Llambés Fernando, Silvestre Francisco-Javier, Caffesse Raúl
J Periodontol. 2007 Oct;78(10):2036-42. doi: 10.1902/jop.2007.070017.
Guided bone regeneration (GBR) is a very useful surgical technique to increase limited alveolar bone for implant placement. The use of non-resorbable barriers is well established; however, bioabsorbable collagen membranes may simplify the surgical technique and make it more predictable.
Vertical ridge augmentation was performed on 11 patients at the time of implant placement. The part of the implant out of bone was covered with autogenous bone/graft, and a slow-resorption collagen membrane was placed on top. Gingival tissues were closed with horizontal mattress and interrupted sutures. Second-stage surgery was performed 4 to 6 months later, and healing abutments were placed. The length of the implant out of bone was determined at stage 1 and stage 2 surgeries on a periapical x-ray 1 year after implant load. Histology was obtained from one of the cases at second-stage surgery.
Measurements revealed that the mean implant out of bone was 3.5 mm at stage 1 and 0.5 mm at stage 2. Mean bone gain was 3 mm, which represented 83% of the exposed implant at stage 1. One year after loading, implants showed a mean marginal bone loss of 1.4 mm. Minimal complications were detected, and only one case failed. Histology from one successful case showed new trabecular bone with large cellular marrow spaces in the regenerated area.
Slow-resorption collagen membranes have the potential to promote vertical ridge augmentation when used with autogenous bone at the time of implant placement.
引导骨再生（GBR）是一种非常有用的外科技术，可增加用于种植体植入的有限牙槽骨。不可吸收屏障的使用已得到充分证实；然而，可生物吸收的胶原膜可能会简化手术技术并使其更具可预测性。
在11例患者植入种植体时进行垂直牙槽嵴增高术。种植体露出骨面的部分用自体骨/移植物覆盖，并在顶部放置一张缓慢吸收的胶原膜。牙龈组织用水平褥式缝合和间断缝合关闭。4至6个月后进行二期手术，并放置愈合基台。在种植体负载1年后，通过根尖X线片在一期和二期手术时确定种植体露出骨面的长度。在二期手术时从其中1例获取组织学样本。
测量显示，一期手术时种植体露出骨面的平均长度为3.5 mm，二期手术时为0.5 mm。平均骨增量为3 mm，占一期手术时暴露种植体的83%。负载1年后，种植体的平均边缘骨吸收为1.4 mm。检测到的并发症极少，仅1例失败。1例成功病例的组织学检查显示，再生区域有新的小梁骨，伴有大的细胞骨髓腔。
缓慢吸收的胶原膜在种植体植入时与自体骨联合使用，有促进垂直牙槽嵴增高的潜力。
