title: Early loading of implants in vertically augmented bone with non-resorbable membranes and deproteinised anorganic bovine bone. An uncontrolled prospective cohort study.
abstract: BACKGROUND
  All materials used in this study were purchased by the author and it is therefore free of any commercial or institutional interest.
  
  
  OBJECTIVE
  To evaluate the success rate 1 year after loading of early loaded implants placed in vertically augmented bone using deproteinised bovine bone (Bio-Oss) and a titanium-reinforced membrane (Gore-Tex).
  
  
  METHODS
  Twenty patients provided 25 sites that were treated with vertical guided tissue regeneration (GBR) using Bio-Oss and expanded polytetrafluoroethylene titanium-reinforced membranes. After 1 year of healing, the membranes were removed and 64 implants were placed (baseline) and loaded 30 days later. Standardised periapical radiographs were obtained at baseline and 1 year thereafter. One independent assessor clinically evaluated the amount of tissue regenerated and peri-implant bone level based on the radiographs. Outcome measures were prosthesis success, implant success, complications, amount of vertically regenerated bone, peri-implant marginal bone levels and histology.
  
  
  RESULTS
  No patient dropped out. A total of 23 out of 25 sites healed uneventfully. Two sites showed early membrane exposure. In these sites, the surgery was repeated with success 2 months later. Clinical evaluation showed a mean vertical bone defect of 5.6 mm (SD 1.7). Mean vertical bone gain after GBR was 5.2 mm (SD 1.5). The histology of five samples retrieved from four patients showed a total percentage of xenograft and new bone of 52.6%, with dispersed graft particles surrounded by layers of bone. All implants were stable after 1 year of function, yielding a survival rate of 100%. Statistically significant peri-implant bone loss (0.95 mm; SD 0.21; 95% confidence interval 0.85 to 1.05; P < 0.001) was observed radiographically from baseline to the 1-year follow-up.
  
  
  CONCLUSIONS
  This prospective cohort study shows that by using deproteinised bovine bone and a non-resorbable titanium-reinforced membrane, vertical bone gain can be obtained and implants can be loaded after 30 days. The vertical regenerated tissue exhibited good stability over 1 year of implant function.
authors.affiliation: Brescia, Italy. todiscomarzio@libero.it
authors.forename: Marzio
authors.initials: M
authors.lastname: Todisco
mesh_terms: D000328:Adult; D000368:Aged; D016301:Alveolar Bone Loss / Q000000981:diagnostic imaging / Q000209:etiology; D000540:Alveolar Ridge Augmentation / Q000379:methods*; D001861:Bone Regeneration; D018786:Bone Substitutes; D015331:Cohort Studies; D003758:Dental Implantation, Endosseous; D015921:Dental Implants / Q000009:adverse effects; D019094:Dental Prosthesis, Implant-Supported; D005260:Female; D016557:Guided Tissue Regeneration, Periodontal / Q000379:methods*; D006801:Humans; D008297:Male; D008567:Membranes, Artificial; D008875:Middle Aged; D008903:Minerals; D011138:Polytetrafluoroethylene; D011446:Prospective Studies; D011859:Radiography; D013997:Time Factors; D014025:Titanium; D016896:Treatment Outcome; D014716:Vertical Dimension
chemical_list: C077540:Bio-Oss; D018786:Bone Substitutes; D015921:Dental Implants; D008567:Membranes, Artificial; D008903:Minerals; D011138:Polytetrafluoroethylene; D014025:Titanium