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

Abstract

BackgroundThe 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.MethodsTwenty-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.ResultsSeventeen 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).ConclusionThe 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.