Recipient Site Perforation Enhances Bone Formation in Autogenous Onlay Grafts: A Controlled Human Histomorphometric Study

Objective: The aim of this research is to identify whether the method of perforating the bone recipient site influences the bone neoformation process in corticocancellous autogenous onlay grafts. Materials and Methods: Following clinical and radiographic examinations, 8 patients (2 men, 6 women; mean age 56.9 y) were included, showing atrophic alveolar ridges in the premaxilla requiring horizontal augmentation using corticocancellous autogenous onlay bone grafting, with the mandibular symphysis as the donor site. Patients underwent 2 surgical procedures: first, the bone grafting was performed, and 6 months later, a biopsy for histomorphometry and dental implant placement was performed. Each patient participated simultaneously in both study groups (split mouth model), being one side as the test group (TG), in which the recipient site was perforated before graft placement, and the contralateral side as the control group (CG), in which the recipient site remained unperforated. Statistical analysis was performed, considering a P value <0.05. Results: Microscopic analysis of both groups confirmed the presence of bone neoformation. A statistically significant difference was observed between groups ( P =0.046), with a mean of 5.74% (±1.82) of newly formed bone in the TG and 3.68% (±1.82) in the CG. Conclusions: Perforation of the recipient site demonstrated a positive influence on the bone neoformation process in autogenous bone grafts.