title: A prospective randomized split-mouth study comparing iliac onlay grafts in atrophied edentulous patients: covered with periosteum or a bioresorbable membrane.
abstract: 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.
authors.affiliation: Department of Oral and Maxillofacial Surgery, Clinical Navigation and Robotics, Charité-Campus Virchow Clinic, Berlin, Germany.
authors.forename: Susanne
authors.initials: S
authors.lastname: Heberer
authors.forename: Bärbel
authors.initials: B
authors.lastname: Rühe
authors.forename: Leif
authors.initials: L
authors.lastname: Krekeler
authors.forename: Tania
authors.initials: T
authors.lastname: Schink
authors.forename: John J
authors.initials: JJ
authors.lastname: Nelson
authors.forename: Katja
authors.initials: K
authors.lastname: Nelson
mesh_terms: 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
chemical_list: D008567:Membranes, Artificial