Research on bone grafting

Wheaton cosmetic dentist Bryan Bauer

Bone grafting research

Major review article – Darby
Cochrane review found basically the same

  1. No technique is superior in socket preservation post ext (ie type graft, type membrane)
  2. AB use inconclusive
  3. Mebrane helps in amount bone formed
  4. Primary closure when using membrane is required for optimal results
  5. Primary closure not always needed

Ridge expansion better than DO, GBR, inlay and onlay grafts and revasculariztion flap

3D preservation with allograft and membrane better than ungrafted – Iasella
FDBA better DFDBA – Becker  Why perio likes DFDBA so much for this is silly.  More effort to produce since need to demin, less proteins because of that, and increase in cost.

Implants in bone graft

No difference in survival of dental implants in grafted or native bone.  Smoking and lack professional care did impact survival rate.  Tran 2016 IJOMI

Bone to dental implant gap – When to graft the gap?

Implant placed into fresh extraction site with a bone to implant gap of 2mm or less without the use of barrier membrane has no impact on outcome.

So less than or equal to 2mm no membrane needed.

Ref. Botticelli

2mm is fine to leave according to many but I prefer to bone graft no matter what if can. Sanz 2017 COIR found less horizontal bone loss on grafted sites.