BMAC and xenograft with prebent Ti mesh versus autograft and xenograft in edentulous patients with atrophic maxillary ridges

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The International journal of oral & maxillofacial implants Published April 13, 2026 Medically reviewed April 25, 2026 Study authors: Moustafa Ahmed, Shawky Mohamed, Moshy Sara El, Mounir Mohamed, Nassar Yasmine, Bahaa Moataz PubMed ↗ DOI ↗ By Dr. Lars van Dijk, PhD · Surgical, Procedural & Diagnostic

Key Takeaway

Consider 3D alveolar reconstruction with BMAC/xenograft and prebent Ti mesh for atrophied maxillary ridges, noting limited sample size.

This randomized controlled trial involved ten fully edentulous patients suffering from severe maxillary vertical and horizontal bone loss. The study compared a test intervention of bone marrow aspirate concentrate (BMAC) and xenograft mixed with prebent titanium (Ti) mesh against a control intervention of autograft and xenograft with prebent Ti mesh. Primary outcomes assessed bone quality and quantity, including vertical and horizontal bone gain, resorption rate, bone area percentage, and mature bone percentage. The follow-up period was six months.

Regarding bone gain, the test side demonstrated a vertical gain of 3.47 ± 0.87 mm versus 4.10 ± 0.67 mm on the control side; this difference was not statistically significant. However, horizontal bone gain was 3.476 ± 0.59 mm on the test side compared to 2.918 ± 0.80 mm on the control side, where the test side was higher. The resorption rate was lower on the test side (106.2 ± 108.6 mm) compared to the control side (193.3 ± 107.9 mm).

Significant differences were observed in bone composition. The bone area percentage was 47.9% on the test side versus 28.5% on the control side, a statistically significant difference favoring the test side. Similarly, the percentage of mature bone was 67.7% on the test side compared to 26.5% on the control side, also statistically significant. No adverse events, serious adverse events, discontinuations, or tolerability issues were reported.

The study has notable limitations, primarily the very small sample size of ten patients, which restricts the statistical power and generalizability of the results. While the practice relevance suggests this technique could be a reliable and less complicated option for atrophied ridges, the lack of reported p-values for most comparisons and the observational nature of the safety data require cautious interpretation. Further research with larger cohorts is needed to confirm these findings.

Study Details

Study typeRct

EvidenceLevel 2

Follow-up6.0 mo

PublishedApr 2026

PMID40343919

View Original Abstract ↓

PURPOSE: To evaluate bone quality and quantity after 3D augmentation of vertically and horizontally atrophied maxillary ridges and compare the use of bone marrow aspirate concentrate (BMAC) and xenograft versus autograft and xenograft, both using prebent titanium (Ti) mesh over a virtually augmented model. MATERIALS AND METHODS: Ten fully edentulous patients with severe maxillary vertical and horizontal bone loss were recruited. Virtual horizontal and vertical bone augmentation was performed for the deficient ridge to produce virtually augmented models for prebent Ti meshes preoperatively. Each patient was rehabilitated with BMAC and xenograft on one side of their mouth (test side) and with autograft and xenograft on the other (control side). For the test side, the mesh was loaded with a mix of xenograft and BMAC from the anterior iliac crest. For the control side, the mesh was loaded with a 1:1 ratio of xenograft to autograft mix. The meshes on both sides were fixed in place using miniscrews. RESULTS: CBCT scans were performed 6 months postoperatively for all patients. The test side showed a mean vertical bone gain of 3.47 ± 0.87 mm, which was comparable to that of the control side (4.10 ± 0.67 mm). The test side also showed a mean horizontal bone gain of 3.476 ± 0.59 mm, which was higher than that of the control side (2.918 ± 0.80 mm). While the mean resorption rate in the test side (106.2 ± 108.6 mm) was lower than the mean value in the control side (193.3 ± 107.9 mm), the differences in bone gain were not statistically significant. However, a statistically significant higher bone area percentage (47.9%) as well as a higher percentage of mature bone (67.7%) were detected in the test side compared to the control side (28.5% and 26.5%, respectively). CONCLUSIONS: 3D alveolar reconstruction using prebent Ti meshes loaded with xenograft mixed with BMAC could be a reliable and less complicated technique for vertically and horizontally atrophied maxillary ridges.

BMAC and xenograft with prebent Ti mesh versus autograft and xenograft in edentulous patients with atrophic maxillary ridges

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BMAC and xenograft with prebent Ti mesh versus autograft and xenograft in edentulous patients with atrophic maxillary ridges

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