Research Article
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Comparison of two different augmentation techniques

Year 2022, Volume: 27 Issue: 2, 162 - 172, 24.05.2022
https://doi.org/10.21673/anadoluklin.1034650

Abstract

Aim: This study aims to compare Guided Bone Regeneration (GBR) performed using autogenous block graft to particulate autograft with xenograft from physicians’ and patients’ perspectives.

Methods: 30 systemically healthy individuals participated in this study. GBR using block graft (GBR-BAX) was performed in 15 of the patients and GBR using particulate autograft with xenograft (GBR-PAX) was performed in the other 15 patients. Bone thickness was recorded preoperatively and in the 6th month postoperatively. Bleeding, hematoma, flap dehiscence, infection, and paresthesia were evaluated. Patients were requested to record pain intensity and swelling levels using the visual analog scale (VAS) on the 3rd, 7th, and 14th days after surgery. The swelling levels were also recorded by a clinician on the 3rd, 7th, and 14th days after surgery. The cost of the surgery, the time spent on preparing the patient for the surgery, the time spent during the surgery, and the fatigue levels of the physician resulting from surgery were also determined.

Results: Both GBR-BAX and GBR-PAX provided significant bone gain. Bleeding, hematoma, flap dehiscence, infection, and paresthesia levels found also similar. Both techniques caused similar pain, swelling, and discomfort on the 3rd, 7th, and 14th days. VAS results showed no differences in terms of pain and discomfort. GBR-BAX was found more time-consuming in both preparation and surgical period and tiring for the physician but was less costly compared to GBR-PAX.

Conclusion: Within the limitation of the present study, GBR with autogenous block graft and particulate autograft plus xenograft provided similar bone gain and caused similar complications, pain, and discomfort. In terms of efficacy, none of the two techniques was found superior to the other; however, block graft was more time-consuming, tiring, and costly.

Supporting Institution

yok

Project Number

yok

Thanks

Erciyes University Faculty of Dentistry Department of Periodontology staff and research assistants for their assistance in preparing the present study

References

  • Marcenes W, Kassebaum NJ, Bernabé E, Flaxman A, Naghavi M, Lopez A, et al. Global burden of oral conditions in 1990-2010: a systematic analysis. J Dent Res. 2013;92(7):592-7.
  • White D, Tsakos G, Pitts N, Fuller E, Douglas G, Murray J, et al. Adult Dental Health Survey 2009: common oral health conditions and their impact on the population. Br Dent J. 2012;213(11):567.
  • Reisine S, Freilich M, Ortiz D, Pendrys D, Shafer D, Taxel P. Quality of life improves among post-menopausal women who received bone augmentation during dental implant therapy. Int J Oral Maxillofac Surg. 2012;41(12):1558-62.
  • Smith B, Baysan A, Fenlon M. Association between Oral Health Impact Profile and General Health scores for patients seeking dental implants. J. Dent. 2009;37(5):357-9.
  • Demet K, Martinet N, Guillemin F, Paysant J, Andre J-M. Health related quality of life and related factors in 539 persons with amputation of upper and lower limb. Disabil Rehabil. 2003;25(9):480-6.
  • Johannsen A, Westergren A, Johannsen G. Dental implants from the patients perspective: transition from tooth loss, through amputation to implants–negative and positive trajectories. J. Clin. Periodontol. 2012;39(7):681-7.
  • Gates III WD, Cooper LF, Sanders AE, Reside GJ, De Kok IJ. The effect of implant‐supported removable partial dentures on oral health quality of life. Clin. Oral Implants Res. 2014;25(2):207-13.
  • de Sousa CA, Lemos CAA, Santiago-Júnior JF, Faverani LP, Pellizzer EP. Bone augmentation using autogenous bone versus biomaterial in the posterior region of atrophic mandibles: A systematic review and meta-analysis. J Dent. 2018;76:1-8.
  • de Groot R, Oomens M, Forouzanfar T, Schulten E. Bone augmentation followed by implant surgery in the edentulous mandible: A systematic review. J. Oral Rehabil. 2018;45(4):334-43.
  • Starch-Jensen T, Jensen JD. Maxillary sinus floor augmentation: a review of selected treatment modalities. . J Oral Maxillofac Res. 2017;8(3):e3.
  • Hämmerle CH, Jung RE. Bone augmentation by means of barrier membranes. Periodontol 2000. 2003;33(1):36-53.
  • Hämmerle CH, Karring T. Guided bone regeneration at oral implant sites. Periodontol 2000. 1998;17(1):151-75.
  • McAllister BS, Haghighat K. Bone augmentation techniques. J Periodontol. 2007;78(3):377-96.
  • Elnayef B, Monje A, Lin G-H, Gargallo-Albiol J, Chan H-L, Wang H-L, et al. Alveolar ridge split on horizontal bone augmentation: a systematic review. Int J Oral Maxillofac Implants. 2015;30(3):596-606.
  • Altiparmak N, Akdeniz S, Bayram B, Gulsever S, Uckan S. Alveolar ridge splitting versus autogenous onlay bone grafting: complications and implant survival rates. Implant Dent. 2017;26(2):284-7.
  • Gultekin BA, Bedeloglu E, Kose TE, Mijiritsky E. Comparison of Bone Resorption Rates after Intraoral Block Bone and Guided Bone Regeneration Augmentation for the Reconstruction of Horizontally Deficient Maxillary Alveolar Ridges. Biomed Res Int. 2016;2016:4987437.
  • Von Arx T, Buser D. Horizontal ridge augmentation using autogenous block grafts and the guided bone regeneration technique with collagen membranes: a clinical study with 42 patients. Clin. Oral Implants Res. 2006;17(4):359-66.
  • Alérico FA, Bernardes SR, Fontão FNGK, Diez GF, Alérico JHS, Claudino M. Prospective tomographic evaluation of autogenous bone resorption harvested from mandibular ramus in atrophic maxilla. J Craniofac Surg. 2014;25(6):e543-e6.
  • Cordaro L, Amadè DS, Cordaro M. Clinical results of alveolar ridge augmentation with mandibular block bone grafts in partially edentulous patients prior to implant placement. Clin. Oral Implants Res. 2002;13(1):103-11.
  • Nkenke E, Neukam FW. Autogenous bone harvesting and grafting in advanced jaw resorption: morbidity, resorption and implant survival. Eur J Oral Implantol. 2014;7(Suppl 2):S203-S17.
  • Nkenke E, Schultze‐Mosgau S, Kloss F, Neukam F, Radespiel‐Tröger M. Morbidity of harvesting of chin grafts: a prospective study. Clin. Oral Implants Res. 2001;12(5):495-502.
  • Benic GI, Hämmerle CH. Horizontal bone augmentation by means of guided bone regeneration. Periodontol 2000. 2014;66(1):13-40.
  • Jung RE, Fenner N, Hämmerle CH, Zitzmann NU. Longterm outcome of implants placed with guided bone regeneration (GBR) using resorbable and non‐resorbable membranes after 12–14 years. Clin. Oral Implants Res. 2013;24(10):1065-73.
  • Chappuis V, Cavusoglu Y, Buser D, von Arx T. Lateral ridge augmentation using autogenous block grafts and guided bone regeneration: A 10‐year prospective case series study. Clin Implant Dent Relat Res. 2017;19(1):85-96.
  • Santana RB, Santana CM. A clinical comparison of guided bone regeneration with platelet-derived growth factor-enhanced bone ceramic versus autogenous bone block grafting. Int J Oral Maxillofac Implants. 2015;30(3):700-6.
  • De Freitas RM, Susin C, Spin‐Neto R, Marcantonio C, Wikesjö UM, Pereira LAVD, et al. Horizontal ridge augmentation of the atrophic anterior maxilla using rhBM-2/ACS or autogenous bone grafts: a proof‐ofconcept randomized clinical trial. J Clin Periodontol. 2013;40(10):968-75.
  • Barone A, Toti P, Menchini-Fabris G-B, Felice P, Marchionni S, Covani U. Early volumetric changes after vertical augmentation of the atrophic posterior mandible with interpositional block graft versus onlay bone graft: A retrospective radiological study. J Craniomaxillofac Surg. 2017;45(9):1438-47.
  • Ersanli S, Arısan V, Bedeloğlu E. Evaluation of the autogenous bone block transfer for dental implant placement: Symphysal or ramus harvesting? BMC Oral Health. 2016;16(1):4.
  • Nkenke E, Radespiel‐Tröger M, Wiltfang J, Schultze‐Mosgau S, Winkler G, Neukam FW. Morbidity of harvesting of retromolar bone grafts: a prospective study. Clin. Oral Implants Res. 2002;13(5):514-21.
  • Sbordone C, Toti P, Guidetti F, Califano L, Santoro A, Sbordone L. Volume changes of iliac crest autogenous bone grafts after vertical and horizontal alveolar ridge augmentation of atrophic maxillas and mandibles: a 6-year computerized tomographic follow-up. J. Oral Maxillofac. Surg. 2012;70(11):2559-65.
  • Alayan J, Ivanovski S. A prospective controlled trial comparing xenograft/autogenous bone and collagenstabilized xenograft for maxillary sinus augmentation—Complications, patient‐reported outcomes and volumetric analysis. Clin. Oral Implants Res. 2018;29(2):248-62.
  • Miron RJ, Zhang Q, Sculean A, Buser D, Pippenger BE, Dard M, et al. Osteoinductive potential of 4 commonly employed bone grafts. Clin Oral Investig. 2016;20(8):2259-65.
  • Monje A, Monje F, Hernández-Alfaro F, Gonzalez-García R, Suárez-López del Amo F, Galindo-Moreno P, et al. Horizontal bone augmentation using autogenous block grafts and particulate xenograft in the severe atrophic maxillary anterior ridges: a cone-beam computerized tomography case series. Oral Implantol. 2015;41(S1):366-71.
  • Meloni SM, Jovanovic SA, Urban I, Canullo L, Pisano M, Tallarico M. Horizontal ridge augmentation using gbr with a native collagen membrane and 1: 1 ratio of particulated xenograft and autologous bone: A 1‐year prospective clinical study. Clin Implant Dent Relat Res. 2017;19(1):38-45.
  • Galindo‐Moreno P, de Buitrago JG, Padial‐Molina M, Fernández‐Barbero JE, Ata‐Ali J, O′ Valle F. Histopathological comparison of healing after maxillary sinus augmentation using xenograft mixed with autogenous bone versus allograft mixed with autogenous bone. Clin. Oral Implants Res. 2018;29(2):192-201.
  • Chavda S, Levin L. Human Studies of Vertical and Horizontal Alveolar Ridge Augmentation Comparing Different Types of Bone Graft Materials: A Systematic Review. Oral Implantol. 2018;44(1):74-84.
  • Taşdemir Z, Alkan BA, Albayrak H. Effects of Ozone Therapy on the Early Healing Period of Deepithelialized Gingival Grafts: A Randomized Placebo‐Controlled Clinical Trial. J Periodontol. 2016;87(6):663-71.
  • Jensen MP, Karoly P, Braver S. The measurement of clinical pain intensity: a comparison of six methods. Pain. 1986;27(1):117-26.
  • Pistilli R, Felice P, Piatelli M, Nisii A, Barausse C, Esposito M. Blocks of autogenous bone versus xenografts for the rehabilitation of atrophic jaws with dental implants: preliminary data from a pilot randomised controlled trial. Eur J Oral Implantol. 2014;7(2):153-71.

İki kemik arttırım yönteminin karşılaştırılması

Year 2022, Volume: 27 Issue: 2, 162 - 172, 24.05.2022
https://doi.org/10.21673/anadoluklin.1034650

Abstract

Amaç: Bu çalışmanın amacı, otojen blok greft veya partikül otogreft ve ksenograft ile uygulanan yönlendirilmiş kemik rejenerasyonu (YKR) uygulamalarını hekim ve hasta açısından karşılaştırmaktır.

Yöntemler: Bu çalışmaya sistemik olarak sağlıklı olan 30 birey katıldı. 15 hastaya blok greft ile (YKRBOK) YKR ve 15 hastaya partiküler otogreft ve ksenogreft (YKR-POK) ile YKR uygulaması yapıldı. Kemik kalınlıkları ameliyat öncesi ve 6. ayda kaydedildi. Kanama, hematom, flep açılması, enfeksiyon ve uyuşma değerlendirildi. Hastalardan ameliyat sonrası 3., 7. ve 14. günlerde görsel analog skala ile ağrı ve şişlikleri kaydetmeleri istendi. Şişlik, ameliyattan sonraki 3., 7. ve 14. günlerde bir klinisyen tarafından kaydedildi. Maliyet, hasta hazırlık süresi, ameliyat süresi ve hekimin ameliyattan kaynaklanan yorgunluğu da belirlendi.

Bulgular: YKR-BOK ve YKR-POK uygulamaları önemli ölçüde kemik kazanımı sağladı. Her iki uygulama sonrası kanama, hematom, flep ayrılması, enfeksiyon, uyuşma seviyeleri de benzer bulundu. Her iki teknik de 3., 7. ve 14. günlerde benzer ağrı, şişlik ve rahatsızlığa neden oldu. Sonuçlar ağrı
ve rahatsızlık açısından farklılık göstermedi. YKR-BOK’nin hem hazırlık hem de cerrahi dönemde daha fazla zaman alıcı ve hekim için yorucu olduğu ancak YKR-POK’e göre daha az maliyetli olduğu bulundu.

Sonuç: Bu çalışmanın sınırlamaları dahilinde, otojen blok greft veya partikül otogreft artı ksenograft ile benzer kemik kazanımı sağlandı ve teknikler benzer komplikasyonlara, ağrıya ve rahatsızlığa neden oldu. Etkinlik açısından iki teknikten biri diğerine üstün bulunmadı, ancak blok greft daha fazla zaman alıcı ve maliyetli bununla birlikte hekim açısından daha yorucuydu.

Project Number

yok

References

  • Marcenes W, Kassebaum NJ, Bernabé E, Flaxman A, Naghavi M, Lopez A, et al. Global burden of oral conditions in 1990-2010: a systematic analysis. J Dent Res. 2013;92(7):592-7.
  • White D, Tsakos G, Pitts N, Fuller E, Douglas G, Murray J, et al. Adult Dental Health Survey 2009: common oral health conditions and their impact on the population. Br Dent J. 2012;213(11):567.
  • Reisine S, Freilich M, Ortiz D, Pendrys D, Shafer D, Taxel P. Quality of life improves among post-menopausal women who received bone augmentation during dental implant therapy. Int J Oral Maxillofac Surg. 2012;41(12):1558-62.
  • Smith B, Baysan A, Fenlon M. Association between Oral Health Impact Profile and General Health scores for patients seeking dental implants. J. Dent. 2009;37(5):357-9.
  • Demet K, Martinet N, Guillemin F, Paysant J, Andre J-M. Health related quality of life and related factors in 539 persons with amputation of upper and lower limb. Disabil Rehabil. 2003;25(9):480-6.
  • Johannsen A, Westergren A, Johannsen G. Dental implants from the patients perspective: transition from tooth loss, through amputation to implants–negative and positive trajectories. J. Clin. Periodontol. 2012;39(7):681-7.
  • Gates III WD, Cooper LF, Sanders AE, Reside GJ, De Kok IJ. The effect of implant‐supported removable partial dentures on oral health quality of life. Clin. Oral Implants Res. 2014;25(2):207-13.
  • de Sousa CA, Lemos CAA, Santiago-Júnior JF, Faverani LP, Pellizzer EP. Bone augmentation using autogenous bone versus biomaterial in the posterior region of atrophic mandibles: A systematic review and meta-analysis. J Dent. 2018;76:1-8.
  • de Groot R, Oomens M, Forouzanfar T, Schulten E. Bone augmentation followed by implant surgery in the edentulous mandible: A systematic review. J. Oral Rehabil. 2018;45(4):334-43.
  • Starch-Jensen T, Jensen JD. Maxillary sinus floor augmentation: a review of selected treatment modalities. . J Oral Maxillofac Res. 2017;8(3):e3.
  • Hämmerle CH, Jung RE. Bone augmentation by means of barrier membranes. Periodontol 2000. 2003;33(1):36-53.
  • Hämmerle CH, Karring T. Guided bone regeneration at oral implant sites. Periodontol 2000. 1998;17(1):151-75.
  • McAllister BS, Haghighat K. Bone augmentation techniques. J Periodontol. 2007;78(3):377-96.
  • Elnayef B, Monje A, Lin G-H, Gargallo-Albiol J, Chan H-L, Wang H-L, et al. Alveolar ridge split on horizontal bone augmentation: a systematic review. Int J Oral Maxillofac Implants. 2015;30(3):596-606.
  • Altiparmak N, Akdeniz S, Bayram B, Gulsever S, Uckan S. Alveolar ridge splitting versus autogenous onlay bone grafting: complications and implant survival rates. Implant Dent. 2017;26(2):284-7.
  • Gultekin BA, Bedeloglu E, Kose TE, Mijiritsky E. Comparison of Bone Resorption Rates after Intraoral Block Bone and Guided Bone Regeneration Augmentation for the Reconstruction of Horizontally Deficient Maxillary Alveolar Ridges. Biomed Res Int. 2016;2016:4987437.
  • Von Arx T, Buser D. Horizontal ridge augmentation using autogenous block grafts and the guided bone regeneration technique with collagen membranes: a clinical study with 42 patients. Clin. Oral Implants Res. 2006;17(4):359-66.
  • Alérico FA, Bernardes SR, Fontão FNGK, Diez GF, Alérico JHS, Claudino M. Prospective tomographic evaluation of autogenous bone resorption harvested from mandibular ramus in atrophic maxilla. J Craniofac Surg. 2014;25(6):e543-e6.
  • Cordaro L, Amadè DS, Cordaro M. Clinical results of alveolar ridge augmentation with mandibular block bone grafts in partially edentulous patients prior to implant placement. Clin. Oral Implants Res. 2002;13(1):103-11.
  • Nkenke E, Neukam FW. Autogenous bone harvesting and grafting in advanced jaw resorption: morbidity, resorption and implant survival. Eur J Oral Implantol. 2014;7(Suppl 2):S203-S17.
  • Nkenke E, Schultze‐Mosgau S, Kloss F, Neukam F, Radespiel‐Tröger M. Morbidity of harvesting of chin grafts: a prospective study. Clin. Oral Implants Res. 2001;12(5):495-502.
  • Benic GI, Hämmerle CH. Horizontal bone augmentation by means of guided bone regeneration. Periodontol 2000. 2014;66(1):13-40.
  • Jung RE, Fenner N, Hämmerle CH, Zitzmann NU. Longterm outcome of implants placed with guided bone regeneration (GBR) using resorbable and non‐resorbable membranes after 12–14 years. Clin. Oral Implants Res. 2013;24(10):1065-73.
  • Chappuis V, Cavusoglu Y, Buser D, von Arx T. Lateral ridge augmentation using autogenous block grafts and guided bone regeneration: A 10‐year prospective case series study. Clin Implant Dent Relat Res. 2017;19(1):85-96.
  • Santana RB, Santana CM. A clinical comparison of guided bone regeneration with platelet-derived growth factor-enhanced bone ceramic versus autogenous bone block grafting. Int J Oral Maxillofac Implants. 2015;30(3):700-6.
  • De Freitas RM, Susin C, Spin‐Neto R, Marcantonio C, Wikesjö UM, Pereira LAVD, et al. Horizontal ridge augmentation of the atrophic anterior maxilla using rhBM-2/ACS or autogenous bone grafts: a proof‐ofconcept randomized clinical trial. J Clin Periodontol. 2013;40(10):968-75.
  • Barone A, Toti P, Menchini-Fabris G-B, Felice P, Marchionni S, Covani U. Early volumetric changes after vertical augmentation of the atrophic posterior mandible with interpositional block graft versus onlay bone graft: A retrospective radiological study. J Craniomaxillofac Surg. 2017;45(9):1438-47.
  • Ersanli S, Arısan V, Bedeloğlu E. Evaluation of the autogenous bone block transfer for dental implant placement: Symphysal or ramus harvesting? BMC Oral Health. 2016;16(1):4.
  • Nkenke E, Radespiel‐Tröger M, Wiltfang J, Schultze‐Mosgau S, Winkler G, Neukam FW. Morbidity of harvesting of retromolar bone grafts: a prospective study. Clin. Oral Implants Res. 2002;13(5):514-21.
  • Sbordone C, Toti P, Guidetti F, Califano L, Santoro A, Sbordone L. Volume changes of iliac crest autogenous bone grafts after vertical and horizontal alveolar ridge augmentation of atrophic maxillas and mandibles: a 6-year computerized tomographic follow-up. J. Oral Maxillofac. Surg. 2012;70(11):2559-65.
  • Alayan J, Ivanovski S. A prospective controlled trial comparing xenograft/autogenous bone and collagenstabilized xenograft for maxillary sinus augmentation—Complications, patient‐reported outcomes and volumetric analysis. Clin. Oral Implants Res. 2018;29(2):248-62.
  • Miron RJ, Zhang Q, Sculean A, Buser D, Pippenger BE, Dard M, et al. Osteoinductive potential of 4 commonly employed bone grafts. Clin Oral Investig. 2016;20(8):2259-65.
  • Monje A, Monje F, Hernández-Alfaro F, Gonzalez-García R, Suárez-López del Amo F, Galindo-Moreno P, et al. Horizontal bone augmentation using autogenous block grafts and particulate xenograft in the severe atrophic maxillary anterior ridges: a cone-beam computerized tomography case series. Oral Implantol. 2015;41(S1):366-71.
  • Meloni SM, Jovanovic SA, Urban I, Canullo L, Pisano M, Tallarico M. Horizontal ridge augmentation using gbr with a native collagen membrane and 1: 1 ratio of particulated xenograft and autologous bone: A 1‐year prospective clinical study. Clin Implant Dent Relat Res. 2017;19(1):38-45.
  • Galindo‐Moreno P, de Buitrago JG, Padial‐Molina M, Fernández‐Barbero JE, Ata‐Ali J, O′ Valle F. Histopathological comparison of healing after maxillary sinus augmentation using xenograft mixed with autogenous bone versus allograft mixed with autogenous bone. Clin. Oral Implants Res. 2018;29(2):192-201.
  • Chavda S, Levin L. Human Studies of Vertical and Horizontal Alveolar Ridge Augmentation Comparing Different Types of Bone Graft Materials: A Systematic Review. Oral Implantol. 2018;44(1):74-84.
  • Taşdemir Z, Alkan BA, Albayrak H. Effects of Ozone Therapy on the Early Healing Period of Deepithelialized Gingival Grafts: A Randomized Placebo‐Controlled Clinical Trial. J Periodontol. 2016;87(6):663-71.
  • Jensen MP, Karoly P, Braver S. The measurement of clinical pain intensity: a comparison of six methods. Pain. 1986;27(1):117-26.
  • Pistilli R, Felice P, Piatelli M, Nisii A, Barausse C, Esposito M. Blocks of autogenous bone versus xenografts for the rehabilitation of atrophic jaws with dental implants: preliminary data from a pilot randomised controlled trial. Eur J Oral Implantol. 2014;7(2):153-71.
There are 39 citations in total.

Details

Primary Language English
Subjects Health Care Administration
Journal Section ORIGINAL ARTICLE
Authors

Hatice Balci Yuce 0000-0003-3574-9751

Zekeriya Taşdemir 0000-0003-0359-2462

Project Number yok
Publication Date May 24, 2022
Acceptance Date February 16, 2022
Published in Issue Year 2022 Volume: 27 Issue: 2

Cite

Vancouver Balci Yuce H, Taşdemir Z. Comparison of two different augmentation techniques. Anatolian Clin. 2022;27(2):162-7.

13151 This Journal licensed under a CC BY-NC (Creative Commons Attribution-NonCommercial 4.0) International License.