ABSTRACT Rationale Autogenous bone is considered the “gold standard” amongst grafting materials when a large volume of bone is required for alveolar ridge augmentation. However, harvesting autogenous grafts may result in complications and patient morbidity. Non‐autogenous grafts may offer viable alternatives and have gained popularity despite a limited evidence base available to support their use. There is a distinct lack of recent high‐quality evidence that directly compares autogenous and non‐autogenous grafting materials or considers their success in terms of histomorphometric outcomes such as new bone formation. The amount of new bone formation could be considered the most appropriate parameter to assess the success of bone grafts. Objective To evaluate whether non‐autogenous bone block grafts may be considered as a suitable alternative to autogenous bone block grafts based on their histomorphometric and clinical outcomes. Methods The protocol for this review was registered on PROSPERO (CRD42023396783). An electronic search of MEDLINE, EMBASE, CINAHL, and CENTRAL was carried out to March 2025. Randomised controlled trials (RCTs), non‐randomised controlled trials, and uncontrolled clinical studies that included adult patients who underwent alveolar ridge augmentation with bone block grafts were included. A narrative synthesis was conducted, and the studies were assessed for risk of bias using a number of tools. Principal Findings Eight studies were included in the review with a total of 199 patients undergoing alveolar ridge augmentation. Studies reported data on histomorphometric outcomes alongside clinical outcomes. One study compared autogenous bone blocks with xenograft bone blocks. No differences between new bone formation % were identified, but xenograft bone blocks had higher residual graft % at the time of bone biopsy. No differences in implant survival rates between grafts were reported; however, complication rates were higher with autogenous bone blocks. Two studies compared autogenous and allograft bone blocks. Inconsistent findings were identified when comparing histomorphometric outcomes and implant survival rates. However, complication rates were higher with allograft bone blocks. Remaining studies evaluated outcomes of allograft bone blocks with no comparison group. Practical Implications There is insufficient evidence to advocate the use of non‐autogenous bone blocks over traditional autogenous bone blocks. Autogenous bone blocks may not always be feasible for patients, and despite the limitations of the evidence identified in this review, it is promising to see that alternative graft materials may be available for these patients.
Chana et al. (Wed,) studied this question.