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Bone remodeling is a continuous and balanced process of bone resorption by osteoclasts and bone formation by osteoblasts. In adults, it helps maintain bone mass and calcium homeostasis. While mechanical stress can stimulate turnover as part of the normal maintenance and reparative process, several hormones also regulate bone remodeling.
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Osteoclasts are cells responsible for bone resorption and remodeling. They originate from hematopoietic progenitor cells present in the bone marrow. Numerous progenitor cells fuse to form multinucleated cells, each with 10-20 nuclei. A single osteoclast has a diameter of 150 to 200 µM. These cells have ruffled borders that break down the underlying bone tissue and release minerals such as calcium into the blood in bone resorption. Osteoclasts cling to bones with their ruffled edges during...
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Related Experiment Video

Updated: May 8, 2025

Real-Time Dynamic Navigation System for the Precise Quad-Zygomatic Implant Placement in a Patient with a Severely Atrophic Maxilla
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Premature Bone Resorption in Vertical Ridge Augmentation: A Systematic Review and Network Meta-Analysis of Randomised

Faisal Faihan Alotaibi1,2, Jacopo Buti1, Isabella Rocchietta1

  • 1Unit of Periodontology, UCL Eastman Dental Institute, London, UK.

Clinical Oral Implants Research
|March 21, 2025
PubMed
Summary

Vertical ridge augmentation (VRA) techniques that preserve the periosteum, such as inlay, distraction osteogenesis (DO), and tissue expansion + tunnelling (TET), show less premature bone resorption (PBR). Clinicians should account for volume loss with full flap elevation techniques.

Keywords:
complicationsnetwork meta‐analysispremature resorptionridge augmentationsystematic review

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Area of Science:

  • Oral and Maxillofacial Surgery
  • Periodontology
  • Regenerative Dentistry

Background:

  • Vertical ridge augmentation (VRA) is crucial for dental implant placement in atrophic jaws.
  • Premature bone resorption (PBR) following VRA can compromise treatment outcomes.
  • Evidence comparing various VRA techniques regarding PBR is limited.

Purpose of the Study:

  • To systematically review and appraise evidence on PBR after different VRA techniques.
  • To identify and rank VRA techniques with the least PBR using Bayesian Network Meta-Analysis (NMA).

Main Methods:

  • Systematic search of six databases for randomized clinical trials (RCTs) on staged VRA.
  • Outcomes included overall PBR% and PBR% in sites with uneventful vs. complicated healing.
  • Bayesian NMA was used to estimate treatment effects and rankings; risk of bias and certainty of evidence were assessed.

Main Results:

  • Ten RCTs (220 participants) were included; mean PBR ranged from 6% to 44% (average 26%).
  • Inlay, distraction osteogenesis (DO), and tissue expansion + tunnelling (TET) showed the highest probability of being ranked first for lowest PBR.
  • Healing complications significantly increased PBR (10% difference).

Conclusions:

  • VRA techniques preserving the periosteum (inlay, DO, TET) demonstrate reduced PBR.
  • Techniques involving full flap elevation necessitate anticipating volume loss and potentially larger grafting volumes.
  • Understanding PBR is vital for optimizing VRA outcomes and long-term implant success.