Augmentation procedures for deficient edentulous ridges, using onlay autologous grafts: an update

The purpose of this review was to analyze publications related to augmentation procedures using autologous onlay grafts and to evaluate the survival/success rates of implants placed in the augmented areas. An automated search was made in Medline, of clinical publications from 2002 to 2007, including at least 5 patients and with a minimum follow-up of 6 months. Ten papers were included. These suggested that grafts are indicated when the height of the alveolar crest is less than 5mm, or the width less than 4mm. The surface resorption of grafts protected by guided bone regeneration membranes was less than for unprotected grafts. Calvarial grafts suffered less resorption than did iliac grafts. The healing period of the graft until implant placement was, in most cases, 4-6 months. The most frequent complications in the recipient site were wound dehiscences. Prosthetic loading time was, in almost all patients, 3 months after implant placement. Implant survival rate ranged from 97.1% to 100%. Although , due to the difficulty in finding homogenous studies, the sample is small, we can conclude that autologous onlay block bone grafts are an effective procedure for alveolar crest augmentation; graft surface resorption is reduced when the grafts are protected by regeneration membranes; few complications arise from the procedure; and the success rate for implants placed in the reconstructed area is between 89.5 and 95.7%.