Effect of biologic materials on the outcomes of horizontal alveolar ridge augmentation: A retrospective study

Abstract

Purpose: The purpose of this study was to investigate if the addition of biologic agents to a particulate bone graft enhances horizontal ridge augmentation outcomes in terms of bone dimensions, bone density, and successful implant placement.

Materials and methods: A retrospective chart review was done to assess the clinical and radiographic outcomes in 52 horizontal ridge augmentation sites in 43 patients. Information was gathered regarding surgical technique, type of graft material, biologic agents used (PRP or rhPDGF-BB), method of space maintenance, and achieved alveolar ridge width and bone density changes as quantified on CBCT scans.

Results: The use of tenting screws, a resorbable membrane, and a combination of particulate allogenic and xenogenic bone graft material provided an average horizontal bone gain of 3.6 mm in the 52 augmented sites. There was no statistically significant difference observed in the amount of horizontal bone gain between sites treated with the addition of biologic agents (n = 21), or with a particulate bone graft alone (n = 31). A marginally statistically significant difference was found in the density of the grafted bone with the addition of biologics (p value = .0653).

Conclusion: The addition of biologic agents to the graft materials did not have a significant effect on the amount of horizontal bone gain or successful implant placement; however, it marginally enhanced the bone density of the grafted area.

Keywords: PRP; biologics; bone density; bone gain; horizontal ridge augmentation; radiographic evaluation; rhPDGF-BB.

FIGURE 1

Radiographic analysis with linear measurement of alveolar ridge before (a) and after (b) augmentation

FIGURE 2

Comparison of frequency and type of biologics used for anterior versus posterior sites

FIGURE 3

Average baseline alveolar ridge width, bone gain, and postoperative alveolar ridge width for biologics and non‐biologics ridge augmentation groups (in mm)

FIGURE 4

Clinical view of alveolar ridge augmentation using tenting screws and bone graft and platelet‐rich plasma (PRP) (a), bone graft with no biologics (b), and bone graft and recombinant human platelet‐derived growth factor‐ββ (rhPDGF‐BB) (c); before (first row images) and after augmentation (second row images)