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Assessment of bone quality using buccal and palatal autogenous cortical shells harvested from two different mandibular donor sites for maxillary alveolar ridge augmentation: a histomorphometric randomized clinical trial

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Abstract

Purpose

This study aims to compare the quality of free autogenous bone grafts harvested from two different mandibular donor sites, used as onlay shells to augment horizontally and vertically deficient anterior maxillary alveolar ridges.

Methods

Fourteen patients with edentulous and atrophic anterior maxillae are randomly allocated into two groups. Seven symphyseal chin (group I) and seven retromolar (group II) mandibular bone grafts were harvested and fashioned to construct buccal and palatal frameworks, fixed in place with mini-screws, followed by compacting the inter-positional gaps with an equal particulate mix of xenograft and autogenous cancellous particulates. Six months later, 42 core biopsies, three from each patient, 21 for each study group, were retrieved before the implants’ insertion and subjected to histomorphometric bone area percent analysis.

Results

The bone area percent of the newly formed bone augmented with the chin shells was 52.53 ± 1.68% versus 47.97 ± 1.83% for the retromolar grafts. The mean area percent difference between both groups was statistically significant (p = 0.0004).

Conclusion

A higher bone quality and more volumetric stability were associated with the symphyseal cortical shells.

Clinical trial registration

The study was registered on www.clinicaltrials.gov (#: NCT03607006) in July 2018 by Ola Alaa El Morsy.

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Abbreviations

CBCT:

cone beam computed tomography

EDTA:

ethylenediaminetetraacetic acid

H&E:

hematoxylin and eosin stain

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Acknowledgments

The authors would like to acknowledge Noura M. Kamal, Assistant Lecturer of Oral and Maxillofacial Pathology, Faculty of Dentistry, Cairo University, for her help in the statistical analysis.

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Authors and Affiliations

  1. Oral and Maxillofacial Surgery, Faculty of Dentistry, Cairo University, Cairo, Egypt

    Mohamed Mounir

  2. Oral and Maxillofacial Surgery, Faculty of Dentistry, Future University in Egypt, Cairo, Egypt

    Ola Alaa EL Morsy

  3. Oral and Maxillofacial Pathology, Faculty of Dentistry, Cairo University, Cairo, Egypt

    Hatem Amer

  4. Oral and Maxillofacial Surgery, Faculty of Dentistry, October University for Modern Sciences and Arts, Sixth of October City, Egypt

    Samy Mounir

  5. Oral and Maxillofacial Surgery, Faculty of Dentistry, Beni-Suef University, East Nile educational compound, Beni-Suef, 62764, Egypt

    Amr Gibaly

Authors
  1. Mohamed Mounir
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  2. Ola Alaa EL Morsy
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  3. Hatem Amer
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  4. Samy Mounir
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  5. Amr Gibaly
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Contributions

1. Mohamed Mounir: the leading operator in all the cases and assisted in the writing of the manuscript.

2. Ola Alaa: assisted in the operative work and the writing of the manuscript.

3. Samy Mounir: assisted in the operative work and the writing of the manuscript.

4. Hatem Amer: the histology sample work and assisted in the writing of the manuscript.

5. Amr Gibaly: the corresponding author, assisted in the operative work and writing of the manuscript.

Corresponding author

Correspondence to Amr Gibaly.

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Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. The ethics and research committee of the Faculty of Dentistry, Cairo University, authorized both the purpose and design of the study. The clinical trial was registered on www.clinicaltrials.gov (registration number NCT03607006).

Informed consent

Informed consent was obtained from all individual participants included in the study. All the patients were informed clearly about the study’s nature and the expected outcomes of the surgical interference as well as the related complications before obtaining the written informed consents.

Approval of final manuscript

All authors discussed and approved the final form of the manuscript.

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Mounir, M., Morsy, O.A.E., Amer, H. et al. Assessment of bone quality using buccal and palatal autogenous cortical shells harvested from two different mandibular donor sites for maxillary alveolar ridge augmentation: a histomorphometric randomized clinical trial. Oral Maxillofac Surg 25, 263–269 (2021). https://doi.org/10.1007/s10006-020-00924-w

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  • DOI: https://doi.org/10.1007/s10006-020-00924-w

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