Inlay versus Onlay Iliac Bone Grafting in Atrophic Posterior Mandible: A Prospective Controlled Clinical Trial for the Comparison of Two Techniques
Authors:
- Pietro FelicePFPietro Felice
- Roberto PistilliRPRoberto Pistilli
- Giuseppe LizioGiuseppe Lizio
- Gerardo PellegrinoGerardo Pellegrino
- Alessandro NisiiANAlessandro Nisii
- Claudio MarchettiCMClaudio Marchetti
- 1 October 2009
- journal article
- research article
- Published by Wiley in Clinical Implant Dentistry and Related Research
- Vol. 11 (s1) , e69-82
Abstract
Purpose: To compare the efficacy of inlay and onlay bone grafting techniques in terms of vertical bone formation and implant outcomes for correcting atrophic posterior mandibles.Materials and Methods: Twenty surgical sites were assigned to two treatment groups, inlay and onlay, with iliac crest as donor site. After 3 to 4 months, 43 implants were placed and loaded 4 months later. The median follow up after loading was 18 months.Results: For the inlay versus onlay group, median bone gain was 4.9 versus 6.5 mm (p = .019), median bone resorption was 0.5 versus 2.75 mm (p < .001), and median final vertical augmentation was 4.1 versus 4 mm (p = .190). The implant survival rate was 100% in both groups, while the implant success rate was 90% versus 86.9% (p = .190, not significant). A minor and major complication rate of 20% and 10%, respectively, for both groups was encountered.Conclusions: Inlay results in less bone resorption and more predictable outcomes, but requires an experienced surgeon. In contrast, onlay results in greater bone resorption and requires a bone block graft oversized in height, but involves a shorter learning curve. Once implant placement has been carried out, the outcomes are similar for both procedures.Keywords
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