In-Situ vs. Ex-Situ Bone Onlay Grafting for Horizontal Ridge Augmentation of Anterior Teeth: A Retrospective Study

Area of Science:

• Oral and Maxillofacial Surgery
• Periodontology
• Regenerative Dentistry

Background:

• Alveolar ridge defects pose challenges for dental implant placement.
• Autogenous bone onlay grafting is a common technique for horizontal alveolar ridge augmentation.
• Comparing in-situ and ex-situ bone grafting methods is crucial for optimizing outcomes.

Purpose of the Study:

• To systematically compare the efficacy and resorption of in-situ versus ex-situ autogenous bone onlay grafting.
• To evaluate bone augmentation and stability in reconstructing horizontal alveolar ridge defects in the anterior teeth region.

Main Methods:

• A comparative study involving 125 patients with horizontal alveolar ridge defects.
• Inclusion of 55 patients (in-situ group) and 70 patients (ex-situ group) undergoing bone onlay grafting.
• Utilized CBCT scanning at multiple time points (T0-T4) to measure horizontal bone width (HBW) and bone volume (BV).

Main Results:

• In-situ bone grafting showed significantly lower HBW resorption (23.84%) compared to ex-situ grafting (38.77%) from T1 to T2 (p < 0.0001).
• Similarly, in-situ grafting exhibited lower bone volume resorption (20.03%) than ex-situ grafting (28.20%) from T1 to T2 (p < 0.05).
• No significant differences in resorption rates were observed between groups from T3 to T4 for both HBW and BV.

Conclusions:

• Both in-situ and ex-situ onlay grafting techniques yield satisfactory bone augmentation results.
• In-situ bone grafting provides superior bone augmentation and enhanced stability compared to ex-situ bone grafting.
• The findings suggest in-situ bone grafting as a potentially more effective method for anterior alveolar ridge reconstruction.