Dental Implant Outcomes Following Horizontal Guided Bone Regeneration Using Allograft and Periosteal-Secured Sutures: A Retrospective Single-Cohort Stud

Abstract

This single-cohort retrospective study evaluates outcomes of dental implants placed in sites reconstructed with horizontal guided bone regeneration (GBR) using a particulate allogeneic bone substitute and a resorbable membrane stabilized with the periosteal-secured suture (PSS) technique. Patients who underwent horizontal GBR with allograft and a membrane stabilized using the PSS technique, followed by implant placement after ≥6 months of healing, were included. We recorded patient- and procedure-related characteristics. Outcomes included preloading crestal bone loss (PLCBL), post-loading crestal bone loss (PoLCBL), early and late implant failure, and peri-implantitis. We evaluated 96 implants in 62 patients. Early failure occurred in 5.2% of implants, and PLCBL ≥1.0 mm in 7.7%. Additional grafting at implant placement was associated with increased odds of PLCBL (OR=3.50; 95%CI:1.11–11.00; p=0.032), whereas the use of autogenous graft during GBR was associated with reduced odds (OR=0.12; 95%CI:0.04–0.39; p<0.001). Among 67 implants with post-loading follow-up, PoLCBL ≥1.0 mm occurred in 17.9%, with late failure and peri-implantitis observed in 7.5% and 4.5%, respectively. Diabetes was associated with a higher hazard of PoLCBL (HR=3.48; 95% CI: 1.04–11.64; p=0.043). The 1- and 3-year survival rates were 100% for both late failure and peri-implantitis, decreasing to 94.1% at 5 years. Survival free of PoLCBL ≥0.5 mm at 5 years was 60%. PLCBL and PoLCBL were observed in a subset of implants placed in sites reconstructed with allograft and PSS-fixed resorbable collagen membranes. Overall, the limited crestal bone loss, along with high implant survival rates and a low incidence of periimplantitis, supports the clinical predictability of this approach.