Lateral Ridge Augmentation Research Articles

Addition of autogenous bone chips to deproteinized bovine bone mineral does not have additional benefit in lateral ridge augmentation-A preclinical in vivo experimental study.

To compare the outcome after extensive lateral guided bone regeneration using deproteinized bovine bone mineral (DBBM) with or without autogenous bone chips in a canine model of chronic horizontal alveolar ridge defect. The second, third and fourth lower premolars of both sides were extracted, and the buccal bone walls were completely removed in five beagle dogs. After 4weeks, DBBM particles mixed with autogenous bone chips at a ratio of 1:1 were grafted at one side (DBBM/Auto group), while DBBM particles alone were grafted at the contralateral side (DBBM group). The graft materials on both sides were covered by a resorbable collagen membrane and fixation pins. Microcomputed tomographic volume and histomorphometric analyses were performed at 16weeks post-surgery. The ridges of both groups were recovered horizontally, but new bone formation beyond the original ridge contour at the defect site was not found. The DBBM group exhibited a larger total radiographic augmented volume and new bone volume compared with the DBBM/Auto group, but the differences were minimal (p>.05). Histologically, the regenerated area and new bone area were also slightly larger without any statistical significance in the DBBM group than in the DBBM/Auto group (p>.05). The addition of autogenous bone chips to DBBM for lateral ridge augmentation may confer no advantage over grafting DBBM alone with respect to both space maintenance and de novo bone formation in dogs.

Retrospective Study on Tooth Shell Technique Using Endodontically Treated Teeth in Lateral Ridge Augmentation

Autogenous dentin has been reported to be a suitable grafting material for certain indications. The purpose of this study was to assess the feasibility of using endodontically treated teeth for this application. In the present retrospective study, one-stage augmentation of lateral ridge defects with a dentin shell and particulate (tooth shell technique (TST)) either obtained from endodontically treated teeth (ETT, 17 patients with 21 implants) or non-endodontically treated teeth (NETT, 17 patients with 24 implants) were analyzed. Follow-up was conducted 3 months after augmentation. The target parameters were biological complications, horizontal hard tissue loss, osseointegration, and the integrity of the buccal lamella. Only minor complications occurred in three implants from three patients, including two cases of wound dehiscence (one each in ETT and NETT) and a localized three-walled defect in the NETT group, which was solved by re-augmentation. All the implants were osseointegrated and the integrity of the buccal lamella was preserved. The mean difference of the resorption of the crestal width and the buccal lamella did not differ statistically between the two groups. As TST using ETT showed, the results comparable to those of NETT dentin from endodontically treated teeth can be safely applied with predictable results for this grafting technique.

Retrospective Study: Lateral Ridge Augmentation Using Autogenous Dentin: Tooth-Shell Technique vs. Bone-Shell Technique.

In the literature, autogenous dentin is considered a possible alternative to bone substitute materials and autologous bone for certain indications. The aim of this proof-of-concept study was to use autogenous dentin for lateral ridge augmentation. In the present retrospective study, autogenous dentin slices were obtained from teeth and used for the reconstruction of lateral ridge defects (tooth-shell technique (TST): 28 patients (15 females, 13 males) with 34 regions and 38 implants). The bone-shell technique (BST) according to Khoury (31 patients (16 females, 15 males) with 32 regions and 41 implants) on autogenous bone served as the control. Implants were placed simultaneously in both cases. Follow-up was made 3 months after implantation. Target parameters during this period were clinical complications, horizontal hard tissue loss, osseointegration, and integrity of the buccal lamella. The prosthetic restoration with a fixed denture was carried out after 5 months. The total observation period was 5 months. A total of seven complications occurred. Of these, three implants were affected by wound dehiscences (TST: 1, BST: 2) and four by inflammations (TST: 0, BST: 4). There were no significant differences between the two groups in terms of the total number of complications. One implant with TST exhibited a horizontal hard tissue loss of 1 mm and one with BST of 0.5 mm. Other implants were not affected by hard tissue loss. There were no significant differences between the two groups. Integrity of the buccal lamella was preserved in all implants. All implants were completely osseointegrated in TST and BST. All implants could be prosthetically restored with a fixed denture 5 months after augmentation. TST showed results comparable to those of the BST. Dentin can therefore serve as an alternative material to avoid bone harvesting procedures and thus reduce postoperative discomfort of patients.

Long-term outcomes following lateral alveolar ridge augmentation using a collagenated xenogeneic bone block: a monocenter, prospective single-arm clinical study

ObjectivesTo assess the long-term clinical outcomes following lateral alveolar ridge augmentation using a collagenated xenogeneic bone block (CXBB) and staged implant placement.Material and methodsA total of n = 9 patients (9 implants) were available for the analysis. Each subject had received lateral ridge augmentation using a size-adapted rigidly fixed CXBB and contour augmentation at single-tooth gaps. Implant placement was performed after 24 weeks of submerged healing. Clinical parameters (e.g., bleeding on probing (BOP), probing pocket depth (PD), mucosal recession (MR)) were recorded at 16 to 20 weeks after the cementation of the crown (baseline) and scheduled for 0.5 (visit 1 (V1)), 1.5 (V2), 2.5 (V3), 3.5 (V4), and 4.5 (V5) years after implant loading.ResultsChanges in clinical parameters commonly remained low throughout the entire observation period. Significant changes to baseline were merely noted for mean BOP scores at V4 (19.14 ± 17.75%; n = 7; P = 0.029) and mean PD scores at V2 (0.78 ± 0.98 mm; n = 9; P = 0.044) and V3 (1.33 ± 1.05 mm; n = 9; P = 0.009), respectively.ConclusionCXBB was associated with high clinical implant success and survival rates on the long-term.

The Influence of Different Guided Bone Regeneration Procedures on the Contour of Bone Graft after Wound Closure: A Retrospective Cohort Study.

The aim of this study was to evaluate the impact of different guided bone regeneration (GBR) procedures on bone graft contour after wound closure in lateral ridge augmentation. A total of 48 patients with 63 augmented sites were included in this study. Participants were divided into 4 groups (n = 12 in each group) based on different surgical procedures: group 1: particulate bone substitute + collagen membrane; group 2: particulate bone substitute + collagen membrane + healing cap, group 3: particulate bone substitute + injectable platelet-rich fibrin (i-PRF) + collagen membrane; group 4: particulate bone substitute + i-PRF + surgical template + collagen membrane. After wound closure, the thickness of labial graft was measured at 0–5 mm apical to the implant shoulder (T0–T5). At T0–T2, the thickness of labial graft in group 4 was significantly higher than the other three groups (p < 0.05). And group 4 showed significantly more labial graft thickness than group 1 and group 2 at T3–T5 (p < 0.05). Within the limitations of this study, the use of i-PRF in combination with the surgical template in GBR may contribute to achieving an appropriate bone graft contour after wound closure.

Surgical Case Report of Buccal Bone Block of Impacted Maxillary Permanent Canine Teeth for Lateral Alveolar Ridge Augmentation in the Maxilla

Surgical Case Report of Buccal Bone Block of Impacted Maxillary Permanent Canine Teeth for Lateral Alveolar Ridge Augmentation in the Maxilla

Surgical Case Report of Buccal Bone Block of Impacted Maxillary Permanent Canine Teeth for Lateral Alveolar Ridge Augmentation in the Maxilla

Surgical Case Report of Buccal Bone Block of Impacted Maxillary Permanent Canine Teeth for Lateral Alveolar Ridge Augmentation in the Maxilla

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.

Flapless Piezotome Crest Split Achieves Comparable Outcomes to Autologous Onlay Grafts With Significant Less Patient Morbidity and Complications—A Randomized Clinical Study

In the management of the narrow alveolar ridge, the flapless piezotome crest split (FPCS) technique with horizontal distraction was introduced as an alternative to lateral alveolar ridge augmentation using autologous bone block grafting (ABBG). The study purpose was to measure and compare the alveolar crest width and complications between FPCS and ABBG. We implemented a nonblinded, randomized clinical trial. The sample included patients requiring lateral alveolar ridge augmentation before implant insertion. The predictor variable was lateral alveolar ridge augmentation performed using ABBG (control group) or FPCS using an ultrasonic surgical device (Piezotome II or Piezotome CUBE; Acteon, Norwich, UK) and specific crest split working tips (test group). The primary outcome variable was the overall coronal crest width achieved after completed healing measured at 6months using 3-dimensional imaging studies. Other study variables included the postoperative morbidity, staged using the Universal Pain Assessment Scale, complications, and surgery duration. Descriptive and bivariate statistics were computed using SPSS, version 22.0 (IBM Corp, Armonk, NY), and P≤.05 was considered to indicate statistical significance. The sample included 567 patients treated with ABBG (56.1% female; age, 64.1±20.2years) and 562 treated with FPCS (57.2% female; age, 62.3±18.2years). The baseline crest width in the control and test groups was 2.1±0.5mm and 1.9±0.4mm, respectively. The final crest width achieved with ABBG and FPCS was 5.8±0.8mm and 6.5±0.7mm, respectively (P>.05). Statistically significant differences (P<.05) were found between the ABBG and FPCS groups in the postoperative complication rate, morbidity, and operative time, all in favor of FPCS. FPCS seems to be a significantly less traumatic alternative to buccal onlay grafting with autologous bone blocks, providing a comparable or better net gain in the alveolar crest width with a significantly shorter operative time and less postoperative morbidity.

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.

Histology of augmented autogenous bone covered by a platelet-rich fibrin membrane or deproteinized bovine bone mineral and a collagen membrane: A pilot randomized controlled trial.

This study aimed to evaluate histologic and histomorphometric bone characteristics with a focus on vitality after lateral alveolar ridge augmentation using an autogenous bone graft as a block covered by either a platelet-rich fibrin (PRF) membrane (test group) or a standard procedure involving coverage of the bone block with a deproteinized bovine bone mineral and a resorbable collagen membrane (control group). A total of 27 (test=14, control=13) partially edentulous patients with indication for bone block augmentation before implant installation were included. For analyses, a biopsy of augmented bone was retrieved six months after bone grafting. Histologic evaluation of augmented bone revealed a predominance of non-vital bone toward the periosteum and few localized areas of vital bone in the center of the graft in both groups. In contrast, augmented bone toward the native bone demonstrated extensive bone remodeling in both groups. Histomorphometric analyses demonstrated a mean of 14% vital bone, 80% non-vital bone, 5% soft tissue, and 1% blood vessels in the test group. In the control group, the corresponding shares were 14% vital bone, 63% non-vital bone, 22% soft tissue, and 1% blood vessels. We observed no significant differences between the groups (p>.05). In conclusion, a comparable low bone vitality of augmented bone was observed in the PRF and in the control group. Consequently, the present study could not verify the potential beneficial effect of a PRF membrane on bone vitality of an autogenous bone graft used as a block.

Compression-Resistant Polymer/Ceramic Composite Scaffolds Augmented with rhBMP-2 Promote New Bone Formation in a Nonhuman Primate Mandibular Ridge Augmentation Model.

This study was designed to test the hypothesis that compression-resistant (CR) scaffolds augmented with recombinant human bone morphogenetic protein-2 (rhBMP-2) at clinically relevant doses in a nonhuman primate lateral ridge augmentation model enhances bone formation in a dose-responsive manner without additional protective membranes. Defects (15 mm long × 8 mm wide × 5 mm deep) were created bilaterally in the mandibles of nine hamadryas baboons. The defect sites were implanted with poly(ester urethane) (PEUR)/ceramic CR scaffolds augmented with 0 mg/mL rhBMP-2 (CR control), 0.75 mg/mL rhBMP-2 (CR-L), or 1.5 mg/mL rhBMP-2 (CR-H). The primary outcome of ridge width and secondary outcomes of new bone formation, cellular infiltration, and integration with host bone were evaluated using histology, histomorphometry, and microcomputed tomography (micro-CT) at 16 weeks following implantation. New bone formation in the mandible was observed in a dose-responsive manner. CR-H promoted significantly greater new bone formation compared with the CR control group. In all groups, ridge width was maintained without an additional protective membrane. CR scaffolds augmented with a clinically relevant dose of rhBMP-2 (1.5 mg/mL) promoted significant new bone formation. These results suggest that a CR PEUR/ceramic composite scaffold without a protective membrane may be a potential new rhBMP-2 carrier for clinical use.

Evaluation of polycaprolactone scaffold for guided bone regeneration in maxillary and mandibular defects: A clinical study.

Objective:This study was carried out to assess bone regeneration following the use of polycaprolactone (PCL) scaffold in maxillary and mandibular osseous defects.Materials and Methods:This prospective study included ten patients with maxillary or mandibular osseous defects present due to enucleation of periapical cysts or alveolar clefts requiring bone grafting and for lateral ridge augmentation that were treated with PCL scaffold. The patients were assessed clinically for pain, swelling, infection, and graft exposure at 1 week, 3rd, and 5th month postoperatively and were also evaluated radiographically for bone fill using intraoral periapical and/or panoramic radiographs at 4th, 6th, and 9th month postoperatively.Results:PCL scaffold was used in a total of six alveolar clefts and three cases of periapical cysts and one case of lateral ridge augmentation. Nine out of ten cases demonstrated wound dehiscence and scaffold exposure in the oral cavity. Radiographically, on comparison to the control regions, all these nine cases failed to demonstrate appreciable bone density gain. Only one case of radicular cyst in the mandible was recorded to have satisfactory healing.Conclusion:Although PCL scaffold has the potential for bone regeneration in osseous defects, the scaffold exhibited marked tendency for dehiscence in intraoral defects that significantly affected bone healing. A long-term study designed with a larger sample size and categorization of the defects is required to assess its efficacy in varied defects. Moreover, comparative evaluation of PCL and autogenous or alloplastic bone grafting material could provide assenting results.

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.

Cell-Based Therapies for Alveolar Bone and Periodontal Regeneration: Concise Review.

Current regenerative strategies for alveolar bone and periodontal tissues are effective and well adopted. These are mainly based on the use of a combination of synthetic/natural scaffolds and bioactive agents, obviating the incorporation of cells. However, there are some inherent limitations associated with traditional techniques, and we hypothesized that the use of cell‐based therapies as part of comprehensive regenerative protocols may help overcome these hurdles to enhance clinical outcomes. We conducted a systematic review of human controlled clinical trials investigating the clinical and/or histological effect of the use of cell‐based therapies for alveolar bone and periodontal regeneration and explored the translational potential of the different cell‐based strategies identified in the included trials. A total of 16 studies (11 randomized controlled trials, 5 controlled clinical trials) were included for data synthesis and qualitative analysis with meta‐analyses performed when appropriate. The results suggest a clinical benefit from the use of cell therapy. Improved outcomes were shown for alveolar ridge preservation, lateral ridge augmentation, and periodontal regeneration. However, there was insufficient evidence to identify best‐performing treatment modalities amongst the different cell‐based techniques. In light of the clinical and histological outcomes, we identify extraction socket and challenging lateral and vertical bone defects requiring bone block grafts as strong candidates for the adjuvant application of mesenchymal stem cells. Given the complexity, invasiveness, and costs associated with techniques that include “substantial manipulation” of tissues and cells, their additional clinical benefit when compared with “minimal manipulation” must be elucidated in future trials. stem cells translational medicine 2019;8:1286&1295

Histological and immunohistochemical comparison of two different allogeneic bone grafting materials for alveolar ridge reconstruction: A prospective randomized trial in humans.

ABSTRACTBackgroundPreclinical studies have hypothesized a possible immunological reponse to allogeneic materials due to detection of remnants of potential immunogenic molecules. However, their impact on integration, bone remodeling and immunological reaction after the augmentation procedure is largely unknown and a direct correlation of analytical data and evaluation of human biopsies is missing.PurposeThe present study aimed to compare two commercially available allogeneic materials regarding their content of cellular remnants as well as the bone remodeling, and integration and potential immunologic reactions on a histological and immunohistochemical level, integrating also in vitro analytical evaluation of the specific batches that were used clinically.Materials and MethodsTwenty patients were randomly assigned to treatment with Maxgraft or Puros for lateral ridge augmentation in a two‐stage surgery. After a mean healing period of 5 months, implants were placed and biopsies were taken for histological, immunhistochemical, and histomorphometrical evaluation regarding bone remodeling and inflammation, protein concentrations in vitro and the presence of MHC molecules of the same batches used clinically.ResultsNo differences in clinical outcome, histological, immunohistochemical, and in vitro protein analysis between the two bone grafting materials were observed. Active bone remodeling, amount of newly formed bone, and residual grafting material was independent of the materials used, but varied between subjects. MHC1 residues were not detected in any sample.ConclusionsWithin the limitations of this study, both tested materials yielded equivalent results in terms of clinical outcome, new bone formation, and lack of immunological potential on a histological and immunohistochemical level.

Clinical and radiographic outcomes of allogeneic block grafts for maxillary lateral ridge augmentation: A randomized clinical trial

A main drawback of bone block graft surgery is the resorption occurring in early stages of healing. To our knowledge, there are no studies comparing outcomes of freeze-dried bone allograft (FDBA) blocks with different architecture. The aim of this work was to investigate different factors that can affect graft resorption and to compare the resorption rates of two different types of allogeneic blocks, corticocancellous and cancellous. A randomized clinical trial was designed. Twenty-eight patients referred for onlay bone augmentation prior to implant placement were included in the study. Preoperative computerized tomography (CT) was taken for all patients. Patients received FDBA blocks of either cancellous or corticocancellous bone obtained from the iliac crest. After a 4-month follow-up, postoperative CT was taken. Then, another surgery was performed, with the purpose to place dental implants. The aforementioned groups were compared for bone resorption and implant outcome using analysis of covariance (ANCOVA) and repeated ANOVA measures, respectively. Demographic data, trabecular bone density, and graft sites were also analyzed. A total of 93 implants were placed in the augmented bone sites over 28 patients. A 100% survival rate was achieved during a mean follow-up period of 24 months in both groups. Higher bone resorption rate was found with cancellous bone grafts (29.2% ± 2.6) compared with corticocancellous grafts (19.3% ± 2.3). Moreover, higher resorption rates in patients with lower bone density (<185 Hounsfield Units) (31.7% ± 3.1) and smokers (26.39% ± 2.3) were observed when compared with patients with higher bone density (>185 Hounsfield Units) (16.8% ± 2.1) and nonsmokers (22.1% ± 2.3), respectively. Within the limitations of this study, these findings indicate that both corticocancellous and cancellous FDBA grafts constitute a clinical acceptable alternative for bone reconstruction, although cancellous grafts present higher resorption rates. Moreover, host factors such as patient's low bone density and smoking habits may also increase graft resorption rates.

Short-term outcomes of staged lateral alveolar ridge augmentation using autogenous tooth roots. A prospective controlled clinical study.

To assess the short-term clinical outcomes of lateral alveolar ridge augmentation using autogenous tooth roots (TR) and autogenous bone blocks (AB). A total of n=23 patients (23 implants) were available for the analysis. Each subject was allocated to lateral ridge augmentation using either (a) healthy autogenous tooth roots (e.g., retained wisdom or impacted teeth; n=13) or (b) cortical autogenous bone blocks harvested from the retromolar area (n=10). Clinical parameters (e.g., bleeding on probing-BOP, probing pocket depth-PD, mucosal recession-MR, clinical attachment level-CAL) were recorded at (V8) and after 26±4weeks (V9) of implant loading. TR and AB groups were associated with comparable (p>0.05) changes in mean BOP (-23.0±34.3%; -11.75±24.9%), PD (-0.03±0.14mm; -0.1±0.29mm), MR (0.0±0.0mm; 0.0±0.0mm) and CAL (-0.03±0.14mm; -0.1±0.29mm) values. The regression analysis failed to reveal any significant correlations between changes in BOP and PD values and the initial as well as the ridge width measured at 26weeks. TR and AB were associated with comparable clinical short-term outcomes.

Leukocyte- and platelet-rich fibrin is an effective membrane for lateral ridge augmentation: An in vivo study using a canine model with surgically created defects.

Leukocyte- and platelet-rich fibrin (L-PRF) has been suggested to enhance bone healing and the effects of L-PRF need to be evaluated in lateral residual alveolar bone augmentation. This in vivo study aimed to analyze the effects of L-PRF as a membrane on bone regeneration in lateral residual alveolar augmentation. Eight mongrel dogs were used; the mandibular premolars were extracted and then three lateral ridge defects were surgically created on each side of the arch. After 4 weeks, guided bone ridge augmentation was performed in each defect with the following treatment groups: N+D (nonresorbable membrane with deproteinized bovine bone mineral [DBBM]), N+B (nonresorbable membrane with β-tricalcium phosphate [β-TCP]), R+D (resorbable membrane with DBBM), R+B (resorbable membrane with β-TCP), and P+D (L-PRF with DBBM), and P+B (L-PRF and β-TCP). Following 4 weeks of bone healing, the new bone amount for each group was measured by light microscopy (primary outcome) and microcomputed tomography (micro-CT) (secondary outcome). The mean values were compared at the 0.05 significance level. The P+D group showed the most newly formed bone in histology and in micro-CT analyses. L-PRF was more effective in bone regeneration when compared to nonresorbable and resorbable barrier membranes. Additionally, this study indicated DBBM was the more favorable osseous graft material for bone regeneration than β-TCP when barrier membranes are used. From the results of this in vivo study using surgically created defects, L-PRF plays an effective role as a barrier membrane for lateral ridge augmentation. L-PRF may be an excellent barrier membrane in place of other nonresorbable and resorbable membranes.

Cone beam computed tomography evaluation of staged lateral ridge augmentation using platelet‐rich fibrin or resorbable collagen membranes in a randomized controlled clinical trial

To evaluate the volumetric changes following lateral alveolar ridge augmentation using autogenous bone graft covered by either a platelet-rich fibrin membrane (test group) or an inorganic bovine bone substitute and a resorbable collagen barrier membrane (control group). A total of 27 partially edentulous patients (test n=14, control n=13) with the indication for lateral bone block augmentation were included in this randomized, controlled clinical trial. Cone beam computed tomography (CBCT) examination was performed prior to grafting and 2weeks and 6months after grafting. The volumetric changes between the various examinations times were evaluated by planimetric measurements on two-dimensional CBCT images of the grafted regions. The mean bone volumetric loss in the test group was 14.7%, SD ±8.9%, while the mean bone volume loss in the control group was 17.8%, SD ±13.3%. This difference was not significant (p=0.48). A total of ten patients were operated in the incisor and canine region with a mean bone volume loss of 23.41% SD, ±10.87%, while 17 patients were operated in the premolar region with a mean bone volume loss of 11.89% SD ±9.05%. This difference was significant (p=0.01). The test and control group demonstrated no overall difference in volumetric bone changes of the augmented bone at the 6-month follow-up. The second major finding revealed a significantly larger amount of bone resorption in the incisor and canine region than in the premolar region of the maxilla, particularly in the control group.