Evaluation of Premature Membrane Exposure and Early Healing in Guided Bone Regeneration of Peri-Implant Dehiscence and Fenestration Defects With a Slowly Resorbing Porcine Collagen Ribose Cross-Linked Membrane: A Consecutive Case Series.

INTRODUCTION

Guided bone regeneration (GBR) is a well-known and accepted procedure for effective treatment of oral bony defects that is dependent on sustained barrier membrane function for adequate new bone formation. Cross-linking between collagen fibrils with various agents has proven to be effective in prolonging membrane integrity and function, both critical to positive bone regenerative outcomes. Overlying mucosal dehiscence with membrane exposure may lead to less than adequate new bone formation. The current case series examines guided bone regenerative outcomes for peri-implant defects using a ribose cross-linked porcine collagen membrane that appears to reduce the risk of cross-linking-associated membrane exposure.

CASE SERIES

Seven patients with nine sites having peri-implant dehiscence and fenestration defects were enrolled in this consecutive case series pilot study. At surgery, the linear range of implant thread exposure was 5 to 10 mm (mean of ≈6.3 mm). After implant insertion, grafting with mineralized allograft, and placement of a ribose cross-linked collagen membrane, patients were followed for a minimum of 6 months. At 6-month reentry surgery, all dehiscence and fenestration defects were eliminated with newly regenerated bone covering previously exposed implant threads. No membrane exposure occurred during this study.

CONCLUSIONS

Successful GBR outcomes may be enhanced by avoiding premature membrane exposure. Although collagen cross-linking may be associated with increased mucosal dehiscence, the ribose cross-linked membrane examined in the current study may help promote positive regenerative outcomes by sustained functional and structural integrity and a reduction in membrane exposure incidence.