Complications with allogeneic, cancellous bone blocks in vertical alveolar ridge augmentation: prospective clinical case study and review of the literature

Publication date: Available online 17 March 2016
Source:Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology
Author(s): G.F. Draenert, P.W. Kämmerer, M. Berthold, A. Neff
ObjectivesVertical bone augmentation procedures in dental implantology are an indication for cancellous allogeneic bone blocks (ABB). Though, these materials may lead to adverse reactions as known well from orthopedics but rarely published. Therefore, an evaluation of ABB in vertical bone augmentation in clinical dental implantology was conducted.Material and MethodsThe prospective clinical study was designed for 20 cases with vertical augmentation using ABB and subsequent or simultaneous placement of implants in the lateral maxilla and mandible. Follow up included panoramic X-ray, tissue healing and periimplantitis. Due to limited patients number, observation was planned to be descriptive only. A loss of ABB or periimplantitis of more than 30% of the intraosseous implant length was considered as failure.ResultsThe study was cancelled after 6 cases due to an unexpected high number of complications (5/6; 83%). The average surveillance time was1460 days. Three types of unsatisfying outcome were observed: type I: early complete loss of the augmentation with soft tissue defects after 3-8 weeks (n=2); type II: early soft tissue maceration (up to 8 weeks) without loss of coverage and complete early bony healing with later periimplantitis and bone loss after prosthetic loading (6 months or later; n=2); type III: complication-free bony healing with subsequent periimplantitis after prosthetic loading (6 months or later; n=1).ConclusionsComplications were observed in vertical augmentation with ABB and implant placement. Literature data support these results after careful consideration and also suggest that tissue level implants may be advantageous in vertical bone augmentation with ABB.

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