Localized Bone Augmentation with Cortical Bone Blocks Tented over Different Particulate Bone Substitutes: A Retrospective Study

Purpose: To assess the efficacy of a block tenting technique for reconstruction of vertical or horizontal alveolar ridge defects. Materials and Methods: Patients who underwent a block tenting graft technique between 2005 and 2010 were analyzed retrospectively. Intraoral bone blocks (ramus, chin, or tuberosity) or allogeneic blocks were fixed at 4 mm from the deficient area, and the gap was filled with bone substitutes, with or without plasma rich in growth factors (PRGF). Implants were placed simultaneously or 4 to 5 months postgrafting. Patient demographic information, amount of width/height augmentation after 4 to 5 months of healing, complications, and contributing factors were gathered and analyzed. Results: One hundred two patients were enrolled. Among the horizontal augmentations, the greatest width increase was achieved in the anterior maxilla (4.31 ± 0.93 mm). The average height increase in the vertically augmented regions was greatest in the posterior maxilla (5.75 ± 2.22 mm). Mean horizontal augmentation was the greatest with ramus (3.65 ± 0.65 mm) and allogeneic materials (3.97 ± 0.79 mm). The greatest vertical gain was achieved with tuberosity blocks (4.25 ± 3.06 mm) and a combination of allogeneic/autogenous bone particles (3.90 ± 1.05 mm). Application of PRGF showed no appreciable effect. The most common primary complications of surgery were hematoma and inflammation. The most common complication in the anterior maxilla was hematoma. Inflammation was the most common complication associated with ramus grafts, while hematoma occurred most often in cases with chin and tuberosity grafts. Total graft failure occurred in 13 patients, mainly associated with the allogeneic blocks. Most patients were followed for 11 to 38 months. Five of 237 inserted implants failed to osseointegrate. Conclusion: The block tenting technique might be effective for localized ridge augmentation and may reduce the amount of autograft required from donor sites. Parole chiave: allogeneic bone graft, alveolar ridge augmentation, autogenous bone graft, guided bone regeneration, tenting technique