Vertical ridge augmentation of the atrophic posterior mandible with interpositional bloc grafts: bone from the iliac crest vs. bovine anorganic bone. Clinical and histological results up to one year after loading from a randomized-controlled clinical trial.
OBJECTIVE
To compare two different techniques for vertical bone augmentation of the posterior mandible: bone blocs from the iliac crest vs. anorganic bovine bone blocs used as inlays.


METHODS
Ten partially edentulous patients having 5-7 mm of residual crestal height above the mandibular canal had their posterior mandibles randomly allocated to both interventions. After 4 months implants were inserted, and after 4 months, provisional prostheses were placed. Definitive prostheses were delivered after 4 months. Histomorphometry of samples trephined at implant placement, prosthesis and implant failures, any complication after loading and peri-implant marginal bone-level changes were assessed by masked assessors. All patients were followed up to 1 year after loading.


RESULTS
Four months after bone augmentation, there was statistically significant more residual graft (between 10% and 13%) in the Bio-Oss group. There were no statistically significant differences in failures and complications. Two implants could not be placed in one patient augmented with autogenous bone because the graft failed whereas one implant and its prosthesis of the Bio-Oss group failed after loading. After implant loading only one complication (peri-implantitis) occurred at one implant of the autogenous bone group. In 16 months (from implant placement to 1 year after loading), both groups lost statistically significant amounts of peri-implant marginal bone: 0.82 mm in the autogenous bone group and 0.59 mm in the Bio-Oss group; however, there were no statistically significant differences between the groups.


CONCLUSIONS
Both procedures achieved good results, but the use of bovine blocs was less invasive and may be preferable than harvesting bone from the iliac crest.
Felice
Pietro
P
Department of Periodontology and Implantology, University of Bologna, Bologna, Italy. felicepietro@yahoo.it
Marchetti
Claudio
C
Iezzi
Giovanna
G
Piattelli
Adriano
A
Worthington
Helen
H
Pellegrino
Gerardo
G
Esposito
Marco
M
D000328:Adult; D000368:Aged; D000540:Alveolar Ridge Augmentation / Q000379:methods*; D000818:Animals; D001284:Atrophy; D016025:Bone Transplantation / Q000379:methods*; D002417:Cattle; D016009:Chi-Square Distribution; D015921:Dental Implants; D019094:Dental Prosthesis, Implant-Supported; D019232:Dental Restoration Failure; D005260:Female; D006801:Humans; D007085:Ilium / Q000637:transplantation*; D007576:Jaw, Edentulous, Partially / Q000000981:diagnostic imaging / Q000534:rehabilitation*; D008297:Male; D008334:Mandible / Q000000981:diagnostic imaging / Q000601:surgery*; D008875:Middle Aged; D014057:Tomography, X-Ray Computed; D014182:Transplantation, Autologous; D014183:Transplantation, Heterologous; D016896:Treatment Outcome
D015921:Dental Implants