GBR Advances Make Narrow Ridges Implant-Ready Without the Need for Autogenous Bone

Guided bone regeneration (GBR) has become an integral part of implant dentistry. Initially, only simple bone defects, such as a dehiscence or fenestration, were treated with GBR.¹ It is currently used extensively for vertical and horizontal ridge augmentation with reproducible outcomes, high implant success, and low complication rates.^1-4 Augmentation remains a challenge due to the complexity of hard and soft tissue management. The predictability of the procedure depends on case selection and the anatomy of the defect.

The so-called knife-edged ridge or Cawood and Howell class IV edentulous ridge⁵ presents a unique challenge for horizontal ridge augmentation. The height of the ridge is adequate, but the width is insufficient for implant placement. GBR, using anorganic bovine bone mineral in combination with autogenous bone has been shown to be effective in maintaining atrophic ridges in the maxillary and mandibular arch.^3,4,6-10

Autogenous Bone

The use of the autogenous bone is still considered the gold standard graft material for GBR due to its osteogenic, osteoconductive, and osteoindutive properties.¹¹ Unfortunately, autogenous bone, commonly harvested from the ramus and symphysis area, is associated with increased patient morbidity.^12,13 Furthermore, a recent systematic review reported no significant clinical differences in implant success rates between the use of autogenous bone and other bone substitutes. Likewise, a systematic review of randomized clinical trials of different bone graft materials showed no significant differences in the bone gains between the materials with successful clinical and histological outcomes.^11,14-19

This originally appeared in Boeriu S, Hottel TL, Chirla C, Chirla P. Achieving predictable bone regeneration without autogenous grafts. Decisions in Dentistry. 2025;11(2):36-39.