Eskan Mehmet A, Girouard Marie-Eve, Morton Dean, Greenwell Henry
, Sisli, Istanbul, Turkey.
Clinic Eska, Terrace Fulya, Tesvikiye Mah., Hakki Yeten Cad, Sisli, Istanbul, Turkey.
Int J Implant Dent. 2017 Dec;3(1):26. doi: 10.1186/s40729-017-0089-z. Epub 2017 Jun 22.
The effect of membrane exposure on guided bone regeneration (GBR) for lateral ridge augmentation has been poorly addressed. This case-controlled study aimed to investigate potential effect of membrane exposure lateral ridge augmentation and subsequent implant placement.
A total of 14 patients that did receive lateral ridge augmentation procedure using allogeneic cancellous graft particulate in combination with an alloplastic bioresorbable matrix barrier were retrospectively selected for this study. Bone width was measured at the crest with a digital caliper before bone augmentation and at the reopening for implant placement 4 months later for all patients. Cases where primary flap closure was achieved and the barrier did not expose throughout the time until implant placement were assigned to the control group (n = 7). Cases where primary closure could not be achieved or a barrier exposure happened within the first week following the initial surgery were assigned to the test group.
The measured alveolar ridge width before surgery as well as after GBR procedure were not statistically significant different between the two groups (p > 0.05). Both groups showed a significant (p < 0.05) increase in their mean alveolar ridge width 4 months after later augmentation procedure, from 3.4 ± 1.2 to 6.0 ± 1.1 mm in the control group and from 3.6 ± 1.0 to 5.0 ± 1.4 mm in the test group. However, the mean alveolar ridge gain was significantly greater in the control group than in the test group (p < 0.05). Consequently, the reduction of the augmented alveolar ridge was significantly higher in the test group averaging to 4.7 mm than for the control group showing a loss of 3.1 mm after 4 months, respectively. However, in all 14 cases, successful implant placement was achieved after 4 months.
Within the limit of this study, it can be concluded that early exposure of a bioresorbable matrix barrier during lateral ridge augmentation may compromise the results of the GBR procedure but may still result in a favorable alveolar ridge width gain that allows for the placement of dental implants.
膜暴露对侧方牙槽嵴增高引导骨再生（GBR）的影响尚未得到充分研究。本病例对照研究旨在探讨膜暴露对侧方牙槽嵴增高及后续种植体植入的潜在影响。
本研究回顾性选取了14例接受同种异体松质骨颗粒联合异体生物可吸收基质屏障进行侧方牙槽嵴增高手术的患者。所有患者在骨增量术前用数字卡尺测量牙槽嵴顶的骨宽度，并在4个月后再次切开进行种植体植入时测量。初次瓣关闭成功且屏障在种植体植入前全程未暴露的病例被分配到对照组（n = 7）。初次关闭未成功或在初次手术后第一周内发生屏障暴露的病例被分配到试验组。
两组术前及GBR术后测量的牙槽嵴宽度差异无统计学意义（p > 0.05）。两组在侧方牙槽嵴增高术后4个月时平均牙槽嵴宽度均显著增加（p < 0.05），对照组从3.4±1.2 mm增加到6.0±1.1 mm，试验组从3.6±1.0 mm增加到5.0±1.4 mm。然而，对照组的平均牙槽嵴增加量显著大于试验组（p < 0.05）。因此，试验组增高后的牙槽嵴减少量显著高于对照组，试验组平均减少4.7 mm，对照组4个月后减少3.1 mm。然而，在所有14例病例中，4个月后均成功植入了种植体。
在本研究的范围内，可以得出结论，侧方牙槽嵴增高过程中生物可吸收基质屏障的早期暴露可能会影响GBR手术的结果，但仍可能导致牙槽嵴宽度的有利增加，从而允许植入牙种植体。
