Experiment of GBR for repair of peri-implant alveolar defects in beagle dogs

Huiping Li,Chi Yang,Jisi Zheng,Yong-Dae Kwon,Yong-Jin Kim,Shanyong Zhang

doi:10.1038/s41598-018-34805-w

Abstract

To guide barrier membrane choice in the treatment of peri-implant alveolar bone defects, we evaluated guided bone regeneration (GBR) using titanium (Ti) mesh or Bio-Gide membrane, independently or in combination, for repair of alveolar bone defects in Beagle dogs. Six months after extraction of the mandibular premolars and first molars from three beagle dogs, we inserted implants assigned into 3 groups and covered with the following membrane combinations: Group A: Implant + Bio-Oss + Ti-mesh, Group B: Implant + Bio-Oss + Bio-Gide, and Group C: Implant + Bio-Oss + Ti-mesh + Bio-Gide. At 6 months, micro-CT revealed that bone volume/total volume (BV/TV), trabecular number (Tb.N), and trabecular thickness (Tb.Th) was significantly greater in Group C than the other two groups, while trabecular separation (Tb.Sp) was significantly lower, suggesting improved bone regeneration. The distance between bands of three fluorescent tracking dyes was significantly greater in Group C, indicating faster deposition of new bone. The Bio-Oss particles were ideally integrated with newly deposited bone and bone thickness was significantly larger in Group C. These findings suggest that combination of Bio-Gide membrane and titanium mesh can effectively repair peri-implant alveolar bone defects, achieving enhanced bone regeneration compared to titanium mesh or Bio-Gide alone, and therefore providing a novel treatment concept for clinical implant surgery.

Highlights

Adequate bone volume is an important prerequisite for a predictable long-term prognosis in implant dentistry
Micro-computed tomographic (CT) with three-dimensional reconstruction revealed that bone regeneration was significantly enhanced in Group C compared to the other two groups (P < 0.01)
The basic principle of guided bone regeneration (GBR) involves the placement of mechanical barriers to isolate the bone defect from the surrounding connective tissue, providing bone-forming cells with access to a secluded space intended for bone regeneration[21]

Summary

Introduction

Adequate bone volume is an important prerequisite for a predictable long-term prognosis in implant dentistry. GBR is a technique that uses a mechanical barrier to prevent soft tissue from growing into a bony defect before osteogenic cells can seal the gap and develop new bone matrices for osseous regeneration[5]. The Bio-Gide membrane is too soft to endure masticatory pressure on alveolar bone, and provides limited space and mechanical support to the tissue during bone formation. As early as the 1990s, Simion et al.[13] reported the use of titanium mesh in GBR to repair severe alveolar defects at implant sites. The porous titanium mesh can cover the alveolar defects to form the ideal shape of the alveolar ridge, effectively preventing soft tissue collapse and displacement of bone particles during bone regeneration[16,17]. We performed a comparative analysis of implant outcomes using the combination of Bio-Gide (Osstem, Seoul, Korea) and titanium mesh (Osstem, Seoul, Korea) as a framework for a filler containing bovine-derived xenograft (Bio-Oss Collagen, Geistlich Biomaterials, Wolhusen, Switzerland)

Methods

Results

Conclusion