scholarly journals Use of a Partial-thickness Flap for Guided Bone Regeneration in the Upper Jaw

2017 ◽  
Vol 18 (12) ◽  
pp. 1117-1121 ◽  
Author(s):  
Alberto Busa ◽  
Gianluigi Caccianiga

ABSTRACT Introduction Guided bone regeneration (GBR) aims to restore adequate bone volume for the placement of implants in an ideal location. In this article, we analyze different surgical techniques for tissue management during GBR and a modified partialthickness surgical approach. Materials and methods In a year's time span, five patients were enrolled in the study: Four women and one man (aged 44–59 years). In four patients, a GBR with simultaneous implant placement was adopted, whereas in another patient, a delayed implant placement was done. The flap was of full thickness and overturned on the side palatal with the aim of a retractor, thus exposing the bone crest. The graft material was covered and protected with a resorbable collagen membrane (Geistlich Bio- Gide®, Switzerland). The periosteal layer of the flap was then positioned above the resorbable membrane without traction. The sutures as vertical mattress were then positioned. Each patient received an intramuscular betamethasone dose (4 mg/50 kg) and antibiotic therapy for 7 days (amoxicillin + clavulanic acid 1 gm every 12 hours) and was instructed to maintain oral hygiene and appropriate wound cleaning. The patients were recalled at different times to monitor the healing. Results No cases of tissue dehiscence were observed during the period of wound healing. One patient, however, showed a delayed exposure 4 months after surgery. This occurrence was managed without complications for the patient. Conclusion The design of proposed flap seems to be effective in controlling the risk of dehiscence during the healing time in the GBR. The vascular supply was rarely compromised. The results we obtained are encouraging even if further studies on this technique are needed. Clinical significance Lateral partial-thickness flaps seem to be effective in controlling tissue tension and consequently the risk of dehiscence. The incision vestibularly performed should favor the soft tissue healing. How to cite this article Porcaro G, Busa A, Bianco E, Caccianiga G, Maddalone M. Use of a Partial-thickness Flap for Guided Bone Regeneration in the Upper Jaw. J Contemp Dent Pract 2017;18(12):1117-1121.

Author(s):  
Vineetha Venugopalan ◽  
Anegundi Raghavendra Vamsi ◽  
Santhosh Shenoy ◽  
Karishma Ashok ◽  
Biju Thomas

Successful implant treatment requires prosthetically driven placement of an implant, primary stability at placement, and careful living bone management. The resorptive changes of alveolar bone are an inevitable process following tooth loss, periodontal disease or trauma which causes bone defects. This results in various aesthetic and functional complications such as soft tissue recession, infection and inflammation. Various methods have been tried and advocated for augmenting these bone deficiencies. Guided Bone Regeneration (GBR) is a successful modality for bone augmentation with a wide range of indications and helps restore the alveolar ridge dimensions. It utilises the principle of Guided Tissue Regeneration (GTR) for space maintenance within a bony defect. Different types of barrier membranes are being utilised along with various bone grafts in GBR. Thorough knowledge regarding the biology of bone is required before the initiation of any bone augmentation procedure. A combination of Collagen Membrane (CM) and graft material was found successful for GBR. Hence, this review focuses on presentation of best available evidence for various aspects of GBR.


PRILOZI ◽  
2021 ◽  
Vol 42 (2) ◽  
pp. 103-108
Author(s):  
Darko Veljanovski ◽  
Denis Baftijari ◽  
Zoran Susak ◽  
Aneta Atanasovska Stojanovska

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.


2011 ◽  
Vol 2011 ◽  
pp. 1-5 ◽  
Author(s):  
Daesung Kim ◽  
Taeheon Kang ◽  
Daniel Gober ◽  
Chad Orlich

Membranes made of several different materials are available in the market, nonresorbable (e.g. ePTFE), resorbable (e.g. synthetic or collagen) and liguid applicable (e.g. Polyethylene glycol or Atrisorb). The purpose of the present study was to evaluate whether or not in situ application of Atrisorb could be used as a barrier membrane for guided bone regeneration. Ten patients with insufficient alveolar ridge width for implant placement participated in the study. Atrisorb in conjunction with various bone grafts was used to treat 10 different sites, 3 sites treated prior to implant placement and 7 sites in conjunction with implant placement. Augmented sites were allowed to heal for 3 to 7 months, with mean healing time of 4.7 months. Healing was uneventful with no major complications. Two sites experienced a flap dehiscence accompanied by barrier exposure during the initial healing period. Secondary healing was achieved soon after with no signs of infection, giving Atrisorb a barrier exposure rate of 20% for the present study, which corresponds to favorably to that of resorbable membranes. The liquid membrane has the potential of being a viable alternative to traditional resorbable membranes for use in GBR procedures.


2017 ◽  
Vol 54 (2) ◽  
pp. 312-315 ◽  
Author(s):  
Doriana Agop Forna ◽  
Norina Consuela Forna ◽  
Kamel Earar ◽  
Eugenia Popescu

This paper aims to assess the postoperative evolution of edentulous patients treated by guided bone regeneration technique using a xenograft bone substitute (Cerabone) and collagen membrane. A group of 40 patients, programmed for guided bone regeneration, randomly divided between laser-assisted technique and scalpel technique, were investigated to compare the postoperative evolution, healing time and prevalence of new bone formation, graft stability and inflammatory reactions. The guided bone regeneration technique associated with laser or scalpel technique offers reliable and predictable treatment results in the implant-prosthetic treatments. The accelerated healing time recommends the laser technique in the surgical procedures used for the alveolar augmentation.


2017 ◽  
Vol 18 (7) ◽  
pp. 614-621 ◽  
Author(s):  
Danilo Alessio Di Stefano ◽  
Umberto Garagiola ◽  
Mirko A Bassi

ABSTRACT Aim This study aimed to report a well-succeeded use of equine enzyme-deantigenic cortical membrane and bone granules for guided bone regeneration (GBR) in the esthetic zone concomitant with implant placement. Background In the anterior maxilla, where patients typically have the highest expectations for implant-supported restorations, bone resorption in the wake of tooth loss often leads to a lack of soft tissue support and ultimately to unsatisfactory esthetic results. Buccal bone augmentation at the time of implant placement has thus become common. This is usually accomplished following GBR principles and employing membranes made from various materials to serve as a barrier between the soft tissue and graft material. One of the more recently introduced membrane materials is made from thin, flexible equine cortical bone, i.e., rendered nonantigenic in an enzymatic process that preserves native bone collagen. Case report This report describes the treatment of a patient who received an equine enzyme-deantigenic graft and membrane in conjunction with placement of an implant in the right maxillary lateral incisor site. Conclusion After 5 years of follow-up, the patient was very satisfied with her appearance. A cone-beam computed tomography scan showed that the peri-implant bone levels and ridge thickness had been maintained, and the cortical layer in the pristine ridge had also undergone remodeling. Clinical significance Guided bone regeneration with the concomitant use of enzyme-deantigenic membrane and graft is a valuable and suitable option for effective implant-supported prosthetic rehabilitation in the esthetic zone. How to cite this article Di Stefano DA, Garagiola U, Bassi MA. Preserving the Bone Profile in Anterior Maxilla using an Equine Cortical Bone Membrane and an Equine Enzyme-treated Bone Graft: A Case Report with 5-year Follow-up. J Contemp Dent Pract 2017;18(7):614-621.


1998 ◽  
Vol 9 (5) ◽  
pp. 303-312 ◽  
Author(s):  
Gérard Brunel ◽  
Edmond Benqué ◽  
Frédéric Elharar ◽  
Catherine Sansac ◽  
Jean François Duffort ◽  
...  

2018 ◽  
Vol 2018 ◽  
pp. 1-9 ◽  
Author(s):  
Nikolaos Soldatos ◽  
Georgios E. Romanos ◽  
Michelle Michaiel ◽  
Ali Sajadi ◽  
Nikola Angelov ◽  
...  

Background. The placement of an implant in a previously infected site is an important etiologic factor contributing to implant failure. The aim of this case report is to present the management of retrograde peri-implantitis (RPI) in a first maxillary molar site, 2 years after the implant placement. The RPI was treated using an air-abrasive device, Er,Cr:YSGG laser, and guided bone regeneration (GBR). Case Description. A 65-year-old Caucasian male presented with a draining fistula associated with an implant at tooth #3. Tooth #3 revealed periapical radiolucency two years before the implant placement. Tooth #3 was extracted, and a ridge preservation procedure was performed followed by implant rehabilitation. A periapical radiograph (PA) showed lack of bone density around the implant apex. The site was decontaminated with an air-abrasive device and Er,Cr:YSGG laser, and GBR was performed. The patient was seen every two weeks until suture removal, followed by monthly visits for 12 months. The periapical X-rays, from 6 to 13 months postoperatively, showed increased bone density around the implant apex, with no signs of residual clinical or radiographic pathology and probing depths ≤4 mm. Conclusions. The etiology of RPI in this case was the placement of an implant in a previously infected site. The use of an air-abrasive device, Er,Cr:YSGG, and GBR was utilized to treat this case of RPI. The site was monitored for 13 months, and increased radiographic bone density was noted.


Materials ◽  
2021 ◽  
Vol 14 (9) ◽  
pp. 2166
Author(s):  
Jeong-Kui Ku ◽  
In-Woong Um ◽  
Mi-Kyoung Jun ◽  
Il-hyung Kim

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.


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