augmentation Using Cross-Linked or Non-Cross-Linked Collagen Membrane: A Pilot Randomized Clinical Trial

Purpose: The aim of this investigation is to test, in a lateral ridge augmentation model without simultaneous implant placement, the effect of using a cross-linked collagen membrane and a non-cross-linked collagen membrane on guided bone regeneration. Material and Methods: Edentulous alveolar ridges of less than 5 mm width were treated with guided bone regeneration using a glutaraldehyde cross-linked collagen membrane (CL) or a non-cross-linked collagen membrane (NonCL). In all treated cases the bone graft used was a combination of autogenous bone scrapings and deproteinized bovine bone mixed in a 1:3 ratio. Ridge measurements were recorded clinically (during augmentation surgery and during implant placement surgery) and radiographically on the CBCT scans (pre-op, 1 week post-op and at implant placement). All ridge measurements were recorded at 1, 3 and 5 mm from the ridge crest. Soft tissue healing was assessed during the follow-up visits at 1, 2, 4, 8, 12, 16, 20 and 24 weeks post-op. A histological analysis was performed on core biopsies retrieved axially from implant or pontic sites. Results: Four patients were recruited and randomly allocated to treatment groups. Ridge width gain (RWgain) was significantly better for the CL group as assessed clinically. At 1, 3 and 5 mm from ridge crest, the clinically assessed gain was respectively 5.50 mm ± 2.121, 5.40 mm ± 2.074, 5.60 mm ± 1.140 for the CL group and -1.33 mm ± 0.577, 1.33 mm ± 2.517 and 2.00 mm ± 1.000 for the NonCL group. Graft volume resorption was significantly higher in the NonCL group (62%) in comparison to the CL group (10.9%). No soft tissue complications occurred during follow-ups in neither group. Histologically, both groups showed signs of bone remodeling and vital bone formation. New bone formation in the NonCL group was 23.64 % ± 0.64 and in the CL group was 15.75% ± 8.73. Conclusion: Despite the limitations of this pilot study, The CL membrane showed better performance than the NonCL membrane in terms of ridge width gain and in terms of graft volume consolidation as assessed clinically and radiographically. Although no statistical comparison was possible, the NonCL group presented a higher percentage of new bone formation than the CL group.

Lateral alveolar ridge augmentation using an equine-derived collagen-containing bone block: A prospective case series.

To assess the clinical performance of an equine-derived collagen-containing bone block (CXBB) for lateral alveolar ridge augmentation and staged implant placement. A total of n=16 patients (16 implants) had received a modified surgical protocol for lateral ridge augmentation using a size-adapted rigidly fixed CXBB and contour augmentation. After 26weeks of submerged healing, the primary endpoint was defined as the final ridge width (RW26) sufficient to place an adequately dimensioned titanium implant at the respective sites. Secondary outcomes included the gain in ridge width (RWg) and the need for secondary grafting. Clinical outcomes (bleeding on probing-BOP, probing depth-PD, and mucosal recession-MR) were assessed at implant loading and after a median observation period of 12.3months. In all patients (n=16) investigated, RW26 allowed for a successful placement of an adequately dimensioned titanium implant at respective sites exhibiting mean RWg values of 5.09±1.07mm. A soft tissue dehiscence was noted in one patient (6.3%), and a secondary grafting was needed in two patients (12.5%) The changes in mean BOP, PD, and MR values at V9 amounted to 10.23±30.11%, 0.14±0.80mm, and -0.01±0.04mm, respectively. CXBB may represent a feasible approach for lateral alveolar ridge augmentation and two-stage implant placement.

Lateral Ridge Augmentation with Guided Bone Regeneration Using Particulate Bone Substitutes and Injectable Platelet-Rich Fibrin in a Digital Workflow: 6 Month Results of a Prospective Cohort Study Based on Cone-Beam Computed Tomography Data.

This study aimed to test whether or not a digital workflow for GBR with particulate bone substitutes and injectable platelet-rich fibrin improved the thickness of the hard tissue compared to the conventional workflow. 26 patients in need of lateral bone augmentation were enrolled. GBR with particulate bone substitutes and injectable platelet-rich fibrin was performed in all patients. Patients were divided into two groups: control (conventional workflow; n = 14) and test (digital workflow; n = 12). CBCT scans were performed before surgery, immediately after wound closure, and 6 months post-surgery, and the labial thickness of the hard tissue (LT) was assessed at 0–5 mm apical to the implant shoulder (LT0–LT5) at each time point. A total of 26 patients were included in this study. After wound closure, the test group showed significantly greater thickness in LT0–LT2 than the control group (LT0: test: 4.31 ± 0.73 mm, control: 2.99 ± 1.02 mm; LT1: test: 4.55 ± 0.69 mm, control: 3.60 ± 0.96 mm; LT2: test: 4.76 ± 0.54 mm, control: 4.05 ± 1.01 mm; p < 0.05). At 6 months, significant differences in LT0–LT1 were detected between the groups (LT0: test: 1.88 ± 0.57 mm, control: 1.08 ± 0.60 mm; LT1: test: 2.36 ± 0.66 mm, control: 1.69 ± 0.58 mm; p < 0.05). Within the limitations of this study, the use of digital workflow in GBR with particulate bone substitutes and i-PRF exerted a positive effect on the labial thickness of hard tissue in the coronal portion of the implant after wound closure and at 6 months.

Lateral Alveolar Ridge Augmentation with an Autogenous Bone Block Graft Alone with or without Barrier Membrane Coverage: a Systematic Review and Meta-Analysis.

ABSTRACTObjectivesTo test the hypothesis of no difference in implant treatment outcome following lateral alveolar ridge augmentation with autogenous bone block graft with or without barrier membrane coverage.Material and MethodsPubMed (MEDLINE), Embase and Cochrane library search in combination with a hand-search of relevant journals was conducted. Human studies published in English until the 8th of February 2021 were included. Randomised controlled trials with an observation period longer than three months were included. Survival of implants and suprastructures were considered as primary outcomes measures, whereas peri-implant marginal bone loss, dimensional changes of the alveolar ridge, bone regeneration, patient-reported outcome measures, biological and mechanical complications were secondary outcome measures, as evaluated by descriptive statistics and meta-analysis including 95% confidence interval (CI). ResultsElectronic search and hand-searching resulted in 411 entries. Five randomised controlled trials characterised by low or high risk of bias fulfilled inclusion criteria. No statistically significant difference between the two treatment modalities was observed in any of the outcome measures. However, barrier membrane coverage was associated with a non-significant gain in alveolar ridge width of 0.5 mm (95% CI = -0.1 to 1.1) and diminished resorption of -0.9 mm (95% CI = -2.4 to 0.7) compared with no barrier membrane coverage.ConclusionsComparable implant treatment outcomes were revealed following lateral alveolar ridge augmentation with autogenous bone block graft alone with or without barrier membrane coverage. However, postoperative dimensional changes of the augmented seems to be diminished with the use of barrier membrane coverage as evaluated by two-dimensional linear measurements.