Guided Bone Regeneration Clinical Trial
Official title:
Assessment of Guided Bone Regeneration in Atrophic Anterior Maxilla Using Native Collagen vs Titanium Reinforced Polytetraflouroethelene Membranes Using an Organic Bovine Bone Mineral
Guided bone regeneration (GBR) is a surgical technique that uses barrier membranes to promote
osteoblast cells proliferation and exclude other cells such as epithelium and connective
tissue cells. GBR is often combined with bone grafting procedures.
Using Absorbable membranes like collagen membrane will reduce treatment time by decreasing
need for second surgery
Assessment of Guided Bone Regeneration in Atrophic Anterior Maxilla using native Collagen vs
Titanium Reinforced Polytetraflouroethelene Membranes using an organic bovine Bone
mineral.Reconstructive surgery is necessary before implant placement to regenerate bone
defects caused by atrophy, dental trauma, extractions or periodontal disease . Success rate
of implants is related to the correct position and angulation of implants in residual crest,
so that height and thickness of bone augmentation can allow predictable results ,With this in
mind, it is important to establish sound clinical concepts with clearly defined parameters
that lead to successful esthetics in the anterior maxilla, with long-term stability of the
peri-implant tissues.
The most popular surgical procedures to obtain bone augmentation are: bone grafts, guided
bone regeneration, maxillary sinus floor elevation, and bone osteogenesis distraction.
Guided bone regeneration (GBR) is a surgical technique that uses barrier membranes to promote
osteoblast cells proliferation and exclude other cells such as epithelium and connective
tissue cells. GBR is often combined with bone grafting procedures.
Bone grafts are integrated into native bone with three different processes: osteogenesis,
osteoinduction and osteoconduction; Osteogenesis is the formation of new bone from
osteocompetent cells and is the only process where the graft itself can induce Bone
augmentation, Osteoinduction induces Bone Augmentation from the differentiation and
stimulation of mesenchymal cells by the bone-inductive proteins, Osteoconduction is the
formation of Bone Augmentation along a scaffold from osteocompetent cells of the recipient
site .
There are 2 Types of membranes:
III. Non Resorbable membrane IV. Resorbable membrane
Non-resorbable membranes:
With the presentation of the first successful GBR procedures and the subsequent wide and
successful application of ePTFE membranes, this material became a standard for bone
regeneration. Expanded PTFE is characterized as a polymer with high stability in biological
systems. It resists breakdown by host tissues and by microbes and does not elicit immunologic
reactions. A frequent complication with membrane application in conjunction with implants is
membrane exposure and infection Wound dehiscence and membrane exposure have been reported to
impair the amount of bone regenerated in a number of experimental animal and clinical
investigations
Bioresorbable membranes:
The requirement of second surgical procedure for the removal of Non Resorbable barrier
membrane(NRBM) led to the introduction of bioresorbable barrier membranes (RBM). The
advantages of RBM compared to NRBM were as follows:
1. Improved soft tissue healing,
2. Incorporation of the membranes by the host tissues (depending on material properties),
3. Quick resorption in case of exposure, eliminating bacterial contamination. Today, a lot
of RBM are commercially available including collagen, freeze-dried fascia lata,
freeze-dried dura mater allografts, polyglactin-acid, polylactic acid, polyglycolic
acid, polyorthoester, polyurethane, polyhydroxybutyrate, etc.
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