On the Feasibility of Utilizing Allogeneic Bone Blocks for Atrophic Maxillary Augmentation

Table 1

Description of the studies included in the present systematic review aiming to assess the feasibility of allogeneic bone block grafts.

(a)  

Author (year)

Study design

Groups

Number of patients

Number of sites grafted

Location of grafted sites

Bone agumentation (V/H)

Type of bone block graft

Membrane (Y/N)

Additional grafting material/growth factor

Bone augmentation achieved at baseline

Healing period (months)

Resorption (%)

Acocella et al., (2012) [15]

Prospective case series

NCG

16

18

Anterior/posterior

H

Monocortical fresh-frozen

N

N

4.62 ± 0.8 mm

9

11.45 ± 8.37

Barone et al., (2009) [16]

Prospective case series

NCG

13

24

Anterior (13)/posterior (9)

H (19)/V (5)

Corticocancellous deep-frozen

N

Cancellous allograft particles

NM

5

NM

Chaushu et al., (2010) [17]

Prospective case series

NCG

101

90

Anterior (58)/posterior (32)

NC

Cancellous fresh-frozen

Y

N

NM

6

NM

Contar et al., (2009) [19]

Prospective case series

NCG

15

34

Anterior/posterior

H

Cancellous/cortical fresh-frozen

N

N

NM

NC

NM

Contar et al., (2011) [18]

Prospective case series

NCG

18

39

Anterior/posterior

NC

Cancellous/cortical fresh-frozen

N

N

NM

9

NM

Cortical fresh-frozen

Wallace and Gellin (2010) [31]

Prospective case series

NCG

12

16

Anterior/posterior

H

Cancellous fresh-frozen

Y

MCA + rhPDGF-BB

4.6 ± 5.2 mm

5

NM

Spin-Neto et al. (2013) [29]

Prospective case series

AL

13

17

Anterior (14)/posterior (3)

H

Corticocancellous deep-frozen

Y

N

NC

6

NC

AT

13

17

Mandibular ramus

Novell et al., (2012) [27]

Prospective case series

NCG

12

20

Anterior/posterior

H/H + V

Cortical/cancellous fresh-frozen

Y

Freeze-dried allograft particles

NC

NM

NM

Deluiz et al., (2013) [20]

Prospective case series

NCG

24

24

Anterior/posterior

H

Corticocancellous fresh-frozen

N

Freeze-dried allograft particles

NC

8

13.02 ± 3.86

Nissan et al., (2011) [26]

Prospective case series

NCG

20

28

Anterior

H (27)/V (12)

Cancellous fresh-frozen

Y

Particulate BBM

NM

6

NM

Nissan et al. (2011) [24]

Prospective case series

NCG

31

46

Anterior

H (42)/V (27)

Cancellous fresh-frozen

Y

Particulate BBM

NM

6

10 ± 1

Nissan et al., (2008) [25]

Prospective case series

NCG

11

11

Anterior

H/V

Cancellous fresh-frozen

Y

Particulate BBM

NM

6

NM

Lumetti et al., (2014) [21]

RCT

AL

12

12

Anterior/posterior

H

Corticocancellous fresh-frozen

Y

Particulate fresh-frozen

1.5 ± 0.91 cm^3

6

52 ± 25.87

AT

12

12

Mandibular ramus

0.44 ± 1.04 cm^3

25 ± 12.73

Spin-Neto et al. (2013) [30]

Prospective case series

AL

6

17

Anterior/posterior

H

Cortical fresh-frozen

Y

N

NM

7

NM

AT

6

12

Mandibular ramus

NM

NM

Peleg et al., (2010) [28]

Prospective case series

NCG

34

38

Anterior (31)/posterior (7)

H/H + V

Corticocancellous fresh-frozen

Y

N

NM

4

NM

(b)  

Author (year)	Final bone gain (mm)	Number of implant placed	Implant loading protocol	Followup of implants (months)	Implant survival	Failed blocks (%)			Histological findings
						Failed blocks (%)	Timing (months)	Cause	Timepoint (months)	Newly formed bone (%)	Characteristics
Acocella et al., (2012) [15]	4.09 ± 0.8	34	4	30	100	0	—	—	9	61.96 ± 11.77	A high number of empty osteocyte lacunae were still present and, fibrous tissue was more present than in the samples taken previously. Newly-formed bone was surrounded by non-vital bone with empty osteocyte lacunae in way of resorption
Barone et al., (2009) [16]	NM	38	NM	6	94.73	8.33	1	Early exposure and infection of vertical onlay grafts	NM	NM	NM
Chaushu et al., (2010) [17]	NM	NM	NM	NM	NM	6.66	NC	Membrane exposure, incision line opening, soft tissue perforations, recipient site infection	NM	NM	NM
Contar et al., (2009) [19]	NM	51	NC	35	100	0	—	—	NC	NM	Mature and compact osseous tissue surrounded by marrow spaces
Contar et al., (2011) [18]	NM	58	NM	NM	NM	0	—	—	9	NM	Lamellar arrangement around Haversian canals interspersed with osteocytes in lacunae. No evidence of inflammatory infiltrate. The central portions revealed osteocytes with higher number of empty lacunae
Wallace & Gellin (2010) [31]	8.39 ± 1.95	NM	NM	NM	NM	0	—	—	NM	NM	NM
Spin-Neto et al. (2013) [29]	NC	NM	NM	NM	NM	11.76	2	Fixation screws loosened causing inflammation	NM	NM	NM
		NM	NM	NM	NM	0	—	—
Novell et al., (2012) [27]	NM	NC	NC	60	100	5	1	Failure occurred in the posterior area	NM	NM	NM
Deluiz et al., (2013) [20]	NC	75	NM	NM	98.67	0	—	—	4, 6, 8	NM	Newly formed bone with osteocytes observed in all the timepoints. Osteocyte presence was higher at 4 months. Vessels were also detected abundantly in the samples
Nissan et al., (2011) [24]	H (5 ± 0.5)/V (2 0.5)	31	0 (12)/6 (19)	42	96	7.2	1	Because of soft tissue breakdown, infection and loss of fixation	NM	NM	NM
Nissan et al. (2011) [24]	H (5 ± 0.5)/V (2 ± 0.5)	63	6	34	100	4.4	1	Because of soft tissue breakdown, infection and loss of fixation	NM	NM	NM
Nissan et al., (2008) [25]	H (5 ± 0.5)/V (NM)	11	0	18	100	0	—	—	NM	NM	NM
Lumetti et al., (2014) [21]	NC	NM	NM	NM	NM	0	—	—	6	NC	Osteocyte lacunae mostly empty. Newly formed bone contained viable osteocytes. Bone forming osteoblasts and fluorescent labeling detected. Dense connective tissue with the presence of inflammatory cells (WM score = 1.67) and eroded areas
						0	—	—		NC	Osteocyte lacunae mostly empty. Newly formed bone contained viable osteocytes. Bone forming osteoblasts and fluorescent labeling detected. WM inflammatory score = 1
Spin-Neto et al. (2013) [29]	NM	40	NM	NM	NM	0	—	—	7	NM	Large segments of necrotic bone with empty osteocytes lacunae and little osteoclastic activity. Blood vessels were invading the Haversian canals of the material. No direct contact was found between remodeled and grafted bone. Some osteoclastic activity surrounded by connective tissue with no presence of inflammatory cells by newly formed bone failed to invade the graft.
	NM					0	—	—		NM	Small areas of necrotic bone with abundant presence of osteocytes. Inexistent difference between the grafted and the host bone
Peleg et al., (2010) [28]	NM	NC	NC	NC	NC	0	—	—	NM	NM	NM

RCT: randomized controlled trial; AL: allogenous graft; AT: autogenous graft; H: horizontal; V: vertical; Y: yes; N: no; MCA: mineralized cortical allograft; BBM: bobine bone mineral; NC: no clear; NM: not metioned; NCG: no control group.