Clinical study of autogenous bone grafting for reconstruction of atrophic alveolar ridges in long-term performance

doi:10.12337/zgkqzzxzz.2021.02.005

Abstract

Abstract: Objective The aim of this study is to evaluate the efficacy and long-term clinical outcomes of autogenous bone block/laminar reconstruction of alveolar ridge defect, and analyze the key factors affecting the success rate of autogenous bone graft and implants. Methods And Materials This retrospective study was conducted from January 2000 to December 2015. A total of 66 patients underwent autogenous onlay bone graft to reconstruct bone defect were enrolled in this trial, and all the patients were followed-up for at least 5 years, The width and vertical height of alveolar bone were measured at the time of surgery and reentry surgery. Integration of graft, implant survival rates and complications were recorded. Results 89 patients were screened for eligibility. Eventually, 66 patients with 116 implant sites were enrolled in this trial. Of these, 50 patients received horizontal augmentation, while 16 received vertical augmentation. The average of follow-up was 8.1 years. Bone resorption rate after horizontal and vertical augmentation was 9.0% and 10.9% respectively. Graft integration and implant survival rates were 95.8% and 95.7% respectively. 3 bone blocks failed to integrate. Among all the 116 implants, periimplantitis occurred in 5 cases. 1 case presented paresthesia lasting up to 6 months because of minor nerve impairment. Conclusion This study demonstrated that autogenous bone graft was effective and reliable for reconstruction of severe atrophic alveolar ridges. Favorable fixation, appropriate technology selection and flap management had great influence on graft integration and bone maintenance.

Key words: autogenous bone, bone defect, guided bone regeneration

Yu Huajie, Qiu Lixin. Clinical study of autogenous bone grafting for reconstruction of atrophic alveolar ridges in long-term performance[J]. Chinese Journal of Oral Implantology, 2021, 26(1): 18-24.

References

[1] Roccuzzo M, Ramieri G, Bunino M, et al.Autogenous bone graft alone or associated with titanium mesh for vertical alveolar ridge augmentation: a controlled clinical trial[J]. Clin Oral Implants Res, 2007,18(3):286-294. DOI: 10.1111/j.1600-0501.2006.01301.x.
[2] Chiapasco M, Zaniboni M, Rimondini L.Autogenous onlay bone grafts vs. alveolar distraction osteogenesis for the correction of vertically deficient edentulous ridges: a 2-4-year prospective study on humans[J]. Clin Oral Implants Res, 2007,18(4):432-440. DOI: 10.1111/j.1600-0501.2007.01351.x.
[3] Yamauchi K, Takahashi T, Nogami S, et al.Horizontal alveolar distraction osteogenesis for dental implant: long-term results[J]. Clin Oral Implants Res, 2013,24(5):563-568. DOI: 10.1111/j.1600-0501.2011.02417.x.
[4] de Wijs FL, Cune MS. Immediate labial contour restoration for improved esthetics: a radiographic study on bone splitting in anterior single-tooth replacement[J]. Int J Oral Maxillofac Implants, 1997,12(5):686-696.
[5] Funato A, Ishikawa T, Kitajima H, et al.A novel combined surgical approach to vertical alveolar ridge augmentation with titanium mesh, resorbable membrane, and rhPDGF-BB: a retrospective consecutive case series[J]. Int J Periodontics Restorative Dent, 2013,33(4):437-445. DOI: 10.11607/prd.1460.
[6] Kontogiorgos E, Elsalanty ME, Zakhary I, et al.Osseointegration of dental implants placed into canine mandibular bone regenerated by bone transport distraction osteogenesis[J]. Int J Oral Maxillofac Implants, 2013,28(3):677-686. DOI: 10.11607/jomi.2977.
[7] Misch CM, Jensen OT, Pikos MA, et al.Vertical bone augmentation using recombinant bone morphogenetic protein, mineralized bone allograft, and titanium mesh: a retrospective cone beam computed tomography study[J]. Int J Oral Maxillofac Implants, 2015,30(1):202-207. DOI: 10.11607/jomi.3977.
[8] Khoury F, Hanser T.Mandibular bone block harvesting from the retromolar region: a 10-year prospective clinical study[J]. Int J Oral Maxillofac Implants, 2015,30(3):688-697. DOI: 10.11607/jomi.4117.
[9] Maiorana C, Sigurtà D, Mirandola A, et al.Bone resorption around dental implants placed in grafted sinuses: clinical and radiologic follow-up after up to 4 years[J]. Int J Oral Maxillofac Implants, 2005,20(2):261-266.
[10] Roccuzzo M, Ramieri G, Bunino M, et al.Autogenous bone graft alone or associated with titanium mesh for vertical alveolar ridge augmentation: a controlled clinical trial[J]. Clin Oral Implants Res, 2007,18(3):286-294. DOI: 10.1111/j.1600-0501.2006.01301.x.
[11] Pikos MA.Block autografts for localized ridge augmentation: Part II. The posterior mandible[J]. Implant Dent, 2000,9(1):67-75. DOI: 10.1097/00008505-200009010-00012.
[12] Iizuka T, Smolka W, Hallermann W, et al.Extensive augmentation of the alveolar ridge using autogenous calvarial split bone grafts for dental rehabilitation[J]. Clin Oral Implants Res, 2004,15(5):607-615. DOI: 10.1111/j.1600-0501.2004.01043.x.
[13] Laino L, Iezzi G, Piattelli A, et al.Vertical ridge augmentation of the atrophic posterior mandible with sandwich technique: bone block from the chin area versus corticocancellous bone block allograft--clinical and histological prospective randomized controlled study[J]. Biomed Res Int, 2014,2014:982104. DOI: 10.1155/2014/982104.
[14] Kane AA, Lo LJ, Chen YR, et al. The course of the inferior alveolar nerve in the normal human mandibular ramus and in patients presenting for cosmetic reduction of the mandibular angles[J]. Plast Reconstr Surg, 2000,106(5):1162-1174; discussion 1175-1176. DOI: 10.1097/00006534-200010000-00029.
[15] Sakkas A, Schramm A, Karsten W, et al.A clinical study of the outcomes and complications associated with zygomatic buttress block bone graft for limited preimplant augmentation procedures[J]. J Craniomaxillofac Surg, 2016,44(3):249-256. DOI: 10.1016/j.jcms.2015.12.003.
[16] Burkhardt R, Lang NP.Role of flap tension in primary wound closure of mucoperiosteal flaps: a prospective cohort study[J]. Clin Oral Implants Res, 2010,21(1):50-54. DOI: 10.1111/j.1600-0501.2009.01829.x.
[17] Yu H, Qiu L.Efficacy of the split-thickness labial flap method for soft tissue management in anterior ridge horizontal augmentation procedures: A clinical prospective study in the anterior maxilla[J]. J Craniomaxillofac Surg, 2018,46(2):323-328. DOI: 10.1016/j.jcms.2017.11.018.
[18] Khojasteh A, Behnia H, Shayesteh YS, et al.Localized bone augmentation with cortical bone blocks tented over different particulate bone substitutes: a retrospective study[J]. Int J Oral Maxillofac Implants, 2012,27(6):1481-1493.
[19] Sbordone L, Toti P, Menchini-Fabris GB, et al.Volume changes of autogenous bone grafts after alveolar ridge augmentation of atrophic maxillae and mandibles[J]. Int J Oral Maxillofac Surg, 2009,38(10):1059-1065. DOI: 10.1016/j.ijom.2009.06.024.
[20] Antoun H, Sitbon JM, Martinez H, et al.A prospective randomized study comparing two techniques of bone augmentation: onlay graft alone or associated with a membrane[J]. Clin Oral Implants Res, 2001,12(6):632-639. DOI: 10.1034/j.1600-0501.2001.120612.x.
[21] Maiorana C, Beretta M, Salina S, et al.Reduction of autogenous bone graft resorption by means of bio-oss coverage: a prospective study[J]. Int J Periodontics Restorative Dent, 2005,25(1):19-25.
[22] Zitzmann NU, Naef R, Schärer P.Resorbable versus nonresorbable membranes in combination with Bio-Oss for guided bone regeneration[J]. Int J Oral Maxillofac Implants, 1997,12(6):844-852.
[23] Peleg M, Sawatari Y, Marx RN, et al.Use of corticocancellous allogeneic bone blocks for augmentation of alveolar bone defects[J]. Int J Oral Maxillofac Implants, 2010,25(1):153-162.
[24] Eaton MJ, Santiago DI, Dancausse HA, et al.Lumbar transplants of immortalized serotonergic neurons alleviate chronic neuropathic pain[J]. Pain, 1997,72(1-2):59-69. DOI: 10.1016/s0304-3959(97)00015-8.
[25] Wilson JW, Rhinelander FW, Stewart CL.Vascularization of cancellous chip bone grafts[J]. Am J Vet Res, 1985,46(8):1691-1699.
[26] Yu H, Chen L, Zhu Y, et al.Bilamina cortical tenting grafting technique for three-dimensional reconstruction of severely atrophic alveolar ridges in anterior maxillae: A 6-year prospective study[J]. J Craniomaxillofac Surg, 2016,44(7):868-875. DOI: 10.1016/j.jcms.2016.04.018.
[27] Qiu L, Yu H.Onlay grafting with bovine bone mineral block for horizontal reconstruction of severely atrophic alveolar ridges in anterior maxillae: A 6-year prospective study[J]. J Craniomaxillofac Surg, 2018,46(8):1199-1204. DOI: 10.1016/j.jcms.2018.04.004.
[28] Blokhuis TJ, Arts JJ. Bioactive and osteoinductive bone graft substitutes: definitions, facts and myths[J]. Injury, 2011,42 Suppl 2:S26-29. DOI: 10.1016/j.injury.2011.06.010.