The aim of the current systematic review was to critically appraise evidence from randomized and prospective non-randomized comparative clinical trials about the efficacy of lateral bone augmentation prior to implant placement and their outcome regarding bone-width gain.
MATERIAL AND METHODS
Eight databases were searched until May 2018 for randomized and prospective non-randomized comparative trials on lateral bone augmentation prior to implant placement. After elimination of duplicate studies, data extraction and risk-of-bias assessment according to the Cochrane guidelines, random-effects meta-analyses of Mean Differences (MD) or Relative Risks (RR) and their 95% CIs were performed, followed by subgroup, meta-regression, and sensitivity analyses.
A total of 25 trials (16 randomized / 9 non-randomized) were identified, which included a total of 553 patients (42.2% male; mean age of 43.9 years). In these included studies and populations, various modalities for primary lateral bone augmentation rendered implant placement feasible. Bone width gain was significantly inversely associated with baseline bone width (pooled effect: -0.35 mm/mm; 95% CI: -0.63 to -0.07 mm; p=0.01). % graft resorption demonstrated a correlation with patient age (36% /year, 95% CI: -0.62 to -0.11 mm; p=0.01). The presence of xenograft added to autogenous graft led to less resorption compared to autograft alone (MD: 1.06 mm; 95% CI: 0.21 to 1.92 mm; p=0.01). Barrier membrane did not yield significant difference in terms of bone width gain (MD: -0.33 mm; 95% CI: -2.24 to 1.58 mm; p>0.05) and graft resorption (MD: 0.84 mm; 95% CI: -1.42 to 3.09 mm; p>0.05).
Initially smaller bone dimension favors larger bone width gain, which indicates that a severe lateral bone deficiency can be effectively augmented applying primary lateral bone augmentation. Patients' age and recipient site (maxilla or mandible) seems to influence graft resorption. The addition of a xenograft can be helpful for reducing graft resorption. This article is protected by copyright. All rights reserved.