Researcher, Unit of Oral and Maxillofacial Surgery, Department of Biomedical and Neuromotor Science (DIBINEM), University of Bologna, Bologna, Italy.
Private Practice, San Pietro in Cariano, Verona, Italy.
Implant Dent. 2019 Aug;28(4):388-399. doi: 10.1097/ID.0000000000000909.
In the past 10 years, long-term studies have demonstrated that guided bone regeneration (GBR) is a successful and reliable technique for vertical and horizontal ridge augmentation, but strict and rigorous protocols must be adopted.
Because no reports have yet been published with statements and clinical recommendations for GBR, a closed meeting of all authors was organized to discuss this matter during a GBR symposium held in Bologna (Italy) in October 2016. The authors focused on the findings of systematic and narrative reviews, prepared before the meeting, covering aspects of the clinical management of GBR techniques. Successively, a discussion based on the scientific evidence and on the experts' opinions led to the formulation of statements, clinical recommendations, and implications for future research.
To avoid complications and to optimize outcomes, the following factors should be considered by clinicians: patient selection; analysis of defect type; blood supply; antibiotic treatment; flap passivation; delayed implant placement; combination of autogenous bone and xenograft or allograft; rigorous fixation of membranes; removal after 6 to 9 months; analysis of complications; soft-tissue management; and high care in scarred sites and in esthetic areas.
The present consensus report reviewed the scientific evidence and provided specific guidelines and recommendations for clinical practice and the different approaches to GBR techniques to ensure surgical success and predictable outcomes.
在过去的 10 年中,长期研究表明引导骨再生(GBR)是一种成功且可靠的垂直和水平嵴增高技术,但必须采用严格和严谨的方案。
由于目前尚无关于 GBR 的声明和临床建议的报告,因此在 2016 年 10 月于意大利博洛尼亚举行的 GBR 研讨会上组织了所有作者的闭门会议来讨论这个问题。作者重点讨论了在会议前准备的系统和叙述性综述的结果,涵盖了 GBR 技术临床管理的各个方面。随后,根据科学证据和专家意见进行了讨论,从而提出了声明、临床建议和对未来研究的影响。
为了避免并发症并优化结果,临床医生应考虑以下因素:患者选择;分析缺损类型;血液供应;抗生素治疗;皮瓣钝化;延迟种植体放置;自体骨与异种骨或同种异体骨的联合使用;膜的严格固定;6 至 9 个月后取出;分析并发症;软组织管理;在瘢痕部位和美学区域的高度护理。
本共识报告回顾了科学证据,并为临床实践和 GBR 技术的不同方法提供了具体的指导方针和建议,以确保手术成功和可预测的结果。