Localized Lateral Alveolar Ridge Augmentation with Block Bone Grafts: Simultaneous Versus Delayed Implant Placement: A Clinical and Radiographic Retrospective Study
Abstract
PURPOSE: To retrospectively evaluate the 1-year outcome of implant therapy involving localized lateral alveolar ridge augmentation with block bone grafts, and to compare outcomes of implants inserted simultaneously with grafting or after a healing period. MATERIALS AND METHODS: Consecutively treated patients undergoing alveolar ridge augmentation with autogenous intraoral block grafts before or simultaneous with implant placement between 2005 and 2010 in the Oral Surgery Unit of the University of Valencia were included. The selection of procedure (simultaneous vs delayed implant placement, donor site) was based upon the criterion of the surgeon and thorough evaluation of each patient. All grafts were obtained with piezosurgery. Complications related to augmentation, implant survival, implant success, and peri-implant marginal bone loss were assessed. RESULTS: Forty-two patients were included; 45 sites were augmented and 71 implants were inserted (33 delayed and 38 simultaneously). Complications (temporary paresthesia, wound dehiscence with bone graft exposure, and exposure of osteosynthesis screw) occurred after bone harvesting in nine patients; four were in the simultaneous group and five were in the delayed group. Six grafts were not successful; four were lost and two provided insufficient bone (after resorption) for ideal implant placement. The implant survival rate was 98.5% (100% for simultaneous and 96.9% for delayed implants) and the implant success rate was 92.9% (89.5% for simultaneous and 96.9% for delayed implants). Average marginal bone loss 1 year after loading was significantly higher for simultaneously placed implants (0.69 ± 0.67 mm) than for delayed implants (0.20 ± 0.50 mm). CONCLUSIONS: In lateral bone atrophy, block bone grafts provided sufficient bone for implant therapy, with few complications. Both simultaneous and delayed implant placement yielded high implant survival and success rates. Average marginal bone loss was significantly higher around simultaneously inserted implants.
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Congenital tooth agenesis in ED often leads to alveolar bone resorption due to lack of occlusal loading and palatal mucosa displacement toward the labial side, significantly increasing the complexity of implant placement and maintenance.
“Evidence indicates that congenital tooth agenesis in ED often leads to alveolar bone resorption due to lack of occlusal loading and palatal mucosa displacement toward the labial side, significantly increasing the complexity of implant placement and maintenance [19].”
From Implant-supported fixed prosthodontic treatment for ectodermal dysplasia: a case report (2026) · cites this paper as [19]
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Complications in bone‐grafting procedures: Classification and management
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“- Quality assessment of trials and risk of bias One study (16) had a low risk of bias, while the other 5 (13-15,17,18) presented a high risk of bias.”
BackgroundMethodInfluentialSelf-citationGuided bone regeneration for the reconstruction of alveolar bone defects
Khojasteh, A., Kheiri, L., Motamedian, S. R., et al. (2017) · Annals of Maxillofacial Surgery · doi:10.4103/ams.ams_76_17 · Cited by 96 · see citing works
“Collagen membrane was the only type of membrane used in all seven studies.[6,34-39] The block bone grafts were harvested from symphysis,[6,34,39] ramus,[34,39] demineralized FDBA (DFDBA),[35] FDBA,[36,38] iliac,[37] retromolar area,[6,39] and tuberosity.”
BackgroundMethodInfluentialAlzahrani, A. A., Murriky, A. A., & Shafik, S. (2017) · The Saudi Dental Journal · doi:10.1016/j.sdentj.2017.07.003 · Cited by 90 · see citing works
“In addition, post extraction bone loss necessitates bone-grafting procedures for implant placement to predictably restore function and esthetic (Penarrocha-Diago and Aloy-Prosper, 2013).”
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“Other studies reported few occurrences of minor complications including peri‐implantitis,[37,39] exposure of the membrane,[55] exposure of the graft,[12,15,41,43,47‐49] infection,[31,38,47] soft tissue dehiscence,[31,38,40,41,43,45,48] hematoma,[27,33] discomfort,[37,38] and graft loss.”
BackgroundInfluentialHorizontal augmentation techniques in the mandible: a systematic review
Smeets, R., Matthies, L., Windisch, P., Gosau, M., Jung, R. E., Brodala, N., Stefanini, M., Kleinheinz, J., Payer, M., Henningsen, A., et al. (2022) · International Journal of Implant Dentistry · doi:10.1186/s40729-022-00421-7 · Cited by 65 · see citing works
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“Moreover, temporary and permanent paraesthesia as well as gait disturbances have been described after harvesting autogenous bone graft in conjunction with HARA [47,62,66].”
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Ortiz‐Vigón, A., Suarez, I., Martínez‐Villa, S., et al. (2017) · Clinical Oral Implants Research · doi:10.1111/clr.13036 · Cited by 51 · see citing works
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“Although the dehisced area healed spontaneously in the majority of the cases [39, 40, 49], the necessity for graft removal was also reported (44% (4/9 exposed sites)) [50].”
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“Complications at the recipient site are often caused by softtissue problems such as wound dehiscence, flap necrosis and membrane exposure (Penarrocha-Diago et al., 2013).”
BackgroundHeimes, D., Pabst, A. M., Becker, P., et al. (2023) · Clinical Implant Dentistry and Related Research · doi:10.1111/cid.13242 · Cited by 37 · see citing works
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Survival Rates of Dental Implants in Autogenous and Allogeneic Bone Blocks: A Systematic Review
Donkiewicz, P., Benz, K., Kloss‐Brandstätter, A., et al. (2021) · Medicina · doi:10.3390/medicina57121388 · Cited by 22 · see citing works
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BackgroundInfluentialComplications and treatment errors in peri‐implant hard tissue management
Urbán, I., Sanz‐Sánchez, I., Monje, A., & Montero, E. (2023) · Periodontology 2000 · doi:10.1111/prd.12472 · Cited by 20 · see citing works
“64 In this sense, while intra-oral and calvarium donor sites (intramembranous source) provide stable volume and generally enable implant placement without further bone grafting procedures, 65,66 the iliac crest (endochondral source) is often associated with greater resorption.”
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“2013 [9] Simultaneous placement group: Wound dehiscence with graft exposure (3 patients, 15%) Wound dehiscence w/o graft exposure (1 patient, 5%) Graft loss (2 patients, 20%) Delayed placement group: Wound dehiscence with graft exposure (4 patients, 18.”
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Zaki, J. G., Alnawawy, M., Yussif, N. M., & Elkhadem, A. (2017) · Journal of Evidence Based Dental Practice · doi:10.1016/j.jebdp.2017.11.001 · Cited by 16 · see citing works
Diago, M. P., Alonso‐González, R., Aloy-Prósper, A., et al. (2015) · Medicina oral, patología oral y cirugía bucal · doi:10.4317/medoral.20212 · Cited by 11 · see citing works
“Membrane-barries are useful to provide both of these requisites; however the risk of a membrane exposure may involve the grafting success and lead to a failure (29).”
BackgroundSelf-citationCohen, D. J., Scott, K. M., Kulkarni, A. N., et al. (2019) · Clinical Oral Implants Research · doi:10.1111/clr.13544 · Cited by 11 · see citing works
“It is still debated whether the quality of bone and healing is the same using this method (Peñarrocha-Diago et al., 2013; Tosun et al., 2018).”
BackgroundMethodYang, S., Wang, S., Shen, X., et al. (2023) · Clinical Implant Dentistry and Related Research · doi:10.1111/cid.13213 · Cited by 10 · see citing works
Bayram, F., Göçmen, G., & Özkan, Y. (2024) · Clinical Oral Investigations · doi:10.1007/s00784-024-05613-6 · Cited by 10 · see citing works
“However, if dehiscence and the consequent exposure of the graft worsen, removal of the bone may also be necessary [30].”
BackgroundDental implant failure and bone augmentation: A retrospective study
Chatzopoulos, G. S., & Wolff, L. F. (2023) · Journal of Clinical and Experimental Dentistry · doi:10.4317/jced.60171 · Cited by 9 · see citing works
“In addition, it is expected that the marginal bone loss around implants inserted simultaneously with bone graft may be significantly higher than implants placed following the delayed protocol (40).”
BackgroundChallenges in the Rehabilitation Handling of Large and Localized Oral and Maxillofacial Defects
Khojasteh, A., & Hosseinpour, S. (2019) · Springer eBooks · doi:10.1007/978-3-030-21583-5_11 · Cited by 8 · see citing works
Evaluation of deproteinized bone mineral (DBM) as an onlay bone-graft in the rabbit mandible
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“For cases in which the horizontal ridge dimension is less than 4 mm (major hard tissue correction), a staged approach, wherein the grafting in the first stage followed by implant placement in the second stage is recommended.(32,33) The duration between both FIGURE 5.”
BackgroundMinimally Invasive Approaches to Optimize Block Grafting: A Case Report
Sammartino, G., Pantaleo, G., Nuzzolo, P., et al. (2014) · Journal of Oral Implantology · doi:10.1563/aaid-joi-d-14-00076 · Cited by 4 · see citing works
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“[8] the patients underwent lateral ridge augmentation by intraoral block grafts (lateral ramus and symphysis donor sites), and MBL and implant survival rate were evaluated.”
BackgroundMethodTilted implants for implant-supported fixed hybrid prostheses: retrospective review
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“Two previous studies 18,19 have compared the success rates and marginal bone loss of those two methods and found that delayed placement after bone grafting generally produces better outcomes.”
ResultSimultaneous Block Bone Grafting Using “L-Shaped Notch” Preparation in Mandible
Lee, D., Lee, J.-W., Lim, H., et al. (2015) · Implant Dentistry · doi:10.1097/id.0000000000000311 · Cited by 2 · see citing works
“In recent studies, implant placement with simultaneous block bone grafting neither increased the rate of complications nor reduced that of implant success.(22,23) It is generally recommended that the introduced surgical methods be used with at least 2 screws for sufficient fixation.”
BackgroundPre-Implant Reconstructive Surgery
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Implant-supported fixed prosthodontic treatment for ectodermal dysplasia: a case report
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Delayed versus simultaneous implant placement with ramus block grafts: A retrospective cohort study
Ekinci, S. A., Küçük, C., & Göçmen, G. (2024) · Anadolu Kliniği Tıp Bilimleri Dergisi · doi:10.21673/anadoluklin.1453783
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Additional file 1 of Horizontal augmentation techniques in the mandible: a systematic review
Smeets, R., Matthies, L., Windisch, P., Gosau, M., Jung, R., Brodala, N., Stefanini, M., Kleinheinz, J., Payer, M., Henningsen, A., et al. (2022) · Figshare · doi:10.6084/m9.figshare.19738586
- Authors
- Peñarrocha-Diago, M., Aloy-Prósper, A., Peñarrocha-Oltra, D., Guirado, J. L. C., & Peñarrocha-Diago, M.
- ORCID
- Aloy-Prósper, Amparo
- Venue
- The International Journal of Oral & Maxillofacial Implants
- Publisher
- Quintessence Publishing
- Published
- 2013
- Volume
- 28
- Issue
- 3
- Pages
- 846-853
- ISSN
- 0882-2786 (ISSN-L)
- OpenAlex
- W2331713312
- Cited by
- 41
- References
- 0
- Citations by year
- 2026: 1 · 2025: 1 · 2024: 2 · 2023: 7 · 2022: 4 · 2021: 3 · 2020: 3 · 2019: 5 · 2018: 1 · 2017: 5 · 2016: 3 · 2015: 4 · 2014: 2
- FWCI
- 3.44
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- The International Journal of Oral & Maxillofacial Implants (publishedVersion)
- PubMed (publishedVersion)
- Repository of Digital Objects for Teaching Research and Culture (University of Valencia) (submittedVersion)
- Topics
- Health Sciences › Dentistry › Oral Surgery › Dental Implant Techniques and Outcomes
- Health Sciences › Dentistry › Oral Surgery › Dental Radiography and Imaging
- Health Sciences › Medicine › Urology › Periodontal Regeneration and Treatments
- Keywords
- block bone graft, simultaneous implant placement, delayed implantation, dental implants, implant survival, implant success, peri-implant marginal bone loss, autologous bone graft, piezosurgery, bone graft complications
- MeSH terms
- Adult, Aged, Aged, 80 and over, Alveolar Ridge Augmentation, Dental Implantation, Endosseous, Female, Humans, Male, Middle Aged, Retrospective Studies, Young Adult, Immediate Dental Implant Loading, Sinus Floor Augmentation
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