Bone Regeneration Techniques for Dental Implant Placement Comparing the Effect of Graft Material on Bone Volume and Long-Term Graft Stability: A Systematic Review.

Abstract

The natural physiological bone resorption following tooth loss often results in reduced bone volume to place dental implants in a restoratively driven position. Bone regeneration procedures such as guided bone regeneration (GBR), sinus augmentation (SA), and alveolar ridge preservation (ARP) have therefore been developed to promote new bone formation. These procedures utilize bone grafting materials of which there are four types, namely, autogenous, allograft, xenograft, and alloplastic grafts. However, there is still no consensus on which material is superior. This systematic review aimed to analyze the current literature to compare alloplastic bone graft materials with autogenous bone, allograft, and xenograft materials when used in GBR, SA, and ARP to determine which is superior. Electronic searches were performed on MEDLINE, Embase, and CENTRAL, along with manual searches to identify relevant randomized control trials and controlled clinical trials. Fifty-three studies were included. Although variations in the methods used between the studies prevented direct comparisons of the outcomes, overall, alloplastic materials were found to have osteoconductive properties, showing promising results with augmentation and preservation of alveolar ridge volume. Clinical parameters were also largely comparable with other graft materials. Alloplastic materials show promising results, with biphasic calcium phosphate being the most studied at present. There are many potential advantages to alloplastic grafts compared with the other materials; however, due to the lack of high-quality evidence in this review, definitive conclusions on which material is superior was not possible, and further research is required.