Horizontal guided bone regeneration on knife-edge ridges: A retrospective case-control pilot study comparing two surgical techniques

Clin Implant Dent Relat Res. 2022 Apr;24(2):211-221. doi: 10.1111/cid.13073. Epub 2022 Feb 15.


Introduction: Studies evaluating guided bone regeneration (GBR) on knife-edge ridges using absorbable membranes with staged approaches have reported various horizontal bone gains. This study compared the horizontal bone gain obtained via a conventional technique of GBR and a recently-reported technique. Bone loss during the healing process was also measured.

Methods: Consecutive patients who underwent GBR on knife-edge ridges via a conventional technique (control group) or the Sausage Technique (test group) were included in this study. GBR was performed using a collagen membrane and deproteinized bovine bone mineral combined with an autogenous graft at a 1:1 ratio. Cone-beam computed tomography (CBCT) was performed preoperatively, postoperatively, and after the patient healed. Horizontal bone width was measured on CBCT images 2 mm apical from the top of the crest. The preoperative CBCT and posthealing CBCT were superimposed to calculate the bone gain after healing, and the preoperative and postoperative CBCT scans were superimposed to calculate the bone gain after surgery. Bone loss during healing was calculated by subtracting the width of the ridge after healing from the postoperative width.

Results: The mean horizontal bone gain was significantly lower in the control group (2.7 ± 1.8 mm; 83.2%) than in the test group (5.3 ± 2.3 mm; 216.8%) (p = 0.003). The average horizontal bone loss between regeneration and implant placement was 0.9 mm in the control group (27.9%) and 2.1 mm in the test group (29.4%). While the absolute bone loss was significantly different (p = 0.012), the percentage of bone resorption was not (p = 0.608).

Conclusion: The new technique resulted in significantly more bone gain than a conventional GBR technique. The rate of graft resorption during healing was stable regardless of the amount of grafted material.

Keywords: biomaterials; bone gain; bone resorption; guided bone regeneration; horizontal ridge augmentation; resorbable membrane; sausage technique.

MeSH terms

  • Alveolar Ridge Augmentation* / methods
  • Animals
  • Bone Regeneration
  • Bone Transplantation / methods
  • Cattle
  • Dental Implantation, Endosseous
  • Dental Implants*
  • Guided Tissue Regeneration, Periodontal / methods
  • Humans
  • Pilot Projects
  • Retrospective Studies


  • Dental Implants