Preoperative buccal bone volume predicts long-term graft retention following augmentation in the esthetic zone: a retrospective case series.

Feher, Balazs; Frommlet, Florian; Ulm, Christian; Gruber, Reinhard; Kuchler, Ulrike (2022). Preoperative buccal bone volume predicts long-term graft retention following augmentation in the esthetic zone: a retrospective case series. Clinical oral implants research, 33(5), pp. 492-500. Wiley-Blackwell 10.1111/clr.13909

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OBJECTIVES

Buccal bone augmentation in the esthetic zone is routinely used to achieve optimal clinical outcomes. Nonetheless, long-term data are sparse, and it is unknown how baseline buccal bone volume affects the retention of the augmented volume over time.

MATERIAL AND METHODS

This is a long-term follow-up retrospective case series. After a preoperative computed tomography scan, implants were placed in the anterior maxilla following guided bone regeneration, autogenous block grafting, or both. At the follow-up, patients received a computed tomography scan and a clinical examination. Buccal bone volume was the primary outcome. Buccal bone thickness, peri-implant, and esthetic parameters were secondary outcomes.

RESULTS

After a median follow-up of 6.7 years (interquartile range: 4.9-9.4), 28 implants in 19 patients (median age at augmentation: 43.3 years, interquartile range: 34.4-56.7, 53% female) were followed up. Preoperative buccal bone volume at baseline (V0 ) showed a moderate correlation to final buccal bone volume (Vt , rs  = 0.43) but a strong correlation to the absolute volumetric change (ΔV = Vt - V0 , rs  = -0.80). A linear mixed model for Vt had a large intercept of 91.39 (p < 0.001) and a rather small slope of 0.11 for V0 (p = 0.11). Observed differences between treatments were not statistically significant in the mixed model. V0 above 105 mm3 predicted a negative volume change (ΔV < 0) with a specificity of 100% and a sensitivity of 96%.

CONCLUSIONS

The results suggest higher gains in sites with lower V0 and point to a cutoff V0 above which the augmented volume is not retained long-term.

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