Particulate Bone Grafts vs Split Bone Cortical Plates: Resorbable and Nonresorbable Membranes in Vertical...

Area of Science:

• Oral and Maxillofacial Surgery
• Regenerative Medicine
• Dental Implantology

Background:

• Severe vertical alveolar ridge atrophy presents challenges for dental implant placement.
• Bone augmentation techniques are crucial for restoring bone height and width.
• Comparing different graft and membrane materials is essential for optimizing outcomes.

Purpose of the Study:

• To evaluate vertical bone gain in the anterior edentulous mandible using the split cortical bone plate technique.
• To compare two graft and membrane combinations: autogenous particulate grafts with titanium-reinforced polytetrafluoroethylene membrane (T1) versus a mixture of autogenous and xenograft particulate grafts with a collagen membrane (T2).
• To assess long-term soft tissue stability and peri-implant health.

Main Methods:

• Split cortical bone plate technique for vertical bone augmentation.
• Randomized controlled trial with 22 patients divided into two equal groups (T1 and T2).
• Cone beam computerized tomography (CBCT) for assessing vertical bone gain and crestal bone loss at 6 months, 1 year, and 5 years.
• Measurement of keratinized tissue width and peri-implant probing depth at the same intervals.

Main Results:

• Both groups achieved comparable vertical bone gain.
• The T1 group (titanium-reinforced membrane) demonstrated better maintenance of keratinized gingiva.
• The T1 group showed reduced crestal bone loss over the 5-year follow-up period.
• Both groups showed stable peri-implant health over time.

Conclusions:

• The split cortical bone plate technique is effective for vertical bone augmentation.
• Non-resorbable membranes, like titanium-reinforced polytetrafluoroethylene, may enhance soft and hard tissue outcomes in complex augmentation cases.
• Autogenous particulate grafts with titanium-reinforced membranes offer potential advantages in long-term tissue stability.