Daylene Jack-Min Leong1, Tae-Ju Oh, Erika Benavides, Khalid Al-Hezaimi, Carl E Misch, Hom-Lay Wang. 1. *Private Practitioner, Singapore, Singapore. †Clinical Professor and Vice Chair, Department of Periodontics and Oral Medicine, School of Dentistry, University of Michigan, Ann Arbor, MI. ‡Clinical Associate Professor, Department of Periodontics and Oral Medicine, School of Dentistry, University of Michigan, Ann Arbor, MI. §Associate Professor, Engineer Abdullah Bagshan Research Chair for Growth Factors and Bone Regeneration, College of Dentistry, King Saud University, Riyadh, Saudi Arabia. ‖Private Practice, Beverly Hills, MI. ¶Professor and Director of Graduate Periodontics, Department of Periodontics and Oral Medicine, School of Dentistry, University of Michigan, Ann Arbor, MI.
Abstract
INTRODUCTION: The purpose of this randomized controlled clinical trial was to evaluate 2 different techniques for vertical ridge augmentation (VRA) of the posterior mandible. MATERIALS AND METHODS:Sixteen subjects with 19 posterior mandibular edentulous sites requiring VRA were recruited for the study. Sites were randomly treated with either block allograft (BA; N = 9) or sandwich bone augmentation (SBA; N = 10). Clinical measurements were recorded at the time of surgery (baseline) and 6-month reentry with a custom-made acrylic surgical template. RESULTS: The mean vertical bone gain (VBG) after mean 6.8 months was 44.5% (mean = 1.78 mm [0-5 mm]) in the BA group and 33.3% (mean = 1.0 mm [-1 to 3 mm]) in the SBA group. Significantly higher rates of incision line openings and wound dehiscences were found in the BA group (n = 7/9, 77.8%) as compared with the SBA group (n = 3/10, 30%) (P = 0.037). After adjusting for graft exposure, BA group demonstrated significantly higher VBG than SBA (difference = 2.26 mm, P < 0.001). In addition, graft exposure resulted in significantly less VBG in both groups (P < 0.001). CONCLUSIONS: A higher tendency of wound exposure during VRA was demonstrated when a BA was used compared with the SBA technique. However, if wound exposure could be prevented, higher vertical ridge gain could be achieved with a BA. SUMMARY: The use of a BA in VRA resulted in a maximum of 2 mm more bone height gain compared with the SBA technique if the primary coverage can be achieved during the healing.
RCT Entities:
INTRODUCTION: The purpose of this randomized controlled clinical trial was to evaluate 2 different techniques for vertical ridge augmentation (VRA) of the posterior mandible. MATERIALS AND METHODS: Sixteen subjects with 19 posterior mandibular edentulous sites requiring VRA were recruited for the study. Sites were randomly treated with either block allograft (BA; N = 9) or sandwich bone augmentation (SBA; N = 10). Clinical measurements were recorded at the time of surgery (baseline) and 6-month reentry with a custom-made acrylic surgical template. RESULTS: The mean vertical bone gain (VBG) after mean 6.8 months was 44.5% (mean = 1.78 mm [0-5 mm]) in the BA group and 33.3% (mean = 1.0 mm [-1 to 3 mm]) in the SBA group. Significantly higher rates of incision line openings and wound dehiscences were found in the BA group (n = 7/9, 77.8%) as compared with the SBA group (n = 3/10, 30%) (P = 0.037). After adjusting for graft exposure, BA group demonstrated significantly higher VBG than SBA (difference = 2.26 mm, P < 0.001). In addition, graft exposure resulted in significantly less VBG in both groups (P < 0.001). CONCLUSIONS: A higher tendency of wound exposure during VRA was demonstrated when a BA was used compared with the SBA technique. However, if wound exposure could be prevented, higher vertical ridge gain could be achieved with a BA. SUMMARY: The use of a BA in VRA resulted in a maximum of 2 mm more bone height gain compared with the SBA technique if the primary coverage can be achieved during the healing.
Authors: D Joshua Cohen; Kayla M Scott; Aniket N Kulkarni; Jennifer S Wayne; Barbara D Boyan; Zvi Schwartz Journal: Clin Oral Implants Res Date: 2019-10-10 Impact factor: 5.977