title: Tomodensitometric and histologic evaluation of the combined use of a collagen membrane and a hydroxyapatite spacer for guided bone regeneration: a clinical report.
abstract: In this report, the problems of insufficient bone and soft tissue after extraction of maxillary incisors were addressed concurrently prior to endosseous implant placement, by combining the use of a diphenylphosphorylazide-cross-linked Type I collagen membrane and a resorbable space-making biomaterial composed of 200-micron porous hydroxyapatite granules blended in Type I collagen and chondroitin-4-sulfate. Upon flap reflection 8 months postsurgery, the horizontal deficiencies were almost completely resolved, membranes completely resorbed and the defects filled with hard, bonelike tissue, with a few superficial hydroxyapatite granules. Histologic evaluation of the bone biopsies obtained at the implantation sites revealed dense, well-reconstructed alveolar bone with a few traces of hydroxyapatite granules that had been completely resorbed. Tomodensitometric evaluation indicated that bone regeneration ranged from 14% to 58%, with an average bone gain of 29.77%. Four nonsubmerged ITI titanium implants placed in the augmented bone have been in function for more than 5 years, with no clinical or radiographic signs of hard or soft tissue breakdown. Bacterial sampling at dental sites with periodontitis 1 month prior to periodontal therapy and at implant sites for up to 30 months demonstrated rapid colonization of implant surfaces by periodontopathogens without causing any detrimental effect to implant integration.
authors.affiliation: Department of Dental Medicine, Sart Tilman University Hospital, University of Liège, Belgium.
authors.forename: E
authors.initials: E
authors.lastname: Benqué
authors.forename: S
authors.initials: S
authors.lastname: Zahedi
authors.forename: D
authors.initials: D
authors.lastname: Brocard
authors.forename: P
authors.initials: P
authors.lastname: Marin
authors.forename: G
authors.initials: G
authors.lastname: Brunel
authors.forename: F
authors.initials: F
authors.lastname: Elharar
mesh_terms: D020341:Absorbable Implants; D000328:Adult; D016301:Alveolar Bone Loss / Q000000981:diagnostic imaging* / Q000473:pathology; D000540:Alveolar Ridge Augmentation / Q000295:instrumentation / Q000379:methods; D001861:Bone Regeneration; D002809:Chondroitin Sulfates; D003094:Collagen / Q000737:chemistry; D003758:Dental Implantation, Endosseous / Q000379:methods; D017886:Durapatite; D016557:Guided Tissue Regeneration, Periodontal / Q000295:instrumentation / Q000379:methods*; D006801:Humans; D007180:Incisor; D008297:Male; D008437:Maxilla / Q000000981:diagnostic imaging; D008567:Membranes, Artificial; D014057:Tomography, X-Ray Computed
chemical_list: D008567:Membranes, Artificial; D002809:Chondroitin Sulfates; D003094:Collagen; D017886:Durapatite