Particulate Bone Grafts vs Split Bone Cortical Plates: Resorbable and Nonresorbable Membranes in Vertical Augmentation
Clinical Snapshot
PICO Framework
| P — Population | 22 patients with severe vertical alveolar ridge atrophy in the anterior edentulous mandible |
| I — Intervention | Split cortical bone plate technique with autogenous particulate grafts and titanium-reinforced PTFE membrane (T1) |
| C — Comparator | Split cortical bone plate technique with autogenous/xenograft mixture and collagen membrane Bio-Gide (T2) |
| O — Outcomes | Vertical bone gain, crestal bone loss, keratinized tissue width, and peri-implant probing depth at 6 months, 1 year, and 5 years |
Bottom Line
This small RCT (n=22) compared titanium-reinforced PTFE membranes versus collagen membranes in vertical ridge augmentation using split cortical bone plates. While both approaches achieved comparable bone gain, the titanium-reinforced group showed better keratinized tissue maintenance and reduced crestal bone loss over 5 years. However, the study's clinical utility is limited by its small sample size, lack of quantitative results, and methodological reporting deficiencies. The findings suggest potential advantages for non-resorbable membranes in complex augmentation cases, but larger, well-designed trials are needed before definitive clinical recommendations can be made. Australian practitioners should consider these preliminary findings within the context of patient-specific factors and available expertise.
Key Findings
P Value: Not reported
Effect Size: Not quantified in abstract
Primary Outcome: Vertical bone gain - described as 'comparable' between groups
Nnt Or Sensitivity: Not calculable from available data
Confidence Interval: Not reported
Clinical Application
Requires advanced oral surgery skills and specialised materials; technique complexity may limit widespread adoption Relevant to Australian oral and maxillofacial surgery practice; titanium-reinforced membranes and xenografts available but not PBS-subsidised; technique aligns with ANZAOMS guidelines for complex ridge augmentation Patients with severe vertical alveolar ridge atrophy in anterior mandible requiring pre-implant augmentation
Abstract
This study aimed to evaluate vertical bone gain in the anterior edentulous mandible using the split cortical bone plate technique with 2 different graft and membrane combinations: autogenous particulate grafts with titanium-reinforced polytetrafluoroethylene membrane (T1) and a mixture of autogenous and xenograft particulate grafts with a collagen membrane (Bio-Gide) (T2). Twenty-two patients presenting with severe vertical alveolar ridge atrophy were randomly allocated into 2 equal groups with 11 participants in each group. Cone beam computerized tomography was used to assess vertical bone gain and crestal bone loss at 6 months, 1 year, and 5 years postgrafting. Keratinized tissue width and peri-implant probing depth were also measured at the same intervals to evaluate long-term soft tissue stability and peri-implant health. Whereas both groups demonstrated comparable vertical bone gain, the T1 group exhibited better maintenance of keratinized gingiva. It reduced crestal bone loss over time, suggesting the clinical utility of nonresorbable membranes in enhancing soft and hard tissue outcomes in complex augmentation cases.
References
- 1.Durrani, F., Pandey, A., M, R., Shilpi, S., Agarwal, S., & Gawade, M. (2026). Particulate bone grafts vs split bone cortical plates: Resorbable and nonresorbable membranes in vertical augmentation. The Journal of Oral Implantology. https://doi.org/10.1563/aaid-joi-D-25-00062
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