Dental News - Biological and physical properties of bone block grafting biomaterials for alveolar ridge augmentation

Biological and physical properties of bone block grafting biomaterials for alveolar ridge augmentation

Image of pore morphology of cancellous bovine bone (50× magnification) by Dr. Michael Bufler. (Image courtesy of Geistlich Pharma, 2014)

Drs. Alberto Monje & Hom-Lay Wang

Tue. 4. April 2017

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Objective: Bone resorption of maxillary ridges is an unavoidable process that occurs after tooth extraction. Many treatment alternatives have been proposed to facilitate implant placement in these scenarios. Drawbacks such as morbidity, cost and excessive resorption owing to the procedure have prompted clinicians to seek biomaterials as an alternative to autogenous bone. The objective of this article was to review the current state of the art by means of the biological and physical properties of biomaterials used for block grafting in atrophic maxillary ridges. Secondly, it was aimed herein at presenting the clinical and histological findings when using these biomaterials.

Materials and methods
An electronic and manual literature search was conducted by two independent reviewers using several databases, including MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials and Cochrane Oral Health Group Trials Register databases, for articles written in English up to June 2016. Owing to the heterogeneity of the findings, quantitative assessment could not be conducted. As such, a narrative review was carried out on the biological and physical aspects of biomaterials used for block grafting.

Results
Both allogeneic and xenogeneic block grafts have been developed to overcome deficiencies of autogenous grafts. Allogeneic block grafts have been widely investigated, but there is a lack of long-term follow-up. On the contrary, xenogeneic block grafts have only limited scientific evidence of their suitability for ridge reconstruction.

Conclusion
Allogeneic and xenogeneic bone block grafts represent a promising alternative to autogenous bone for ridge augmentation. Nonetheless, the evidence supporting xenogeneic block graft usage remains minimal; hence, more long-term human studies are needed to validate their effectiveness. In addition, using prefabricated scaffolds impregnated with growth factors provides an interesting field to be further explored.

Editorial note: The full article was published in the 1/2017 issue of the Journal of Oral Science and Rehabilitation. It can be accessed free of charge at www.dtscience.com.