Bone augmentation followed by implant surgery in the edentulous mandible: a systematic review

Abstract

Introduction

Long-standing loss of natural teeth in the mandible can lead to severe jaw atrophy and even mandibular fracture. There is no consensus on the best preprosthetic surgical treatment to reconstruct the atrophic edentulous mandible. The purpose of this review is to provide an overview of the existing literature and to give an evidence-based recommendation for bone grafting and future research.

Materials and methods

This systematic review was conducted according to the PRISMA statement. A literature search was performed in online databases Pubmed and Cochrane library for articles published between January 1980 and September 2017. The search was conducted using Medical Subject Heading (MeSH) terms: alveolar ridge augmentation; mouth, edentulous and mandible. Eligible articles were included according to in- and exclusion criteria and assessed on quality. Dental implant survival and bone stability are the primary outcomes. Secondary outcomes were complications.

Results

Twenty-four text articles matched the criteria and were included. Eleven articles were assessed to be of adequate quality for analysis. Graft stability seems to be higher in vertical distraction and tent-pole grafting but as the dental implant survival is high (91.7% or higher) regardless of the procedure used for bone augmentation, this is of no clinical relevance.

Conclusion

The survival rate of dental implants is high, regardless of the bone augmentation procedure used. High quality clinical trials are needed to support the current evidence and guidelines on pre-implant bone grafting. Reporting of future research should include proper baseline characteristics and treatment description, as well as uniform outcome rendering.

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