journal article·2020Open access

Clinical and histological evaluations of alveolar ridge augmentation using a novel bi-layered porous polyethylene barrier membrane

Ji-Chuan Song, Jintamai Suwanprateeb, Daraporn Sae-Lee, Teerapan Sosakul, Suwadee Kositbowornchai, Poramaporn Klanrit, Waranuch Pitiphat, Saengsome Prajaneh

Journal of Oral Science· Volume 62· Issue 3

Abstract

Guided bone regeneration (GBR) is an effective alveolar ridge reconstruction technique used before or at implant placement. The combination of various barrier membranes and bone substitutes has been employed. This study aimed to perform a preliminarily evaluation of the safety and performance of a new nonabsorbable bi-layered porous polyethylene (PPE) membrane, in combination with a freeze-dried cortical bone allograft in posterior mandibular ridge augmentation. Fifteen adults who had combined posterior mandibular defects were included for ridge augmentation via GBR using PPE membrane and allograft before implant placement. The keratinized mucosa width (KW), ridge width (RW), ridge height (RH), distance from measurement matrix to bone (DMB), and horizontal alveolar width at 14.0 mm apical to the occlusal plane (HAW) were clinically measured at 15 intended implant sites before and after the augmentation. Fifteen biopsy specimens were harvested at the implant sites for histological analysis. All the subjects completed the whole study. The KW and RH showed minor gains by 0.2 ± 1.4 mm and 0.9 ± 2.3 mm respectively; however, no statistically significant differences were found between, before, and after the augmentation (P > 0.05). In contrast, the RW and HAW significantly increased by 4.8 ± 1.6 mm and 2.3 ± 1.7 mm, respectively, (P ≤ 0.001), while DMB significantly decreased by 1.0 ± 0.8 mm after treatment (P < 0.001). Histological analysis revealed that allograft underwent active bone remodeling. The PPE membrane was adequately safe and efficient to use with allograft in GBR for the reconstruction of combined ridge defects. Although some complications were observed, these were manageable and subsequently lead to successful implant placement for all the subjects. However, further randomized controlled trials are still needed to confirm these findings.
Source: openalex_inverted_index · Quality: baseline

Research context

OpenAlex topics: Dental Implant Techniques and Outcomes · Periodontal Regeneration and Treatments · Dental Radiography and Imaging

SciVX discovery tags are terminology-based. OpenAlex topics are source-provided classifications.

Affiliations

Graduate School of Dentistry, Khon Kaen University

Neuroscience Research and Development Group, Khon Kaen University

Biofunctional Materials and Devices Research Group, National Metal and Materials Technology Center

Department of Prosthodontics, Faculty of Dentistry, Khon Kaen University

Department of Oral Biomedical Science, Faculty of Dentistry, Khon Kaen University

Research Group of Chronic Inflammatory Oral Diseases and Systemic Diseases Associated with Oral Health, Khon Kaen University

Department of Preventive Dentistry, Faculty of Dentistry, Khon Kaen University

References (38)

Show source-provided references
1. 1. Hansson S, Halldin A (2012) Alveolar ridge resorption after tooth extraction: a consequence of a fundamental principle of bone physiology. J Dent Biomech 3, 1-8.10.1177/1758736012456543 ↗
2. 2. Van der Weijden F, Dell’Acqua F, Slot DE (2009) Alveolar bone dimensional changes of post-extraction sockets in humans: a systematic review. J Clin Periodontol 36, 1048-1058.10.1111/j.1600-051X.2009.01482.x ↗
3. 3. Tan WL, Wong TL, Wong MC, Lang NP (2012) A systematic review of post-extractional alveolar hard and soft tissue dimensional changes in humans. Clin Oral Implants Res 23, 1-21.10.1111/j.1600-0501.2011.02375.x ↗
4. 4. Esposito M, Grusovin MG, Coulthard P, Worthington HV (2006) The efficacy of various bone augmentation procedures for dental implants: a Cochrane systematic review of randomized controlled clinical trials. Int J Oral Maxillofac Implants 21, 696-710.
5. 5. Rosen PS, Reynolds MA (2001) Guided bone regeneration for dehiscence and fenestration defects on implants using an absorbable polymer barrier. J Periodontol 72, 250-256.10.1902/jop.2001.72.2.250 ↗
6. 6. Sverzut CE, Faria PE, Magdalena CM, Trivellato AE, Mello-Filho FV, Paccola CA et al. (2008) Reconstruction of mandibular segmental defects using the guided-bone regeneration technique with polylactide membranes and/or autogenous bone graft: a preliminary study on the influence of membrane permeability. J Oral Maxillofac Surg 66, 647-656.10.1016/j.joms.2007.06.664 ↗
7. 7. Binsalah MA, Ramalingam S, Alkindi M, Nooh N, Al-Hezaimi K (2018) Guided bone regeneration of femoral segmental defects using equine bone graft: an in-vivo micro-computed tomographic study in rats. J Invest Surg 5, 1-11.
8. 8. Scantlebury TV (1993) 1982-1992: a decade of technology development for guided tissue regeneration. J Periodontol 64, 1129-1137.10.1902/jop.1993.64.11s.1129 ↗
9. 9. Di Stefano DA, Greco GB, Cinci L, Pieri L (2015) Horizontal-guided bone regeneration using a titanium mesh and an equine bone graft. J Contemp Dent Pract 16, 154-162.10.5005/jp-journals-10024-1653 ↗
10. 10. Elgali I, Omar O, Dahlin C, Thomsen P (2017) Guided bone regeneration: materials and biological mechanisms revisited. Eur J Oral Sci 125, 315-337.10.1111/eos.12364 ↗
11. 11. Wessing B, Lettner S, Zechner W (2018) Guided bone regeneration with collagen membranes and particulate graft materials: a systematic review and meta-analysis. Int J Oral Maxillofac Implants 33, 87-100.10.11607/jomi.5461 ↗
12. 12. Dimitriou R, Mataliotakis GI, Calori GM, Giannoudis PV (2012) The role of barrier membranes for guided bone regeneration and restoration of large bone defects: current experimental and clinical evidence. BMC Med 10, 81.10.1186/1741-7015-10-81 ↗
13. 13. Ku Y, Shim IK, Lee JY, Park YJ, Rhee SH, Nam SH et al. (2009) Chitosan/poly(L-lactic acid) multilayered membrane for guided tissue regeneration. J Biomed Mater Res A 90, 766-772.10.1002/jbm.a.31846 ↗
14. 14. Lu J, Cheng C, He YS, Lyu C, Wang Y, Yu J et al. (2016) Multilayered graphene hydrogel membranes for guided bone regeneration. Adv Mater 28, 4025-4031.10.1002/adma.201505375 ↗
15. 15. Klawitter JJ, Bagwell JG, Weinstein AM, Sauer BW (1976) An evaluation of bone growth into porous high density polyethylene. J Biomed Mater Res 10, 311-323.10.1002/jbm.820100212 ↗
16. 16. Spector M, Flemming WR, Kreutner A (1976) Bone growth into porous high-density polyethylene. J Biomed Mater Res 10, 595-603.10.1002/jbm.820100416 ↗
17. 17. Li S, Burstein AH (1994) Ultra-high molecular weight polyethylene. The material and its use in total joint implants. J Bone Joint Surg Am 76, 1080-1090.10.2106/00004623-199407000-00020 ↗
18. 18. Rai A, Datarkar A, Arora A, Adwani DG (2014) Utility of high density porous polyethylene implants in maxillofacial surgery. J Maxillofac Oral Surg 13, 42-46.10.1007/s12663-012-0459-2 ↗
19. 19. Fernandez-Bueno I, Di Lauro S, Alvarez I, Lopez JC, Garcia-Gutierrez MT, Fernandez I et al. (2015) Safety and biocompatibility of a new high-density polyethylene-based spherical integrated porous orbital implant: an experimental study in rabbits. J Ophthalmol 2015, doi: 10.1155/2015/904096.10.1155/2015/904096 ↗
20. 20. Swords GA, Spagnoli DB (2016) Bone graft material containment structures. US Patent 9433707 B2, Sep 6.
21. 21. Suwanprateeb J, Thammarakcharoen F, Suvannapruk W (2013) Preparation and characterization of 3D printed porous polyethylene for medical applications by novel wet salt bed technique. Chiang Mai J Sci 41, 200-212.
22. 22. Song JC, Suwanprateeb J, Sae-Lee D, Sosakul T, Pitiphat W, Prajaneh S et al. (2019) 2D and 3D pore structure characterization of bi-layered porous polyethylene barrier membrane using SEM and Micro-CT. ScienceAsia 45, 159-171.10.2306/scienceasia1513-1874.2019.45.159 ↗
23. 23. Frisch E, Ratka-Krüger P, Ziebolz D (2015) Increasing the width of keratinized mucosa in maxillary implant areas using a split palatal bridge flap: surgical technique and 1-year follow-up. J Oral Implantol 41, e195-e201.10.1563/aaid-joi-D-14-00025 ↗
24. 24. Lin GH, Chan HL, Wang HL (2013) The significance of keratinized mucosa on implant health: a systematic review. J Periodontol 84, 1755-1767.10.1902/jop.2013.120688 ↗
25. 25. Pranskunas M, Poskevicius L, Juodzbalys G, Kubilius R, Jimbo R (2016) Influence of peri-implant soft tissue condition and plaque accumulation on peri-implantitis: a systematic review. J Oral Maxillofac Res 7, e2.10.5037/jomr.2016.7302 ↗
26. 26. Araujo MG, Lindhe J (2018) Peri-implant health. J Clin Periodontol 45 Suppl 20, S230-S236.
27. 27. Reddy VK, Parthasarathy H, Lochana P (2013) Evaluating the clinical and esthetic outcome of apically positioned flap technique in augmentation of keratinized gingiva around dental implants. Contemp Clin Dent 4, 319-324.10.4103/0976-237X.118378 ↗
28. 28. Bruschi GB, Crespi R, Capparé P, Gherlone E (2014) Clinical study of flap design to increase the keratinized gingiva around implants: 4-year follow-up. J Oral Implantol 40, 459-464.10.1563/AAID-JOI-D-11-00236 ↗
29. 29. Thoma DS, Naenni N, Figuero E, Hämmerle CHF, Schwarz F, Jung RE et al. (2018) Effects of soft tissue augmentation procedures on peri-implant health or disease: a systematic review and meta-analysis. Clin Oral Implants Res 29 Suppl 15, 32-49.10.1111/clr.13114 ↗
30. 30. Kao SY, Lui MT, Fong J, Wu DC, Wu CH, Tu HF et al. (2005) A method using vestibulo-sulcoplasty combining a split-thickness skin graft and a palatal keratinized mucosa graft for peri-implant tissue secondary to oral cancer surgery. J Oral Implantol 31, 186-191.10.1563/1548-1336(2005)31[186:AMUVCA]2.0.CO;2 ↗
31. 31. Chiapasco M, Abati S, Romeo E, Vogel G (1999) Clinical outcome of autogenous bone blocks or guided bone regeneration with e-PTFE membranes for the reconstruction of narrow edentulous ridges. Clin Oral Implants Res 10, 278-288.10.1034/j.1600-0501.1999.100404.x ↗
32. 32. Geurs NC, Korostoff JM, Vassilopoulos PJ, Kang TH, Jeffcoat M, Kellar R et al. (2008) Clinical and histologic assessment of lateral alveolar ridge augmentation using a synthetic long-term bioabsorbable membrane and an allograft. J Periodontol 79, 1133-1140.10.1902/jop.2008.070595 ↗
33. 33. Shenoy VK (2012) Single tooth implants: pretreatment considerations and pretreatment evaluation. J Interdiscip Dentistry 2, 149-157.10.4103/2229-5194.113239 ↗
34. 34. Fontana F, Maschera E, Rocchietta I, Simion M (2011) Clinical classification of complications in guided bone regeneration procedures by means of a nonresorbable membrane. Int J Periodontics Restorative Dent 31, 265-273.
35. 35. Elnayef B, Monje A, Gargallo-Albiol J, Galindo-Moreno P, Wang HL, Hernández-Alfaro F (2017) Vertical ridge augmentation in the atrophic mandible: a systematic review and meta-analysis. Int J Oral Maxillofac Implants 32, 291-312.10.11607/jomi.4861 ↗
36. 36. Merli M, Migani M, Esposito M (2007) Vertical ridge augmentation with autogenous bone grafts: resorbable barriers supported by ostheosynthesis plates versus titanium-reinforced barriers. A preliminary report of a blinded, randomized controlled clinical trial. Int J Oral Maxillofac Implants 22, 373-382.
37. 37. Simion M, Jovanovic SA, Tinti C, Benfenati SP (2001) Long-term evaluation of osseointegrated implants inserted at the time or after vertical ridge augmentation. A retrospective study on 123 implants with 1-5 year follow-up. Clin Oral Implants Res 12, 35-45.10.1034/j.1600-0501.2001.012001035.x ↗
38. 38. Gutta R, Baker RA, Bartolucci AA, Louis PJ (2009) Barrier membranes used for ridge augmentation: is there an optimal pore size? J Oral Maxillofac Surg 67, 1218-1225.10.1016/j.joms.2008.11.022 ↗