A Randomised control trial on the efficacy of autogenous bone grafting vs synthetic bone grafts in implant site development

Abstract

Background: Implant site development is crucial for the successful placement of dental implants, especially in patients with insufficient alveolar bone. Both autogenous bone grafting (autograft) and synthetic bone grafts have been used for alveolar bone augmentation, but their relative effectiveness remains unclear. This study aimed to compare the efficacy of autogenous bone grafts and synthetic bone grafts in implant site development, focusing on bone gain, implant stability, postoperative morbidity, and implant survival.

Methods: A randomized controlled trial (RCT) was conducted with 120 participants who required alveolar ridge augmentation prior to dental implant placement. Participants were randomly assigned to receive either an autogenous bone graft (Group A) or a synthetic bone graft (Group B). Primary outcomes included ridge width gain, ridge height gain, and bone density, assessed using CBCT imaging at baseline and 6 months post-grafting. Secondary outcomes included histomorphometric analysis of bone biopsies, implant stability measured by ISQ, and postoperative morbidity evaluated using a visual analog scale (VAS) for pain and swelling.

Results: At 6 months post-grafting, the autogenous group showed significantly greater bone gain in both ridge width (4.21 mm vs. 3.92 mm, p = 0.004) and ridge height (3.14 mm vs. 2.86 mm, p = 0.011) compared to the synthetic group. Histomorphometric analysis revealed a higher percentage of vital bone in the autogenous group (46.8% vs. 38.3%, p < 0.001). Implant stability was higher in the autogenous group immediately after implantation, although both groups showed similar secondary stability by 3 months. Postoperative morbidity was higher in the autogenous group, with more pain (mean VAS 6.8 vs. 4.3, p < 0.001) and swelling. Implant survival was similar across both groups, with 95.0% in the autogenous group and 93.3% in the synthetic group at 12 months.

Conclusions: Both autogenous and synthetic bone grafts were effective for implant site development, with autogenous bone grafts yielding superior biological outcomes. However, synthetic bone grafts provided a less invasive alternative with reduced postoperative morbidity and similar implant survival. Patient needs, with autogenous grafts should guide the choice of graft material preferred for cases requiring maximum bone regeneration and synthetic grafts considered for less complex cases or when minimizing morbidity is a priority.