MANAGEMENT OF THE EXPOSURE OF A DENSE PTFE (d-PTFE) MEMBRANE IN GUIDED BONE REGENERATION (GBR): A CASE REPORT

Abstract

SUMMARYGuided bone regeneration (GBR) is a well-established and generally predictable method for repairing alveolar ridge defects and preparing edentulous sites for implant placement. Standard GBR involves filling the space underneath a membrane with autogenous bone or a mixture composed of autogenous bone particles and allogeneic bone tissue or heterologous biomaterials. The use of a barrier membrane for GBR has sometimes been associated with complications, however -reportedly involving exposure, infection, and collapse -and the non-resorbable types of membrane seem to be involved more often than the resorbable solutions. Such complications may be severe enough to defeat the object of the GBR procedure. A non-resorbable high-density polytetrafluoroethylene (d-PTFE) membrane has recently been designed specifically for use in bone-augmentation procedures that seems to assure a good bone regeneration process even when the membrane is exposed to the oral cavity. This case report describes an exposure of a d-PTFE membrane occurring after a maxillary GBR procedure and how it was overcome successfully, enabling implants insertion.

Horizontal ridge augmentation using native collagen membrane vs titanium mesh in atrophic maxillary ridges: Randomized clinical trial

“…During the follow‐up period, four patients in the titanium mesh group presented with soft tissue complications, cases 6, 9, and 10 showed soft tissue dehiscence with subsequent mesh exposure 3 weeks postoperatively. Broad spectrum antibiotics of amoxicillin/clavulanic acid (Hibiotic, Amoun, Egypt) 1 g every 12 hours orally was prescribed and copious chlorohexidine irrigation was done for 7 days followed by removal of the mesh in cases 6 and 9 . While in case 10, the mesh was left as he had good oral hygiene.…”

“…Management protocol for the cases that showed wound dehiscence or mesh exposure followed the recommendation of Urban and Ghensi et al, which involved broad spectrum antibiotics, copious chlorhexidine irrigation and strict oral hygiene instructions to keep the area clean by a cotton swab moistened with chlorhexidine 0.12%. The mesh was removed in two cases (case 6 and 9) due to failure of the patients to comply with the oral hygiene instructions.…”

“…Broad spectrum antibiotics of amoxicillin/clavulanic acid (Hibiotic, Amoun, Egypt) 1 g every 12 hours orally was prescribed and copious chlorohexidine irrigation was done for 7 days followed by removal of the mesh in cases 6 and 9. 8 While in case 10, the mesh was left as he had good oral hygiene. Case 2 had an exposure after 4 months leading to mesh removal ( Figure 10), and copious chlorhexidine irrigation was performed until healing with secondary intention occurred.…”

Rhamnolipid Coating Reduces Microbial Biofilm Formation on Titanium Implants: an in-vitro Study

“…Up to date, millions of implants are placed every year worldwide and their survival rate is above > 90% over a 10-year period [4,[12][13][14]. However, oral implantology is not free from complications [15][16][17][18]. The past three decades have seen the emergence of two relevant oral diseases: peri-implant mucositis and periimplantitis [19][20][21][22][23][24].…”

Rhamnolipid coating reduces microbial biofilm formation on titanium implants: an in-vitro study

“…Up to date, millions of implants are placed every year worldwide and their survival rate is above > 90% over a 10-year period [3,6]. However, oral implantology is not free from complications [7][8][9]. The past three decades have seen the emergence of two relevant oral diseases: peri-implant mucositis and peri-implantitis [10][11][12][13].…”