Técnicas cirúrgicas para aumento vertical de rebordo alveolar: revisão de literatura

Abstract

The implant placement in area with lost vertical bone can be associated to unfavourable crown/implant ratio, poor aesthetic outcomes and difficulties in performing adequate oral hygiene. Thus, before or during implant placement, the vertical ridge augmentation can be required. Five groups of vertical ridge augmentation surgical techniques has been identified and evaluated after a bibliographic search: onlay bone grafting, guided bone regeneration, interpositional bone grafting, distraction osteogenesis and growth factors. The objective of the present review was to evaluate the vertical ridge augmentation techniques in relation to predictability and complication rate of the procedures and implant survival and success rate. Conclusion: osteodistraction is preferable in cases with a greater need for alveolar bone height, while other techniques are better at reliably resolving common cases of ridge height defects; results are contradictory for vertical ridge augmentation, using recombinant human platelet-derived growth factor-BB (rhPDGF-BB) or recombinant human bone morphogenetic protein-2 (rhBMP-2); the number of complications and failures of the augmentation procedures is still high to recommend widespread use of such procedures; the survival and success rates of implants placed in the treated areas were similar to those obtained with implants placed in native bone, however, there are few randomized control trial (RCTs) reporting this data. It is difficult to establish conclusions by comparisons between the RCTs for vertical ridge augmentation, since the most of the included studies had small sample sizes, relatively short follow-ups and different types of methodologies.