title: Volumetric Stability of Fresh Frozen Bone Blocks in Atrophic Posterior Mandible Augmentation.
abstract: Fresh frozen bone allografts (FFB) have become an alternative for bone augmentation in the past decades, especially because of the absence of recent reports of disease transmission or immunologic reactions when it is used. The aim of this prospective controlled study is to evaluate volumetric changes of newly created bone following reconstruction of the atrophic posterior mandible. Twenty consecutive patients presenting for reconstruction of posterior mandibular alveolar bone ridge width ≤6.0 mm and/or height ≤6.0 who met all inclusion and exclusion criteria were included. FFB blocks were used. The main outcome variable investigated was bone volume dynamics. Vertical, horizontal, and 3-dimensional bone gain data were measured from computerized tomography scans. The main predictor variable was time evaluated at 3 points: immediately after surgery (T1), at implant placement (T2), and 1 year after functional loading (T3). Secondary outcome parameters evaluated were implant survival, histologic findings, and microtomographic morphometry. The study included 28 hemi-mandibles, 50 FFB bone blocks, and 15 female and 5 male patients (mean age, 51.8 years). Block and implant survival rates were 100% and 96%, respectively, after 31.75 months of follow-up. Vertical and horizontal bone gain at T2 was 5.15 and 6.42 mm, respectively. Volumetric resorption was 31% at T2, followed by an additional 10% reduction at T3. Histologic evaluation showed newly formed vital bone in intimate contact with the remaining FFB. Microtomography revealed 31.8% newly formed bone, 14.5% remaining grafted bone, and 53.7% connective tissue and bone marrow. Thus, FFB blocks may lead to new bone formation and consolidation, with satisfactory volumetric bone maintenance, allowing implant-supported rehabilitation with high success rates.
authors.affiliation: 1   Department of Oral and Maxillofacial Surgery and Periodontology, The School of Dentistry of Ribeirão Preto, University of São Paulo, Brazil.
authors.forename: Erick Ricardo
authors.initials: ER
authors.lastname: Silva
authors.affiliation: 1   Department of Oral and Maxillofacial Surgery and Periodontology, The School of Dentistry of Ribeirão Preto, University of São Paulo, Brazil.
authors.forename: Emanuela Prado
authors.initials: EP
authors.lastname: Ferraz
authors.affiliation: 1   Department of Oral and Maxillofacial Surgery and Periodontology, The School of Dentistry of Ribeirão Preto, University of São Paulo, Brazil.
authors.forename: Evandro Carneiro Martins
authors.initials: EC
authors.lastname: Neto
authors.affiliation: 2   Department of Oral and Maxillofacial Surgery, The Maurice and Gabriela Goldschleger School of Dental Medicine, Tel Aviv University, Israel.
authors.forename: Gavriel
authors.initials: G
authors.lastname: Chaushu
authors.affiliation: 3   Department of Periodontology, The Maurice and Gabriela Goldschleger School of Dental Medicine, Tel Aviv University, Israel.
authors.forename: Liat
authors.initials: L
authors.lastname: Chaushu
authors.affiliation: 1   Department of Oral and Maxillofacial Surgery and Periodontology, The School of Dentistry of Ribeirão Preto, University of São Paulo, Brazil.
authors.forename: Samuel Porfírio
authors.initials: SP
authors.lastname: Xavier
mesh_terms: D000540:Alveolar Ridge Augmentation; D016025:Bone Transplantation; D003758:Dental Implantation, Endosseous; D015921:Dental Implants; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008334:Mandible; D008875:Middle Aged; D011446:Prospective Studies; D016896:Treatment Outcome
chemical_list: D015921:Dental Implants
keywords: atrophic mandible; dental implants.; fresh frozen bone allograft; histologic analysis; tomographic analysis