Optimum Dental Clinic, Skopje, N Macedonia.
Vita Dent Clinic, Tetovo, N Macedonia.
Pril (Makedon Akad Nauk Umet Odd Med Nauki). 2021 Oct 26;42(2):103-108. doi: 10.2478/prilozi-2021-0028.
Guided bone regeneration (GBR) is a therapeutic modality to achieve bone regeneration with the use of barrier membranes. The use of deproteinized bovine bone material (DBBM) for ridge preservation allows the preservation of the edentulous ridge dimensions. Here, we present a case of horizontal GBR using DBBM and a resorbable membrane, with simultaneous implant placement. Simultaneously, ridge preservation of the pontic area, using DBBM within a "socket seal" procedure was performed. Two implants were places at sites 23 and 26 to support a fixed partial denture (FPD). The mesial implant showed exposed buccal threads, which were then covered with autogenous bone particles and small size granules of DBBM. The collagen membrane was stabilized with periosteal mattress suture. Six months postoperatively, CBCT images revealed a stable buccal bone layer at the implant site, indicating a successful GBR procedure. At this point in time, tooth 24 was atraumatically extracted. A ridge preservation was done utilizing DBBM, and a soft tissue graft form the tuber. A ceramic-metal FPD with excellent "white aesthetics" and a harmonic transition zone to the soft tissue was fabricated. At 3 years follow up, the peri-implant bone levels were stable, and the clinical outcomes were excellent. It is concluded that a GBR procedure, utilizing DBBM and a collagen barrier membrane with simultaneous implant placement, as well as ridge preservation using DBBM, are predictable therapeutic methods. However, gentle manipulation of the soft tissues, and wound stability, with tension-free passive closure of the wound margins are prerequisites for a long-term clinical success.
引导骨再生（GBR）是一种使用屏障膜实现骨再生的治疗方式。使用脱蛋白牛骨材料（DBBM）进行牙槽嵴保存可保持无牙颌嵴的尺寸。在这里，我们展示了使用 DBBM 和可吸收膜进行水平 GBR 并同时植入的病例。同时，使用 DBBM 在“socket seal”程序中进行桥接区域的牙槽嵴保存。在 23 和 26 位点放置了两个种植体以支持固定局部义齿（FPD）。近中种植体显示颊侧螺纹暴露，随后用自体骨颗粒和 DBBM 的小颗粒覆盖。胶原膜用骨膜褥式缝合固定。术后 6 个月，CBCT 图像显示种植体部位有稳定的颊侧骨层，表明 GBR 手术成功。此时，24 号牙无创伤性拔除。使用 DBBM 进行牙槽嵴保存，并从结节取软组织移植物。制作了具有出色“白色美学”和与软组织和谐过渡区的陶瓷-金属 FPD。3 年随访时，种植体周围骨水平稳定，临床效果极佳。结论是，使用 DBBM 和胶原屏障膜进行 GBR 手术并同时植入，以及使用 DBBM 进行牙槽嵴保存，是可预测的治疗方法。然而，软组织的轻柔处理以及无张力的被动闭合伤口边缘的伤口稳定性是长期临床成功的前提。
