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Inlay versus Onlay Iliac Bone Grafting in Atrophic Posterior Mandible: A Prospective Controlled Clinical Trial for the Comparison of Two Techniques
Author(s) -
Felice Pietro,
Pistilli Roberto,
Lizio Giuseppe,
Pellegrino Gerardo,
Nisii Alessandro,
Marchetti Claudio
Publication year - 2009
Publication title -
clinical implant dentistry and related research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.338
H-Index - 85
eISSN - 1708-8208
pISSN - 1523-0899
DOI - 10.1111/j.1708-8208.2009.00212.x
Subject(s) - inlay , medicine , iliac crest , dentistry , implant , bone grafting , bone resorption , resorption , mandible (arthropod mouthpart) , surgery , botany , biology , genus
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.