Factors influencing the success of GBR. Smoking, timing of implant placement, implant location, bone quality and provisional restoration.
The aim of this retrospective clinical study was to evaluate the influence of different factors on the outcome of GBR treatment. 75 patients, who were not randomly assigned to the investigated parameters for clinical reasons, were included in the study. They presented with defect sites around implants and were treated with a xenogenic grafting material and a resorbable collagen membrane. The defect morphology was described, its dimension was measured and calculated at the time of implant installation and at re-entry. The success of GBR treatment was related to several clinical variables and possible correlations were evaluated. Defect sites around maxillary implants showed significantly more bone fill (96%) compared to those in the mandible (78%). The insertion of a provisional restoration during the healing period was also associated with significantly better results than when no provisional was inserted. Immediate and short-term delayed implant placements showed the best results both with 92% bone fill, when compared with long-term delayed placements with 80% bone fill (n.s.). In sites with type I bone quality (compact bone), a reduced bone fill was observed (64%). The results indicate that successful bone fill can be achieved with GBR; this is more feasible in the maxilla, when a provisional restoration is used. Early implant placement timings seem to be preferable due to the alveolar ridge preservation, more favorable defect morphologies and a higher regenerative capacity.
Zitzmann
N U
NU
Clinic of Fixed and Removable Prosthodontics and TMJ Disorders, University of Basel, Switzerland.
Schärer
P
P
Marinello
C P
CP
D020341:Absorbable Implants; D000539:Alveolar Process / Q000473:pathology; D001861:Bone Regeneration / Q000502:physiology; D018786:Bone Substitutes / Q000627:therapeutic use; D003094:Collagen / Q000627:therapeutic use; D003758:Dental Implantation, Endosseous; D015921:Dental Implants; D019094:Dental Prosthesis, Implant-Supported; D005240:Feasibility Studies; D005260:Female; D005500:Follow-Up Studies; D016557:Guided Tissue Regeneration, Periodontal; D006801:Humans; D007568:Jaw / Q000473:pathology; D008297:Male; D008334:Mandible / Q000473:pathology / Q000601:surgery; D008437:Maxilla / Q000473:pathology / Q000601:surgery; D008567:Membranes, Artificial; D008903:Minerals / Q000627:therapeutic use; D056948:Orthognathic Surgical Procedures; D010012:Osteogenesis; D012189:Retrospective Studies; D012907:Smoking / Q000009:adverse effects*; D013997:Time Factors; D016896:Treatment Outcome; D014945:Wound Healing
C077540:Bio-Oss; D018786:Bone Substitutes; D015921:Dental Implants; D008567:Membranes, Artificial; D008903:Minerals; D003094:Collagen