Ridge Augmentation Solutions

“…a solid block graft is less prone to micromotion than particulate graft, thus providing more predictability…. the use of particulate with the addition of metal mesh or a nonresorbable titanium reinforced membrane make the procedure unnecessarily complex.¹

“The compromised alveolar ridge in the anterior maxilla does not provide a natural cavity to contain the particulated grafting material as seen in the sinuses. Therefore the graft must possess strength and rigidity to allow its fixation in the recipient site, and the three dimensional stability to withstand muscular forces.”²

In a systematic review, it was concluded that the use of allogenic bone block grafts represent a reliable alternative to autogenous block grafts for augmenting the atrophic maxilla.³

Studies have shown that horizontal and vertical augmentation of an atrophied ridge is possible with thin blocks in combination with particulate bone grafts.¹ 

A case was described using allograft bone for the Khoury technique in order to avoid some of the potential problems with autogenous recovery.²

 "...a solid block graft is less prone to micromotion than particulate graft, thus providing more predictability…. the use of particulate with the addition of metal mesh or a nonresorbable titanium reinforced membrane make the procedure unnecessarily complex"¹

“The compromised alveolar ridge in the anterior maxilla does not provide a natural cavity to contain the particulated grafting material as seen in the sinuses. Therefore the graft must possess strength and rigidity to allow its fixation in the recipient site, and the three dimensional stability to withstand muscular forces.”²  

In a systematic review, it was concluded that the use of allogenic bone block grafts represent a reliable alternative to autogenous block grafts for augmenting the atrophic maxilla.³

 “A solid block graft is less prone to micromotion than particulate graft, thus providing more predictability. In some cases, depending on the ridge area needing augmentation, the use of particulate with the addition of metal mesh or a nonresorbable titanium reinforced membrane makes the procedure unnecessarily complex.”¹

“The compromised alveolar ridge in the anterior maxilla does not provide a natural cavity to contain the particulated grafting material as seen in the sinuses. Therefore the graft must possess strength and rigidity to allow its fixation in the recipient site, and the three dimensional stability to withstand muscular forces.”²

“Although autogenous bone block grafting yields satisfactory results, this technique is associated with disadvantages such as prolonged operation times, limited graft acquisition, and risk for damage to adjacent teeth, neurosensory deficits, donor area flap exposure, bleeding and infection.”³

The combination of mineralized and demineralized bone has been shown to maintain space and have some osteoinductive potential¹  

In a review article of block grafting, the authors recommend that the filler for block grafting be a slow resorbing FDBA with the addition of growth factors to accelerate the healing process.²
 

An optimal graft choice for ridge augmentation procedures which, when used a  gap filler, is effective at holding space¹ 

A clinical demonstrated that tenting of the periosteum and soft tissue matrix with titanium screws maintains space and minimizes resorption of mineralized particulate allograft. This technique offers predictable, functional and esthetic reconstruction of large vertical defects without the use of autogenous bone and is capable of osseointegration.¹

Another clinical study describes a technique for maxillary bone grafting that may be used to reconstruct a portion of the maxilla lost due to trauma or tumor surgery, or to augment as osseous deficient edentulous maxillary alveolar ridge.²