A randomized and controlled clinical trial of two different compositions of deproteinized bovine bone and autogenous bone used for lateral ridge augmentation

Clin Oral Implants Res. 2014 Mar;25(3):310-320. doi: 10.1111/clr.12143. Epub 2013 Apr 2.


Objective: The aim of the study was to radiologically and histologically evaluate the graft healing and volumetric changes after lateral augmentation with two different compositions of deproteinized bovine bone (DPBB) and autogenous bone (AB).

Material and methods: Thirteen patients with a mean age of 59.6 ± 12.1 years (six men and seven women) were included in this randomized and controlled trial, designed as a split-mouth study. Ten edentulous and four partially edentulous jaws with an alveolar ridge width of ≤4 mm were laterally augmented with a graft composition of 60 : 40 (DPBB/AB) on one side and 90 : 10 (DPBB/AB) on the contralateral side. Cone beam computed tomography (CB/CT) was obtained immediately postoperatively and after a healing period of 7.5 months. Width changes were measured on CB/CT scans. After a mean healing period of 8.1 months (range, 7.9-8.3), biopsies were retrieved perpendicular to the crest from each graft by means of a trephine bur. Histomorphometry was performed, and the following variables were recorded: Ingrowth of new bone (percentage of total graft width), percentage of DPBB, bone and soft tissue, and percentage of DPBB particles in contact with bone.

Results: The mean gained width of the alveolar crest after 7.5 months was significantly more for the 60 : 40 mixture compared with the 90 : 10 mixture, 3.5 (±1.3) mm and 2.9 (±1.3) mm, respectively. There was a significant difference in graft width reduction between 60 : 40 and 90 : 10 after 7.5 months, 37 (±19.9)% and 46.9 (±23.5)%, respectively. New bone ingrowth had occurred in 82.1 (±23.3)% and 82.3 (±26.6)% of the graft, respectively. There were no statistical differences between fractions of different tissues between the 90 : 10 and 60 : 40 compositions. However, there were significantly more soft tissue and less new bone formation closer to the periosteum compared with the graft portion closer to the residual bone in both 60 : 40 and 90 : 10 compositions.

Conclusions: There was significantly less graft width reduction with a mixture of 60 : 40 (DPBB/AB) compared with a mixture of 90 : 10 composition, but the results from the histomorphometry showed no statistical differences comparing the groups.

Keywords: autogenous bone graft; bovine hydroxyapatite; clinical study; fibrin glue; histology; maxillary sinus floor augmentation.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Adult
  • Aged
  • Alveolar Ridge Augmentation / methods*
  • Animals
  • Cattle
  • Dental Implantation, Endosseous
  • Female
  • Fibrin Tissue Adhesive / chemistry
  • Fibrin Tissue Adhesive / therapeutic use
  • Humans
  • Jaw, Edentulous / diagnostic imaging
  • Jaw, Edentulous / surgery
  • Jaw, Edentulous, Partially / diagnostic imaging
  • Jaw, Edentulous, Partially / surgery
  • Male
  • Middle Aged
  • Minerals / chemistry
  • Minerals / therapeutic use*
  • Oral Surgical Procedures, Preprosthetic
  • Surgical Flaps
  • Sweden
  • Tissue Adhesives / therapeutic use
  • Tomography, X-Ray Computed
  • Treatment Outcome
  • Wound Healing


  • Bio-Oss
  • Fibrin Tissue Adhesive
  • Minerals
  • Tissue Adhesives