title: The influence of collagen membrane and autogenous bone chips on bone augmentation in the anterior maxilla: a preclinical study.
abstract: OBJECTIVE
  To evaluate the effect of a resorbable collagen membrane and autogenous bone chips combined with deproteinized bovine bone mineral (DBBM) on the healing of buccal dehiscence-type defects.
  
  
  METHODS
  The second incisors and the first premolars were extracted in the maxilla of eight mongrels. Reduced diameter, bone-level implants were placed 5 weeks later. Standardized buccal dehiscence-type defects were created and grafted at implant surgery. According to an allocation algorithm, the graft composition of each of the four maxillary sites was DBBM + membrane (group D + M), autogenous bone chips + DBBM + membrane (group A + D + M), DBBM alone (group D) or autogenous bone chips + DBBM (group A + D). Four animals were sacrificed after 3 weeks of healing and four animals after 12 weeks. Histological and histomorphometric analyses were performed on oro-facial sections.
  
  
  RESULTS
  The pattern of bone formation and resorption within the grafted area showed high variability among the same group and healing time. The histomorphometric analysis of the 3-week specimens showed a positive effect of autogenous bone chips on both implant osseointegration and bone formation into the grafted region (P < 0.05). The presence of the collagen membrane correlated with greater bone formation around the DBBM particles and greater bone formation in the grafted region after 12 weeks of healing (P < 0.05). The oro-facial width of the augmented region at the level of the implant shoulder was significantly reduced in cases where damage of the protection splints occurred in the first week of healing (P < 0.05).
  
  
  CONCLUSIONS
  The addition of autogenous bone chips and the presence of the collagen membrane increased bone formation around DBBM particles. Wound protection from mechanical noxa during early healing may be critical for bone formation within the grafted area.
authors.affiliation: Department of Oral Surgery and Stomatology, School of Dental Medicine, University of Bern, Bern, Switzerland.|Department of Periodontics, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA.
authors.forename: Simone F M
authors.initials: SFM
authors.lastname: Janner
authors.affiliation: Robert K. Schenk Laboratory of Oral Histology, School of Dental Medicine, University of Bern, Bern, Switzerland.
authors.forename: Dieter D
authors.initials: DD
authors.lastname: Bosshardt
authors.affiliation: Department of Periodontics, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA.
authors.forename: David L
authors.initials: DL
authors.lastname: Cochran
authors.affiliation: Department of Oral Surgery and Stomatology, School of Dental Medicine, University of Bern, Bern, Switzerland.
authors.forename: Vivianne
authors.initials: V
authors.lastname: Chappuis
authors.affiliation: Department of Periodontics, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA.
authors.forename: Guy
authors.initials: G
authors.lastname: Huynh-Ba
authors.affiliation: Department of Periodontics, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA.
authors.forename: Archie A
authors.initials: AA
authors.lastname: Jones
authors.affiliation: Department of Oral Surgery and Stomatology, School of Dental Medicine, University of Bern, Bern, Switzerland.
authors.forename: Daniel
authors.initials: D
authors.lastname: Buser
mesh_terms: D000539:Alveolar Process / Q000473:pathology / Q000601:surgery; D000540:Alveolar Ridge Augmentation / Q000379:methods*; D000818:Animals; D016025:Bone Transplantation / Q000379:methods*; D002417:Cattle; D003094:Collagen / Q000627:therapeutic use*; D004285:Dogs; D008297:Male; D008437:Maxilla / Q000473:pathology / Q000601:surgery*
chemical_list: D003094:Collagen
keywords: anterior maxilla; autogenous bone; bone healing; bovine bone; collagen membrane; dehiscence defect; dental implant; dog; early implant placement; guided bone regeneration; osseointegration; titanium-zirconium alloy