Titanium mesh, a barrier membrane, has excellent mechanical properties and space maintaining ability. However, one of its disadvantages is that soft tissue over the membrane could be interposed through the pore of the mesh. Conversely, the cross-linked collagen membrane has good soft tissue reaction and reduces the migration of epithelial cells to the guided bone regeneration site. Therefore, we performed guided bone regeneration using a combination of collagen membrane and titanium mesh and analyzed the clinical results. The patients were divided into two groups. Only titanium mesh was used for guided bone regeneration in group A, and a combination of titanium mesh and collagen membrane was used in group B. The degree of soft tissue interposition over the titanium mesh was evaluated after titanium mesh removal, and the surface bone quality was observed. The obtained bone height was measured in the panoramas based on the adjacent tooth cemento-enamel junction, and the bone density was measured using the Hounsfield scale on cone beam computed tomography before titanium mesh removal. In group A, the average soft tissue interposition was 31.50%, and the bone quality was poor when the interposed soft tissue was removed. Therefore, additional bone grafting was performed during implant placement in one case. In group B, there was almost no soft tissue interposition between the titanium mesh pores, and no additional bone graft was performed during implant placement. The combination of two membranes provides a favorable vertically obtained bone height and excellent surface bone quality without soft tissue interposition.

Objective. Tooth extraction causes a wound with hard and soft tissue defects in the alveolar ridge. Few studies have reported the function of microRNAs (miRNAs) in the healing of extraction sockets. This study used bioinformatics analysis to reveal the possible relevance and role of miRNAs during the early stages following tooth extraction. Materials and Methods. Socket tissues from beagle dogs (Canis familiaris; two males and two females) were collected 1 and 12 hours after extraction of premolars on both sides of the mandible. miRNA expression was profiled through miRNA sequencing, and hub miRNAs showing characteristic expression patterns were selected and subjected to target enrichment analysis. Alkaline phosphatase (ALP) activity analysis and reverse transcription-quantitative polymerase chain reaction (RT-qPCR) were performed to verify the effect of hub miRNA on osteoblast differentiation and bone regeneration in vivo. Results. Five miRNAs were identified to have consistently high expression levels, with cfa-miR-451 showing the highest expression. Additionally, 20 hub miRNAs were selected as candidates expected to play an important role in the healing process. Pathways, such as the MAPK, axon guidance, TGF-β, and Wnt signaling, were significantly enriched. Among hub miRNAs, miR-190a-5p increased ALP activity and mRNA expression of osteogenic markers and increased new bone formation in vivo. Conclusions. Our findings suggest that miRNAs may be involved in the earliest stages of socket healing after tooth extraction and can play an important role in moderating the entire socket healing mechanism in the extraction socket.