Comparative Evaluation of Bone Ring versus Particulate Bone Graft using CBCT in Buccal Bone Augmentation with Simultaneous Implant Placement: A Randomised Controlled Trial
Sep 2026· Journal of Clinical and Diagnostic Research· 0 citations
TL;DR
The Bone Ring Technique (BRT) is a newer viable option for restoring complex defects around dental implants with three-dimensional bone augmentation with significant height and width augmentation of buccal bone.
Abstract
Introduction: Dental implant placement in defective sockets often compromises its predictability and long-term success. Although various techniques have been suggested for augmentation of defects around implants, the most recent advanced three-dimensional reconstruction technique is the Bone Ring Technique (BRT).
Aim: To compare and evaluate the buccal bone regenerative capacity of bone ring and particulate bone graft.
Materials and Methods: This randomised controlled parallel group trial was conducted at the Department of Periodontology, Karpaga Vinayaga Institute of Dental Sciences, Kancheepuram, Tamil Nadu, India, for a duration of six months, from August 2025 to February 2026. In the present study, among 24 edentulous sites, 12 were included in the Bone ring group (Group A), and 12 were included in the particulate graft group (Group B). Buccal height, palatal height and ridge width were assessed between baseline and six months. Wilcoxon Signed Ranks Test and Mann-Whitney U Test were used for intra- and intergroup comparison, respectively. The Statistical Package for Social Sciences (SPSS) software, version 21.0 was used, and p<0.05 was considered significant.
Results: The CBCT analysis before and after six months of implant placement showed that both group A and group B demonstrated significant height and width augmentation of buccal bone. While comparing the augmentation between group A and group B, group A showed significantly higher bone gain than group B, in both buccal height and width, with p-values of 0.037 and < 0.001, respectively.
Conclusion: The Bone Ring Technique (BRT) is a newer viable option for restoring complex defects around dental implants with three-dimensional bone augmentation.
Purpose Vertical alveolar bone defects often require advanced augmentation techniques to enable successful implant placement. The aim of this study was to compare short-term vertical bone gain following two approaches: the bone-ring graft technique and guided bone regeneration (GBR) using a non-resorbable membrane in patients with vertical alveolar deficiencies. Materials and Methods A prospective cohort study was conducted involving 30 systemically healthy adult patients with posterior mandibular vertical bone defects measuring ≥4 mm. Participants were assigned to one of two treatment groups: Group A received the bone ring in conjunction with titanium implants and a resorbable collagen membrane; Group B was treated with allogeneic bone grafts and titanium-reinforced dense polytetrafluoroethylene (d-PTFE) membranes. Radiographic evaluations were performed at baseline, 1 week, 1 month, and 3 months postoperatively by cone-beam computed tomography (CBCT) and periapical radiographs. The primary outcome was vertical bone height gain. The data were analyzed using IBM SPSS Statistics Version 28.0. Results Group A demonstrated statistically significantly greater vertical bone gain at all postoperative intervals: 9.1 mm at 1 week, 10.6 mm at 1 month, and 9.7 mm at 3 months, compared to 7.8 mm, 7.0 mm, and 6.9 mm, respectively, in Group B (p < 0.0001). Plaque index scores were comparable between groups, with no statistically significant differences observed in postoperative swelling or infection rates. However, membrane exposure was statistically significantly more frequent in Group B at all follow-up visits (p ≤ 0.02). Conclusion The bone-ring graft technique was associated with greater vertical bone gain and a lower incidence of membrane exposure compared to GBR using a non-resorbable membrane. Further studies with longer follow-up are required to confirm these findings.
A. Almarghlani, Hanin Alqurashy, Mohanad G Alnahdi et al.· Oral Health & Preventive Den...· 0 citations
PURPOSE
This clinical trial was carried out to compare the outcomes of immediate implants positioned 4 mm below free gingival margin versus deeper placement of 6 mm after a period of 1 year.
MATERIALS AND METHODS
Seventy platform-switching implants with a Morse taper conical connection and 1 mm of machined neck were placed in a flapless approach in the molar or premolar region immediately after tooth extraction. A total of 35 implants were positioned 4 mm below the buccal gingival margin (control group), and another 35 were placed 6 mm below the gingival margin (test group). All implant sites were grafted with an allogenic bone substitute and received individual healing abutments (IHAs) made chairside. After 4 months, the implants were restored with final screw-retained zirconia restorations. Radiographic marginal bone loss (MBL) was measured at the delivery of the final restoration (T1) and after 1 year (T2). Peri-implant clinical parameters (probing depth [PD], bleeding on probing [BOP], and plaque index [PI]) were recorded at 1-year follow-up appointment (T2).
RESULTS
In total, 70 implants were evaluated after 1 year of follow-up (35 control and 35 test groups). The test group showed significantly lower (p < 0.001) MBL than the control group at both T1 (mean ± standard deviation: 0.11 ± 0.32 vs. 0.76 ± 0.68 mm) and T2 (0.12 ± 0.23 vs. 0.54 ± 0.49 mm). The PD mean was 3.46 ± 0.74 in the control group and 3.49 ± 1.20 in the test group, with a p-value of 0.890. PI and BOP were also similar in both groups: PI-11% for the control and 8% for the test groups (p = 0.551), BOP-13% for the control and 7% for the test groups (p = 0.214).
CONCLUSIONS
Immediate implants placed 6 mm below the mid-buccal gingival level showed significantly less short-term (up to 1 year) MBL than immediate implants placed 4 mm below the gingiva.
Jonas Alkimavicius, Manish Rathi, Ula Linkeviciute et al.· Journal of Prosthodontics· 0 citations
This retrospective cohort study was performed to compare the long-term survival rates of implants placed following onlay versus interpositional bone grafting in the atrophic mandible. Forty-eight patients with an adequate bone width who required ridge heightening were included. Twenty-six patients received an interpositional bone graft by sandwich technique (sandwich group) and 22 received an onlay graft (onlay group). The results showed a significant difference in implant failure: 17 of 52 implants (32.7%) placed in the onlay group failed, compared with 1 of 63 implants (1.6%) placed in the sandwich group (P < 0.001). Cox regression demonstrated a significantly lower hazard of implant failure in the sandwich group when compared to the onlay group (hazard ratio = 0.022, P = 0.002). Mean marginal bone loss (MBL) from implant placement to final follow-up was significantly lower in the interpositional sandwich group (2.98 ± 1.34 mm; mean follow-up 92.50 ± 20.45 months) than in the onlay group (4.50 ± 0.58 mm; mean follow-up 81.81 ± 18.54 months) (P = 0.004). In the multivariate analysis (general linear model), augmentation type (P < 0.001), follow-up duration (P < 0.001), initial bone gain (P = 0.030), and gingival biotype (P = 0.010) were significantly associated with MBL, while keratinized tissue width was not (P = 0.080). Within the limitations of this study, dental implants placed after interpositional sandwich grafting showed higher long-term survival and less MBL than implants placed after onlay grafting in the atrophic mandible.
M. Dalband, S. Seyfi, H. Behnia et al.· International Journal of Ora...· 0 citations
PURPOSE
This pilot study investigated the effects of different extraction-socket bone-resorption patterns on alveolar ridge preservation (ARP) performed with an open-wound healing technique.
METHODS
Sites were divided into two groups according to cone-beam computed tomography (CBCT) findings obtained immediately after ARP surgery (T1): group 1 included sockets with vertical bone resorption >1/3 of the buccal/labial or lingual/palatal bone wall, and group 2 included sockets with vertical bone resorption ≤1/3 of the buccal/labial and lingual/palatal bone walls. Follow-up CBCT was performed approximately 5 months after surgery (T3). Hard-tissue changes were measured by superimposing CBCT images obtained at T0 (before tooth extraction), T1, and T3. Soft-tissue healing was evaluated at suture removal (T2), and biopsy specimens were collected before implant placement.
RESULTS
Sixteen participants with 19 sites completed this pilot study. All included patients underwent ARP with an intentionally exposed xenogeneic collagen matrix seal; however, one patient did not undergo implant-placement surgery at our hospital. Overall, CBCT measurements of ridge alterations showed excellent intra-rater reliability and minimal systematic bias. Bone resorption occurred in both groups (P<0.05), reflecting the natural bone-remodeling process. However, no intergroup differences were observed in horizontal or vertical dimensional changes. In addition, locally estimated scatterplot smoothing analysis identified bootstrap median inflection points below the 1/3 threshold, suggesting a possible nonlinear relationship between the vertical resorption proportion and three-dimensional changes. No statistically significant differences were observed in soft-tissue healing or implant-related outcomes. Histomorphometric evaluation of biopsy specimens showed new bone formation without signs of inflammation or fibrous encapsulation.
CONCLUSIONS
Within the limitations of this study, intentionally exposing the xenogeneic collagen matrix seal yielded comparable outcomes in non-contained and contained sockets. This finding may reflect the material's ability to reduce the adverse effects of socket-wall resorption; however, larger multicenter studies are warranted.
TRIAL REGISTRATION
Chinese Clinical Trial Registry Identifier: ChiCTR2300078331.
Xinyi Zhou, Yuping Hong, Yang Yang et al.· Journal of Periodontal & Imp...· 0 citations
Background: Dental implants placement in long-standing edentulous areas often encounter the problem of alveolar height deficiency from gradual bone resorption over time. Therefore, vertical bone augmentation prior to implant placement would be much needed.Objectives: To compare the effectiveness of various vertical ridge augmentation techniques.
Methods: This review followed the PRISMA guideline. Electronic and manual searches of randomized controlled trials (RCTs) were conducted through the MEDLINE, CENTRAL, Embase, and Scopus databases. The primary outcome was vertical bone gain. Secondary outcomes were bone resorption, complications, implant survival, and success rates. The Cochrane risk-of-bias assessment tool version 2 was used for quality assessment.
Results: Data analyses of the 29 included studies indicated that distraction osteogenesis (DO) provided the highest final vertical bone gain (8.38±1.74 mm.) followed by inlay bone grafting (2.69±0.37 to 7.00±1.76 mm) and guided bone regeneration (GBR) (1.50±1.60 to 6.86±0.94 mm). The highest degree of bone resorption was observed with onlay bone grafting (0.60±0.70 to 4.77±1.67 mm). The DO and GBR techniques demonstrated 20-60% and 0-47% complication rates, respectively. Implant survival and success rates for all ridge augmentation techniques were over 90% and 60%, respectively.
Conclusions: From this study, all vertical bone augmentation techniques can effectively increase the alveolar ridge height. While DO provides the greatest vertical bone gain, the GBR techniques might be a more clinically practical option. However, future well-planned RCTs to identify effective vertical bone augmentation techniques are still warranted.
BACKGROUND
Primary stability is a critical factor for dental implant success, especially in areas with poor bone quality. This randomized controlled clinical study aimed to evaluate the impact of 2 different osteotomy preparation techniques: osseodensification (OD) and conventional drilling, combined with 2 different implant macrogeometries (tapered and cylindrical), on implant stability in low bone density regions.
METHODS
The study involved 20 patients who received 36 dental implants in the maxilla or mandible. Sites were randomly allocated into 4 groups based on preparation technique (conventional versus OD) and implant design (tapered versus cylindrical). Primary stability and insertion torque (IT) were recorded postinsertion immediately. Secondary stability was assessed at 12 weeks using resonance frequency analysis (RFA). Preoperative CBCT was utilized to evaluate bone density and alveolar dimensions.
RESULTS
Statistical analysis revealed no significant differences between the groups regarding primary stability (P=0.935), insertion torque (P=0.784), and secondary stability (P=0.136), despite the implants placed using the OD technique demonstrating higher primary stability compared with conventional drilling. In addition, tapered implants showed a more pronounced increase in stability than cylindrical designs under the same preparation conditions.
CONCLUSIONS
Neither the choice of drilling technique nor the implant macrogeometry significantly influences insertion torque or stability levels in regions of low bone density. All tested combinations provided comparable and satisfactory clinical outcomes.
Worood A Akram, S. Bede· The Journal of craniofacial...· 0 citations
Related blog posts
MIT News · Artificial Intelligence· news.mit.eduAug 17, 2026
A USAF cadet and a Lincoln Laboratory researcher found AI chatbots can help nontechnical service members produce viable software applications for their unique problems.
