Immediate implant placement using a biodegradable barrier, polyhydroxybutyrate‐hydroxyvalerate reinforced with polyglactin 910. An experimental study in dogs.

Abstract

The purpose of this study was to evaluate the use of a biodegradable membrane of polyhydroxybutyrate-hydroxyvalerate copolymer reinforced with polyglactin 910 fibers, as an occlusive barrier over implants placed into fresh extraction sockets. Ten dogs had the 3rd and 4th mandibular premolars extracted bilaterally. Each dog had 4 Astra Dental Implants placed directly into the fresh extraction sockets. The top of the fixtures was placed at the same level as the top of the buccal cortical bone. The two implants in the right side were covered with the hydrolyzable polyester material (polyhydroxybutyrate-hydroxyvalerate reinforced with polyglactin 910 fibers; PHB-HV/PG), and the 2 implants in the left side were controls without occlusive membranes. Soft tissue dehiscences were registered for half of the implants in the test side but were not noted in the control side. The histomorphological measurements after 12 weeks showed that the mean distance from the top of the fixtures to the first bone-to-implant contact was significantly greater than for the control side. The membrane-covered implants without dehiscences showed also significantly less bone fill compared with the control side. Inflammatory cell infiltrates were seen adjacent to all PHB-HV/PG membranes, and frequently the membrane material was surrounded by a fibrous tissue capsule. The polyester membranes used in this study interfered with the marginal bone healing adjacent to the immediately placed implants. An increased inflammatory reaction and significantly less marginal bone healing was registered in the membrane side compared with the control side.

Immediate implant placement: treatment planning and surgical steps for successful outcomes

“…Multi-centre studies have validated the predictability of placing implants at the time of extraction provided these procedures are appropriately treatment planned. PRACTICE 5,7,8,11,30,70,71 To date, evidence for placement of bone substitutes adjacent to small bone defects related to immediately placed implants appears safe, although these materials do not appear to predictably promote osseointegration. There is insufficient evidence that 'socket preservation' procedures predictably maintain socket anatomy without crestal resorption.…”

Research in Biomaterials Center, National Institute for Materials Science

“…Thus, the carboxy group in collagen is likely to form a chemical bond with calcium ion, and this bonding is thought to be involved in apatite crystal alignment. We also investigated an influence of Ca, PO 4 and collagen concentrations on the HAp/Col fiber growth and find that reducing these concentrations in the reaction vessel during synthesis allow to grow the fibers up to 75 mm as shown in Fig. 11.…”

“…Recently, the regeneration of periodontal tissues was applied using a bioinert Teflon ® membrane or biodegradable collagen and polyester membranes. [1][2][3][4][5][6][7][8][9][10] These membranes were useful to regenerate periodontal tissues with a small bone defect less than 5 mm 3 in size, but were not applicable for a large bone defect because of their insufficient mechanical strength and low bone tissue affinity. Further, they still have connatural problems, i.e., Teflon ® needs operation for its excision, collagen has no mechanical strength even to handle it in operation and polyester sometimes induces serious inflammation with decreasing of surrounding pH by its degradation.…”

Degradable Bisphosphonate-Alkaline Phosphatase-Complexed Hydroxyapatite Implants In Vitro

“…(7)(8)(9)(10)(11) However, it has been reported that this rather complicated technique is not always successful. (12) This drawback argues for the alternative method with delayed titanium implant placement when membranes are used, as proposed by Buser et al ramic. (14,15) The purpose of the brittle HA implant is to maintain the bulk of the alveolar ridge by its physical presence for a limited time until a fixture can be placed.…”