scholarly journals Clinical and histological sequelae of surgical complications in horizontal guided bone regeneration: a systematic review and proposal for management

2020 ◽  
Vol 6 (1) ◽  
Author(s):  
John Rong Hao Tay ◽  
Xiaotong Jacinta Lu ◽  
Wei Ming Clement Lai ◽  
Jia-Hui Fu
Keyword(s):  
Bone Regeneration ◽  
Surgical Complications ◽  
Wound Dehiscence ◽  
Guided Bone Regeneration ◽  
Cochrane Central Register ◽  
Weighted Mean ◽  
Recipient Site ◽  
Barrier Membrane ◽  
Incidence Proportion ◽  
Level Analysis

AbstractIt is not uncommon to encounter post-surgical complications after horizontal guided bone regeneration (GBR). The primary aim of this review was to evaluate the incidence and types of complications that occur after horizontal GBR and propose management strategies to deal with these clinical situations. A secondary aim was to conduct a histomorphometric review of the wound healing process at sites that experienced post-surgical complications after GBR. A keyword search of MEDLINE, EMBASE, and the Cochrane Central Register of Controlled Trials for studies published in English from January 2015 to January 2020 was conducted for the primary aim and 23 studies were selected. A second search addressing the secondary aim was conducted, and five studies were included. Site-level analysis showed that the weighted mean incidence proportion of minor wound dehiscence and minor infections occurring at the augmented site was 9.9% [95% CI 6.4, 13.9, P < 0.01] and 1.5% [95% CI 0.4, 3.1, P = 0.21) respectively. Patient-level analysis showed minor and major complications occurring at a weighted mean incidence proportion of 16.1% [95% CI 11.9, 20.8, P = 0.01] and 1.6% [95% CI 0.0, 4.7, P < 0.01] respectively, while neurosensory alterations at the donor site was 7.0% [95% CI 1.3, 15.5, P < 0.01]. Subgroup analysis also revealed that the use of block grafts increased the incidence proportion of minor post-surgical complications, whereas a staged GBR procedure increased the incidence proportion of both minor and major post-surgical complications. Although exposure of the barrier membrane is often associated with less bone regeneration and graft resorption, the type of membrane used (resorbable or non-resorbable) had no statistically significant influence on any post-surgical complication. Histologically, a layer of fibrous connective tissue instead of bone is commonly observed at the interface between the native bone at the recipient site and the regenerated bone in cases with membrane exposure after GBR procedure. Minor wound dehiscence was the highest incidence proportion of post-surgical complications. Methods ranging from daily application of antiseptics, use of systemic antimicrobials, regular reviews, and total removal of the non-integrated biomaterials are commonly prescribed to manage these post-surgical complications in attempt to minimise the loss of tissue at the surgical site.

scholarly journals Dentin-Derived-Barrier Membrane in Guided Bone Regeneration: A Case Report

Materials ◽  
2021 ◽  
Vol 14 (9) ◽  
pp. 2166
Author(s):  
Jeong-Kui Ku ◽  
In-Woong Um ◽  
Mi-Kyoung Jun ◽  
Il-hyung Kim
Keyword(s):  
Case Report ◽  
Bone Regeneration ◽  
Guided Bone Regeneration ◽  
Successful Outcome ◽  
Collagen Membrane ◽  
Type I ◽  
Barrier Membrane ◽  
Dentin Matrix ◽  
Demineralized Dentin Matrix ◽  
Demineralized Dentin

An autogenous, demineralized, dentin matrix is a well-known osteo-inductive bone substitute that is mostly composed of type I collagen and is widely used in implant dentistry. This single case report describes a successful outcome in guided bone regeneration and dental implantation with a novel human-derived collagen membrane. The authors fabricated a dentin-derived-barrier membrane from a block-type autogenous demineralized dentin matrix to overcome the mechanical instability of the collagen membrane. The dentin-derived-barrier acted as an osteo-inductive collagen membrane with mechanical and clot stabilities, and it replaced the osteo-genetic function of the periosteum. Further research involving large numbers of patients should be conducted to evaluate bone forming capacity in comparison with other collagen membranes.

Superficial Topography and Porosity of an Absorbable Barrier Membrane Impacts Soft Tissue Response in Guided Bone Regeneration

2010 ◽  
Vol 81 (6) ◽  
pp. 926-933 ◽  
Author(s):  
Ronaldo Barcellos de Santana ◽  
Carolina Miller Leite de Mattos ◽  
Carlos Eduardo Francischone ◽  
Thomas Van Dyke
Keyword(s):  
Soft Tissue ◽  
Bone Regeneration ◽  
Guided Bone Regeneration ◽  
Tissue Response ◽  
Barrier Membrane ◽  
Soft Tissue Response

scholarly journals The Condensation of Collagen Leads to an Extended Standing Time and a Decreased Pro-inflammatory Tissue Response to a Newly Developed Pericardium-based Barrier Membrane for Guided Bone Regeneration

In Vivo ◽  
2020 ◽  
Vol 34 (3) ◽  
pp. 985-1000 ◽  
Author(s):  
TRISTAN GUELDENPFENNIG ◽  
ALIREZA HOUSHMAND ◽  
STEVO NAJMAN ◽  
SANJA STOJANOVIC ◽  
TADAS KORZINSKAS ◽  
...  
Keyword(s):  
Bone Regeneration ◽  
Guided Bone Regeneration ◽  
Tissue Response ◽  
Standing Time ◽  
Barrier Membrane ◽  
Inflammatory Tissue

Investigating the Potential of Amnion-Based Scaffolds as a Barrier Membrane for Guided Bone Regeneration

Langmuir ◽  
2015 ◽  
Vol 31 (31) ◽  
pp. 8642-8653 ◽  
Author(s):  
Wuwei Li ◽  
Guowu Ma ◽  
Bryn Brazile ◽  
Nan Li ◽  
Wei Dai ◽  
...  
Keyword(s):  
Bone Regeneration ◽  
Guided Bone Regeneration ◽  
Barrier Membrane

scholarly journals Comparison of Bone Resorption Rates after Intraoral Block Bone and Guided Bone Regeneration Augmentation for the Reconstruction of Horizontally Deficient Maxillary Alveolar Ridges

2016 ◽  
Vol 2016 ◽  
pp. 1-9 ◽  
Author(s):  
B. Alper Gultekin ◽  
Elcin Bedeloglu ◽  
T. Emre Kose ◽  
Eitan Mijiritsky
Keyword(s):  
Bone Resorption ◽  
Bone Regeneration ◽  
Guided Bone Regeneration ◽  
Outcome Variable ◽  
Insertion Torque ◽  
Recipient Site ◽  
Implant Placement ◽  
Bone Atrophy ◽  
Augmentation Techniques ◽  
Bone Gain

Purpose. Bone atrophy after tooth loss may leave insufficient bone for implant placement. We compared volumetric changes after autogenous ramus block bone grafting (RBG) or guided bone regeneration (GBR) in horizontally deficient maxilla before implant placement. Materials and Methods. In this retrospective study, volumetric changes at RBG or GBR graft sites were evaluated using cone-beam computed tomography. The primary outcome variable was the volumetric resorption rate. Secondary outcomes were bone gain, graft success, and implant insertion torque. Results. Twenty-four patients (28 grafted sites) were included (GBR, 15; RBG, 13). One patient (RBG) suffered mucosal dehiscence at the recipient site 6 weeks after surgery, which healed spontaneously. Mean volume reduction in the GBR and RBG groups was 12.48 ± 2.67% and 7.20 ± 1.40%, respectively. GBR resulted in significantly more bone resorption than RBG (P<0.001). Mean horizontal bone gain and width after healing were significantly greater in the GBR than in the RBG group (P=0.002 and 0.005, resp.). Implant torque was similar between groups (P>0.05). Conclusions. Both RBG and GBR hard-tissue augmentation techniques provide adequate bone graft volume and stability for implant insertion. However, GBR causes greater resorption at maxillary augmented sites than RBG, which clinicians should consider during treatment planning.

scholarly journals The Early Fragmentation of a Bovine Dermis-Derived Collagen Barrier Membrane Contributes to Transmembraneous Vascularization—A Possible Paradigm Shift for Guided Bone Regeneration

Membranes ◽  
2021 ◽  
Vol 11 (3) ◽  
pp. 185
Author(s):  
Eleni Kapogianni ◽  
Said Alkildani ◽  
Milena Radenkovic ◽  
Xin Xiong ◽  
Rumen Krastev ◽  
...  
Keyword(s):  
Bone Regeneration ◽  
Blood Vessels ◽  
Structural Integrity ◽  
Guided Bone Regeneration ◽  
Control Group ◽  
Collagen Membrane ◽  
Secondary Porosity ◽  
Standing Time ◽  
Barrier Membranes ◽  
Barrier Membrane

Collagen-based barrier membranes are an essential component in Guided Bone Regeneration (GBR) procedures. They act as cell-occlusive devices that should maintain a micromilieu where bone tissue can grow, which in turn provides a stable bed for prosthetic implantation. However, the standing time of collagen membranes has been a challenging area, as native membranes are often prematurely resorbed. Therefore, consolidation techniques, such as chemical cross-linking, have been used to enhance the structural integrity of the membranes, and by consequence, their standing time. However, these techniques have cytotoxic tendencies and can cause exaggerated inflammation and in turn, premature resorption, and material failures. However, tissues from different extraction sites and animals are variably cross-linked. For the present in vivo study, a new collagen membrane based on bovine dermis was extracted and compared to a commercially available porcine-sourced collagen membrane extracted from the pericardium. The membranes were implanted in Wistar rats for up to 60 days. The analyses included well-established histopathological and histomorphometrical methods, including histochemical and immunohistochemical staining procedures, to detect M1- and M2-macrophages as well as blood vessels. Initially, the results showed that both membranes remained intact up to day 30, while the bovine membrane was fragmented at day 60 with granulation tissue infiltrating the implantation beds. In contrast, the porcine membrane remained stable without signs of material-dependent inflammatory processes. Therefore, the bovine membrane showed a special integration pattern as the fragments were found to be overlapping, providing secondary porosity in combination with a transmembraneous vascularization. Altogether, the bovine membrane showed comparable results to the porcine control group in terms of biocompatibility and standing time. Moreover, blood vessels were found within the bovine membranes, which can potentially serve as an additional functionality of barrier membranes that conventional barrier membranes do not provide.

scholarly journals Implant Site Guided Bone Regeneration and Pontic Site Ridge Preservation: A Case Report

PRILOZI ◽  
2021 ◽  
Vol 42 (2) ◽  
pp. 103-108
Author(s):  
Darko Veljanovski ◽  
Denis Baftijari ◽  
Zoran Susak ◽  
Aneta Atanasovska Stojanovska
Keyword(s):  
Soft Tissue ◽  
Bone Regeneration ◽  
Soft Tissues ◽  
Guided Bone Regeneration ◽  
Autogenous Bone ◽  
Collagen Membrane ◽  
Ridge Preservation ◽  
Bovine Bone ◽  
Implant Placement ◽  
Barrier Membrane

Abstract Guided bone regeneration (GBR) is a therapeutic modality to achieve bone regeneration with the use of barrier membranes. The use of deproteinized bovine bone material (DBBM) for ridge preservation allows the preservation of the edentulous ridge dimensions. Here, we present a case of horizontal GBR using DBBM and a resorbable membrane, with simultaneous implant placement. Simultaneously, ridge preservation of the pontic area, using DBBM within a “socket seal” procedure was performed. Two implants were places at sites 23 and 26 to support a fixed partial denture (FPD). The mesial implant showed exposed buccal threads, which were then covered with autogenous bone particles and small size granules of DBBM. The collagen membrane was stabilized with periosteal mattress suture. Six months postoperatively, CBCT images revealed a stable buccal bone layer at the implant site, indicating a successful GBR procedure. At this point in time, tooth 24 was atraumatically extracted. A ridge preservation was done utilizing DBBM, and a soft tissue graft form the tuber. A ceramic-metal FPD with excellent “white aesthetics” and a harmonic transition zone to the soft tissue was fabricated. At 3 years follow up, the peri-implant bone levels were stable, and the clinical outcomes were excellent. It is concluded that a GBR procedure, utilizing DBBM and a collagen barrier membrane with simultaneous implant placement, as well as ridge preservation using DBBM, are predictable therapeutic methods. However, gentle manipulation of the soft tissues, and wound stability, with tension-free passive closure of the wound margins are prerequisites for a long-term clinical success.

Sign in / Sign up

Export Citation Format

Share Document