Evaluation of complication rates and vertical bone gain after guided bone regeneration with non‐resorbable membranes versus titanium meshes and resorbable membranes. A randomized clinical trial

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Abstract

Background

The partial edentulous posterior mandible is often a challenge area that requires a bone reconstructive surgery for implants placement.

Purpose

This RCT was aimed to evaluate complications rate and vertical bone gain after Guided Bone Regeneration (GBR) with dense non‐resorbable d‐PTFE titanium‐reinforced membranes (Group A) versus titanium meshes covered by cross‐linked collagen membranes (Group B).

Material and Methods

40 partially edentulous patients with atrophic posterior mandible, were randomly divided into two study group: 20 patients were treated with one stage GBR by means of non‐resorbable d‐PTFE titanium‐reinforced membranes (Group A); and 20 patients, by means of titanium mesh covered by cross‐linked collagen membranes (Group B). All complications were recorded, distinguishing between “surgical” and “healing” and between “minor” or “major.”. Primary implants stability and vertical bone gain were also evaluated.

Results

In the group A, surgical and healing complication rates were 5.0% and 15.0%, respectively. In the group B, surgical and healing complication rates were 15.8% and 21.1%, respectively. No significant differences between two study group were observed regarding complications rate implant stability and vertical bone gain.

Conclusions

Both GBR approaches for the restoration of atrophic posterior mandible achieved similar results regarding complications, vertical bone gain and implant stability.

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Most cited references 52

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A classification of the edentulous jaws.

J.I. Cawood, R.A. Howell (1988)

A classification of the edentulous jaws has been developed based on a randomised cross-sectional study from a sample of 300 dried skulls. It was noted that whilst the shape of the basalar process of the mandible and maxilla remains relatively stable, changes in shape of the alveolar process is highly significant in both the vertical and horizontal axes. In general, the changes of shape of the alveolar process follows a predictable pattern. Such a classification serves to simplify description of the residual ridge and thereby assist communication between clinicians; aid selection of the appropriate surgical prosthodontic technique; offer an objective baseline from which to evaluate and compare different treatment methods; and help in deciding on interceptive techniques to preserve the alveolar process. An awareness of the pattern of resorption that takes place in various parts of the edentulous jaws, enables clinicians to anticipate and avert future problems.

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10-year survival and success rates of 511 titanium implants with a sandblasted and acid-etched surface: a retrospective study in 303 partially edentulous patients.

Simone Janner, Daniel Buser, Christoph Ramseier … (2012)

This retrospective study assessed the 10-year outcomes of titanium implants with a sandblasted and acid-etched (SLA) surface in a large cohort of partially edentulous patients. Records of patients treated with SLA implants between May 1997 and January 2001 were screened. Eligible patients were contacted and invited to undergo a clinical and radiologic examination. Each implant was classified according to strict success criteria. Three hundred three patients with 511 SLA implants were available for the examination. The mean age of the patients at implant surgery was 48 years. Over the 10-year period, no implant fracture was noted, whereas six implants (1.2%) were lost. Two implants (0.4%) showed signs of suppuration at the 10-year examination, whereas seven implants had a history of peri-implantitis (1.4%) during the 10-year period, but presented with healthy peri-implant soft tissues at examination. The remaining 496 implants fulfilled the success criteria. The mean Plaque Index was 0.65 (±0.64), the mean Sulcus Bleeding Index 1.32 (±0.57), the mean Probing Depth 3.27 mm (±1.06), and the mean distance from the implant shoulder to the mucosal margin value -0.42 mm (±1.27). The radiologic mean distance from the implant shoulder to the first bone-to-implant contact was 3.32 mm (±0.73). The present retrospective analysis resulted in a 10-year implant survival rate of 98.8% and a success rate of 97.0%. In addition, the prevalence of peri-implantitis in this large cohort of orally healthy patients was low with 1.8% during the 10-year period.

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Augmentation procedures for the rehabilitation of deficient edentulous ridges with oral implants.

Matteo Chiapasco, Marco Zaniboni, Maurizio Boisco (2006)

To analyze publications related to augmentation procedures and to evaluate the success of different surgical techniques for ridge reconstruction and the survival/success rates of implants placed in the augmented areas. Clinical investigations published in English involving at least 5 patients and with a minimum follow-up of 6 months were included. The following procedures were considered: a) Guided bone regeneration (GBR); 2) Onlay bone grafts; 3) Inlay grafts; 4) Bone splitting for ridge expansion (RE); 5) Distraction osteogenesis (DO); and 6) Revascularized flaps. Success rates of augmentation procedures and related morbidity, as well as survival and success rates of implants placed in the augmented sites were analyzed. Success rates of surgical procedures ranged from 60% to 100% for GBR, from 92% to 100% for onlay bone grafts, from 98% to 100% for ridge expansion techniques, from 96,7% to 100% for DO, and was 87.5% for revascularized flaps, whereas survival rates of implants ranged from 92% to 100% for GBR, from 60% to 100% for onlay bone grafts, from 91% to 97.3% for RE, from 90.4% to 100% for DO, and, finally, was 88.2% for revascularized flaps. On the basis of available data it was shown that it was difficult to demonstrate that a particular surgical procedure offered better outcome as compared to another. The main limit encountered in this review has been the overall poor methodological quality of the published articles. Therefore larger well-designed long term trials are needed.

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Author and article information

Contributors

Alessandro Cucchi: alessandro.cucchi3@unibo.it

Journal

Journal ID (nlm-ta): Clin Implant Dent Relat Res

Journal ID (iso-abbrev): Clin Implant Dent Relat Res

Journal ID (doi): 10.1111/(ISSN)1708-8208

Journal ID (publisher-id): CID

Title: Clinical Implant Dentistry and Related Research

Publisher: John Wiley and Sons Inc. (Hoboken )

ISSN (Print): 1523-0899

ISSN (Electronic): 1708-8208

Publication date (Electronic): 26 July 2017

Publication date (Print): October 2017

Volume: 19

Issue: 5 ( doiID: 10.1111/cid.2017.19.issue-5 )

Pages: 821-832

Affiliations

[ ¹ ] Unit of Oral and Maxillofacial Surgery, Department of Biomedical and Neuromotor Science (DIBINEM) Alma Mater Studiorum ‐ University of Bologna Bologna Italy

Author notes

[*] [* ] Correspondence Alessandro Cucchi, Via della resistenza, 10 – 46036 – Revere (MN), Italy.Email: alessandro.cucchi3@ 123456unibo.it

Article

Publisher ID: CID12520

DOI: 10.1111/cid.12520

PMC ID: 5655714

PubMed ID: 28745035

SO-VID: 648f2576-e092-4673-8103-ca88cd4a2727

License:

This is an open access article under the terms of the Creative Commons Attribution‐NonCommercial‐NoDerivs License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non‐commercial and no modifications or adaptations are made.

History

Date received : 04 January 2017

Date revision received : 01 May 2017

Date accepted : 10 June 2017

Page count

Figures: 20, Tables: 4, Pages: 12, Words: 8036

Custom metadata

source-schema-version-number 2.0

component-id cid12520

cover-date October 2017

details-of-publishers-convertor Converter:WILEY_ML3GV2_TO_NLMPMC version:5.2.1 mode:remove_FC converted:25.10.2017

Keywords: alveolar ridge reconstruction,atrophy,bone augmentation,bone defects,bone regeneration,edentulous mandible,guided bone regeneration

Data availability:

Keywords: alveolar ridge reconstruction, atrophy, bone augmentation, bone defects, bone regeneration, edentulous mandible, guided bone regeneration

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Evaluation of complication rates and vertical bone gain after guided bone regeneration with non‐resorbable membranes versus titanium meshes and resorbable membranes. A randomized clinical trial

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Most cited references 52

A classification of the edentulous jaws.

10-year survival and success rates of 511 titanium implants with a sandblasted and acid-etched surface: a retrospective study in 303 partially edentulous patients.

Augmentation procedures for the rehabilitation of deficient edentulous ridges with oral implants.

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