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Purpose: The use of autogenous block bone grafts in bone regeneration procedures for alveolar ridge augmentation can be limited by donor site morbidity and complications. The purpose of the present study was to evaluate the efficacy of allogeneic corticocancellous iliac block grafts used for ridge augmentation prior to implant placement. Materials and Methods: Forty-one patients with severe ridge volume deficiency underwent augmentation using allogeneic corticocancellous iliac block bone grafts. After rigid fixation of the graft, the site was covered with a freeze-dried allogeneic dura mater membrane, and the wound was closed with tension-free suturing. Implants were placed 3 to 4 months after surgery. Three to 6 months after implant placement, panoramic radiographs were taken and implants were uncovered for prosthetic restoration. Results: Of the 57 grafts placed, one showed 2.5 mm of resorption at the superior buccal aspect of the graft. No other clinical problems were observed. The block grafts were clinically well integrated into the recipient sites and the augmented bone remained stable throughout the implant placement procedures. Of the 84 implants placed, only one failed to integrate. Conclusion: These results demonstrate that the use of allogeneic corticocancellous iliac block bone grafts in conjunction with guided bone regeneration principles is a viable alternative to autogenous grafts in selected patients with alveolar ridge deficiencies. [ABSTRACT FROM AUTHOR]

A deformed alveolar ridge may result from periodontal disease, trauma, tooth extraction, tumor, or congenital defects. The ridge deformity is directly related with the volume of the root structure and associated bone that is missing or has been destroyed. The esthetic, hygiene, and functional concerns can be the formation of "black triangles" interdentally, loss of buccal/facial contour, an unesthetic thick pontic made to compensate the horizontal ridge defect, food impaction in the open interdental spaces under the pontic, difficulty in speech and unesthetic gingival texture. In today's practice, patients with normal skeletal pattern who have lost a substantial degree of their original osseous dimensions due to tooth loss or trauma are much more prevalent. Alveolar ridge defects are common and poise a significant problem in dental treatment and rehabilitation. A thorough knowledge of ridge augmentation is required for successful interdisciplinary approaches. Therefore, the time-honored proverb that "an ounce of prevention is worth a pound of cure" is most applicable to the many problems involved in the successful reconstruction of localized defects that exist within the alveolar ridge. The following databases were searched to collect all relevant articles in relation to ridge augmentation procedures "PubMed" and "Medline" using the following descriptors-ridge augmentation, ridge preservation, allografts, autografts, block bone grafts, interdisciplinary approach, and the data was accumulated and analyzed. All the articles available from 1920 to December 2014 were included for review analysis. A total number of 520 articles were collected out of which most relevant ones were included in this article. [ABSTRACT FROM AUTHOR]

The purpose of the current investigation was to evaluate the clinical success of horizontal ridge augmentation in severely atrophic maxilla (Cawood and Howell class IV) using freeze-dried custom made bone harvested from the tibial hemiplateau of cadaver donors, and to analyze the marginal bone level gain prior to dental implant placement at nine months subsequent to bone grafting and before prosthetic rehabilitation. A 52-year-old woman received custom made bone grafts. The patient underwent CT scans two weeks prior and nine months after surgery for graft volume and density analysis. The clinical and radiographic bone observations showed a very low rate of resorption after bone graft and implant placement. The custom-made allograft material was a highly effective modality for restoring the alveolar horizontal ridge, resulting in a reduction of the need to obtain autogenous bone from a secondary site with predictable procedure. Further studies are needed to investigate its behavior at longer time periods. [ABSTRACT FROM AUTHOR]

Bone graft infections represent a challenge in daily clinics, resulting in increased patient discomfort and graft removal. The aim of this study was to investigate the initial adhesion of five representative pathogens on three different block bone graft materials (xenogeneic, alloplastic and allogeneic) and to assess if chlorhexidine (CHX) can effectively control the initial bacterial adhesion. Three different block bone grafting materials (Tutobone®, Endobon® and human spongiosa) were incubated with Escherichia coli , Staphylococcus aureus , Streptococcus mutans , Enterococcus faecalis and Pseudomonas aeruginosa in the presence or absence of 0.2% CHX solution. Bacterial adhesion was assessed by the direct counting of the colony-forming units (CFUs) and visualized by scanning electron microscopy (SEM). Overall, the selected bacterial species adhered successfully to all tested bone replacement scaffolds, which showed similar bacterial counts. The lg CFU values ranged from 5.29 ± 0.14 to 5.48 ± 0.72 for E. coli , from 4.37 ± 0.62 to 5.02 ± 0.48 for S. aureus , from 4.92 ± 0.34 to 4.95 ± 0.21 for S. mutans , from 4.97 ± 0.40 to 5.22 ± 0.13 for E. faecalis and from 4.23 ± 0.54 to 4.58 ± 0.26 for P. aeruginosa. CHX did not interfere with initial microbial adhesion, and yet it killed all adhered bacterial cells. Thus, CHX can be used to prevent subsequent biofilm infections.