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Home / Equine Research Bank / Clin Oral Implants Res / Horizontal bone grafting using equine-derived cancellous bon...
Clinical oral implants research2020; 31(11); 1149-1158; doi: 10.1111/clr.13661

Horizontal bone grafting using equine-derived cancellous bone blocks is associated with severe complications: A prospective clinical and histological pilot study.

Abstract: The aim of this prospective, clinical study was to evaluate the clinical performance and histological outcome of a new equine hydroxyapatite collagenated bone block (eHAC) for horizontal bone grafting prior to implant placement. Methods: Five patients (two male/three female) with a mean age of 51.6 years (range 22-66 years) and a reduced horizontal bone width of the alveolar ridge (mean 3.5 mm) underwent horizontal bone grafting using eHAC at 10 grafting sites. Reentry was performed 6.9 months after the horizontal grafting procedure. Clinical follow-up (mean 28.9 month) considered width gain of the alveolar ridge, soft tissue healing, and complications. To evaluate graft incorporation, four additional patients underwent histological assessment of equine blocks adjacent to autologous blocks 3 and 6 months after grafting. Results: The study was terminated after graft failure was observed in four of five patients. Mean horizontal bone width had increased by 3.6 ± 1.22 mm. Three out of nine implants placed had to be removed due to graft failure. Histological evaluation revealed large amounts of soft connective tissue within the grafts (mean 67.3 ± 9.5%). The proportion of new bone formation 3 months after the lateral grafting procedure revealed an average of 8.6%, compared to 11.4% after 6 to 7 months. Conclusions: Lateral ridge grafting using eHAC achieved measurable horizontal width gain but revealed high rates of severe complications. Conclusions: Within the limitations of this study, eHAC bone blocks cannot be recommended for horizontal bone grafting.
© 2020 The Authors. Clinical Oral Implants Research published by John Wiley & Sons Ltd.
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Publication Date: 2020-09-17 PubMed ID: 32881075DOI: 10.1111/clr.13661Google Scholar: Lookup
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  • Journal Article

Summary

This research summary has been generated with artificial intelligence and may contain errors and omissions. Refer to the original study to confirm details provided. Submit correction.

The research study aimed to assess the effectiveness and clinical outcome of an equine hydroxyapatite collagenated bone block (eHAC) for performing horizontal bone grafts. However, the results indicated high failure rates and various complications, leading the researchers to advise against the use of eHAC blocks for horizontal bone grafting.

Methodology

  • The research involved a clinical study on five patients, two males and three females, with a reduced horizontal bone width averaging 3.5mm, who were given eHAC for horizontal bone grafting in ten specific grafting sites.
  • They were reevaluated after 6.9 months post-grafting.
  • A mean of 28.9 months of clinical analysis further considered the gain in alveolar ridge width, soft tissue healing condition, and any developing complications.
  • Additionally, four more patients were observed histologically to evaluate graft incorporation with eHAC blocks compared to autologous blocks three and six months post-grafting.

Results

  • The study had to be shifted focus after a graft failure was observed in four out of the five initial patients.
  • While their average horizontal bone width increased by around 3.6mm, the grafting highly unsuccessful – three out of the nine implants had to be removed due to graft failure.
  • Histological analysis showed that there were high amounts of soft connective tissue within the grafts, averaging around 67.3%.
  • Compared to a new bone formation rate of just 8.6% three months after grafting and 11.4% after six to seven months, the graft failure rate was considerably high.

Conclusions

  • While the eHAC vertical ridge grafting technique resulted in measurable horizontal width gain, the rate of severe complications was staggeringly high.
  • Considering these substantial drawbacks, the study concludes that eHAC bone blocks are not advised for horizontal bone grafting.

Cite This Article

APA
Angermair J, Bosshardt DD, Nelson K, Flügge TV, Stricker A, Fretwurst T. (2020). Horizontal bone grafting using equine-derived cancellous bone blocks is associated with severe complications: A prospective clinical and histological pilot study. Clin Oral Implants Res, 31(11), 1149-1158. https://doi.org/10.1111/clr.13661

Publication

Clinical oral implants research
ISSN: 1600-0501
NlmUniqueID: 9105713
Country: Denmark
Language: English
Volume: 31
Issue: 11
Pages: 1149-1158

Researcher Affiliations

Angermair, Johannes
  • Clinic of Oral- and Maxillofacial Surgery, Translational Implantology, Medical Center Freiburg - Faculty of Medicine, University of Freiburg, Freiburg, Germany.
Bosshardt, Dieter D
  • Robert K. Schenk Laboratory of Oral Histology, School of Dental Medicine, University of Bern, Bern, Switzerland.
  • Department of Periodontology, School of Dental Medicine, University of Bern, Bern, Switzerland.
Nelson, Katja
  • Clinic of Oral- and Maxillofacial Surgery, Translational Implantology, Medical Center Freiburg - Faculty of Medicine, University of Freiburg, Freiburg, Germany.
Flügge, Tabea V
  • Clinic of Oral- and Maxillofacial Surgery, Translational Implantology, Medical Center Freiburg - Faculty of Medicine, University of Freiburg, Freiburg, Germany.
Stricker, Andres
  • Clinic of Oral- and Maxillofacial Surgery, Translational Implantology, Medical Center Freiburg - Faculty of Medicine, University of Freiburg, Freiburg, Germany.
  • Center of Implantology, Periodontology and 3D Head-and-Neck Imaging Lake Constance, Konstanz, Germany.
Fretwurst, Tobias
  • Clinic of Oral- and Maxillofacial Surgery, Translational Implantology, Medical Center Freiburg - Faculty of Medicine, University of Freiburg, Freiburg, Germany.

MeSH Terms

  • Adult
  • Aged
  • Alveolar Ridge Augmentation
  • Animals
  • Bone Transplantation
  • Cancellous Bone
  • Dental Implantation, Endosseous
  • Female
  • Horses
  • Humans
  • Male
  • Middle Aged
  • Pilot Projects
  • Prospective Studies
  • Treatment Outcome
  • Young Adult

Grant Funding

  • Geistlich Pharma AG

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Citations

This article has been cited 4 times.
  1. Christensen JG, Grønlund GP, Georgi SR, Starch-Jensen T, Bruun NH, Jensen SS. Horizontal Alveolar Ridge Augmentation with Xenogenic Block Grafts Compared with Autogenous Bone Block Grafts for Implant-retained Rehabilitation: a Systematic Review and Meta-Analysis.. J Oral Maxillofac Res 2023 Apr-Jun;14(2):e1.
    doi: 10.5037/jomr.2023.14201pubmed: 37521322google scholar: lookup
  2. Smeets R, Matthies L, Windisch P, Gosau M, Jung R, Brodala N, Stefanini M, Kleinheinz J, Payer M, Henningsen A, Al-Nawas B, Knipfer C. Horizontal augmentation techniques in the mandible: a systematic review.. Int J Implant Dent 2022 May 9;8(1):23.
    doi: 10.1186/s40729-022-00421-7pubmed: 35532820google scholar: lookup
  3. Canullo L, Pesce P, Antonacci D, Ravidà A, Galli M, Khijmatgar S, Tommasato G, Sculean A, Del Fabbro M. Soft tissue dimensional changes after alveolar ridge preservation using different sealing materials: a systematic review and network meta-analysis.. Clin Oral Investig 2022 Jan;26(1):13-39.
    doi: 10.1007/s00784-021-04192-0pubmed: 34669038google scholar: lookup
  4. Schwarz F, Sahin D, Civale-Schweighöfer S, Becker J. Long-term outcomes following lateral alveolar ridge augmentation using a collagenated xenogeneic bone block: a monocenter, prospective single-arm clinical study.. Int J Implant Dent 2021 Feb 22;7(1):9.
    doi: 10.1186/s40729-021-00293-3pubmed: 33615414google scholar: lookup
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