The influence of cortical bone perforation on guided bone regeneration in humans.

The purpose of this study was to evaluate the effect of cortical bone perforation on angiogenesis and osteogenesis of the augmented ridge in guided bone regeneration. Eighteen patients who had osseous defects in the mandible were selected. In the test group (n=9), alveolar cortical bone in the area of regeneration was perforated. No decortication was performed in the control group (n=9). Subsequently, defects were augmented by guided bone regeneration using resorbable membrane and bovine bone. After a healing period of 7 months, trephine cores were harvested for histological and histomorphometric analysis of the grafted areas. Histomorphometry demonstrated that the amount of newly formed bone in the test group (27.8%) was greater than that in the control group (25.3%), but the difference was not statistically significant (P=0.13). However, the mean number of microvessels in the test group was significantly higher than that in the control group (P=0.01). This study found that cortical bone perforation favourably affects the amount of new bone formation in the grafted sites after 7 months of healing. Cortical bone perforation significantly increase number of new vessels (angiogenesis) of the regenerated bone. Further randomized clinical trials are required to confirm these results.