News

07. September 2016

Bone block + biomaterial = less resorption

A recently published study with 10 yrs of data shows that autologous bone blocks resorb only minimally if they are protected by a slowly resorbing bone substitute and a collagen membrane.1

Bone blocks harvested from the retromolar region or the chin are the gold standard for the regeneration of large horizontal bone atrophies. The advantages: mechanical stability and the ability to stimulate new bone formation. Major disadvantages, however, are donor site morbidity and the marked resorption of the graft in situ. The literature describes resorption rates between 18 and 60 percent.2-8

Biomaterials with a low replacement rate significantly reduce the resorption rate of autologous bone blocks

Covering the autologous bone blocks with a slowly resorbing biomaterial and a collagen membrane in double-layer technique minimizes the graft shrinkage.9,10 Researchers in Switzerland were able to show that the resorption remains minimal over a period of 10 years.1 They treated 42 patients (58 sites) with an autologous bone block taken from ramus or chin and covered the graft with Geistlich Bio-Oss® granulate and a Geistlich Bio-Gide® collagen membrane. Six months later they placed the implants into the augmented bone. The evaluation after ten years - including 38 patients (52 sites) - revealed that 98.1 percent of the implants were "successful" according to the criteria of Buser et al. and Albrektsson.11,12 The graft had resorbed only slightly, by 7.7 percent ­on the average - which means about 0.38 mm. Graft resorption was more pronounced in women, and bone from the retromolar region resorbed slightly more than bone from the chin.

 

References:

  1. Chappuis V, et al. : Clin Implant Dent Relat Res 2016, Jul 31 [Epub ahead of print].
  2. Widmark G, et al.: Int J Oral Maxillofac Surg 1997; 26: 106-09
  3. Ozaki W, Buchman SR: Plast Reconstr Surg 1998; 102: 291-99.
  4. Antoun H, et al.: Clin Oral Implants Res 2001; 12: 632-39.
  5. Cordaro L, et al.: Clin Oral Implants Res 2002; 13:103-11.
  6. Maiorana C, et al.: Int J Periodontics Restorative Dent 2005; 25:19-25.
  7. Sbordone L, et al.: Int J Oral Maxillofac Surg 2009; 38: 1059-65.
  8. Dasmah A, et al.: J Craniomaxillofac Surg 2012; 40: 654-59.
  9. von Arx T, Buser D.: Clin Oral Implants Res 2006;17(4): 359-66.
  10. Cordaro L, et al. : Clin Oral Implants Res 2011; 22(10): 1145-50
  11. Buser D, et al.: Clin Oral Implants Res 1990; 1: 33-40.
  12. Albrektsson T, et al.: Int J Oral MaxillofacImplants 1986; 1: 11-25.