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Larger Vertical Ridge Augmentation: A Retrospective Multicenter Comparative Analysis of Seven Surgical Techniques.

Andreas Pabst1,2, Abdulmonem Alshihri3, Philipp Becker1,2

  • 1Department of Oral and Maxillofacial Surgery, German Armed Forces Central Hospital, Rübenacherstr. 170, 56072 Koblenz, Germany.

Journal of Clinical Medicine
|June 26, 2025
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Summary

Vertical alveolar ridge augmentation (ARA) techniques vary significantly in complexity, outcomes, and costs. Less invasive methods like CAD/CAM-based or resorbable scaffolds offer reduced complications and biological expenses compared to traditional grafts.

Keywords:
CAD/CAM titanium meshallogeneic bone graftalveolar ridge augmentationautogenous bone graftbone gainbone regenerationdonor site morbiditygraft resorptionmagnesium scaffoldvertical ridge augmentation

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Area of Science:

  • Oral and Maxillofacial Surgery
  • Regenerative Medicine
  • Biomaterials Science

Background:

  • Vertical alveolar ridge augmentation (ARA) exceeding 3 mm presents surgical challenges and higher complication risks.
  • Limited comparative clinical data exist for various ARA techniques and graft materials.
  • This study retrospectively evaluated seven established vertical ARA techniques.

Purpose of the Study:

  • To compare surgical and patient-relevant outcomes of seven distinct vertical ARA techniques for augmentations > 3 mm.
  • To provide data for informed clinical decision-making in complex alveolar ridge reconstruction.

Main Methods:

  • Retrospective multicenter study of 70 cases (10 per technique).
  • Seven techniques evaluated: iliac crest graft (ICG), intraoral autogenous bone block (IBB), allogeneic bone block (ABB), CAD/CAM ABB, CAD/CAM titanium mesh (CAD/CAM TM), magnesium scaffold (MS), and allogeneic shell technique (ST).
  • Outcome parameters included: harvesting/insertion time, bone gain (1-year follow-up), resorption (1-year follow-up), donor site morbidity, dehiscence, material removal, and costs.

Main Results:

  • Significant variations in harvesting and insertion times among techniques; ICG and IBB had longest harvesting times.
  • Highest vertical and horizontal bone gain observed with ICGs (5.6 mm); lowest with ABBs (~3.0 mm).
  • Highest resorption rates for ICGs (25.9%); lowest for MSs (5.1%). Donor site morbidity was 100% for ICGs and 50% for IBBs. CAD/CAM TM showed a 30% dehiscence rate.

Conclusions:

  • Vertical ARA techniques demonstrate significant differences in efficiency, efficacy, morbidity, and cost.
  • While ICGs provide substantial bone volume, less invasive options like CAD/CAM or MS reduce complications and costs.
  • Individualized technique selection is crucial, considering defect characteristics, patient factors, and reconstructive goals.