Interventions for replacing missing teeth: horizontal and vertical bone augmentation techniques for dental implant...

Area of Science:

• Oral surgery
• Periodontology
• Biomaterials science

Background:

• Dental implant success relies on adequate bone volume for stability.
• Bone augmentation techniques are crucial for patients with insufficient bone height or width.
• Various materials and surgical methods exist for bone augmentation procedures.

Purpose of the Study:

• To determine the necessity and optimal timing of bone augmentation procedures.
• To identify the most effective techniques for horizontal and vertical bone augmentation in implant dentistry.

Main Methods:

• A systematic review and meta-analysis of randomized controlled trials (RCTs) was conducted.
• Searches included Cochrane Oral Health Group's Trials Register, CENTRAL, MEDLINE, EMBASE, and hand searches of journals.
• Data extraction and quality assessment were performed independently by two reviewers.

Main Results:

• Few RCTs (13) met inclusion criteria, with limited patient numbers and follow-up.
• Vertical augmentation showed higher implant failure and complication rates compared to short implants.
• No significant differences were found between various horizontal augmentation techniques.
• Osteodistraction yielded greater vertical bone gain than inlay autografts; bone substitutes were effective in guided bone regeneration.

Conclusions:

• Evidence is limited due to small sample sizes and high risk of bias in included trials.
• Short implants are a potentially better alternative to vertical bone grafting for resorbed mandibles.
• Bone substitutes may be preferable to autogenous bone in specific augmentation scenarios.
• Titanium screws are recommended over resorbable screws for onlay bone graft fixation.