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Horizontal ridge augmentation in the anterior maxilla with in situ onlay bone grafting: a retrospective cohort study

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Abstract

Objectives

This study aimed to introduce a digitally guided in situ autogenous onlay grafting technique and compare its effectiveness with the conventional (ex situ) onlay technique in augmenting horizontal bone defects of the anterior maxilla.

Materials and methods

This retrospective cohort study included 24 patients who had received autogenous onlay bone grafts combined with guided bone regeneration (GBR) in the anterior maxilla. Fourteen patients were recruited into the in situ onlay grafting group (EG), and 10 were recruited into the ex situ onlay group (CG), defined by the donor sites. The clinical parameters, radiographic changes, micro-CT, and histological processes were evaluated after a mean follow-up period of 1.7 years.

Results

The horizontal bone width reflected significant bone modeling over time (p < 0.001) in the first 6 months. Multivariable analysis showed that the treatment modality (grouping) was a critical factor positively associated with vertical bone height alteration. However, neither the alteration rate of horizontal bone width nor the bone volume was associated with the treatment modality. The number of periosteal screws per graft positively affected horizontal contour maintenance (p < 0.05). No significant differences were observed between the groups in the clinical parameters (complications, success rate, and peri-implant parameters). The micro-CT and histological outcomes were similar between the groups.

Conclusion

Despite the limitations of this study, in situ onlay grafting combined with GBR was an effective and reliable approach for horizontal bone augmentation in the anterior maxilla and appeared to demonstrate better stability in vertical bone remodeling.

Clinical relevance

This study introduces a modified and minimally invasive technique of onlay grafting for horizontal bone augmentation. This in situ onlay grafting demonstrates superior stability in vertical bone remodeling.

The trial registration number is ChiCTR2100054683.

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Data availability

The datasets generated during and analyzed during the current study are available from the corresponding author on reasonable request.

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Funding

This work was supported by the Key Research and Development Project of the Science and Technology Department of Sichuan Province (Grant/Award Number: 2021YFS0030).

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Authors and Affiliations

  1. State Key Laboratory of Oral Diseases and National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, No. 14, 3rd Section, Renmin Nan Road, Chengdu, 610041, Sichuan, China

    Jing Wang, Yilin Luo, Yili Qu & Yi Man

  2. Department of Oral Implantology, West China Hospital of Stomatology, Sichuan University, Chengdu, China

    Jing Wang, Yilin Luo & Yi Man

  3. Department of Prosthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, China

    Yili Qu

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Contributions

YM conceived the study and critically revised the manuscript. JW conducted the experiments, collected and analyzed the data, and drafted the manuscript. YL collected, analyzed, and interpreted the data. YQ interpreted the data and critically revised the manuscript. All the authors approved the final version and agreed to be accountable for all aspects of the work.

Corresponding author

Correspondence to Yi Man.

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Ethics approval

This retrospective study involving human participants was performed in accordance with the ethical standards of the institutional and national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. Approval was granted by the Ethics Committee of Sichuan University (Approval number: WCHSIRB-D-2021–518).

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Informed consent was obtained from all individual participants included in the study. Patients signed informed consent regarding publishing their data and photographs.

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The authors declare no competing interests.

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Wang, J., Luo, Y., Qu, Y. et al. Horizontal ridge augmentation in the anterior maxilla with in situ onlay bone grafting: a retrospective cohort study. Clin Oral Invest 26, 5893–5908 (2022). https://doi.org/10.1007/s00784-022-04547-1

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