A prospective randomized split-mouth study comparing iliac onlay grafts in atrophied edentulous patients: covered with periosteum or a bioresorbable membrane

Purpose: In this prospective study, solid monocortical iliac onlay grafts of the maxilla were randomly covered with a bioresorbable membrane and periosteum within the maxilla. Histologic specimens were analyzed by light microscopy after a healing period of three months and the rate of resorption of the grafts were measured. Materials and methods: Fourteen patients (9 females and 5 males), with a mean age of 56 years (range 25–72) underwent augmentation with avascular iliac onlay bone grafts. The grafts were randomly covered either with a bioresorbable membrane (MC) or periosteum (PC). Resorption was measured with a digital caliper at the microscrews (∅1.5 mm) used to fixate the graft. Histologic evaluation of the specimens derived from the graft with a trephine bur (∅2 mm) from the implant site at implant placement after a 3‐month healing period. Statistical evaluation of the data was performed using Analysis of variance and the Wilcoxon signed rank test. Results: Clinical appearance of the augmented bone after 3 months showed a dense cortical layer with good vascular perfusion. Thirty‐three sites in 13 patients (one dropped put) were analyzed histomorphometrically and showed an average of 46% newly formed bone with no significant difference between the groups (P=0.46). The mean resorption rate at 56 measured sites was 1.2 mm (range 0.3–3.4 mm) after 3 months, with no significant difference between the MC sites and the PC sites (P=0.38). Discussion: Histomorphometry of new bone formation after 3 months demonstrates no significant difference between the PC and MC groups. Initialization of graft resorption can be seen after 3 months with no significant difference as to whether the graft was covered with a membrane or the periosteum. Conclusion: This study provides evidence that after avascular iliac bone grafting, the revascularization of the graft was sufficient after 3 months regardless of the graft coverage with no effect on the amount of initial resorption of the graft.