The effect of bone particle size on the histomorphometric and clinical outcomes following lateral ridge augmentation procedures: A randomized double-blinded controlled trial.

ABSTRACT

BACKGROUND: The aim of this randomized clinical trial was to clinically and histologically compare the amount and quality of bone gained after lateral ridge augmentation (LRA) procedures performed using small-particle (SP)-size (250-1000 µm) versus large-particle (LP)-size (1000-2000 µm) size corticocancellous bone allografts at 6 months following surgical intervention. METHODS: Twenty-two patients, each presenting with ridge width <5 mm were enrolled. Patients were randomly allocated to SP- and LP-size graft. The gain in ridge width at the level of the crest and 4 mm apical to the crest was assessed via a standardized procedure before grafting and at time of implant placement, using a surgical caliper and a novel digital technique using cone-beam computed tomography (CBCT). Six months following the procedure, trephine bone cores were taken from 19 augmented sites of 17 patients (14/19 sites were in the posterior mandible) who completed the study for clinical, histologic, and histomorphometric analysis. RESULTS: Seventeen patients (19 sites) completed the study. An LP-size graft resulted in greater ridge width gain at the level of the crest (LP 5.1 ± 1.7; SP 3.7 ± 1.3 mm; p = 0.0642) and 4 mm apical to the crest (LP 5.9 ± 2.2; SP 5.1 ± 1.8 mm; p = 0.4480) compared with the SP. No statistical significance for the bone density at the time of implant placement (p = 1.00) was found. Vital bone formation was more extensive in the SP compared with the LP (41.0 ± 10.1% vs. 31.4 ± 14.8%, respectively; p = 0.05). CONCLUSION: The results of the present study show a trend of higher ridge gain using LP during the bone augmentation procedure. Future research with bigger sample size should confirm the results of the present research.