Bone regeneration using particulate grafts : an update

Objective: A review is made of the publications on bone regeneration using particulate grafts, with an evaluation of the success of implants placed in such regenerated areas. Material and Method: A Medline search using different key words was made of the articles published between 1999-2009 involving at least two patients subjected to grafting with autologous, homologous or xenogenic bone, non-bony substitutes, or a combination of these grafts for the placement of dental implants. Studies involving block grafting were excluded. A total of 11 studies were evaluated. Results: These grafts are indicated in cases of small or peri-implant bone defects such as dehiscences and fenestrations, with the possibility of combining a barrier membrane. However, some authors have used particulate block grafts to secure vertical or horizontal increments of the alveolar process. In most of these cases, graft healing until implant placement lasted 6-9 months. The most frequent complications in the receptor zone were wound dehiscences with exposure of the membrane. In almost all cases, prosthetic loading of the implants took place more than three months after their placement. The implant survival rate varied from 90.9% to 100%, with an implantation success rate of 85.7% to 100%. Conclusions: Although our sample is small, due to the difficulty of finding homogeneous studies, it can be concluded that particulate grafts are effective in correcting localized defects of the alveolar process. The complications of particulate grafting are few, and the success rate of implants placed in the reconstructed areas varies from 85.7% to 100%