J Korean Assoc Oral Maxillofac Surg.  2023 Dec;49(6):324-331. 10.5125/jkaoms.2023.49.6.324.

Horizontal ridge augmentation with porcine bone-derived grafting material: a long-term retrospective clinical study with more than 5 years of follow-up

• Choi JW
• Hwang SS
• Yun PY
• Kim YK

• KMID: 2550295
• DOI: http://doi.org/10.5125/jkaoms.2023.49.6.324

Abstract

Objectives
The purpose of this study was to evaluate the outcomes of implants placed in horizontally augmented alveolar ridges using porcine bone grafts and to investigate the long-term stability of the porcine bone grafts.
Materials and Methods
A retrospective analysis was conducted on 49 sites that underwent horizontal ridge augmentation using porcine bone grafts and implant placement with a follow-up period longer than 5 years. Furthermore, additional analysis was conducted on 24 sites where porcine bone grafts were used exclusively for horizontal ridge augmentation and implant placement.
Results
The mean follow-up period after prosthesis loading was 67.5 months, with a mean marginal bone loss of 0.23 mm at 1 year and a cumulative mean marginal bone loss of 0.40 mm over the entire follow-up period. Of the 49 implants, 2 were lost and 3 did not meet the success criteria, resulting in a survival rate of 95.9% and a success rate of 89.8%. In 24 sites, the mean marginal bone loss was 0.23 mm at 1 year and 0.41 mm at 65.8 months, with 100% survival and success rates.
Conclusion
Porcine bone grafts can be successfully used in horizontal ridge augmentation for implant placement in cases of ridges with insufficient horizontal width.

Keyword

Bone transplantation; Alveolar bone augmentation; Dental implant

Figure

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  Fig. 1 Measurement of marginal bone level. a: Shoulder to mesial contact point (mm), b: Shoulder to distal contact point (mm). The mean of a and b was the marginal bone level.

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  Fig. 2 Radiographic results of implant placed in horizontally augmented ridge using porcine bone grafts. A. Immediately after the operation. B. Immediately after the prosthetic restoration. C. Final follow-up.

Reference

References

1. Esposito M, Worthington HV, Coulthard P, Thomsen P. 2003; Maintaining and re-establishing health around osseointegrated oral implants: a Cochrane systematic review comparing the efficacy of various treatments. Periodontol 2000. 33:204–12. https://doi.org/10.1046/j.0906-6713.2003.03317.x. DOI: 10.1046/j.0906-6713.2003.03317.x. PMID: 12950853.

2. Čandrlić M, Tomas M, Karl M, Malešić L, Včev A, Perić Kačarević Ž, et al. 2022; Comparison of injectable biphasic calcium phosphate and a bovine xenograft in socket preservation: qualitative and quantitative histologic study in humans. Int J Mol Sci. 23:2539. https://doi.org/10.3390/ijms23052539. DOI: 10.3390/ijms23052539. PMID: 35269686. PMCID: PMC8910217.

3. Koo TH, Song YW, Cha JK, Jung UW, Kim CS, Lee JS. 2020; Histologic analysis following grafting of damaged extraction sockets using deproteinized bovine or porcine bone mineral: a randomized clinical trial. Clin Oral Implants Res. 31:93–102. https://doi.org/10.1111/clr.13557. DOI: 10.1111/clr.13557. PMID: 31724239.

4. Addis A, Canciani E, Campagnol M, Colombo M, Frigerio C, Recupero D, et al. 2022; A new anorganic equine bone substitute for oral surgery: structural characterization and regenerative potential. Materials (Basel). 15:1031. https://doi.org/10.3390/ma15031031. DOI: 10.3390/ma15031031. PMID: 35160976. PMCID: PMC8840601.

5. Juodzbalys G, Raustia AM, Kubilius R. 2007; A 5-year follow-up study on one-stage implants inserted concomitantly with localized alveolar ridge augmentation. J Oral Rehabil. 34:781–9. https://doi.org/10.1111/j.1365-2842.2006.01679.x. DOI: 10.1111/j.1365-2842.2006.01679.x. PMID: 17824891.

6. Beretta M, Cicciù M, Poli PP, Rancitelli D, Bassi G, Grossi GB, et al. 2015; A retrospective evaluation of 192 implants placed in augmented bone: long-term follow-up study. J Oral Implantol. 41:669–74. https://doi.org/10.1563/aaid-joi-d-14-00123. DOI: 10.1563/AAID-JOI-D-14-00123. PMID: 25686360.

7. Schmitt CM, Moest T, Lutz R, Neukam FW, Schlegel KA. 2015; Anorganic bovine bone (ABB) vs. autologous bone (AB) plus ABB in maxillary sinus grafting. A prospective non-randomized clinical and histomorphometrical trial. Clin Oral Implants Res. 26:1043–50. https://doi.org/10.1111/clr.12396. DOI: 10.1111/clr.12396. PMID: 24730602.

8. Lutz R, Berger-Fink S, Stockmann P, Neukam FW, Schlegel KA. 2015; Sinus floor augmentation with autogenous bone vs. a bovine-derived xenograft: a 5-year retrospective study. Clin Oral Implants Res. 26:644–8. https://doi.org/10.1111/clr.12352. DOI: 10.1111/clr.12352. PMID: 25906198.

9. Hölzer A, Pietschmann MF, Rösl C, Hentschel M, Betz O, Matsuura M, et al. 2012; The interrelation of trabecular microstructural parameters of the greater tubercle measured for different species. J Orthop Res. 30:429–34. https://doi.org/10.1002/jor.21525. DOI: 10.1002/jor.21525. PMID: 21834128.

10. Lee JH, Yi GS, Lee JW, Kim DJ. 2017; Physicochemical characterization of porcine bone-derived grafting material and comparison with bovine xenografts for dental applications. J Periodontal Implant Sci. 47:388–401. https://doi.org/10.5051/jpis.2017.47.6.388. DOI: 10.5051/jpis.2017.47.6.388. PMID: 29333325. PMCID: PMC5764765.

11. Lee JS, Cha JK, Kim CS. 2018; Alveolar ridge regeneration of damaged extraction sockets using deproteinized porcine versus bovine bone minerals: a randomized clinical trial. Clin Implant Dent Relat Res. 20:729–37. https://doi.org/10.1111/cid.12628. DOI: 10.1111/cid.12628. PMID: 30051954. PMCID: PMC6220803.

12. Lee JS, Shin HK, Yun JH, Cho KS. 2017; Randomized clinical trial of maxillary sinus grafting using deproteinized porcine and bovine bone mineral. Clin Implant Dent Relat Res. 19:140–50. https://doi.org/10.1111/cid.12430. DOI: 10.1111/cid.12430. PMID: 27324175.

13. Agop-Forna D, Törok R, Törok B, Dragomir R, Ehrenfest DMD, Dascălu C, et al. 2021; Postoperative study of bone gain in mandibular alveolar bone reconstructed with screw-guided bone regeneration technique and porcine-derived xenograft in 42 edentulous patient candidates for implant-prosthetic therapy. Appl Sci. 11:9826. https://doi.org/10.3390/app11219826. DOI: 10.3390/app11219826.

14. Scarano A, Piattelli A, Assenza B, Quaranta A, Perrotti V, Piattelli M, et al. 2010; Porcine bone used in sinus augmentation procedures: a 5-year retrospective clinical evaluation. J Oral Maxillofac Surg. 68:1869–73. https://doi.org/10.1016/j.joms.2009.09.015. DOI: 10.1016/j.joms.2009.09.015. PMID: 20452112.

15. Roberto C, Paolo T, Giovanni C, Ugo C, Bruno B, Giovanni-Battista MF. 2021; Bone remodeling around implants placed after socket preservation: a 10-year retrospective radiological study. Int J Implant Dent. 7:74. https://doi.org/10.1186/s40729-021-00354-7. DOI: 10.1186/s40729-021-00354-7. PMID: 34322836. PMCID: PMC8319280.

16. Marconcini S, Giammarinaro E, Derchi G, Alfonsi F, Covani U, Barone A. 2018; Clinical outcomes of implants placed in ridge-preserved versus nonpreserved sites: a 4-year randomized clinical trial. Clin Implant Dent Relat Res. 20:906–14. https://doi.org/10.1111/cid.12682. DOI: 10.1111/cid.12682. PMID: 30307130.

17. Barone A, Orlando B, Cingano L, Marconcini S, Derchi G, Covani U. 2012; A randomized clinical trial to evaluate and compare implants placed in augmented versus non-augmented extraction sockets: 3-year results. J Periodontol. 83:836–46. https://doi.org/10.1902/jop.2011.110205. DOI: 10.1902/jop.2011.110205. PMID: 22141358.

18. Albrektsson T, Zarb G, Worthington P, Eriksson AR. 1986; The long-term efficacy of currently used dental implants: a review and proposed criteria of success. Int J Oral Maxillofac Implants. 1:11–25.

19. Tolstunov L, Hicke B. 2013; Horizontal augmentation through the ridge-split procedure: a predictable surgical modality in implant reconstruction. J Oral Implantol. 39:59–68. https://doi.org/10.1563/aaid-joi-d-12-00112. DOI: 10.1563/AAID-JOI-D-12-00112. PMID: 23402358.

20. Mordenfeld A, Aludden H, Starch-Jensen T. 2017; Lateral ridge augmentation with two different ratios of deproteinized bovine bone and autogenous bone: a 2-year follow-up of a randomized and controlled trial. Clin Implant Dent Relat Res. 19:884–94. https://doi.org/10.1111/cid.12512. DOI: 10.1111/cid.12512. PMID: 28656713.

21. Hellem S, Astrand P, Stenström B, Engquist B, Bengtsson M, Dahlgren S. 2003; Implant treatment in combination with lateral augmentation of the alveolar process: a 3-year prospective study. Clin Implant Dent Relat Res. 5:233–40. https://doi.org/10.1111/j.1708-8208.2003.tb00206.x. DOI: 10.1111/j.1708-8208.2003.tb00206.x. PMID: 15127994.

22. Meloni SM, Jovanovic SA, Urban I, Baldoni E, Pisano M, Tallarico M. 2019; Horizontal ridge augmentation using GBR with a native collagen membrane and 1:1 ratio of particulate xenograft and autologous bone: a 3-year after final loading prospective clinical study. Clin Implant Dent Relat Res. 21:669–77. https://doi.org/10.1111/cid.12808. DOI: 10.1111/cid.12808. PMID: 31286654.

23. Le BT, Borzabadi-Farahani A. 2014; Simultaneous implant placement and bone grafting with particulate mineralized allograft in sites with buccal wall defects, a three-year follow-up and review of literature. J Craniomaxillofac Surg. 42:552–9. https://doi.org/10.1016/j.jcms.2013.07.026. DOI: 10.1016/j.jcms.2013.07.026. PMID: 24529349.

24. Gielkens PF, Bos RR, Raghoebar GM, Stegenga B. 2007; Is there evidence that barrier membranes prevent bone resorption in autologous bone grafts during the healing period? A systematic review. Int J Oral Maxillofac Implants. 22:390–8.

25. Karoussis IK, Brägger U, Salvi GE, Bürgin W, Lang NP. 2004; Effect of implant design on survival and success rates of titanium oral implants: a 10-year prospective cohort study of the ITI Dental Implant System. Clin Oral Implants Res. 15:8–17. https://doi.org/10.1111/j.1600-0501.2004.00983.x. DOI: 10.1111/j.1600-0501.2004.00983.x. PMID: 14731173.