title: Microstructural and densiometric analysis of extra oral bone block grafts for maxillary horizontal bone augmentation: a comparison between calvarial bone and iliac crest.
abstract: OBJECTIVE
  The main purpose of the present clinical study was to compare architectural metric parameters using micro-computed tomography (μ-CT) between sites grafted with blocks harvested from the intramembranous origin calvarium and endochondral origin iliac crest for horizontal bone augmentation in the maxilla. The second aim was to compare primary stability of implants placed in both types of block grafts.
  
  
  METHODS
  Nine consecutive healthy partially edentulous patients requiring extensive horizontal bone reconstruction in the maxilla were included in this study from July 2011 to March 2012. A total of 14 block grafts (seven each from the calvarium and iliac crest) were studied. After 6-7 months of the bone regeneration surgery, 43 implants were placed. Twenty-four implants (55.2%) were placed on calvaria (group 1) and 19 (44.8%) on iliac crest (group 2). All implants were clinically stable. A resonance frequency analysis (RFA) and μ-CT analysis were performed. Furthermore, two randomly biopsies were selected for histomorphometric analysis.
  
  
  RESULTS
  Micro-CT analyses evidenced completely different parametric values between intramembranous and endochondral extra oral bone block grafts, being the group 1 higher in density and in % of bone volume. However, these parametric values cannot be considered statistically different due to the sample size, excepting the trabecular thickness, which is statistically higher for group 1 (P = 0.06).
  
  
  CONCLUSIONS
  Calvarial bone blocks for horizontal maxillary augmentation provided a higher degree of bone volume and density than the iliac crest bone grafts. Nonetheless, both grafts provide implant with the same primary stability, as assessed by RFA.
authors.affiliation: Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, MI, USA.
authors.forename: Alberto
authors.initials: A
authors.lastname: Monje
authors.forename: Florencio
authors.initials: F
authors.lastname: Monje
authors.forename: Pablo
authors.initials: P
authors.lastname: Galindo-Moreno
authors.forename: Jesus
authors.initials: J
authors.lastname: Montanero-Fernandez
authors.forename: Fernando
authors.initials: F
authors.lastname: Suarez
authors.forename: Hom-Lay
authors.initials: HL
authors.lastname: Wang
mesh_terms: D000540:Alveolar Ridge Augmentation / Q000379:methods*; D001706:Biopsy; D003758:Dental Implantation, Endosseous / Q000379:methods*; D005260:Female; D006801:Humans; D007085:Ilium / Q000637:transplantation*; D007576:Jaw, Edentulous, Partially / Q000000981:diagnostic imaging; D008297:Male; D008437:Maxilla / Q000000981:diagnostic imaging* / Q000601:surgery*; D008875:Middle Aged; D012886:Skull / Q000637:transplantation*; D016896:Treatment Outcome; D055114:X-Ray Microtomography
keywords: alveolar ridge augmentation; bone; dental implant; grafting; maxillary ridge augmentation