Evaluation of the effect of bone decortication on alveolar bone augmentation: A pilot study

Of all the different techniques used to reconstruct local bone defects guided bone regeneration (GBR) has proved the best choice. Angiogenesis and blood products are important for GBR and are usually derived from blood vessels in the bone. Animal studies have not shown consistent effects of decortication on improving the results of GBR. The aim of this preliminary study was to assess the success rate of bone augmentation with and without bone decortication.

In this quasi-experimental preliminary study, 8 edentulous areas of the mandible were selected in 30-50-year-old patients, with adequate height but inadequate buccolingual width, for augmentation before implant surgery. In the first surgery buccolingual width of the ridge was measured at a height of 2-5 mm from the crest. Augmentation with GBR was performed without decortication of the buccal cortical bone, except in three cases. Seven months later, measurements of the buccolingual width were repeated and biopsies were taken, followed by evaluation of histopathological and histomorphometrical parameters. Descriptive variables were studied and reported.

In areas without decortication, at 2- and 5-mm distances from the crest the mean buccolingual width increases were 0.2 ± 0.05 and 0.6 ± 0.03 mm, respectively. The mean increases in width for decortication areas were 0.33 ± 0.24 and 2.5 ± 0.50 mm, respectively. In all the cases, contact of the newly formed bone with the xenograft was the dominant view.

Under the limitations of the present study, decortication before lateral augmentation of mandibular ridges by using GBR yielded better results in terms of bone reconstruction.