Vertical ridge augmentation around dental implants using a membrane technique and autogenous bone or allografts in humans.
This study investigated the effect on vertical bone regeneration of the addition of demineralized freeze-dried bone allograft or autogenous bone chips to a membrane technique. Twenty partially edentulous patients with vertical jawbone deficiencies were selected for this study. The patients were divided into two groups of 10 individuals. The 10 patients of Group A received 26 Brånemark implants in 10 surgical sites. The 10 patients of Group B received 32 implants in 12 surgical sites. Fifty-two out of 58 implants (22 in Group A and 30 in Group B) extended 1.5 to 7.5 mm superior to the bone crest. Titanium-reinforced expanded polytetrafluoroethylene membranes were used to cover the implants and, before complete membrane fixation, demineralized freeze-dried bone allograft particles were condensed under the membrane in Group A, and autogenous bone chips were used in Group B. At the reentry after 7 to 11 months the membranes were removed and a small biopsy was collected from 11 sites comprehending the miniscrews. The clinical measurements from Group A demonstrated a mean vertical bone gain of 3.1 mm (SD = 0.9 mm, range 1 to 5 mm) with a mean percentage of bone gain of 124% (SD = 46.6%). The measurements from Group B showed a mean vertical bone gain of 5.02 mm (SD = 2.3 mm, range 1 to 8.5 mm) with a mean percentage of bone gain of 95% (SD = 26.8%). Histomorphometric analysis of the present study clearly demonstrated a direct correlation between the density of the pre-existing bone and the density of the regenerated bone. The mean percentage of new bone-titanium contact was from 39.1% to 63.2%, depending on the quality of the pre-existing bone. Both the clinical and histologic results indicate a beneficial effect of the addition of demineralized freeze-dried bone allograft or autogenous bone particles to vertical ridge augmentation procedures in humans.
Simion
M
M
Department of Dentistry, University of Milan School of Dentistry, San Raffaele Hospital, Italy.
Jovanovic
S A
SA
Trisi
P
P
Scarano
A
A
Piattelli
A
A
D000328:Adult; D000368:Aged; D000540:Alveolar Ridge Augmentation / Q000379:methods*; D001706:Biopsy; D015519:Bone Density; D001863:Bone Screws; D016025:Bone Transplantation / Q000379:methods*; D003758:Dental Implantation, Endosseous / Q000295:instrumentation; D006801:Humans; D007576:Jaw, Edentulous, Partially / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery; D008334:Mandible / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery; D008875:Middle Aged; D011138:Polytetrafluoroethylene / Q000627:therapeutic use; D011859:Radiography; D014025:Titanium
D011138:Polytetrafluoroethylene; D014025:Titanium