Author/
Year/Location
| Study design and subject size | Mean age ± S.D. (Range) | Smoking status
(%)
| Periodontal status
(%)
| Test
(No. of subjects, augmented sites, intervention)
| Control
(No. of subjects, augmented sites, intervention)
| Method of harvesting autogenous bone (if applicable) | Staged/ Simult-aneous GBR | Vertical bone gained after surgery Mean ± S.D. (Range) | Method of assessing vertical bone gained | Size of vertical defect at baseline Mean ± S.D. (Range) | Method of assessing size of vertical defect | Specifications of complications | Appropriateness of site-level and patient-level reporting on complications | Single or multiple augmented/donor site(s) per subject? |
Abrahamsson et al. 2012
University
| RCT (n=20) | T: 27 (range 18-55)
C: 25 (range 18-49 years)
| 4 smokers (20%)
16 non-smokers (80%)
T: 3 smokers
C: 1 smoker
| NR | 10 subjects (10 sites): Soft tissue expander + pABG + Ti mesh + non-cross-linked rCM | 10 subjects (10 sites): Ramus bone block | T: Bone scraper from a second surgical donor site (ramus)
C: Bone block from ramus
| Staged | At time of bone grafting
T: 4.1±1.7mm (range 3-8mm)
C: 2.9±0.9mm (range 2-4mm)
At re-entry:
T: 3.0±1.4mm (range 0-5mm)
C: 1.6±0.8mm (range 0-3mm)
| Periodontal probe to measure the distance from titanium mesh to alveolar crest, using mesh as a fixed reference point | NR | N.A. | T:
2 patients (1 site each) had minor perforation during the soft tissue expanding phase
No infection or paraesthesia after bone grafting
2 patients (1 site each) with Ti mesh exposure after a few weeks
Treated with topical CHX gel 2x/day
C: None of the bone blocks were exposed
| Yes (one augmented site complication occurred per patient) | Single augmented site; Single donor site |
Chiapasco et al. 2004
University
| RCT (n=21) | 39.8 (range 18-59) | Excluded smokers who smoked >15 cig/day | Excluded patients with active periodontal disease | 11 subjects (11 sites): pABG + Ti-reinforced ePTFE membrane Tenting screws placed for staged cases | 10 subjects (10 sites): Distraction osteogenesis | Bone blocks from ramus (9 patients) or ramus+ chin (2 patients) and particulated with bone mill | Simultaneous (6 subjects); staged (5 subjects) | At time of bone grafting:
4.78±1.25mm
| Transparent millimetre ruler to measure distance from top of implant head or tenting screw to most coronal level of direct bone-to-implant contact at mesial and distal of each implant | NR | N.A. | 1 patient (1 site) with membrane exposure at 4w
Suppuration even after oral antibiotics, local antiseptics (0.2% CHX 3 times/day + topical CHX gel), therefore membrane removed
1 patient (1 site) with membrane exposure and suppuration at 10w
Membrane immediately removed
1 patient (1 site) with membrane exposure at 8w
Treated with topical CHX gel for 5mo until membrane removal
2 patents who underwent chin bone block harvest reported paraethesia of lower lip that resolved after 1 and 4 weeks respectively.
| Yes (one augmented site complication occurred per patient) | Single augmented site; Multiple donor sites |
Cucchi et al. 2017
University
| RCT (n=40) | 52 | 29 non-smokers (72.5%)
11 smokers (<10 cig/day) (27.5%)
| 23 no periodontal disease (57.5%)
12 chronic periodontitis (30%)
5 aggressive periodontitis (12.5%)
All periodontitis patients treated with periodontal therapy prior to surgery
| 20 subjects (20 sites): pABG + pFDBA + Ti-reinforced dPTFE membrane
| 20 subjects (20 sites): pABG + pFDBA + Ti-mesh + cross-linked rCM | Bone scraper within the same surgical site | Simultaneous | At re-entry:
T: 4.2±1.0mm
C: 4.1±1.0mm
| Periodontal probe to measure distance from implant shoulder to first visible bone-implant contact at mesial, distal buccal and lingual sites around each implant | T: 3.8±0.7mm
C: 4.0±0.8mm
| Periodontal probe to measure distance from implant shoulder to first visible bone-implant contact at mesial, distal buccal and lingual sites around each implant | T:
1 patient (1 site) abscess at 0-1mo: implants, graft, membrane completely removed
1 patient (1 site) with membrane exposure with infection at 1-3mo: implants, graft, membrane completely removed
1 patient (1 site) with membrane exposure without infection at 3-6mo
1 patient reported paraesthesia of the mental nerve with resolution of symptoms during the first mo of surgery
C:
1 patient (1 site) abscess at 0-1mo: implants, graft, membrane completely removed
1 patient (1 site) with membrane exposure with infection at 0-1mo: implants, graft, membrane completely removed
1 patient (1 site) with membrane exposure with infection at 1-3mo: only Ti mesh removed
1 patient (1 site) with membrane exposure without infection at 3-6mo
3 patients reported temporary paraesthesia of the mental nerve with resolution of symptoms during the first mo of surgery
| No (no information whether paraesthesia occurred in the same patients that experienced membrane exposure) | Single augmented site |
Fontana et al. 2008
University
| RCT (n=5, split-mouth design) | 55 (range 47-66) | Excluded smokers who smoked >10 cig/day
| Excluded patients with FMPS and FMBS>25%; no active periodontal disease | 5 subjects (5 sites): pABG + tenting screws + Ti-ePTFE membrane | 5 subjects (5 sites): pDFDBA + tenting screws+ Ti-ePTFE membrane | Trephined from retromolar area and particulated with bone mill (same surgical site)
| Staged | At re-entry:
T: 5.15±0.34mm (range 4.75-5.50mm)
C: 4.90±0.93mm (range 3.25-5.50mm)
| Periodontal probe to measure distance from top of tenting screw head to first visible bone-screw contact at mesial and distal sites around each screw | T: 4.70±0.48mm (range 4.00-5.25mm)
C: 4.10±0.8mm (range 3.00-5.25mm)
| Periodontal probe to measure distance from top of tenting screw head to first visible bone-screw contact at mesial and distal sites around each screw | T:
1 patient reported paraesthesia with resolution of symptoms within 2mo
C:
1 patient (1 site) abscess without membrane exposure at 2mo
Membrane and infected tissue removed
1 patient reported paraesthesia with resolution of symptoms within 1mo
| Yes (one augmented site complication occurred per patient) | Single augmented site |
Leong et al. 2015
University
| RCT (n=16) | 59.4±7.5 (range 44-71) | Excluded all smokers | Excluded patients with poor oral hygiene, periodontal status unknown | ? subjects (9 sites): Block SDBA + tenting screws + non-cross-linked rCM | ? subjects (10 sites): pSDBA + tenting screws + non-cross-linnked rCM | N.A. | Staged | At time of bone grafting:
T: 4.0mm
C: 4.0mm
At re-entry:
T: 1.78mm (range 0.0-5.0mm)
C: 1.0mm (range -1.0-3.0mm)
| Periodontal probe to measure bone height difference after augmentation with a customised stent | Ridge deficiency of 4-6mm | NR | T:
7 sites with wound dehiscence, resulting in one site with total graft failure
C:
3 sites with wound dehiscence
| No (no mention of how many site-level complications occurred per patient) | NR for augmented sites |
Merli et al. 2020
Private practice
| RCT (n=30) | T: 51.6±14.0 (range 29-77)
C: 57.9±13.6 (range 21-74)
| 3 smokers (≤20 cig/day) (10%)
17 non-smokers (90%)
| NR | 15 subjects (15 sites): pABG + non-cross-linked rCM + osteosynthesis plates (Fence technique) | 15 subjects (15 sites): pABG + pDBBM + non-cross-linked rCM + osteosynthesis plates (Fence technique) | Harvested from intra-oral sites preferably from corpus-ramus of the mandible and particulated with a bone mill | Staged | At re-entry:
T: 2.2±1.4mm
C: 3.7±1.9mm
| Linear vertical distance between the greatest difference, in the superimposed CBCT scans at pre-grafting and re-entry, in the area with gain of bone after grafting | NR | N.A. | T:
2 patients (1 site each) with osteosynthesis plate exposure at 1 and 2mo respectively
Treated with topical CHX gel 3x/day for 4mo
C:
1 patient reported hypoesthesia with resolution of symptoms at 2mo
Treated with α-lipoic acid and Vitamin B complex
| Yes (one augmented site complication occurred per patient) | Single augmented site; NR for donor sites |
Merli et al. 2007
Private practice
| RCT (n=22) | T: 44.6 (range 29-59)
C: 49.9 (range 36-69)
| 4 smokers (18.2%)
18 non-smokers (81.8%)
T: 2 smokers
C: 2 smokers
| NR | 11 subjects (11 sites): pABG + non-cross-linked rCM + osteosynthesis plates (Fence technique) | 11 subjects (11 sites): pABG + Ti-reinforced ePTFE membrane | Captured by filter trap from implant osteotomies and from various intraoral locations | Simultaneous | At re-entry:
T: 2.16±1.51mm
C: 2.48±1.13mm
| Average of maximum and minimum defect height, using the top of the implant-abutment junction as a reference point. Measurements photographed with periodontal probe in situ to identify reference points | T: 2.93±0.86mm
C: 2.73±0.79mm
| Average of maximum and minimum defect height, using the top of the implant-abutment junction as a reference point. Measurements photographed with periodontal probe in situ to identify reference points | T:
2 patients (1 site each) with abscess
Bone graft and barrier membrane completely removed, treated with systemic antibiotics
1 patient (1 site) with membrane exposure without infection
Treated with topical application of CHX gel
1 patient (1 site) with abscess at 1w due to not taking the prescribed antibiotics
Treated with antibiotics successfully
C:
1 patient (1 site) with membrane exposure with infection
Bone graft and barrier membrane completely removed, treated with systemic antibiotics
1 patient (1 site) with fistula at 2w, resolved with systemic antibiotics
1 patient (1 site) with fistula at 5mo, resolved with oral hygiene measures
1 patient (1 site) with fistula at 2mo, treated with removal of barrier membrane and systemic antibiotics
1 patient (1 site) with lymph node swelling at 1mo, treated with systemic antibiotics
| Yes (one augmented site complication occurred per patient) | Single augmented site; NR for donor sites |
Rokn et al. 2018
University
| RCT (n=11, split-mouth design) | 50.3 | NR | Excluded patients with untreated periodontal disease | 11 subjects (11 sites): Ultrashort (4mm) implants | 11 subjects (11 sites): pABG + pDFDBA + tenting screws + non-cross-linked rCM | Rotary bone harvester from external oblique ridge within the same surgical site | Staged | At re-entry:
2.2±1.1mm
| Periodontal probe to measure distance from tenting screw head to cementoenamel junction of adjacent tooth (reference point) | NR
Baseline height was 8.1 mm (SD0.9)
| N.A. | C:
5 patients (1 site each) with membrane exposure
Treated with topical CHX
Out of these 5 patients, 3 reported paraesthesia with resolution of symptoms at 2w
| Yes (three augmented sites experienced two different complications; two augmented sites experienced one complication) | Single augmented site |
Ronda et al. 2014
Private practice
| RCT (n=23) | 49.6±11.6 (range 30-78) | 8 smokers (<10 cig/day) (34.8%)
15 non-smokers (65.2%)
| Excluded patients with untreated or uncontrolled periodontal disease | 12 subjects (13 sites): pABG + pSDBA + Ti-reinforced dPTFE membrane | 11 subjects (13 sites): pABG + pSDBA + Ti-reinforced ePTFE membrane | Bone scraper within the same surgical site | Simultaneous | At re-entry:
T: 5.49±1.58mm
C: 4.91±1.78mm
| Periodontal probe to measure distance from implant shoulder to first visible bone-implant contact on mesial and distal sites around each implant | T: 4.70±1.69mm
C: 4.10±1.86mm
| Periodontal probe to measure distance from implant shoulder to first visible bone-implant contact on mesial and distal sites around each implant | 3 patients reported paraesthesia with resolution of symptoms 1-4w after surgery
No membrane exposures and/or infections
| Yes (one augmented site complication occurred per patient) | Multiple augmented sites |
C, control; CBCT, cone beam computed tomography; CHX, chlorhexidine; cig, cigarettes; CT, computerised tomography; dPTFE, dense polytetrafluoroethylene; ePTFE, expanded polytetrafluoroethylene; FMPS, full mouth plaque score; FMBS, full mouth bleeding score; GBR, guided bone regeneration; mo, months; N.A., not applicable; NR, not reported; no., number; pABG, particulate autogenous bone graft; pDBBM, particulate deproteinised bovine bone mineral; pDFDBA, particulate demineralised freeze-dried bone allograft; pFDBA, particulate mineralised freeze-dried bone allograft; pSDBA, particulate solvent dehydrated bone allograft; PTFE, polytetrafluoroethylene; rCM, resorbable collagen membrane; RCT, randomised controlled trial; SDBA, solvent dehydrated bone allograft; T, test; Ti, titanium; y, years
