Bone augmentation procedures in implant dentistry

Purpose: This review evaluated: a) the success of different surgical techniques for the reconstruction of edentulous deficient alveolar ridges and b) the survival/success rates of implants placed in the augmented areas. Material and methods: Clinical investigations published in English involving more than 10 consecutively treated patients and mean follow-up of at least 12 months after commencement of prosthetic loading were included. The following procedures were considered: 1) Onlay bone grafts; 2) Sinus floor elevation via a lateral approach; 3) Le Fort I osteotomy with interpositional grafts; 4) Split ridge/ ridge expansion techniques; and 5) Alveolar distraction osteogenesis. Full-text articles were identified using computerized and hand search by key words. Success and related morbidity of augmentation procedures, and survival/success rates of implants placed in the augmented sites were analyzed. Results and conclusion: A wide range of surgical procedures were identified. However, it was difficult to demonstrate that a particular surgical procedure offered better outcomes compared to another. Moreover, it is not yet known if some surgical procedures, e.g. reconstruction of atrophic edentulous mandibles with onlay autogenous bone grafts or maxillary sinus grafting procedures in case of limited/moderate sinus pneumatization, improve long-term implant survival. Every surgical procedure presents advantages and disadvantages. Priority should be given to those procedures which look simpler, less invasive, involve less risk of complications, and reach their goals within the shortest time frame. The main limit encountered in this literature review was the overall poor methodological quality of the published articles. Larger well designed long-term trials are needed