Alveolar Bone Ridge Augmentation Using Polymeric Membranes: A Systematic Review and Meta-Analysis

Abstract

Alveolar bone ridge resorption occurred after natural teeth loss and it can restrict the possibility of dental implants placement. The use of bone regenerative procedures is frequently required. The existing evidence regarding the efficacy of horizontal bone ridge augmentation trough guided bone regeneration (GBR) using polymeric membranes was stated. A systematic review and meta-analysis were performed. Electronic and manual literature searches were conducted. Screening process was done using the National Library of Medicine (MEDLINE by PubMed), Embase, and the Cochrane Oral Health. Included articles were randomized controlled trials and observational studies. Weighted means were calculated. Heterogeneity was determined using Higgins (I2). If I2 > 50% a random-effects model was applied. It was found that the mean of horizontal bone gain was 3.95 mm, ranging from 3.19 to 4.70 mm (confidence interval 95%). Heterogeneity is I2 = 99% (confidence interval 95%) and significance of the random-effects model was p < 0.001. The complications rate was 8.4% and membrane exposure was the most frequent. Through this study, we were able to conclude that the existing scientific evidence suggests that GBR using polymeric membranes is a predictable technique for achieving horizontal bone augmentation, thus, permitting a proper further implant placement.

Treating Gingival Recessions Using Coronally Advanced Flap or Tunnel Techniques with Autografts or Polymeric Substitutes: A Systematic Review and Meta-Analysis

“…Secondly, the heterogeneity of our study was I 2 = 93%, which is a relatively high value that may be due to the small sample sizes of the RCTs included in the meta-analysis. This effect has been named the “small-studies effect” [ 63 , 64 ]. However, it should be recognized that most of them were classified as having a low risk of bias.…”

Polymeric Scaffolds for Dental, Oral, and Craniofacial Regenerative Medicine

“…The main complication was membrane exposure. Moreover, greater defect reduction was observed in using non-exposed barrier membranes [93,94]. Several different combinations of surgical modalities in GBR may be used to treat bony defects (i.e., fenestration, dehiscence, vertical defects, horizontal defects) and to obtain adequate bone volume for staged or simultaneous implant placement.…”

“…The usage of composite grafts consisting of bone allografts or xenografts with a resorbable membrane showed comparable clinical outcomes to autologous bone grafts [75,93,[95][96][97]. In the staged approach of GBR prior to implant placement, the combination of particulate xenograft, autologous bone and resorbable membrane achieved the maximum bone width gain; in the simultaneous approach, the combination of particulate xenograft with a resorbable membrane was most frequently used and achieved significant reduction in defect height changes [94].…”

Antibiotic-Loaded Polymeric Barrier Membranes for Guided Bone/Tissue Regeneration: A Mini-Review

“…This barrier membrane should avoid soft tissue cell invasion of the regenerating area, maintaining the space and facilitating the periodontal ligament derived cells or bone cells to grow into the defective area. These principles have also been employed to promote guide bone regeneration at those sites where an intraoral bone defect or insufficient bone exists, mainly caused by teeth loss, trauma, tumoral pathology or infections [ 2 ]. Currently, these guided tissue regeneration and guided bone regeneration techniques are widely accepted and are often used for clinical applications [ 3 , 4 ].…”