Calvaria and iliac crest bone grafts: long-term morphostructural analysis

The goal of pre-implant bone augmentation of the deficient alveolar ridge is reconstruction of the proper alveolar anatomy through the techniques of socket preservation, horizontal and vertical ridge augmentation, sinus bone grafting, and others. A variety of bone grafts and bone grafting materials have been used for augmentation of deficient alveolar ridge for the purpose of implant treatment of partially and completely edentulous patients. Both bone substitutes showed a good integration with the host tissue at light microscope observation. Both samples at T1showed strong remodelling phenomena, even if in sites regenerated with calvaria grafts a more dynamic aspect could be detected. Moreover, the presence of new blood vessels could be observed in both type of samples. After ten years, both bone grafts appeared well integrated with the host tissue. Once more, the appearance of sites treated with calvaria graft seem to have a better morphology, very similar to native bone tissue. The microscopic observation of bone samples from sites treated with grafts from different sites allowed to evaluate the presence of regenerative and neoangiogenic phenomena. These phenomena, more evident after six months from the grafting, that is at the moment of implant insertion, are important for grafts integration and for the success of further implant therapy. The calvaria graft microscopic aspect at T1 seems to be more organized and regular than that observed in sites regenerated with iliac crest graft at the same experimental time, suggesting a better clinical performance. However, these differences appear much less evident at T2.