The effect of resorbable membranes on one-stage ridge augmentation in anterior single-tooth replacement: A randomized, controlled clinical trial.

Abstract

To evaluate the effect of resorbable membranes on one-stage ridge augmentation procedures in small (2-4mm) buccal bony dehiscences in anterior maxillary single-tooth replacement. Patients with a buccal bony dehiscence after implant placement in the esthetic zone were randomly allocated to one-stage ridge augmentation with (M+) or without a membrane (M-). Second-phase surgery was performed after 8weeks, and follow-up was performed 1, 6, and ≥12months after loading. Outcomes included implant survival and success, complications, clinical and radiographic parameters, esthetic results and patient satisfaction. Fifty-two patients were randomized to one-stage ridge augmentation with (n=25) or without use of a membrane (n=27). No significant differences in implant survival and success have been observed. The risk of having a small mucosal dehiscence was more than six times higher in the M+ group than in the M- group (RR 6.24, 95% CI 0.81 to 48.21). At the last follow-up, the bleeding index (BI) was marginally higher in the M+ group (14/9/2/0) compared to the M- group (24/2/0/0) (U=205, Z=-2.97, p=.003, r=.42). The median change in marginal bone level was statistically lower in the M+ group (0.06mm) than the M- group (0.60mm) at last follow-up (U=120, Z=-2.73 a p=.006 r=.42). Total pink esthetic index (PES) and white esthetic score (WES) and combined PES/WES were not significantly different between treatment groups at more than 12months after loading. Only the subcategory root convexity/soft tissue color scored significantly lower in the M+ group (1.5) compared to the M- group (2.0) at the last follow-up (U=172, Z=-2.34, p=.019 r=.34). No differences were found in patient satisfaction. The use of a resorbable membrane in small buccal bony dehiscences in anterior maxillary single-tooth replacement resulted in less marginal bone loss, but showed more mucosal dehiscences, higher bleeding scores and lower scores on root convexity and soft tissue color after at least one year of loading. No effect was seen on implant survival and success, overall esthetic results, and patient satisfaction. The research protocol was registered at the Dutch Trial Register (NTR) with ID NTR6137.