Vertical-guided bone regeneration with a titanium-reinforced d-PTFE membrane utilizing a novel split-thickness flap design: a prospective case series.

Windisch, Peter; Orban, Kristof; Salvi, Giovanni E.; Sculean, Anton; Molnar, Balint (2020). Vertical-guided bone regeneration with a titanium-reinforced d-PTFE membrane utilizing a novel split-thickness flap design: a prospective case series. (In Press). Clinical oral investigations Springer-Verlag 10.1007/s00784-020-03617-6

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OBJECTIVES

To evaluate the feasibility of a newly proposed minimally invasive split-thickness flap design without vertical-releasing incisions for vertical bone regeneration performed in either a simultaneous or staged approach and to analyze the prevalence of adverse events during postoperative healing.

MATERIALS AND METHODS

Following preparation of a split-thickness flap and bilaminar elevation of the mucosa and underlying periosteum, the alveolar bone was exposed over the defects, vertical GBR was performed by means of a titanium-reinforced high-density polytetrafluoroethylene membrane combined with particulated autogenous bone (AP) and bovine-derived xenograft (BDX) in 1:1 ratio. At 9 months after reconstructive surgery, vertical and horizontal hard tissue gain was evaluated based on clinical and radiographic examination.

RESULTS

Twenty-four vertical alveolar ridge defects in 19 patients were treated with vertical GBR. In case of 6 surgical sites, implant placement was performed at the time of the GBR (simultaneous group); in the remaining 18 surgical, sites implant placement was performed 9 months after the ridge augmentation (staged group). After uneventful healing in 23 cases, hard tissue fill was detected in each site. Direct clinical measurements confirmed vertical and horizontal hard tissue gain averaging 3.2 ± 1.9 mm and 6.5 ± 0.5 mm respectively, in the simultaneous group and 4.5 ± 2.2 mm and 8.7 ± 2.3 mm respectively, in the staged group. Additional radiographic evaluation based on CBCT data sets in the staged group revealed mean vertical and horizontal hard tissue fill of 4.2 ± 2.0 mm and 8.5 ± 2.4 mm. Radiographic volume gain was 1.1 ± 0.4 cm3.

CONCLUSION

Vertical GBR consisting of a split-thickness flap and using titanium-reinforced non-resorbable membrane in conjunction with a 1:1 mixture of AP+BDX may lead to a predictable vertical and horizontal hard tissue reconstruction.

CLINICAL RELEVANCE

The used split-thickness flap design may represent a valuable approach to increase the success rate of vertical GBR, resulting in predicable hard tissue regeneration, and favorable wound healing with low rate of membrane exposure.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > School of Dental Medicine > Department of Periodontology

UniBE Contributor:

Salvi, Giovanni Edoardo and Sculean, Anton

Subjects:

600 Technology > 610 Medicine & health

ISSN:

1432-6981

Publisher:

Springer-Verlag

Language:

English

Submitter:

Doris Burri

Date Deposited:

21 Dec 2020 09:16

Last Modified:

23 Feb 2021 21:07

Publisher DOI:

10.1007/s00784-020-03617-6

PubMed ID:

33040203

Uncontrolled Keywords:

Autogenous bone Guided bone regeneration Implant placement Non-resorbable membrane Split-thickness flap Vertical augmentation Xenograft

BORIS DOI:

10.7892/boris.148720

URI:

https://boris.unibe.ch/id/eprint/148720

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