The effect of membrane exposure on lateral ridge augmentation: a case-controlled study

Mehmet A Eskan,Henry Greenwell,Dean Morton,Marie-Eve Girouard

doi:10.1186/s40729-017-0089-z

Abstract

BackgroundThe effect of membrane exposure on guided bone regeneration (GBR) for lateral ridge augmentation has been poorly addressed. This case-controlled study aimed to investigate potential effect of membrane exposure lateral ridge augmentation and subsequent implant placement.MethodsA total of 14 patients that did receive lateral ridge augmentation procedure using allogeneic cancellous graft particulate in combination with an alloplastic bioresorbable matrix barrier were retrospectively selected for this study. Bone width was measured at the crest with a digital caliper before bone augmentation and at the reopening for implant placement 4 months later for all patients. Cases where primary flap closure was achieved and the barrier did not expose throughout the time until implant placement were assigned to the control group (n = 7). Cases where primary closure could not be achieved or a barrier exposure happened within the first week following the initial surgery were assigned to the test group.ResultsThe measured alveolar ridge width before surgery as well as after GBR procedure were not statistically significant different between the two groups (p > 0.05). Both groups showed a significant (p < 0.05) increase in their mean alveolar ridge width 4 months after later augmentation procedure, from 3.4 ± 1.2 to 6.0 ± 1.1 mm in the control group and from 3.6 ± 1.0 to 5.0 ± 1.4 mm in the test group. However, the mean alveolar ridge gain was significantly greater in the control group than in the test group (p < 0.05). Consequently, the reduction of the augmented alveolar ridge was significantly higher in the test group averaging to 4.7 mm than for the control group showing a loss of 3.1 mm after 4 months, respectively. However, in all 14 cases, successful implant placement was achieved after 4 months.ConclusionsWithin the limit of this study, it can be concluded that early exposure of a bioresorbable matrix barrier during lateral ridge augmentation may compromise the results of the GBR procedure but may still result in a favorable alveolar ridge width gain that allows for the placement of dental implants.

Highlights

The effect of membrane exposure on guided bone regeneration (GBR) for lateral ridge augmentation has been poorly addressed
PTFE membrane might lead to compromised vascular supply of the flaps [9] and exhibited a higher incidence of premature membrane exposures [8, 10, 11] as well as gingival recession [12], which might cause an esthetic problems in the anterior regions
The effect of early membrane exposure on alveolar ridge width changes To assess if the baseline situations of the patients in the two treatment groups were comparable and well balanced, the distribution of gender, age, and the initial ridge measurements were compared

Summary

Introduction

The effect of membrane exposure on guided bone regeneration (GBR) for lateral ridge augmentation has been poorly addressed. One of the main components in GBR procedures is the use of a resorbable or non-resorbable barrier membranes that stabilize the bone grafting material and protect it from the ingrowth of surrounding soft tissues [6, 7]. Periosteal releasing incisions might cause more swelling, bleeding, and patient discomfort They may compromise blood circulation [14], and repositioning flap coronally can result in a misaligned mucogingival line (MGL) if not properly performed [13]. This misaligned MGL might cause esthetic problems especially in the anterior regions. The use of resorbable membrane in the patients might be beneficial, especially in patients with thin soft tissue biotypes

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Conclusion