Preoperative buccal bone volume predicts long-term graft retention following augmentation in the esthetic zone: A retrospective case series

Clin Oral Implants Res. 2022 May;33(5):492-500. doi: 10.1111/clr.13909. Epub 2022 Mar 2.

Abstract

Objectives: Buccal bone augmentation in the esthetic zone is routinely used to achieve optimal clinical outcomes. Nonetheless, long-term data are sparse, and it is unknown how baseline buccal bone volume affects the retention of the augmented volume over time.

Material and methods: This is a long-term follow-up retrospective case series. After a preoperative computed tomography scan, implants were placed in the anterior maxilla following guided bone regeneration, autogenous block grafting, or both. At the follow-up, patients received a computed tomography scan and a clinical examination. Buccal bone volume was the primary outcome. Buccal bone thickness, peri-implant, and esthetic parameters were secondary outcomes.

Results: After a median follow-up of 6.7 years (interquartile range: 4.9-9.4), 28 implants in 19 patients (median age at augmentation: 43.3 years, interquartile range: 34.4-56.7, 53% female) were followed up. Preoperative buccal bone volume at baseline (V0 ) showed a moderate correlation to final buccal bone volume (Vt , rs = .43) but a strong correlation to the absolute volumetric change (ΔV = Vt -V0 , rs = -.80). A linear mixed model for Vt had a large intercept of 91.39 (p < .001) and a rather small slope of .11 for V0 (p = .11). Observed differences between treatments were not statistically significant in the mixed model. V0 above 105 mm3 predicted a negative volume change (ΔV < 0) with a specificity of 100% and a sensitivity of 96%.

Conclusions: The results suggest higher gains in sites with lower V0 and point to a cutoff V0 above which the augmented volume is not retained long-term.

Keywords: autogenous block; bone augmentation; buccal bone; guided bone regeneration; long-term clinical study.

MeSH terms

  • Alveolar Ridge Augmentation* / methods
  • Bone Transplantation
  • Dental Implantation, Endosseous / methods
  • Esthetics, Dental
  • Female
  • Humans
  • Male
  • Maxilla / diagnostic imaging
  • Maxilla / surgery
  • Retrospective Studies
  • Treatment Outcome