SUCCESS VERSUS FAILURE IN BONE REGENERATION FOR MAXILLARY EDENTATION

Background: Edentulism in the maxilla often leads to pronounced alveolar bone loss, posing challenges for dental implant rehabilitation. Bone regeneration techniques are employed to reconstruct atrophic maxillary ridges, but outcomes vary. This systematic review (conducted per PRISMA 2020 guidelines) analyzes factors associated with successful vs. failed bone regeneration in the edentulous maxilla, drawing on recent clinical trials, systematic reviews, and meta-analyses. Methods: A comprehensive literature search (PubMed, Scopus, Web of Science, Cochrane Library) was performed for studies (2015–2025) on maxillary ridge augmentation outcomes. Inclusion criteria were peer-reviewed clinical studies (RCTs, controlled trials, observational studies) and high-level reviews focusing on bone regeneration in fully or partially edentulous maxillae, with reported outcomes such as bone gain, graft survival, implant success, and complications. Data on augmentation techniques, biomaterials, patient factors, and clinical outcomes were extracted. Results: A total of Forty-two studies (12 RCTs, 15 prospective, 8 retrospective, 7 systematic reviews/meta-analyses; encompassing >1,200 patients) met inclusion criteria. Augmentation approaches included guided bone regeneration (GBR), onlay bone grafts, maxillary sinus floor augmentation, interpositional (Le Fort I) grafts, and combined techniques. Overall, bone regeneration enabled high implant success rates (typically 85–100% implant survival in regenerated bone). Conclusions: In the edentulous maxilla, ridge augmentation can predictably facilitate implant placement with high success rates when proper techniques and materials are selected. Failures are often attributable to excessive vertical augmentation, poor vascular/soft-tissue conditions, or adverse patient factors like smoking. Autogenous bone and modern biomaterials both can succeed; tailoring the choice to defect size and patient profile is vital. Future long-term trials should refine protocols for vertical bone regeneration and evaluate emerging bioengineering approaches. Clinicians should employ a risk-mitigated, patient-specific strategy to maximize bone regeneration success in the atrophic maxilla.