Clinical performance of alveolar ridge augmentation with xenogeneic bone block grafts versus autogenous bone block grafts. A systematic review - 27/11/20

Doi : 10.1016/j.jormas.2020.10.009

Luis Sánchez-Labrador ^a, Pedro Molinero-Mourelle ^b, Fabián Pérez-González ^a, Luis Miguel Saez-Alcaide ^a, Jorge Cortés-Bretón Brinkmann ^a,⁎ , Juan López-Quiles Martínez ^a, Jose María Martínez-González ^a
^a Department of Dental Clinical Specialties Faculty of Dentistry, Complutense University of Madrid, Spain
^b Department of Reconstructive Dentistry and Gerodontology, School of Dental Medicine, University of Bern., Switzerland

^⁎Corresponding author at: Department of dental Clinical Specialties, School of dentistry, Complutense University of Madrid, Pza Ramon y Cajal s/n, 28040 Madrid, Spain.Department of dental Clinical SpecialtiesSchool of dentistryComplutense University of MadridPza Ramon y Cajal s/nMadrid28040Spain

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Highlights

•	In cases of atrophic jaws, several bone augmentation techniques are available.
•	Autogenous bone graft is considerate the ´gold standard´ for bone regeneration.
•	Xenogeneic bone blocks would appear to be a reliable alternative.
•	This option provides unlimited graft availability and undergoes less morbidity.
•	Further investigations generating long term data are needed.

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Abstract

Introduction

This systematic literature review aimed to evaluate the feasibility of xenogeneic bone blocks for ridge augmentation compared with autogenous blocks by analyzing block survival rates, block resorption, subsequent implant survival rate, post-surgical complications, and histomorphometric findings.

Materials and Methods

Electronic searches were conducted in the Medline (PubMed), Web of Science and Cochrane databases, complimented by a manual search in specialist journals, for relevant articles published up to March 2020. Inclusion criteria were human studies in which the outcomes of xenogeneic bone block grafts were evaluated by means of their survival rates and subsequent implant survival rates.

Results

Sixteen articles fulfilled the inclusion criteria and were analyzed. 333 patients were recruited with a total of 337 xenogeneic bone blocks and 82 autogenous bone blocks, showing block failure rates of 6.82% and 6.1%, respectively. Bone gain, in both height and width, was similar among xenogeneic and autogenous bone blocks, but autogenous bone blocks suffered greater resorption. Implant survival rates were slightly lower for xenogeneic bone blocks. Histological and histomorphometric analysis observed more bone formation and less residual bone substitute with autogenous bone blocks than xenogeneic bone blocks.

Conclusions

Atrophic alveolar crest reconstruction with xenogeneic bone block grafts would appear to offer a viable alternative to autogenous bone block grafts, obtaining similar block graft failure rate, fewer sensitive postoperative complications but a slightly lower implant survival rate. Further investigations generating long term data are needed to confirm the feasibility of xenogeneic bone blocks in different clinical scenarios.

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Keywords : Xenogeneic block, Clinical outcome, Ridge augmentation, Dental implants