A RETROSPECTIVE STUDY OF CLINICAL AND RADIOGRAPHIC OUTCOMES OF COMPLICATIONS FOLLOWING RIDGE AUGMENTATION PROCEDURES
Abstract
Purpose: The aim of this study is to evaluate complications related to the use of
Titanium mesh and Titanium-reinforced membrane following ridge augmentation
procedures and their effect on bone gain using CBCT measurements
Methods:
Clinical and CBCT scans were retrieved from subjects who underwent pre-surgical
consultation and completed surgical procedures from 2017 to 2021.
Measurements were recorded into two groups based on the space maintainer used
during ridge augmentation surgeries, titanium mesh (TI-M) and titanium-
reinforced (TI-R). Bone gain dimensions at the crest (BG-C) and middle of the
ridge (BG-M) were also noted. From the clinical data, the complications analyzed
were early exposures of membranes and infections.
Results:
The mean BG-C with TI-R in sites with complications is 1.155 mm compared to
1.7mm in sites without complications. The mean BG-M with TI-R is 1.118mm
compared to 1.830mm in sites without complications.
Mean BG-C in sites with TI-M with complications is 0.786 mm compared to
1.7mm in sites without complications. Mean BG-M in TI-M sites with
complications is 0.964 mm compared to 1.757mm in sites without complications.
Conclusion:
Given the constraints of the study, TI-R had slightly better outcomes in mean bone
gain compared to the TI-M group at BG-C and BG-M following complications.
However, the sample size of the TI-R group was small (n=21) compared to the TI-
M group (n=57).
Description
Bone augmentation procedures are usually indicated to allow implant placement in
an optimal three-dimensional position to attain long-term function and predictable
esthetic outcomes for the later prosthetic restoration1. However, this ideal situation
might not be readily achievable due to the changes in bone volume that occur
within the first 3 months of tooth loss. In addition, atrophy of the alveolar crest
may result from tooth agenesis, dental and maxillofacial trauma, periodontal
disease, tooth extractions, tumor surgery, etc. It may take place in the horizontal as
well as in the vertical dimension. Therefore, guided bone regeneration (GBR) has
been proposed to restore the lost bone volume to accommodate the dental implant
prostheses. The factors that are important to the successful outcome of a GBR
treatment include: the surgical technique, the occlusion and stability of the barrier,
the dimensions of barrier perforations, the tightness of the seal between the barrier
and the host bone, the adequacy of the blood supply and the availability of bone-
forming cells bone cells are given a protected environment to populate and mature
into the functional living bone by excluding epithelial cells and connective tissue
through barrier membranes and bone grafts 2.
Several different types of membranes have been considered in recent years that
facilitate new bone generation and stabilize the underlying bone graft. Space
maintaining membranes minimize the risks of the newly formed ridge collapsing or
the space being occupied by ingrowing soft tissue. Experimental and clinical
studies have been conducted to test bioresorbable and non-resorbable membrane
materials, such as polytetrafluoroethylene (PTFE), expanded PTFE (e-PTFE),
titanium meshes, collagen3-6
Published studies have shown that both resorbable and non-resorbable membranes
effectively prevent soft tissue cells from invading the area of the bone defect and
promoting bone regeneration 7-9. However, the use of such membranes for GBR has
sometimes been associated with complications, reportedly involving exposure,
infection, and collapse – and the non-resorbable types of membrane seem to be
applied more often than the resorbable materials, resulting in the need for
additional grafting at a later surgical intervention or implant failure. Many reviews
have assessed post-surgical complications in patients who underwent horizontal
GBR.1, 10-12
This study aims to evaluate the outcomes associated with complications between
the titanium mesh group and the titanium-reinforced group; it also assesses the
effect on bone gain after the following complication in the ridge augmentation
procedure.
Keywords
PURPOSE OF RIDGE AUGMENTATION, CLASSIFICATION OF RIDGE DEFECTS, SURGICAL PRINCIPLES OF BONE AUGMENTATION, BIOMATERIALS, HISTOLOGICAL FEATURES FOLLOWING SURGERY, TREATMENT OUTCOMES OF RIDGE AUGMENTATIONS