Clinical and Three-Dimensional Radiographic Evaluation of Autogenous Iliac Block Bone Grafting and Guided Bone Regeneration in Patients with Atrophic Maxilla

Publication date: Available online 26 November 2016
Source:Journal of Oral and Maxillofacial Surgery
Author(s): B. Alper Gultekin, Erol Cansiz, M. Oguz Borahan
PurposeTo evaluate the rate of graft resorption in autogenous iliac bone grafting (IBG) and guided bone regeneration (GBR) in patients with atrophic maxilla.MethodsThe investigators performed a retrospective study involving patients requiring implant placement who underwent IBG or GBR. Volumetric changes of the graft sites were evaluated by imaging studies. The primary predictor and outcome variables were augmentation technique and rate of volumetric resorption, respectively. Secondary outcome variables included bone gain, success of grafting, insertion torque of implants, and requirement for vestibuloplasty.ResultsThe sample comprised 39 patients (GBR, 21; IBG, 18). One patient each in the IBG and GBR groups experienced temporary sensory disturbance at donor site and late exposure of non-resorbable membrane, respectively. The average values of percent volume reduction of the GBR and IBG groups were 12.26 ± 2.35 and 35.94 ± 7.94 after healing and 15.87 ± 1.99 and 41.62 ± 6.97 at last follow-up, respectively. The IBG group exhibited significantly higher reduction in bone volume than the GBR group at both time points (P = 0.001). The mean values of horizontal and vertical bone gain after healing in the IBG group were significantly higher compared to those in the GBR group (P = 0.006 and 0.001, respectively). The mean implant torque during implant placement in the GBR group was significantly higher compared to that in the IBG group (P = 0.024). The was no significant difference in the requirement for vestibuloplasty between the two groups (P > .05).ConclusionsAlthough both hard tissue augmentation approaches provide adequate volume of bone graft for implant insertion, IBG results in greater graft resorption at maxillary augmented sites than GBR. Clinicians should consider the differences in extent of graft resorption between the two methods while choosing the treatment approach.



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