Histologic analysis of alveolar bone following guided bone regeneration

Background: Questions on new bone quality following guided bone regeneration (GBR) with various graft materials and its importance in osseointegration have been raised. This study reports histologic analysis of bone sections from future implant sites at upper and lower jaws that were augmented with bovine porous bone mineral graft material plus a porcine collagen membrane. Methods: Due to severe atrophy of the alveolar crest, GBR prior to implant placement was indicated in 11 patients (mean age 45.5 years). Following an average of 7 months of healing, implant placement surgery was performed. Bone sections from implant beds were fixed in formalin, decalcified in sodium citrate and formic acid, and placed in paraffin. Sections 5 to 7 mum thick were prepared, stained with hematoxylin and eosin, and analyzed under light microscopy. Results for 27 implant sites are presented. Results: Compared to the lower jaw, segments from the upper jaw had a lower percentage of bone and higher percentage of residual material and vascularization. Conclusions: Within the limits of this study, we concluded that osteogenesis is completed and the rate of vascularization and osteoclastic activity was reduced by 7 months. Also, the upper jaw significantly differed from the lower jaw in bone formation, vascularization, and the amount of residual material. Thus, the anatomical location of the defect may be as important as the properties of the graft material used in obtaining successful osteogenesis using guided bone regeneration techniques.