https://pubmed.ncbi.nlm.nih.gov/38117445/
Tunkel J, Hoffmann F, Schmelcher Y, Kloss-Brandstätter A, Kämmerer PW. Int J Implant Dent. 2023;9(1):52. doi:10.1186/s40729-023-00505-y

Original title: Allogeneic versus autogenous shell technique augmentation procedures: a prospective‑observational clinical trial comparing surgical time and complication rates

SUMMARY

This clinical trial is the first study to compare the efficacy of maxgraft^® cortico with autologous shells with respect to operation time and intra- and postoperative complications. A total of 177 patients were included in the study with single-tooth defects, free-end situations in the maxilla and mandible, or edentulous maxilla. Results from the study showed that shell augmentation with maxgraft^® cortico has a significantly shorter surgical time on average (maxgraft^® cortico: 69 min.; autologous shells: 91.2 min.) mainly due to the absence of a bone harvesting procedure. A significant increase in operation time was also seen when both materials were used for the same patient (119.2 min). Similar rates of intra- and postoperative complications were found with autologous shells and maxgraft^® cortico.

OBJECTIVES

Autogenous and allogeneic blocks for shell augmentation of the jaw have shown comparable results. This observational clinical study aimed to compare both materials for shell augmentation concerning surgery time and intra- and postoperative complications.

MATERIAL AND METHODS

Bone augmentation with the shell technique using autogenous or allogenous bone (maxgraft^® cortico) was performed in 117 patients with segmental jaw atrophy. The primary study parameter was the surgical time, comparing both materials. Subsequently, intra- and postoperative complications were recorded.

RESULTS

maxgraft^® cortico (n = 60), autogenous shells (n = 52), or both materials (n = 5) were used. The use of maxgraft^® cortico led to a significantly shorter operation time (p < 0.001). A more experienced surgeon needed significantly less time than a less experienced surgeon (p < 0.001). An increasing number of bone shells (p < 0.001), an additional sinus floor elevation, and intraoperative complications also significantly increased the operation time (p = 0.001). Combining allogeneic and autogenous shells (p = 0.02) and simultaneous sinus floor elevation (p = 0.043) significantly impacted intraoperative complications. No correlations were found between the included variables for postoperative complications (all p > 0.05). In total, 229 implants were inserted after a healing time of 4-6 months, with a survival of 99.6% after a mean follow-up duration of 9 months.

CONCLUSIONS

Compared to the autogenous technique, shell augmentation with maxgraft^® cortico has a shorter surgical time and a similar rate of intra- and postoperative complications as autogenous bone. Together with its promising clinical results, this technique can be recommended.