Vertical Ridge Gain with Various Bone Augmentation Techniques: A Systematic Review and Meta-Analysis. 2019

Muhammad Hasan Hameed, and Meisha Gul, and Robia Ghafoor, and Farhan Raza Khan
Department of Surgery, Section of Dentistry, Aga Khan University Hospital, Karachi, Pakistan.

OBJECTIVE The aim of this systematic review was to determine the most effective alveolar augmentation technique for vertical bone gain. METHODS A systematic search to select clinical trials and retrospective studies done on patients with reduced vertical bone height was conducted. The intervention of interest was autogenous block graft done compared to procedures such as distraction osteogenesis (DO), particulate grafting, block plus particulate grafting with titanium mesh, and tent pole technique in systematically healthy adult patients age 18 and older. The following electronic databases were explored: PubMed, CINAHL, and Dental and Oral Science. A supplementary manual search of published full-text articles from January 2005 to December 2017 was done using Google Scholar. Grey literature was also sought using greylit.org. The review protocol was registered at the Prospero registry (CRD # 42017072432). The risk of bias of the included studies was assessed using EPOC criteria. Meta-analysis was performed using Review Manager for studies with quantitative data on mean values of vertical bone gain and bone resorption achieved with various bone augmentation techniques. Random effect model was used. Heterogeneity among studies was evaluated using the I2 statistic. RESULTS A total of 2322 articles were found. After excluding the irrelevant papers, only 8 papers were finally selected for the detailed evaluation. Of these 8, 5 were clinical trials, and 3 were retrospective studies. Four studies were on DO, 2 on particulate grafting, 1 on autogenous block grafting plus particulate grafting, and 1 on tent pole grafting. The control group in all studies were autogenous block graft. Meta-analysis revealed no significant difference between DO and autogenous block grafting for vertical bone gain (mean difference 0.82 [-1.28, 2.91]). Similarly, no significant difference was observed in the 2 techniques for bone resorption (mean difference 0.38 [-0.23, 0.99]). CONCLUSIONS DO was not superior to autogenous block grafting for vertical bone augmentation. Both techniques were associated with a number of complications. There was no difference in the bone resorption observed in the 2 techniques. No conclusive results can be drawn on other techniques on account of limited data.

UI MeSH Term Description Entries
D003758 Dental Implantation, Endosseous Insertion of an implant into the bone of the mandible or maxilla. The implant has an exposed head which protrudes through the mucosa and is a prosthodontic abutment. Dental Implantation, Osseointegrated,Endosseous Dental Implant Therapy,Endosseous Implantation,Osseointegrated Dental Implantation,Endosseous Dental Implantation,Implantation, Endosseous,Implantation, Endosseous Dental,Implantation, Osseointegrated Dental
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000328 Adult A person having attained full growth or maturity. Adults are of 19 through 44 years of age. For a person between 19 and 24 years of age, YOUNG ADULT is available. Adults
D000540 Alveolar Ridge Augmentation Preprosthetic surgery involving rib, cartilage, or iliac crest bone grafts, usually autologous, or synthetic implants for rebuilding the alveolar ridge. Mandibular Ridge Augmentation,Maxillary Ridge Augmentation,Alveolar Ridge Augmentations,Augmentation, Alveolar Ridge,Augmentation, Mandibular Ridge,Augmentation, Maxillary Ridge,Augmentations, Alveolar Ridge,Augmentations, Mandibular Ridge,Augmentations, Maxillary Ridge,Mandibular Ridge Augmentations,Maxillary Ridge Augmentations,Ridge Augmentation, Alveolar,Ridge Augmentation, Mandibular,Ridge Augmentation, Maxillary,Ridge Augmentations, Alveolar,Ridge Augmentations, Mandibular,Ridge Augmentations, Maxillary
D012189 Retrospective Studies Studies used to test etiologic hypotheses in which inferences about an exposure to putative causal factors are derived from data relating to characteristics of persons under study or to events or experiences in their past. The essential feature is that some of the persons under study have the disease or outcome of interest and their characteristics are compared with those of unaffected persons. Retrospective Study,Studies, Retrospective,Study, Retrospective
D014025 Titanium A dark-gray, metallic element of widespread distribution but occurring in small amounts with atomic number, 22, atomic weight, 47.867 and symbol, Ti; specific gravity, 4.5; used for fixation of fractures.
D015921 Dental Implants Biocompatible materials placed into (endosseous) or onto (subperiosteal) the jawbone to support a crown, bridge, or artificial tooth, or to stabilize a diseased tooth. Dental Implants, Mini,Dental Prosthesis, Surgical,Implants, Dental,Dental Implant,Dental Prostheses, Surgical,Implant, Dental,Prostheses, Surgical Dental,Prosthesis, Surgical Dental,Surgical Dental Prostheses,Surgical Dental Prosthesis,Dental Implant, Mini,Mini Dental Implant,Mini Dental Implants
D016025 Bone Transplantation The grafting of bone from a donor site to a recipient site. Grafting, Bone,Transplantation, Bone,Bone Grafting

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