Long-term stability of vertical bone augmentation in implant dentistry: A domain-based review

Vertical ridge deficiency remains one of the most challenging conditions in preimplant surgery. Several techniques aim to restore lost vertical alveolar height, each with specific indications and limitations. Although these procedures often yield favorable short-term outcomes with stable bone levels, their long-term performance is crucial for determining true clinical value.

A systematic search of three databases identified 614 records, of which 35 studies met the eligibility criteria of a minimum of 5 years of follow-up that performed vertical ridge augmentation. This review applied a domain-based evaluation framework derived from the Implant Dentistry Core Outcome Set and Measurement (ID-COSM) and the Bone Augmentation Core Outcome Set (BA-COSM). Implant survival and marginal bone loss were synthesized using random-effects models with inverse-variance weighting, with analyses stratified by follow-up duration and vertical ridge augmentation approach.

Implants placed in vertically augmented bone showed high long-term success, with survival rates of 96% at 5 years, 94% at 10 years, 98% at 15 years, and 95% at 20 years. Marginal bone levels remained stable, with a mean bone loss of 0.67 mm at 5 years and 0.72 mm at 10 years, 1.52 mm at 15 years and 1.53 mm at 20 years.

Vertical ridge augmentation techniques support predictable implant survival and bone stability. However, heterogeneous reporting of outcomes limits comparability. A standardized, domain-based framework enhances evidence synthesis and clinical relevance in implant dentistry.