Article Options


Advanced Search

This service is provided on D[e]nt Publishing standard Terms and Conditions. Please read our Privacy Policy. To enquire about a licence to reproduce material from and/or JofER, click here.
This website is published by D[e]nt Publishing Ltd, Phoenix AZ, US.
D[e]nt Publishing is part of the specialist publishing group Oral Science & Business Media Inc.

Creative Commons License

Recent Articles RSS:
Subscribe to recent articles RSS
or Subscribe to Email.

Blog RSS:
Subscribe to blog RSS
or Subscribe to Email.

 »  Home  »  Dental Implant 2  »  A Survey Of Clinical Members Of The Association Of Dental Implantology in the United Kingdom. Part II. The Use Of Augmentation Materials In Dental Implant Surgery
A Survey Of Clinical Members Of The Association Of Dental Implantology in the United Kingdom. Part II. The Use Of Augmentation Materials In Dental Implant Surgery
Discussion - References.

Bookmark and Share

It is widely held that the choice of an augmentation material is an important factor in determining the outcome of a bone augmentation procedure. The last question of this survey invited comments on the survey. Forty-four respondents (16%) who identified themselves as clinicians whose practice is restricted to the restorative phases of implantology stated that the choice of augmentation materials rests solely with those surgeons who insert dental implants. It, therefore, follows that a relatively small number of surgeons decide which materials (and presumably techniques) are chosen for bone augmentation in relation to oral implant procedures. The majority of surgeons participating in this survey preferred to use autogenous bone. DFDB was the second most frequent choice. This survey found that 26.3% of the participants that use autogenous bone as their preferred augmentation material indicated that there was at least one RCT with histological evidence to support its use. At the same time, a large proportion of users (43%) stated that they were uncertain of the evidence available to support the autogenous bone as an augmentation material.
With regard to DFDB, 30.5% of surgeons who favor its use stated there was at least one RCT with histological evidence to support its use. Only a small proportion indicated that they were uncertain of the levels of supporting evidence. The efficacy of DFDB remains disputed. On the one hand it has been reported that it does not contribute to bone healing and that it remains in the tissue as an inert foreign body. On the other hand, it has been reported that implanted DFDB is resorbed by osteoclasts and that new bone is apposed to the material. A wide range of particulate materials is currently available for use in the correction of localized alveolar ridge defects. It is widely accepted that the size and morphology of a bone defect influences the method of augmentation chosen and might affect the implant success rates achieved in grafted sites. However, there seem to be few if any scientific publications that have defined the volume and morphology of bone defects that can be predictably corrected by using specified augmentation materials. With regard to alloplastic and allogenic mate rials, the majority of participants involved in augmentation procedures (51.6%) stated that these materials should only be used for the correction of small bone defects. At the same time, a significant proportion supported the statement that these materials should be used as volume expanders in conjunction with autogenous bone.
Bone collectors are devices that are used to retain the bone debris produced during dental implant surgery or bone surgery. Autogenous bone is widely regarded as the gold standard for bone augmentation. Therefore, the use of collected bone debris might be expected to be widespread. However, 42.3% of the implant surgeons in this survey do not use these devices, perhaps because of concerns that have been raised over the bacterial contamination of bone debris collected in the oral cavity. More recently, both a stringent aspiration protocol and the use of a preoperative chlorhexidine rinse have been shown to significantly reduce the bacterial contaminants in collected bone debris. This survey has established that collected bone debris continues to be used as an immediate autograft to correct dehiscences and fenestrations around dental implants.


Springfield DS. Autogenous bone grafts: Nonvascular and vascular.   Orthopedics. 1992;15:1237-1241.
Raghoebar GM, Batenburg RH, Vissink A, et al. Augmentation of localized defects   of the anterior maxillary ridge with autogenous bone before insertion of implants.   J Oral Maxillofac Surg. 1996;54: 1180-1185.
Misch CM, Misch CE. The repair of localized severe ridge defects for implant   placement using mandibular bone grafts. Implant Dent. 1995;4:261-267.
Perrott DH, Smith RA, Kaban LB. The use of fresh frozen allogeneic bone for   maxillary and mandibular reconstruction. Int J Oral Maxillofac Surg. 1992;21:   260-265.
Niederwanger M, Urist MR. Demineralized bone matrix supplied by bone banks   for a carrier of recombinant human bone morphogenetic protein (rhBMP-2): A substitute   for autogeneic bone grafts. J Oral Implantol. 1996;22:210-215.
Lytle JL. Freeze-dried demineralized bone in dental implant reconstruction.   J Calif Dent Assoc. 1994;2:47-51.
Mellonig JT. Autogenous and allogeneic bone grafts in periodontal therapy.   Crit Rev Oral Biol Med. 1992;3:333-352.
Hammerle CH, Chiantella GC, Karring T, et al. The effect of a deproteinized   bovine bone mineral on bone regeneration around titanium dental implants.   Clin Oral Implants Res. 1998;9:151-162.
Zitzmann NU, Naef R, Scharer P. Resorbable versus nonresorbable membranes   in combination with Bio-Oss for guided bone regeneration. Int J Oral Maxillofac   Implants. 1997;12:844-852.
Froum SJ, Tarnow DP, Wallace SS, et al. Sinus floor elevation using anorganic   bovine bone matrix (OsteoGraf/N) with and without autogenous bone: A clinical,   histologic, radiographic, and histomorphometric analysis. Part 2 of an ongoing   prospective study. Int J Periodontics Restorative Dent. 1998;18:528- 543.
Schepers E, Barbier L, Ducheyne P. Implant placement enhanced by bioactive   glass particles of narrow size range. Int J Oral Maxillofac Implants. 1998;13:   655-665.
Hurzeler MB, Quinones CR, Kirsch A, et al. Maxillary sinus augmentation using   different grafting materials and dental implants in monkeys. Part III. Evaluation   of autogenous bone combined with porous hydroxyapatite. Clin Oral Implants   Res. 1997;8:401-411.
Haris AG, Szabo G, Ashman A, et al. Five-year 224-patient prospective histological   study of clinical applications using a synthetic bone alloplast. Implant   Dent. 1998;7:287-299.
Nery EB, LeGeros RZ, Lynch KL, et al. Tissue response to biphasic calcium   phosphate ceramic with different ratios of HA/beta TCP in periodontal osseous   defects. J Periodontol. 1992;63:729-735.
Young MPJ, Carter DH, Sloan P, et al. A survey of clinical members of the   association of dental implantology in the United Kingdom. Part I: levels of   activity and experience in oral implantology. Implant Dentistry. 2001;1:68-74.
Nevins M, Jovanovic SA. Localized bone reconstruction as an adjunct to dental   implant placement. Curr Opin Periodontol. 1997;4:109-118.
Becker W, Becker BE, Caffesse R. A comparison of demineralized freezedried   bone and autologous bone to induce bone formation in human extraction sockets.   J Periodontol. 1994;65:1128- 1133.
Becker W, Schenk R, Higuchi K, et al. Variations in bone regeneration adjacent   to implants augmented with barrier membranes alone or with demineralized freeze-dried   bone or autologous grafts: a study in dogs. Int J Oral Maxillofac Implants.   1995;10:143-154.
Becker W, Urist M, Becker BE, et al. Clinical and histologic observations   of sites implanted with intraoral autologous bone grafts or allografts. 15 human   case reports. J Periodontol. 1996;67:1025- 1033.
Brugnami F, Then P, Moroi H, et al. GBR in human extraction sockets and ridge   defects prior to implant placement: Clinical results and histological evidence   of osteoblastic activities in DFDBA. Int J Periodontics Restorative Dent.   1999;19: 259-267.
Hall E, Meffert R, Hermann J, et al. Comparison of bioactive glass to demineralized   freeze-dried bone allograft in the treatment of intrabony defects around implants   in the canine mandible. J Periodontol. 1999;70:526-535.
Kainulainen V, Oikarinen K. Comparison of four bone collectors designed for   oral and maxillofacial surgery: An in vitro study. Clin Oral Implants Res.   1998; 9:327-332.
Young MPJ, Korachi M, Carter DH, et al. Microbial analysis of bone collected   during implant surgery: A clinical and laboratory study. Clin Oral Implants   Res (in press).
Young MPJ, Korachi M, Carter DH, et al. The effects of an immediately pre-surgical   oral rinse (containing 0.1% chlorhexidine) on the bacterial contaminants of   bone debris collected during dental implant surgery. Clin Oral Implants   Res. 2001;12:95-103.
Lauer G, Schilli W. Collected, implant-cavity borings used as periimplant   osseous augmentation material. Int J of Oral Maxillofac Impl. 1994;9:437-   443.
Nevins M, Mellonig JT, Clem DS 3rd, et al. Implants in regenerated bone:   Long-term survival. Int J Periodontics Restorative Dent. 1998;18:34-45.
Creugers NH, Kreulen CM, Snoek PA, et al. A systematic review of singletooth   restorations supported by implants. J Dent. 2000;28:209-217.
Sackett DL, Cook DJ. Can we learn anything from small trials? Ann N Y   Acad Sci. 1993;703:25-32.
Sackett DL, Rosenberg WM. The need for evidence-based medicine. J R Soc   Med. 1995;88:620-624.
Monaghan N. Human nature and clinical freedom, barriers to evidence based   practice? Br Dent J. 1999;186: 154-155.