Horizontal ridge augmentation using autogenous block grafts and the guided bone regeneration technique with collagen membranes: a clinical study with 42 patients.
OBJECTIVE
To analyze the clinical outcome of horizontal ridge augmentation using autogenous block grafts covered with an organic bovine bone mineral (ABBM) and a bioabsorbable collagen membrane.


METHODS
In 42 patients with severe horizontal bone atrophy, a staged approach was chosen for implant placement following horizontal ridge augmentation. A block graft was harvested from the symphysis or retromolar area, and secured to the recipient site with fixation screws. The width of the ridge was measured before and after horizontal ridge augmentation. The block graft was subsequently covered with ABBM and a collagen membrane. Following a tension-free primary wound closure and a mean healing period of 5.8 months, the sites were re-entered, and the crest width was re-assessed prior to implant placement.


RESULTS
Fifty-eight sites were augmented, including 41 sites located in the anterior maxilla. The mean initial crest width measured 3.06 mm. At re-entry, the mean width of the ridge was 7.66 mm, with a calculated mean gain of horizontal bone thickness of 4.6 mm (range 2-7 mm). Only minor surface resorption of 0.36 mm was observed from augmentation to re-entry.


CONCLUSIONS
The presented technique of ridge augmentation using autogenous block grafts with ABBM filler and collagen membrane coverage demonstrated successful horizontal ridge augmentation with high predictability. The surgical method has been further simplified by using a resorbable membrane. The hydrophilic membrane was easy to apply, and did not cause wound infection in the rare instance of membrane exposure.
von Arx
Thomas
T
Department of Oral Surgery and Stomatology, School of Dental Medicine, University of Berne, Berne, Switzerland. thomas.vonarx@zmk.unibe.ch
Buser
Daniel
D
D000293:Adolescent; D000328:Adult; D000368:Aged; D000539:Alveolar Process / Q000033:anatomy & histology / Q000000981:diagnostic imaging / Q000601:surgery*; D000540:Alveolar Ridge Augmentation / Q000379:methods*; D000818:Animals; D016025:Bone Transplantation / Q000379:methods*; D002417:Cattle; D015331:Cohort Studies; D003094:Collagen; D005260:Female; D016557:Guided Tissue Regeneration, Periodontal / Q000379:methods*; D006801:Humans; D008297:Male; D008567:Membranes, Artificial; D008875:Middle Aged; D011446:Prospective Studies; D011859:Radiography
D008567:Membranes, Artificial; D003094:Collagen