Guided Bone Regeneration with Collagen Membranes and Particulate Graft Materials: A Systematic Review and Meta-Analysis

Abstract

The aim of this meta-analysis was to evaluate different methods for guided bone regeneration using collagen membranes and particulate grafting materials in implant dentistry. Materials and Methods: An electronic database search and hand search were performed for all relevant articles dealing with guided bone regeneration in implant dentistry published between 1980 and 2014. Only randomized clinical trials and prospective controlled studies were included. The primary outcomes of interest were survival rates, membrane exposure rates, bone gain/defect reduction, and vertical bone loss at follow-up. A metaanalysis was performed to determine the effects of presence of membrane cross-linking, timing of implant placement, membrane fixation, and decortication. Results: Twenty studies met the inclusion criteria. Implant survival rates were similar between simultaneous and subsequent implant placement. The membrane exposure rate of cross-linked membranes was approximately 30% higher than that of non-cross-linked membranes. The use of anorganic bovine bone mineral led to sufficient newly regenerated bone and high implant survival rates. Membrane fixation was weakly associated with increased vertical bone gain, and decortication led to higher horizontal bone gain (defect depth). Conclusion: Guided bone regeneration with particulate graft materials and resorbable collagen membranes is an effective technique for lateral alveolar ridge augmentation. Because implant survival rates for simultaneous and subsequent implant placement were similar, simultaneous implant placement is recommended when possible. Additional techniques like membrane fixation and decortication may represent beneficial implications for the practice. Int J Oral MaxIllOfac IMplants 2017 (14 pages).

Marginal soft tissue stability around conical abutments inserted with the one abutment‐one time protocol after 5 years of prosthetic loading

“…Another key factor of the present study, differently from the protocol proposed by Degidi et al, is the use of a two stages surgical protocol instead of an immediate tooth replacement therapy. A recent review showed that implant survival rates for simultaneous and subsequent implant placement are similar and recommended simultaneous implant placement when possible . However, the use of a second surgical intervention, after ridge preservation and soft tissue healing, could allow a more prosthetically driven implant insertion, even avoiding a connective tissue graft …”

“…A recent review showed that implant survival rates for simultaneous and subsequent implant placement are similar and recommended simultaneous implant placement when possible. 38 However, the use of a second surgical intervention, after ridge preservation and soft tissue healing, could allow a more prosthetically driven implant insertion, even avoiding a connective tissue graft. 39 The present study demonstrated that the simultaneous use of OAOT approach and conical abutment might help in longitudinally stabilizing the peri-implant soft tissues.…”

A multicenter randomized controlled trial using a novel collagen membrane for guided bone regeneration at dehisced single implant sites: Outcome at prosthetic delivery and at 1‐year follow‐up

“…Lateral ridge augmentation via GBR with the combination of a resorbable collagen membrane and particulate graft materials is a frequently reported technique in the literature, especially when treating dehiscence defects (Schwarz, Sahm, & Becker, ; Wang, Misch, & Neiva, ). Application of this technique produces equally high long‐term implant survival rates whether used subsequently to or simultaneously with implant placement (Wessing, Lettner, & Zechner, ). Therefore, a simultaneous approach is indicated whenever possible, as it reduces the number of surgeries, which lowers morbidity, reduces treatment time, and increases patient comfort (Wessing et al, ).…”

Ridge augmentation using sticky bone: A combination of human tooth allograft and autologous fibrin glue

“…For dental implants to be placed in its functionally ideal position, three-dimensional hard-tissue reconstruction of recipient site by guided bone regeneration (GBR) is often necessary. [8] A vast variety of bone grafts and resorbable barrier membranes are available for the purpose of GBR technique. However, for successful hard-tissue regeneration, a bone graft should be biomechanically stable, able to degrade and replaced by new bone within an appropriate period.…”