Volumetric assessment of horizontal augmentation using a porcine xenograft stabilized with collagen gel and simultaneous implant placement: 1-year results from a non-controlled cohort study

Objective: This prospective single-arm cohort study aimed to evaluate the clinical performance of a heterologous cortico-cancellous collagenic bone mix stabilized with a collagen gel for alveolar ridge re-establishement simultaneous to implant placement for a period of 1-year follow-up. Materials & Methods: Twenty partially edentulous patients with up to two missing teeth in posterior regions and minor horizontal bone atrophy were recruited to receive a total of 24 implants (Premium One, Sweden&Martina, Italy) in accordance with manufacturer’s instructions. Following implant placement, the buccal cortical bone was perforated and a porcine heterologous cortico-cancellous collagenated bone (OsteoBiol® Gen-Os®, Tecnoss®, Italy), stabilized with a type I and type III collagen gel (OsteoBiol® TSV Gel, Tecnoss®, Italy) was applied to the buccal surface of the alveolar crest and protected by a xenogenic collagen membrane (OsteoBiol® Evolution®, Tecnoss®, Italy) in order to restore the alveolar architecture and treat existing dehiscences. Outcomes included surgical and adverse events, bone volumetric changes measured by CBCT scan superimposition, marginal bone level changes, complication-free survival of implants and prosthesis, conducted preoperatively, postoperatively, at the time of implant exposure and one year after surgery. Results: No complications or adverse events were reported during the observation period. After applying three-dimensional model superimposition and volumetric analysis, a significant mean volume increase of 607.6±492.0 mm was achieved (p<0.001), ranging from 10.4 mm to 1725.2 mm , corresponding to approximately 3-4 mm of horizontal bone gain. The mean percentage increase relative to baseline was 22.6±20.5%. Despite the post-surgical marginal bone remodulation, bone level changes from loading to one year follow-up was negligible (0.15±0.22 mm), even though statistically significant (p=0.010). Conclusion: Simultaneous guided bone regeneration with cortico-cancellous collagenated bone of porcine origin stabilized with a collagen gel was adequate to re establish crestal bone architecture. Adequate bone volume was maintained over the course of one year.