Bone Ring Grafts Versus Non-Resorbable Membrane GBR for Vertical Ridge Augmentation: A Prospective Cohort Study

Vertical alveolar bone defects often require advanced augmentation techniques to enable successful implant placement. The aim of this study was to compare short-term vertical bone gain following two approaches: the bone-ring graft technique and guided bone regeneration (GBR) using a non-resorbable membrane in patients with vertical alveolar deficiencies.

A prospective cohort study was conducted involving 30 systemically healthy adult patients with posterior mandibular vertical bone defects measuring ≥4 mm. Participants were assigned to one of two treatment groups: Group A received the bone ring in conjunction with titanium implants and a resorbable collagen membrane; Group B was treated with allogeneic bone grafts and titanium-reinforced dense polytetrafluoroethylene (d-PTFE) membranes. Radiographic evaluations were performed at baseline, 1 week, 1 month, and 3 months postoperatively by cone-beam computed tomography (CBCT) and periapical radiographs. The primary outcome was vertical bone height gain. The data were analyzed using IBM SPSS Statistics Version 28.0.

Group A demonstrated statistically significantly greater vertical bone gain at all postoperative intervals: 9.1 mm at 1 week, 10.6 mm at 1 month, and 9.7 mm at 3 months, compared to 7.8 mm, 7.0 mm, and 6.9 mm, respectively, in Group B (p 0.0001). Plaque index scores were comparable between groups, with no statistically significant differences observed in postoperative swelling or infection rates. However, membrane exposure was statistically significantly more frequent in Group B at all follow-up visits (p ≤ 0.02).

The bone-ring graft technique was associated with greater vertical bone gain and a lower incidence of membrane exposure compared to GBR using a non-resorbable membrane. Further studies with longer follow-up are required to confirm these findings.