Bone Augmentation Using Customized Meshes with Or Without Membranes- Randomized Clinical Trial
Author | : Elisabetta Vignudelli |
Publisher | : |
Total Pages | : |
Release | : 2017 |
ISBN-10 | : OCLC:1163823393 |
ISBN-13 | : |
Rating | : 4/5 (93 Downloads) |
Book excerpt: BackgroundThe presence of alveolar ridge deficiencies is considered a major limitation to achieve an implant-prosthetic restoration with high aesthetics and stability over time. Guided Bone Regeneration (GBR) can be considered an effective solution for bone augmentation. The most advanced technology of GBR is the customized titanium mesh (Ti-mesh), which is developed with a fully digital work flow system. Aim: The aim of this randomized clinical trial is to compare complications rates and bone augmentation rates after GBR using customized mesh with collagen membrane versus customized mesh alone.Material & methods 30 patients with horizontal and/or vertical bone defects were enrolled and treated according to the study protocol approved by ethical committee. During reconstructive surgery (T0), patients were randomly divided into two study groups: 15 patients treated by means of Ti-mesh without collagen membrane (Group A), while 15 patients by means of Ti-mesh covered with a collagen membrane (Group B). All sites were grafted with a mixture 50:50 of autogenous bone and xenograft and primary closures were obtained. After 6 months (T1), re-entry surgery was completed to remove the meshes and to place implants. After 3 months (T2), implant exposure and a connective tissue graft were performed, before prosthetic restoration (T3). Data collection included surgical and healing complications, planned bone volume (PBV) and reconstructed bone volume (RBV), pseudo-periosteum type, bone density, implant success, and crestal bone loss. STATA software was used for statistical analysis (significance uf061=0.05).Results Up to date, all patients underwent to GBR surgery:15 belonging to group A and 15 belonging to group B. 27 out 30 patients underwent to implant surgery and they were considered for statistical analysis. Two early exposures and two late exposure of the meshes were observed in Group A (27%); one abscess without exposure and one early exposure were noted in group B(13%) (P=0.039). Mean values of PBV and RBV in the group A were 1.11cc and 0.85cc; while, in the group B, 1.25cc and 1.09cc, respectively. The regeneration rates were 76.6% and 87.2%, giving a significant statistical difference (P=0.042). Pseudo-periosteum type and bone density were not statistically different over the 2 groups (P=0.077). No implants were lost over time. Crestal bone loss of restored implants appeared stable and less than 1.5mm in both groups(P