University of Milano Bicocca, Monza, Italy.
Private Practitioner, Italy.
J Contemp Dent Pract. 2021 Dec 1;22(12):1370-1376.
Nowadays, guided bone regeneration (GBR) is a predictable technique in both vertical and horizontal bone defects treatment. GBR Pocket Technique is an original surgical approach adopted in order to reduce the invasiveness of traditional procedures. The aim of this work is to describe the surgical procedure of GBR Pocket Technique in vertical bone augmentation and to compare the clinical outcomes of this technique with the results reported in literature of vertical bone augmentation and crestal bone remodeling achieved after 1 year after implants insertion.
Twenty-eight patients were recruited for this study and received 28 GBR procedures in the posterior region due to vertical and horizontal defects. A 50/50 mixture of autologous bone component and heterologous bone of equine origin was then made with the use of a bone scraper tunnel with internal reservoir. A PTFE-d membrane with titanium reinforcement was then fixed to the residual bone structure with screws in order to maintain the graft in place. Radiographic checks were made before graft procedures and implants insertion, then 6 months later and 1 year after implants placement.
The average bone augmentation after surgery seems to be aligned, or even better, than the average reported in literature with alternative surgical approach; in addition, the mean crestal remodeling after 1 year and the rate of complications are aligned with other previous surgical techniques with a vertical bone augmentation of 8.78 mm ± SD 2.39 and a bone remodeling after 1 year of 0.59 mm ± SD 0.29.
The advantages of this technique are preservation of blood circulation and consequently risk of flap necrosis, dehiscence, and graft exposure. This technique also reduces mucosal healing times even if it takes longer surgical time.
GBR Pocket Technique is the use of a minimal-invasive surgical wound to reduce patient morbidity and compliance.
如今，引导骨再生（GBR）是治疗垂直和水平骨缺损的一种可预测技术。GBR 口袋技术是一种原始的手术方法，旨在减少传统手术的侵袭性。本研究的目的是描述 GBR 口袋技术在垂直骨增量中的手术过程，并将该技术的临床结果与文献中报告的垂直骨增量和植入物插入后 1 年获得的牙槽嵴骨重塑的结果进行比较。
本研究共纳入 28 例患者，因垂直和水平缺损在后牙区共接受 28 例 GBR 手术。然后使用带有内部储液器的骨刮板隧道将自体骨成分和马源性异种骨以 50/50 的比例混合。然后用钛增强的 PTFE-d 膜用螺钉固定在残留的骨结构上，以保持移植物就位。在移植物手术和植入物插入前、术后 6 个月和植入物放置 1 年后进行放射学检查。
手术后的平均骨增量似乎与文献中报道的替代手术方法一致，甚至更好；此外，1 年后的平均牙槽嵴重塑和并发症发生率与其他具有 8.78mm±2.39SD 的垂直骨增量和 1 年后骨重塑率为 0.59mm±0.29SD 的垂直骨增量的其他先前手术技术一致。
该技术的优点是保留了血液循环，从而降低了皮瓣坏死、裂开和移植物暴露的风险。该技术还可以减少黏膜愈合时间，尽管手术时间较长。
GBR 口袋技术是使用微创性手术切口来降低患者的发病率和顺应性。
