Introduction
Materials and methods
Review development and PICO question
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Population: systemically healthy edentulous and partially edentulous patients.
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Intervention: vertical ridge augmentation with BRT and simultaneous implant placement.
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Comparison: other vertical alveolar ridge augmentation procedures at dental implant sites.
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Outcome: clinical performance of BRT in terms of bone block and dental implant survival rates, bone gain, bone resorption, marginal bone loss, and complications.
“In situations in which vertical ridge augmentation is required to restore partially or fully edentulous patients (population), what is the clinical performance (outcome) of bone ring technique (intervention) compared with other vertical augmentation procedures (comparison)?”
Eligibility criteria
Search strategy
Data collection
Risk of bias in individual studies
Results
Study selection (Fig. 1)
Author-year | Type of study | N | N, IOI | Intervention | Follow-up |
---|---|---|---|---|---|
Chandra et al. 2019 [10] | Non randomized comparative clinical study | 34 | 34 | Autogenous bone ring (chin) (BR group) vs sticky bone + collagen membrane (SB group) IOI at 6 months | 6 months |
Flanagan et al. 2016 [17] | Case series | 8 | 8 | Allogenic bone ring + IOI + allograft + collagen membrane | 1 year |
Fukuda et al. 2005 [18] | Case series | 9 | 13 | Autogenous bone ring (chin) + IOI | 3.1 years |
Giesenhagen et al. 2018 [19] | Case report | 1 | 1 | Allogenic bone ring + IOI + collagen membrane | 6 months |
Giesenhagen et al. 2019 [20] | Case series | 3 | 7 | Allogenic bone ring + IOI + collagen membrane | 36 months |
Giraddi et al. 2017 [21] | Prospective study | 14 | 15 | Autogenous bone ring (chin) + IOI + PRF membrane | 9 months |
Miller J. 2019 [22] | Case report | 1 | 1 | Allogenic bone ring + xenograft + IOI + collagen membrane | 6 months |
Nord et al. 2019 [23] | Retrospective study | 51 | 81 | Allogenic bone ring + autogenous bone chips + IOI + collagen membrane | 12 months |
Omara et al. 2016 [24] | Prospective study | 10 | 12 | Autogenous bone ring (chin) + IOI | 6 months |
Peñarrocha et al. 2005 [25] | Case report | 1 | 3 | Autogenous bone ring (ramus) + IOI | 2 years |
Rizzo et al. 2017 [26] | Case series | 4 | 4 | Crestal sinus floor elevation with autogenous bone ring (chin) and simultaneous IOI | 3 years |
Sindel et al. 2018 [27] | Retrospective study | 10 | 10 | Sinus floor elevation with autogenous bone ring (chin) and simultaneous IOI | 24.3 months |
Stevenes et al. 2010 [28] | Case report | 1 | 4 | Autogenous bone ring (chin) + IOI | 6 months |
Tekin et al. 2011 [29] | Case report | 1 | 1 | Autogenous bone ring (chin) + IOI | 1 year |
Wychowansky et al. 2020 [11] | Non randomized comparative clinical study | 30 | 60 | Autogenous bone ring (chin) + simultaneous IOI (BR group) vs xenograft tunnel (XG group) and delayed IOI after 6m | 24 months |
Yuce et al. 2019 [12] | Prospective study | 8 | 12 | Autogenous bone ring (chin) + IOI | 18 months |
Author, year | Bone density | Bone gain | Bone resorption | MBL | Survival rate | Other findings | Complications |
---|---|---|---|---|---|---|---|
Chandra et al. 2019 [10] | a) BR group: 596.2 ± 115.2 HU b) SB group: 659.6 ± 133.8 HU *(p < 0.001) | a) BR group: 3.09 mm (buccal) and 3.31 mm (lingual) b) SB group: 1.90 mm (buccal) and 1.99 mm (lingual) *(p < 0.001) | – | – | a) BR group: 88,23% b) SB group: 100% | Implant Stability Quotient (ISQ) a) BR group: 61.60 ± 8.9 b) SB group: 45.02± 6.33 *(p < 0.034) Histological analysis a) BR group: 50.39% ± 11.96% b) SB group: 38.91% ± 12.22% *(p < 0.001) | a) BR group: -2 IOI and BR failure -1 dehiscence -3 swelling b) SB group: -1 dehiscence -3 swelling |
Flanagan et al. 2016 [17] | – | – | – | – | 100% | – | No complications |
Fukuda et al. 2005 [18] | – | – | – | – | 92.3% | Radiological stability between baseline and 1.3 years (periapical Rx) | 1 IOI and BR failure |
Giesenhagen et al. 2018 [19] | – | – | – | – | 100% | Radiological stability between baseline and 6 m (panoramic Rx) | No complications |
Giesenhagen et al. 2019 [20] | – | – | – | – | 100% | Clinical and radiological stability between baseline and 2 year (panoramic Rx) | – |
Giraddi et al. 2017 [21] | – | -Mesial bone gain: 3.70 ± 1.10 mm -Distal bone gain: 3.69 ± 1.10 mm | -Mesial bone resorption: 0.73 ± 0.38 mm -Distal bone resorption: 0.78 ± 0.23 mm | – | 93.33% | – | 1 IOI and BR failure |
Miller J. 2019 [22] | – | – | – | – | 100% | Radiological stability between baseline and 6 m (periapical Rx) ISQ 68 at 6 m | No complications |
Nord et al. 2019 [23] | – | – | – | 0.43 mm | 97.5% | – | 2 IOI failure |
Omara et al. 2016 [24] | -Mesial aspect: 420.43 HU -Distal aspect: 325.28 HU | 13.07 ± 1.37 mm | 0.26 ±0.86 mm | – | 100% | – | 2 transient numbness of lower lip |
Peñarrocha et al. 2005 [25] | – | – | – | – | 100% | Radiological stability between baseline and 2 years (panoramic Rx) | No complications |
Rizzo et al. 2017 [26] | – | – | – | z | 100% | Radiological stability between baseline and 6 years (periapical Rx) | No complications |
Sindel et al. 2018 [27] | - | – | – | 1.77 mm | 90% | – | 1 IOI and BR failure |
Stevenes et al. 2010 [28] | – | – | – | – | 100% | – | No complications |
Tekin et al. 2011 [29] | – | – | – | – | 100% | Radiological stability between baseline and 6 years (periapical Rx) | No complications |
Wychowansky et al. 2020 [11] | – | a) BR group: 4.3 ± 1.3 mm b) XG group: 4.4 ± 1.5 mm | – | – | a) BR group: 86,66% b) XG group: 96,66% | Implant stability at baseline (periotest) a) BR group: − 3.2 ± 1.3 b) XG group: − 1.2 ± 1.6 *(p<0,005) Implant stability at 24 m (periotest) a) BR group: − 3.7 ± 1.1 b) XG group: − 3.6 ± 1.2 *(p < 0.005) | a) BR group: -4 IOI failure b) XG group: -1 IOI failure |
Yuce et al. 2019 [12] | – | – | – | – | 100% | – | 1 BR failure (defect repaired and IOI osseointegrated) |
Study characteristics (Table 1)
Results of individual studies (Table 2)
Bone gain
Bone resorption
Marginal Bone Loss (MBL)
Bone ring survival rate
Implant survival rate
Complications
Risk of bias (Tables 3 and 4)
Wychowansky et al. 2020 [11] | Yuce et al. 2019 [12] | Nord et al. 2019 [23] | Giesenhagen et al. 2019 [20] | Chandra et al. 2019 [10] | Sindel et al. 2018 [27] | Giraddi et al. 2017 [21] | Rizzo et al. 2017 [26] | Flanagan et al. 2016 [17] | Omara et al. 2016 [24] | Fukuda et al. 2005 [18] | |
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Selection | |||||||||||
• Representativeness of the exposed cohort | * | * | * | * | * | * | * | * | * | * | * |
• Selection of the non-exposed cohort | * | * | * | * | * | * | * | * | * | * | * |
• Ascertainment of exposure | * | * | * | * | * | * | * | * | * | * | * |
• Demonstration that outcome of interest was not present at start of study | * | * | * | * | * | * | * | * | * | * | * |
Comparability | |||||||||||
• Study controls for bone ring group | * | * | |||||||||
• Study control for any additional factor (duration of exposure) | * | * | |||||||||
Outcome | |||||||||||
• Assessment of outcome | * | * | * | * | * | * | * | * | * | * | * |
• Was follow-up long enough for outcomes to occur? | * | * | * | * | * | * | * | * | |||
• Adequacy of follow up of cohorts | * | * | * | * | * | * | * | * | |||
Newcastle-Ottawa scale | 9 | 7 | 7 | 7 | 9 | 7 | 5 | 7 | 7 | 5 | 7 |
Study | Miller J. 2019 [22] | Giesenhagen et al. 2018 [19] | Tekin et al. 2011 [29] | Stevenes et al. 2010 [28] | Peñarrocha et al. 2005 [25] |
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Were patient´s demographic characteristics clearly described? | + | + | + | + | + |
Was the patient’s history clearly described and presented as a timeline? | + | − | − | − | + |
Was the current clinical condition of the patient on presentation clearly described? | + | + | + | + | + |
Were diagnostic tests or assessment methods and the results clearly described? | − | + | ? | + | + |
Was the intervention or treatment procedure clearly described? | + | + | + | + | + |
Was the post-intervention clinical condition clearly described? | + | + | + | + | + |
Were adverse events (harms) or unanticipated events identified and described? | + | + | + | + | + |
Does the case report provide takeaway lessons? | − | + | + | + | + |