Horizontal Bone Augmentation Using Autogenous Block Grafts and Particulate Xenograft in the Severe Atrophic Maxillary Anterior Ridges: A Cone-Beam Computerized Tomography Case Series.
The aim of the present study was to use cone-beam computerized tomography (CBCT) to assess horizontal bone augmentation using block grafts, harvested from either the iliac crest (IC) or mandibular ramus (MR) combined with particulate xenograft and a collagen membrane for in the severe maxillary anterior ridge defects (cases Class III-IV according to Cadwood and Howell's classification). Fourteen healthy partially edentulous patients requiring extensive horizontal bone reconstruction in the anterior maxilla were selected for the study. Nineteen onlay block grafts (from IC or MR) were placed. The amount of horizontal bone gain was recorded by CBCT at 3 levels (5, 7, and 11 mm from the residual ridge) and at the time of bone grafting as well as the time of implant placement (≈5 months). Both block donor sites provided enough ridge width for proper implant placement. Nonetheless, IC had significantly greater ridge width gain than MR (Student t test) (4.93 mm vs 3.23 mm). This was further confirmed by nonparametric Mann-Whitney test (P = .007). Moreover, mean pristine ridge and grafted ridge values showed a direct association (Spearman coefficient of correlation = .336). A combination of block graft, obtained from the IC or MR, combined with particulate xenograft then covered with an absorbable collagen membrane is a predictable technique for augmenting anterior maxillary horizontal ridge deficiency.
1  Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, Mich.
Alberto
A
Monje
2  Center of Implantology, Oral and Maxillofacial Surgery (CICOM), Badajoz, Spain.
Florencio
F
Monje
3  Department of Oral Surgery and Implantology, The International University of Catalonia, Barcelona, Spain.
Federico
F
Hernández-Alfaro
2  Center of Implantology, Oral and Maxillofacial Surgery (CICOM), Badajoz, Spain.
Raúl
R
Gonzalez-García
1  Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, Mich.
Fernando
F
Suárez-López del Amo
4  Department of Oral Surgery and Implantology, University of Granada, Granada, Spain.
Pablo
P
Galindo-Moreno
5  Department of Mathematics, University of Extremadura, Badajoz, Spain.
Jesús
J
Montanero-Fernández
1  Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, Mich.
Hom-Lay
HL
Wang
D020341:Absorbable Implants; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000540:Alveolar Ridge Augmentation / Q000379:methods*; D001284:Atrophy; D064592:Autografts / Q000000981:diagnostic imaging / Q000637:transplantation*; D018786:Bone Substitutes / Q000627:therapeutic use; D016025:Bone Transplantation / Q000379:methods*; D003094:Collagen; D054893:Cone-Beam Computed Tomography / Q000379:methods*; D064593:Heterografts / Q000000981:diagnostic imaging / Q000637:transplantation*; D006801:Humans; D007085:Ilium / Q000601:surgery; D008334:Mandible / Q000601:surgery; D008437:Maxilla / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D008567:Membranes, Artificial; D008875:Middle Aged; D008903:Minerals / Q000627:therapeutic use; D019651:Plastic Surgery Procedures / Q000379:methods; D020858:Tissue and Organ Harvesting / Q000379:methods; D060053:Transplant Donor Site / Q000601:surgery; D055815:Young Adult
C106416:Bio-Gide; C077540:Bio-Oss; D018786:Bone Substitutes; D008567:Membranes, Artificial; D008903:Minerals; D003094:Collagen
block graft; bone graft; horizontal bone augmentation; iliac crest; mandibular ramus