Clinical and Histologic Evaluation of Bone-Replacement Grafts in the Treatment of Localized Alveolar Ridge Defects. Part 2: Bioactive Glass Particulate

The purpose of this study was to evaluate the feasibility of using a bioactive alloplast and a physical barrier to augment localized alveolar ridge defects for the subsequent placement of dental implants. Twelve systemically healthy patients (aged 29 to 55 years) with inadequate dental alveolar ridge widths were selected for study. All patients completed initial therapy, which included scaling, root planing, and oral hygiene instruction. All ridge defects were augmented with a bioactive glass alloplast and a titanium-reinforced e-PTFE barrier. Vertical (height) and horizontal (width) hard tissue measurements were taken the day of ridge augmentation surgery (baseline) and at the 6-month reentry surgery. The change in ridge width varied from a loss of 1 mm to a gain of 4.5 mm, with a mean gain of 1.1 mm (P .03). Eight of the 12 sites gained 1 mm or less. The difference in mean ridge width gain between maxillary and mandibular sites was not statistically significant (P > .08). Mean ridge width gain was 1.1 mm for both maxillary and mandibular sites. There was a loss in bone height of 0.3 mm from baseline. Four implants in four patients could not be placed because of inadequate ridge width augmentation. Histologic examination of the grafted sites revealed connective tissue encapsulation of most residual graft particles. In this study, bioactive glass particulate and an e-PTFE barrier did not consistently augment localized ridge defects for dental implant placement.