Vertical Bone Augmentation with GBR Pocket Technique: Surgical Procedure and Preliminary Results

Abstract

Nowadays, guided bone regeneration (GBR) is a predictable technique in both vertical and horizontal bone defects treatment. GBR Pocket Technique is an original surgical approach adopted in order to reduce the invasiveness of traditional procedures. The aim of this work is to describe the surgical procedure of GBR Pocket Technique in vertical bone augmentation and to compare the clinical outcomes of this technique with the results reported in literature of vertical bone augmentation and crestal bone remodeling achieved after 1 year after implants insertion. Twenty-eight patients were recruited for this study and received 28 GBR procedures in the posterior region due to vertical and horizontal defects. A 50/50 mixture of autologous bone component and heterologous bone of equine origin was then made with the use of a bone scraper tunnel with internal reservoir. A PTFE-d membrane with titanium reinforcement was then fixed to the residual bone structure with screws in order to maintain the graft in place. Radiographic checks were made before graft procedures and implants insertion, then 6 months later and 1 year after implants placement. The average bone augmentation after surgery seems to be aligned, or even better, than the average reported in literature with alternative surgical approach; in addition, the mean crestal remodeling after 1 year and the rate of complications are aligned with other previous surgical techniques with a vertical bone augmentation of 8.78 mm ± SD 2.39 and a bone remodeling after 1 year of 0.59 mm ± SD 0.29. The advantages of this technique are preservation of blood circulation and consequently risk of flap necrosis, dehiscence, and graft exposure. This technique also reduces mucosal healing times even if it takes longer surgical time. GBR Pocket Technique is the use of a minimal-invasive surgical wound to reduce patient morbidity and compliance.