Author/year | Study design | No. of subjects | Mean age ± S.D. (range) | Smoking status (%) | Periodontal status (%) | Test | Control | No. of implants placed | Staged/simultaneous GBR | Implant survival rate (%) | Implant success rate (%) | Follow-up period | Horizontal bone gained after surgery | Graft resorption | Baseline horizontal ridge crest thickness | Complications |
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
Sakkas et al. 2016 [16] | Retrospective CS | 112 | 34.3 (20–61.5) | 74 smokers (66%) 38 non-smokers (34%) | 7 generalised advanced periodontal disease, treated (6.3%) 105 periodontally healthy (93.7%) | Zygomatic ABG + rCM | NA | 134 | Staged | 100% | 100% | NR | NR | NR | NR | 24 reports of incision line dehiscence, swelling, or wound infection (20 recipient sites, 4 donor sites) 2 pts: postop sinusitis with persistent fistula due to maxillary sinus perforation (donor site) 2 pts: (1.7%) temporary infraorbital nerve paraesthesia (donor site) 2 pts: (1.7%) total graft exposure with wound infection and suppuration Minor complications treated with CHX rinse and antibiotics (either orally or IV) Sinusitis treated surgically and with antibiotics Graft removed in 2 cases with total graft exposure Pts with paraesthesia were given follow-up until resolution at 6w |
Wessing et al. 2016 [17] | Retrospective CS | 36 | 57.7 ± 12.0 (32–76) | 5 smokers (14%) 31 non-smokers (86%) | 21 treated periodontal disease (58%) 15 periodontally healthy (42%) | pDBBM only or DBBM + pABG in 1:1 mixture vol + non-cross-linked CM | NA | 103 | 7 (19%) staged, 29 (81%) simultaneous | 100% | 100% | 18.3mo (6.3–28.6) | NR | NR | < 6 mm ridges were staged augmentations | 6 dehiscences: 3 in simultaneous GBR cases, 3 in staged GBR cases 4 sites with spontaneous closure and no full membrane exposure or graft exposure 2 sites failed; required graft and membrane removals |
Altiparmak et al. 2017 [18] | Retrospective cohort | 48 | 44.8 | NR | All periodontally healthy | Ramus block ABG + pDBBM + rCM | Ridge split + DBBM + rCM | 42 (T) 43 (C) | Staged (T) Simultaneous (C) | 92% (T) 100% (C) | NR | 38.33 mo (T) 31.6 mo (C) | NR | NR | 3–4 mm | T: 6 temporary graft exposures (14.3%); 3 mild infections (7.1%); 3 temporary paraesthesias (7.1%); 2 permanent graft exposures (4.8%) C: 1 temporary graft exposure (2.3%); 2 mild infections (4.7%); 3 bad split (7.1%) |
Chappuis et al. 2017 [19] | Prospective CS | 38 | 45 ± 13 | 5 light smokers (≤ 10 cig/day) (13%) 1 heavy smoker (3%) 32 non-smokers (84%) | NR | Symphysis/Ramus block ABG + pDBBM + rCM | NA | 52 | Staged | 98.1% | 98.1% | 10y | 3.16 ± 0.76 mm pre-op to 8.1 ± 1.02 mm post-op | − 0.34 mm (6.9%) (6mo); − 0.38 mm (7.7%) (10y) | ≤ 5 mm | 7 pts: temporary neurosensory disturbance at chin harvesting sites (3 at lower lip, 3 experienced negative pulp sensitivity of lower incisors, 1 had both), complete resolution between 2 and 6mo |
Gurler et al. 2017 [20] | Retrospective cohort | 50 | 31 (23–53) | NR | NR | Ramus block ABG + rCM | Ridge split + pDBBM + rCM | 44 (T) 33 (C) | Staged (T, C) | 93.1% | 93.9% | 3.3 (T) 3.1 (C) | 1.8–2.7 mm (mean 2.5 mm) pre-op to 4.2–7.75 mm (mean 6.3 mm) post-op (T) 3.2–3.7 mm (mean 3.2 mm) pre-op to 4.0–7.08 mm (mean 5.85 mm) post-op (C) (4–6mo) | − 1.5–2.0 mm (mean -1.62 mm) (T) − 0.3–0.6 mm (mean − 0.5 mm) (C) (1y) | < 3 mm | T: 4 wound dehiscences (17.4%) C: 2 bad split (11.8%), 1 wound dehiscence (5.9%) Wound dehiscence managed with antimicrobial rinse and systemic antibiotics Bad split managed with titanium mini screw and operation resumed. No severe infection, neurosensory disturbance, bleeding |
RCT | 27 | 51.85 ± 29.7 | 6 light smokers (≤ 10 cig/day) (22.2%) 21 non-smokers (77.8%) | 3 treated periodontal disease (11.1%) 24 periodontally healthy (88.9%) | pDBBBM + rCM | pDBBM + non-resorbable membrane | 16(T) 11(C) | Simultaneous | 100% | NR | 6mo | 3.46 ± 0.52 (T) 2.82 ± 0.50 C) | − 2.23 ± 1.21 mm (T) − 0.14 ± 0.79 mm (C) (6mo) | NR | T: 4 wound dehiscences resolved within 4w C: 1 dehiscence resolved within 3mo, 1 dehiscence persisted till 6mo at re-entry Treated with local disinfecting agents once a week for 4w and later once a mo | |
Wessing et al. 2017 [23] | RCT | 49 | 38.6 ± 15.3 (T) 48.9 ± 17.0 (C) | 11 light smokers (≤ 10 cig/day) (22.4%) 38 non-smokers (77.6%) | 6 treated periodontal disease (12.2%) 43 periodontally healthy (87.8%) | pABG + pDBMM + rCM | pABG + pDBMM + non-cross-linked rCM | 24 (T) 25 (C) | Simultaneous | 100% | NR | 6mo | NR | NR | NR | 33 pts: swelling (67.3%) 19 pts: redness (38.8%) 11 pts: wound dehiscence (22.4%) 6 pts membrane exposure (12.2%) No reported infection |
Arunjaroensuk et al. 2018 [24] | RCT | 48 | 51.22 ± 16.19 | NR | NR | pABG covered with biphasic calcium phosphate bone + resorbable PLA membrane | pABG covered with biphasic calcium phosphate bone + rCM | 30 (T) 30 (C) | Simultaneous | 100%(T) 100%(C) | NR | 6 mo | 3.22 ± 1.00 mm (T) 3.42 ± 0.85 mm (C) | − 34.3 ± 23.85% (T) − 34.8 ± 23.68%(C) (6mo) | NR | Minor gingival inflammation and membrane exposure noted, all sites recovered uneventfully |
Meloni et al. 2018 [25] | Prospective CS | 45 | 52.1 (24–78) | 13 moderate smokers (28.8%) | FMPI < 25% and FMBoP < 25% | pABG + pDBBM + rCM + Ti pins | NR | 63 | Simultaneous | 100% | NR | 3y | NR | NR | 4–6 mm | 6 pts: CM exposure after 1–2w Treated with 0.5% CHX gel twice a day for 3w, complete soft tissue healing |
Benic et al. 2019 [26] | RCT | 24 | 62.0 (43.5–78.6) (T) 58.1 (28.7–78.8) (C) | None with heavy smoking (> 20cig/day) | No active periodontal disease | DBBM block + rCM + fixation pins | pDBBM + native bilayer CM + fixation pins | 12 (T) 12 (C) | Simultaneous | 100% | NR | 6mo | 3.38 ± 0.59 mm (T) 2.73 ± 0.69 mm (C) | − 0.68 ± 0.82 mm/− 22.5 ± 30.9% (T) − 2.21 ± 0.98 mm/− 81.8 ± 27.4%(C) (6mo) | NR | T: 1 pt mucosal dehiscence, 1 pt swollen mucosa C: 1 pt mucosal dehiscence, 1 pt swollen mucosa |
Prospective CS | 18 | 56.8 (24–78) | 8 light smokers (≤ 10 cig/day) (44.4%) 10 non-smokers (55.6%) | No active periodontal disease FMPI < 25% and FMBoP < 25% | pABG + pDBBM + rCM + Ti pins | NA | 55 | Staged | 100% | NR | 1y, 3y | 5.03 ± 2.15 mm (7mo) | NR | ≤ 4 mm (mean 3.07 ± 0.54 mm) | 3 pts: CM exposure after 2w Treated with 0.5% CHX gel twice a day for 3w, complete soft tissue healing | |
Mendoza-Azpur et al. 2019 [29] | RCT | 42 | 49.62 ± 10.22 (38–67) (T) 55.06 ± 10.78 (36–69) | None smoking more than 10cig/day | No untreated periodontal disease | Ramus block ABG + pDBBM + rCM | pDBBM + rCM | 31 (T) 34 (C) | Staged | 100% | NR | 18–21mo | 5.1 ± 0.87 mm (T) 5.6 ± 1.35 mm (C) (6mo) | NR | < 4 mm | T: 15 pts (68.1%) swelling 15 pts (68.1%) haematoma 7 pts (31.8%) minor sensory disturbance 1 pt (4.5%) infection 4 pts (18.1%) graft exposure C: 10 pts (50%) swelling 4 pts (20%) haematoma 1 pt (5%) minor sensory disturbance 2 pts (10%) graft exposure Sensory disturbances treated with vitamin B, resolved within 6mo Graft exposure occurred 3–4mo postop, treated with 0.5% CHX gel, 0.12% CHX rinse, 1 g augmentin bd 7d |
Solakoglu et al. 2019 [30] | RCT | 20 | 59.6 ± 10.5 (38.8–78.3) | All non-smokers | 11 treated periodontal disease (55%) 9 periodontally healthy (45%) | Particulate allograft (Maxgraft) + PRGF + rCM | Particulate allograft (Puros) + PRGF + rCM | NR | Simultaneous | NR | NR | 5mo (4–7mo) | NR | NR | NR | No postoperative complications, except for 3 pts who experienced slight wound dehiscences and slightly delayed wound healing |
G F Tresguerres et al. 2019 [31] | RCT | 28 | 67.1 (T) 64.5 (C) | Smokers and non-smokers 31 | NR | Corticocancellous freeze dried bone allograft (iliac block) + PRGF membrane | Cancellous freeze dried bone allograft (iliac block) + PRGF membrane | 53 (T) 39 (C) | Staged | 100% | NR | 2y | NR | − 19.27 ± 2.31 mm (T) − 29.17 ± 2.58 mm (C) (4mo) | < 4 mm | 2 partial graft exposures None with significant pain, no infection Dehiscences sealed with PRGF membrane |
Bartols et al. 2018 [32] | RCT | 30 | 43.1 ± 17.2 (T) 51.5 ± 17.3 (C) | NR | NR | pABG + pDBBM + rCM | Ramus shell ABG + pABG | 10 (T) 14 (C) | Staged | 80% (T) 100% (C) | NR | 1y | 2.20 ± 0.86 mm (preop) to 9.00 ± 1.20 mm (postop) (T) 2.67 ± 0.61 mm (preop) to 8.93 ± 1.05 mm (postop) (C) | − 0.68 ± 0.98 mm (T) − 0.94 ± 0.99 mm (C) (1y) | ≤ 3 mm | T: 5 of 15 sites loss of bone graft (1 due to infection, 4 due to complete resorption) 5 sites wound dehiscence 1 site inflammation (pus) at graft 1 donor site hypaesthesia C: 1 of 15 sites loss of bone graft due to infection 0 sites wound dehiscence 1 site inflammation (pus) at graft 0 donor sites hypaesthesia |
Deeb et al. 2016 [33] | Retrospective cohort | 52 | NR | None smoking more than 20cig/day | NR | Particulate allograft + pDBBM (tunnel incision) | Particulate allograft + pDBBM + non-resorbable PTFE membrane (crestal incision) | 18 (T) 22 (C) | Staged | NR | NR | 6mo | NR | NR | NR | T: 4 of 21 sites wound dehiscence/membrane exposure 4 sites graft loss C: 16 of 31 sites wound dehiscence/membrane exposure 12 sites graft loss |
Ersanli et al. 2016 [34] | Prospective cohort | 32 | NR | NR | NR | Ramus block ABG + pDBBM + rCM | Symphyseal block ABG + pDBBM + rCM | 28 (T) 17 (C) | Staged | 94.11% (T) 96.42% (C) | 94.11% (T) 96.42% (C) | 1y | 4.36 ± 1.01 mm (T) 6.29 ± 0.86 mm (C) | − 0.80 ± 0.56 mm (T) − 0.60 ± 0.78 mm (C) (1y) | NR | T: 4 of 14 patients bleeding 4 hematoma 2 flap dehiscence 1 infection 0 numbness (donor site) C: 5 of 18 patients bleeding 5 hematoma 2 flap dehiscence 2 infection 1 numbness (persisting at the end of 1y follow-up) Bleeding treated with firm gauze compress Amoxicillin and clavulanic acid 1 g bd 10d for other complications All flap dehiscences resolved except for 1 case, treated with free gingival graft at 5th week postop |
Jensen et al. 2016 [35] | Retrospective CS | 171 | NR | None smoking more than 10cig/day | No active periodontal disease | pABG + pDBBM + rCM (simultaneous) pABG/block ABG + pDBBM + rCM (staged) | NA | 275 | 171pts simultaneous; 23pts staged | 98.4% (simultaneous); 0% (staged) | NR | NR | NR | NR | NR | Simultaneous GBR: 2 of 240 sites early dehiscence (≤ 21d postop) 2 late dehiscence (> 21d postop) 1 early infection 4 late infection 0 sensory disturbances Staged GBR (pABG): 0 early/late dehiscence, early/late infection, 0 sensory disturbances Staged GBR (block ABG): 2 of 15 sites early dehiscence 5 late dehiscence 2 early infection 1 late infection 1 transient sensory disturbance |
Lee et al. 2015 [36] | RCT | 30 | 53.3 (31–75) | None smoking more than 20cig/day | None with advanced or untreated periodontal disease | pDBBM + non-cross-linked rCM | pDBBM + cross-linked rCM | 30 | Simultaneous | 93.3% (T) 100% (C) | NR | 16w | 2.6 ± 0.8 mm (T) 2.3 ± 0.8 mm (C) 1 mm below implant platform | NR | NR | T: 2 of 30 sites wound dehiscence/membrane exposure C: 1 of 30 sites local infection 3 of 30 sites wound dehiscence/membrane exposure |
Merli et al. 2018 [37] | RCT | 50 | 56.0 ± 13.0 (T) 53.4 ± 12.4 (C) | None smoking more than 20cig/day | NR | pDBBM + rCM | Particulate alloplast + rCM | 61 | Simultaneous | 100% | NR | 3y | NR | NR | NR | T: 1 of 32 sites mucosal dehiscence 90 days postop 1 purulent exudate 60d postop 1 tingling sensation and hyposensitivity 7d postop C: 1 of 29 sites mucosal dehiscence 30d postop 2 purulent exudate 14d postop |
Moslemi et al. 2016 [38] | Prospective CS | 17 | 31–65 | All non-smokers | NR | Particulate allograft + rCM | NA | 17 | Simultaneous | 100% | 100% | 6mo | NR | NR | NR | 0 wound dehiscence 0 infection 0 swelling spreading beyond surgical zone 9 of 17 sites extraoral swelling |