title: Horizontal ridge augmentation with a collagen membrane and a combination of particulated autogenous bone and anorganic bovine bone-derived mineral: a prospective case series in 25 patients.
abstract: This prospective case series evaluated the use of a resorbable natural collagen membrane with a mixture of autogenous bone and anorganic bovine bone-derived mineral (ABBM) for lateral ridge augmentation and subsequent implant placement. A mixture (1:1) of particulated autogenous bone and ABBM was used for lateral ridge augmentation and covered with a resorbable, natural collagen bilayer membrane to treat knife-edge ridges and prepare them for implant placement. Ridge measurements were obtained pre- and postsurgery, complications recorded, and biopsy specimens examined histologically. Seventy-six implants were placed in 25 patients with 31 knife-edge ridge surgical sites. One defect had a bone graft complication (3.2%; exact 95% confidence interval: 0.1%, 16.7%). Clinical measurements revealed an average of 5.68 mm (standard deviation [SD] = 1.42 mm) of lateral ridge augmentation after a mean 8.9-month (SD = 2.1 months) graft healing period. Clinically, all treated ridges were sufficient in width for subsequent implant placement. All implants survived with an average follow-up of 20.88 months (SD = 9.49 months). Histologic analysis of nine surgical sites showed that ABBM was connected with a dense network of newly formed bone with varying degrees of maturation. Histomorphometric analysis demonstrated that autogenous bone represented a mean of 31.0% of the specimens, ABBM 25.8%, and marrow space 43.2%. The treatment of horizontally deficient alveolar ridges with the guided bone regeneration technique using autogenous bone mixed with ABBM and a natural collagen resorbable barrier membrane can be regarded as successful. Implant success and survival need to be confirmed with long-term follow-up examinations.
authors.affiliation: Graduate Implant Dentistry, Loma Linda University, Loma Linda, CA, USA. istvan@implant.hu
authors.forename: Istvan A
authors.initials: IA
authors.lastname: Urban
authors.forename: Heiner
authors.initials: H
authors.lastname: Nagursky
authors.forename: Jaime L
authors.initials: JL
authors.lastname: Lozada
authors.forename: Katalin
authors.initials: K
authors.lastname: Nagy
mesh_terms: D020341:Absorbable Implants; D000328:Adult; D000368:Aged; D000540:Alveolar Ridge Augmentation / Q000379:methods*; D064592:Autografts / Q000473:pathology / Q000637:transplantation*; D001853:Bone Marrow / Q000473:pathology; D001861:Bone Regeneration / Q000502:physiology; D018786:Bone Substitutes / Q000627:therapeutic use*; D016025:Bone Transplantation / Q000379:methods*; D003094:Collagen; D003758:Dental Implantation, Endosseous; D005260:Female; D005500:Follow-Up Studies; D006085:Graft Survival; D016557:Guided Tissue Regeneration, Periodontal / Q000379:methods; D006801:Humans; D008297:Male; D008334:Mandible / Q000473:pathology / Q000601:surgery; D008437:Maxilla / Q000473:pathology / Q000601:surgery; D008567:Membranes, Artificial; D008875:Middle Aged; D008903:Minerals / Q000627:therapeutic use; D010012:Osteogenesis / Q000502:physiology; D011446:Prospective Studies; D016019:Survival Analysis; D016896:Treatment Outcome
chemical_list: C106416:Bio-Gide; C077540:Bio-Oss; D018786:Bone Substitutes; D008567:Membranes, Artificial; D008903:Minerals; D003094:Collagen