Vertical ridge augmentation by expanded-polytetrafluoroethylene membrane and a combination of intraoral autogenous bone graft and deproteinized anorganic bovine bone (Bio Oss).
OBJECTIVE
To evaluate, from a histological and histomorphometrical perspective, the efficacy of a 1 : 1 mixture of deproteinized bovine bone mineral (DBBM) and autogenous bone graft associated with an expanded-polytetrafluoroethylene (e-PTFE) membrane for vertical ridge augmentation in the human.


METHODS
Seven patients with 10 surgical sites requiring vertical ridge augmentation of partially edentulous lower jaws were included in the study. The vertical augmentation procedure was performed combining a titanium-reinforced e-PTFE Gore-Tex membrane with a composite graft consisting of a 1 : 1 ratio of DBBM (Bio-Oss) and autogenous bone. Twenty-seven Branemark implants have been inserted. Eleven biopsies from the regenerated area were analyzed histologically and histomorphometrically.


RESULTS
The healing period was uneventful in nine surgical sites. In one site the membrane showed an exposure after 3 months. At the abutment connection, all implants appeared stable and submerged by a hard regenerated tissue clinically similar to bone. The histological analysis showed new bone formation and ongoing remodelling of the autogenous bone and the DBBM particles.


CONCLUSIONS
The findings from the present clinical and histological study support the use of a 1 : 1 combination of DBBM and autogenous bone chips for vertical ridge augmentation by means of guided bone regeneration techniques. The regenerated bone may lead to proper osseointegration of a dental implant inserted at the time of the regenerative procedure or after a healing period of at least 6 months. DBBM undergoes very slow resorption and substitution with new bone. Furthermore, long-term clinical studies are needed to confirm the positive effect of DBBM in enhancing the lasting stability of the vertically augmented bone.
Simion
Massimo
M
Department of Periodontology, School of Dentistry, University of Milan, Milan, Italy. massimo.simion@unimi.it
Fontana
Filippo
F
Rasperini
Giulio
G
Maiorana
Carlo
C
D000328:Adult; D000540:Alveolar Ridge Augmentation / Q000379:methods*; D000818:Animals; D001857:Bone Matrix / Q000637:transplantation*; D001861:Bone Regeneration / Q000502:physiology; D016723:Bone Remodeling / Q000502:physiology; D018786:Bone Substitutes / Q000627:therapeutic use*; D016025:Bone Transplantation / Q000379:methods*; D002417:Cattle; D000044:Dental Abutments; D015921:Dental Implants; D005260:Female; D005500:Follow-Up Studies; D016557:Guided Tissue Regeneration, Periodontal / Q000379:methods; D006801:Humans; D007576:Jaw, Edentulous, Partially / Q000601:surgery; D008297:Male; D008334:Mandible / Q000601:surgery; D008567:Membranes, Artificial; D008875:Middle Aged; D008903:Minerals / Q000627:therapeutic use*; D016348:Osseointegration / Q000502:physiology; D010012:Osteogenesis / Q000502:physiology; D011138:Polytetrafluoroethylene; D011446:Prospective Studies
C077540:Bio-Oss; D018786:Bone Substitutes; D015921:Dental Implants; D008567:Membranes, Artificial; D008903:Minerals; D011138:Polytetrafluoroethylene