Full block or split block?-Comparison of two different autogenous block grafting techniques for alveolar ridge
Christian Mertens1, Christopher Büsch2, Konrad Goldenbaum2
1Department of Oral and Cranio-Maxillofacial Surgery, Heidelberg University Hospital, Heidelberg, Germany.
Objective:
To evaluate radiographic bone gain after alveolar ridge augmentation with two different designs of autogenous block graft harvested from the mandible.
Materials And Methods:
Alveolar ridge defects were evaluated by preoperative cone beam computed tomography (CBCT) and grafted in a staged approach using intraoral block grafts. The ridge augmentation was either performed using the full-block technique (group 1) or the split-block technique (cortical plate with autogenous bone chips) (group 2). After 4 months of bone healing, a further CBCT scan was performed before implant placement. Horizontal and vertical bone gain were measured.
Results:
In this retrospective study, 91 patients were grafted with block grafts (36 patients with full-block grafts; 55 patients with split-block grafts) resulting in 171 block grafts in total. The mean horizontal bone gain was 3.37 ± 0.71 mm in group 1 and 5.79 ± 2.20 mm in group 2. A linear mixed-effect model also showed a statistically significant group difference (p < 0.001, estimate: 3.455, 95% CI: [2.082-4.829]). The mean vertical bone gain was 2.85 ± 0.73 mm in group 1 and 7.60 ± 1.87 mm in group 2. A linear mixed-effect model also showed a statistically significant group difference (p: 0.029, estimate: 3.126, 95% CI: [0.718-5.557]). Mean marginal bone level was 0.33 ± 0.37 mm (group 1) and 0.17 ± 0.29 mm (group 2).
Conclusion:
The split-block technique resulted in a greater bone gain than the full-block technique. This effect was observed in both the vertical and the horizontal dimensions.
