A prospective randomized split-mouth study comparing iliac onlay grafts in atrophied edentulous patients: covered with periosteum or a bioresorbable membrane.
OBJECTIVE
In this prospective study, solid monocortical iliac onlay grafts of the maxilla were randomly covered with a bioresorbable membrane and periosteum within the maxilla. Histologic specimens were analyzed by light microscopy after a healing period of three months and the rate of resorption of the grafts were measured.


METHODS
Fourteen patients (9 females and 5 males), with a mean age of 56 years (range 25-72) underwent augmentation with avascular iliac onlay bone grafts. The grafts were randomly covered either with a bioresorbable membrane (MC) or periosteum (PC). Resorption was measured with a digital caliper at the microscrews (slashed circle 1.5 mm) used to fixate the graft. Histologic evaluation of the specimens derived from the graft with a trephine bur (slashed circle 2 mm) from the implant site at implant placement after a 3-month healing period. Statistical evaluation of the data was performed using Analysis of variance and the Wilcoxon signed rank test.


RESULTS
Clinical appearance of the augmented bone after 3 months showed a dense cortical layer with good vascular perfusion. Thirty-three sites in 13 patients (one dropped put) were analyzed histomorphometrically and showed an average of 46% newly formed bone with no significant difference between the groups (P=0.46). The mean resorption rate at 56 measured sites was 1.2 mm (range 0.3-3.4 mm) after 3 months, with no significant difference between the MC sites and the PC sites (P=0.38).


CONCLUSIONS
Histomorphometry of new bone formation after 3 months demonstrates no significant difference between the PC and MC groups. Initialization of graft resorption can be seen after 3 months with no significant difference as to whether the graft was covered with a membrane or the periosteum.


CONCLUSIONS
This study provides evidence that after avascular iliac bone grafting, the revascularization of the graft was sufficient after 3 months regardless of the graft coverage with no effect on the amount of initial resorption of the graft.
Heberer
Susanne
S
Department of Oral and Maxillofacial Surgery, Clinical Navigation and Robotics, Charité-Campus Virchow Clinic, Berlin, Germany.
Rühe
Bärbel
B
Krekeler
Leif
L
Schink
Tania
T
Nelson
John J
JJ
Nelson
Katja
K
D000328:Adult; D000368:Aged; D000540:Alveolar Ridge Augmentation / Q000379:methods*; D000704:Analysis of Variance; D001862:Bone Resorption / Q000517:prevention & control*; D005260:Female; D006085:Graft Survival / Q000502:physiology; D016557:Guided Tissue Regeneration, Periodontal / Q000379:methods*; D006801:Humans; D007085:Ilium / Q000637:transplantation*; D007575:Jaw, Edentulous / Q000601:surgery; D008297:Male; D008437:Maxilla / Q000601:surgery; D008567:Membranes, Artificial; D008875:Middle Aged; D010521:Periosteum / Q000637:transplantation*; D018709:Statistics, Nonparametric; D016896:Treatment Outcome
D008567:Membranes, Artificial