Date on Master's Thesis/Doctoral Dissertation

8-2005

Document Type

Master's Thesis

Degree Name

M.S.

Department

Oral Biology

Committee Chair

Greenwell, Henry

Subject

Dental implants; Dentistry--Research

Abstract

Aims. The primary aim of this randomized, controlled, blinded clinical trial was to compare the clinical and histologic results of ridge augmentation comparing a cancellous block allograft to a particulate mineralized freeze dried bone allograft using acellular dermal matrix as a barrier membrane. Methods. Twenty-four patients that met the following inclusion criteria were sequentially entered into the study: 1) at least age 18; 2) had at least a one tooth ridge defect treatment planned to receive a dental implant; 3) the defect was bordered by at least one tooth; and 3) an IRB approved informed consent was signed. Twelve test patients received a freeze dried bone particulate graft packed around supporting screws while 12 positive control patients received a cancellous block allograft immobilized with 1 or 2 screws. Following elevation of a superficial split-thickness flap, horizontal ridge dimensions were measured with a digital caliper at the crest and 5 mm apical to the crest. Vertical ridge dimensions were measured from a tooth-supported stent. At 4 month re-entry a 2.7 X 6 mm trephine core was obtained prior to implant placement. Results. The crestal ridge width of the particulate group increased from 4.4 ± 1.0 mm to 7.7 ± 1.5 mm for a mean gain of 3.3 ± 1.1 mm (p < 0.05) while the cancellous block cases increased from 3.3 ± 0.9 mm to 7.1 ± 1.0 mm for a mean gain of 3.8 ± 1.3 mm (p < 0.05). There was no significant difference between the two groups (p > 0.05). The width of the particulate group 5 mm apical to the crest increased from 6.9 ± 1.1 mm to 9.7 ± 1.7 mm for a mean gain of 2.9 ± 1.0 mm (p < 0.05) while the cancellous cases increased from 5.6 ± 1.1 mm to 9.0 ± 1.2 mm for a gain of 3.4 ± 1.0 mm (p < 0.05). There was no significant difference between the two groups (p > 0.05). The vertical component of the ridge defects was minimal, therefore, there was negligible gain of ridge height. Implants were placed as treatment planned in 12/12 or 100% of the cancellous block cases. Implants were placed as treatment planned or with a larger diameter in 12/12 or 100% of the particulate cases. Histologic analysis of the implant sites revealed 51 ± 18% vital bone for the cancellous block group and 58 ± 12% for the particulate group. Non-vital bone was 11 ± 9% for the cancellous block group and 9 ± 7% for the particulate group. Conclusions. There were no clinically or statistically significant ridge dimension differences between the particulate or cancellous block allograft groups. Histologic results also revealed minimal differences between groups.

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