Journal of Prosthetic Dentistry

Autogenous bone ring for vertical bone augmentation procedure with simultaneous implant placement: A systematic review of histologic and histomorphometric outcomes in animal studies


      Statement of problem

      The performance of the autogenous bone ring (ABR) technique used for the vertical bone augmentation procedure has not yet been determined.


      The purpose of this systematic review was to investigate whether the ABR technique for the vertical bone augmentation procedure with simultaneous implant placement enhances the histologic and histomorphometric outcomes in surgically created bone defects in animal models.

      Material and methods

      An electronic search of 3 databases, Medline/PubMed, Science Direct, Lilacs, and a manual search of a reference list of relevant studies were performed. Only animal studies regarding vertical bone augmentation by using the ABR technique with simultaneous implant placement in surgically created bone defects were included in the review. The SYstematic Review Center for Laboratory Animal Experimentation tool was used to determine the risk of bias assessment, and the quality of included studies was assessed by using the Animal Research: Reporting in Vivo Experiments guidelines.


      Five studies were included in the qualitative analysis based on the inclusion and exclusion criteria. One study comparing the ABR technique with the bovine and biphasic ring reported a high percentage of bone area and bone implant contact of the ABR at 5 weeks of osseointegration. Similar histologic findings were reported in another study at 4 months of healing, but contrasting data were reported at 8 months. Another study reported an increase in the percentage of bone area and bone implant contact of the ABR technique from 3 months to 6 months of osseointegration. Two studies reported an increase in the percentage of bone area, and 1 study reported a decrease in the mean of bone implant contact, both with simultaneous and staged implant procedures.


      Based on the limited available studies, the use of the ABR technique for the vertical bone augmentation procedure with simultaneous implant placement presented optimal histologic and histomorphometric outcomes in surgically created bone defects in animal models. However, the results of the current review are not sufficiently robust to support the use of the ABR technique for vertical bone augmentation in humans.
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        • Lekovic V.
        • Camargo P.M.
        • Klokkevold P.R.
        • Wienlaender M.
        • Kenny E.B.
        • Demitrijevic B.
        • et al.
        Preservation of alveolar bone in extraction sockets using bioabsorbable membranes.
        J Periodontol. 1998; 69: 1044-1049
        • Hansson S.
        • Halldin A.
        Alveolar ridge resorption after tooth extraction: a consequence of a fundamental principle of bone physiology.
        J Dent Biomech. 2012; 3 (1758736012456543)
        • Jonasson G.
        • Rythen M.
        Alveolar bone loss in osteoporosis: a loaded and cellular affair?.
        Clin Cosmet Investig Dent. 2016; 8: 95-103
        • Jiang N.
        • Guo W.
        • Chen M.
        • Zeng Y.
        • Zhou J.
        • Kim S.G.
        • et al.
        Periodontal ligament and alveolar bone in health and adaptation: tooth movement.
        Front Oral Biol. 2016; 18: 1-8
        • Coradazzi L.F.
        • Garcia Jr., I.R.
        • Manfrin T.M.
        Evaluation of autogenous bone grafts, particulate or collected during osteotomy with implant burs: histologic and histomorphometric analysis in rabbits.
        Int J Oral Maxillofac Implants. 2007; 22: 201-207
        • Pagni G.
        • Pellegrini G.
        • Giannobile W.V.
        • Rasperini G.
        Post extraction alveolar ridge preservation: biological basis and treatments.
        Int J Dent. 2012; 2012: 151030
        • Chiapasco M.
        • Zaniboni M.
        • Boisco M.
        Augmentation procedures for the rehabilitation of deficient edentulous ridges with oral implants.
        Clin Oral Implants Res. 2006; 17: 136-159
        • Xu H.
        • Shimizu Y.
        • Onodera K.
        • Ooya K.
        Long-term outcome of augmentation of the maxillary sinus using deproteinized bone particles experimental study in rabbits.
        Br J Oral Maxillofac Surg. 2005; 43: 40-45
        • Yeroff C.
        • Archdeacon M.
        Autogenous bone graft: donor sites and techniques.
        J Bone Joint Surg Am. 2011; 93: 2227-2236
        • Sittitavornwong S.
        • Gutta R.
        Bone graft harvesting from regional sites.
        Oral Maxillofac Surg Clin North Am. 2010; 22: 317-330
        • Tekin U.
        • Kocyigit D.I.
        • Sahin V.
        Symphyseal bone cylinders tapping with the dental implant into insufficiency bone situated esthetic area at one-stage surgery: a case report and the description of the new technique.
        J Oral Implantol. 2011; 5: 589-594
        • Tonetti M.S.
        • Hammerle C.H.F.
        Advances in bone augmentation to enable dental implant placement: consensus report of the Sixth European Workshop on Periodontology.
        J Clin Periodontol. 2008; 35: 168-172
        • Block M.S.
        • Kaleem A.
        Use of sintered xenograft over allograft for ridge augmentation: technique note.
        J Oral Maxillofac Surg. 2014; 72: 496-502
        • Pieri F.
        • Aldini N.N.
        • Marchetti C.
        • Corinaldesi G.
        Esthetic outcome and tissue stability of maxillary anterior single-tooth implants following reconstruction with mandibular block grafts: a 5-year prospective study.
        Int J Oral Maxillofac Implants. 2013; 28: 270-280
        • Park S.H.
        • Lee K.W.
        • Oh T.J.
        • Misch C.E.
        • Shotwell J.
        • Wang H.L.
        Effect of absorbable membranes on sandwich bone augmentation.
        Clin Oral Implants Res. 2008; 19: 32-41
        • Kang Y.H.
        • Kim H.M.
        • Byun J.H.
        • Kim U.K.
        • Sung I.Y.
        • Cho Y.C.
        • et al.
        Stability of simultaneously placed dental implants with autologous bone grafts harvested from the iliac crest or intraoral jaw bone.
        BMC Oral Health. 2015; 15: 172
        • Friberg B.
        Bone augmentation for single tooth implants: a review of the literature.
        Eur J Oral Implantol. 2016; 9 Suppl 1: S123-S134
        • Gultekin B.A.
        • Bedeloglu E.
        • Kose T.E.
        • Mijiritsky E.
        Comparison of bone resorption rates after intraoral block bone and guided bone regeneration augmentation for the reconstruction of horizontally deficient maxillary alveolar ridges.
        Biomed Res Int. 2016; 2016: 4987437
        • Giesenhagen B.
        • Martin N.
        • Jung O.
        • Barbeck M.
        Bone augmentation and simultaneous implant placement with allogenic bone rings and analysis of its purification success.
        Materials (Basel). 2019; 12: 1291
        • Giraddi G.B.
        • Saifi A.M.
        Bone ring augmentation around immediate implants: a clinical and radiographic study.
        Ann Maxillofac Surg. 2017; 7: 92-97
        • Stevens M.R.
        • Emam H.A.
        • Alaily M.E.
        • Sharawy M.
        Implant bone rings. One-stage three-dimensional bone transplant technique: a case report.
        J Oral Implantol. 2010; 36: 69-74
        • Yuksel O.
        • Giesenhagen B.
        Vertical augmentation and implant placement in just one operation: a case report.
        Tissue Care News. 2010; 1: 1-6
        • Yuce M.O.
        • Adali E.
        • Turk G.
        • Isik G.
        • Gunbay T.
        Three-dimensional bone grafting in dental implantology using autogenous bone ring transplant: clinical outcomes of a one-stage technique.
        Niger J Clin Pract. 2019; 22: 977-981
        • Oncu E.
        Bone ring autogenous graft transplantationing one stage technique and early implant placement: a case report.
        J Dent App. 2015; 2: 174-177
        • Simion M.
        • Fontana F.
        Autogenous and xenogeneic bone grafts for the bone regeneration: a literature review.
        Minerva Stomatol. 2004; 53: 191-206
        • Pikos M.A.
        Mandibular block autografts for alveolar ridge augmentation.
        Atlas Oral Maxillofac Surg Clin North Am. 2005; 13: 91-107
        • Miller R.J.
        • Korn R.J.
        • Miller R.J.
        Indications for simultaneous implantation and bone augmentation using the allograft bone ring technique.
        Int J Periodontics Restorative Dent. 2020; 40: 345-352
        • Nakahara K.
        • Haga-Tsujimura M.
        • Igarashi K.
        • Kobayashi E.
        • Schaller B.
        • Lang N.P.
        • et al.
        Single-staged implant placement using the bone ring technique with and without membrane placement: micro-CT analysis in a preclinical in vivo study.
        Clin Oral Implants Res. 2020; 31: 29-36
        • Omara M.
        • Abdelwahed N.
        • Ahmed M.
        • Hindy M.
        Simultaneous implant placement with ridge augmentation using an autogenous bone ring transplant.
        Int J Oral Maxillofac Surg. 2016; 45: 535-544
        • Cricchio G.
        • Lundgren S.
        Donor site morbidity in two different approaches to anterior iliac crest bone harvesting.
        Clin Implant Dent Relat Res. 2003; 5: 161-169
        • Watzak G.
        • Zechner W.
        • Ulm C.
        • Tangl S.
        • Tepper G.
        • Watzek G.
        Histologic and histomorphometric analysis of three types of dental implants following 18 months of occlusal loading: a preliminary study in baboons.
        Clin Oral Implants Res. 2005; 16: 408-416
        • Dereka X.
        • Calciolari E.
        • Donos N.
        • Mardas N.
        Osseointegration in osteoporotic like condition: a systematic review of preclinical studies.
        J Periodontal Res. 2018; 53: 933-940
        • Benlidayi M.E.
        • Tatli U.
        • Salimov F.
        • Tükel H.C.
        • Yuksel O.
        Comparison of autogenous and allograft bone rings in surgically created vertical bone defects around implants in a sheep model.
        Clin Oral Implants Res. 2018; 29: 1155-1162
        • Jinno Y.
        • Jimbo R.
        • Lindstrom M.
        • Sawase T.
        • Lilin T.
        • Becktor J.P.
        Vertical bone augmentation using ring technique with three different materials in the sheep mandible bone.
        Int J Oral Maxillofac Implants. 2018; 33: 1057-1063
        • Haga-Tsujimura M.
        • Nakahara K.
        • Kobayashi E.
        • Igarashi K.
        • Schaller B.
        • Saulacic N.
        Single-staged implant placement using bone ring technique with and without membrane placement: an experimental study in the beagle dog.
        Clin Oral Implants Res. 2018; 29: 263-276
        • Nakahara K.
        • Haga-Tsujimura M.
        • Sawada K.
        • Kobayashi E.
        • Mottini M.
        • Schaller B.
        • et al.
        Single-staged vs. two-staged implant placement using bone ring technique in vertically deficient alveolar ridges - part 1: histomorphometric and micro-CT analysis.
        Clin Oral Implants Res. 2016; 27: 1384-1391
        • Nakahara K.
        • Haga-Tsujimura M.
        • Sawada K.
        • Kobayashi E.
        • Schaller B.
        • Saulacic N.
        Single-staged vs. two-staged implant placement in vertically deficient alveolar ridges using bone ring technique - part 2: implant osseointegration.
        Clin Oral Implants Res. 2017; 28: e31-e38
        • Hooijmans C.R.
        • Rovers M.M.
        • de Vries R.B.
        • Leenaars M.
        • Ritskes-Hoitinga M.
        • Langendam M.W.
        SYRCLEs’ risk of bias tool for animal studies.
        BMC Med Res Methodol. 2014; 14: 43
        • Higgins J.P.
        • Altman D.G.
        • Gotzsche P.C.
        • Juni P.
        • Moher D.
        • Oxman A.D.
        • et al.
        The Cochrane Collaboration’s tool for assessing risk of bias in randomised trials.
        BMJ. 2011; 18: d5928
        • Kilkenny C.
        • Browne W.J.
        • Cuthill I.C.
        • Emerson M.
        • Altman D.G.
        Improving bioscience research reporting: the ARRIVE guidelines for reporting animal research.
        PLoS Biol. 2010; 8: e1000412
        • Stadlinger B.
        • Pourmand P.
        • Locher M.C.
        • Schulz M.C.
        Systematic review of animal models for the study of implant integration, assessing the influence of material, surface and design.
        J Clin Periodontol. 2012; 39: 28-36
        • Draenert F.G.
        • Kammerer P.W.
        • Palarie V.
        • Wagner W.
        Vertical bone augmentation with simultaneous dental implantation using crestal biomaterial rings: a rabbit animal study.
        Clin Implant Dent Relat Res. 2012; 14 Suppl 1: e169-e174
        • Liu W.J.
        • Yu K.
        • Kang J.
        • Wang M.Y.
        • Tan Z.
        Effects of GBR and delayed loading on bone ring grafting with simultaneous implant insertion: an experimental study on beagle dogs.
        Sichuan Da Xue Xue Bao Yi Xue Ban. 2018; 49: 781-785
        • Ravaglioli A.
        • Krajewski A.
        • Celotti G.C.
        • Piancastelli A.
        • Bacchini B.
        • Montanari L.
        • et al.
        Mineral evolution of bone.
        Biomaterials. 1996; 17: 617-622
        • Pearce A.I.
        • Richards R.G.
        • Milz S.
        • Schneider E.
        • Pearce S.G.
        Animal models for implant biomaterial research in bone: a review.
        Eur Cell Mater. 2007; 13: 1-10
        • Blanco J.
        • Mareque S.
        • Linares A.
        • Perez J.
        • Munoz F.
        • Ramos I.
        Impact of immediate loading on early bone healing at two-piece implants placed in fresh extraction sockets: an experimental study in the beagle dog.
        J Clin Periodontol. 2013; 40: 421-429
        • Bissinger O.
        • Probst F.A.
        • Wolff K.D.
        • Jeschke A.
        • Weitz J.
        • Deppe H.
        • et al.
        Comparative 3D micro-CT and 2D histomorphometry analysis of dental implant osseointegration in the maxilla of minipigs.
        J Clin Periodontol. 2017; 44: 418-427