ABSTRACT
Dental membranes are commonly used in oral and maxillofacial surgery for the regeneration of small osseous defects. A new synthetic resorbable membrane has recently demonstrated its biocompatibility and bone regeneration capacity in preclinical studies. This membrane is made of poly(D,L-lactic/glycolic acid 85/15), has a bi-layered structure with a dense film to prevent gingival epithelial cell invasion, and a microfibrous layer to support osteogenic cells and bone healing. This membrane completely degrades by hydrolysis in 4 to 6 months without signs of inflammation. Based on this research, a clinical study was conducted to evaluate the safety of the new membrane in guided tissue regeneration (GTR). In total, 26 patients (age: 50.5 ± 12.4, min-max 31-72 years; male/female 42/58%) were operated on at 7 independent private dental practices. Dental surgeons used the membrane together with various bone fillers in GTR for immediate and delayed implant placement (23 cases, 88%) and, to a lesser extent, socket preservation (2 cases, 8%) and alveolar crest augmentation (1 case, 4%). Surgeons reported an easy placement of the membrane (satisfaction index: 3.8/5). Fourteen days postsurgery, 15 patients had no pain while the others declared minimal pain (verbal rating scale: 2.2/10), and none had minor or serious complications related to the membrane. Exposure of the membrane without loosening the biomaterial granules was observed in 3 cases while mucosa healed normally over time. At 4 months postimplantation, no infection or mucosal inflammation was reported, and the overall dentist satisfaction with the clinical performance of the membrane was 4.5/5 on average. This clinical study demonstrated that the new synthetic resorbable membrane is safe for guided bone tissue regeneration in various dental surgery indications.
Subject(s)
Alveolar Ridge Augmentation , Biocompatible Materials/chemistry , Bone Regeneration , Guided Tissue Regeneration, Periodontal , Membranes, Artificial , Absorbable Implants , Adult , Aged , Dental Implantation, Endosseous , Epithelial Cells , Female , Gingiva/surgery , Glycolates/chemistry , Humans , Lactic Acid/chemistry , Male , Middle AgedABSTRACT
PURPOSE: Implant-supported prosthetic rehabilitations are in constant augmentation in everyday dental practice. This is largely due to increasing demand from patients for fixed or implant-stabilized prosthesis, although they are frequently reticent to complex preimplant bone augmentation surgeries, whenever bone volume is lacking. Narrow-diameter implants (NDI; ≤3.5 mm) have been developed to offer relatively simple implant solutions in challenging bone-deficient sites. However, concerns regarding their mechanical properties have been raised. Special titanium-zirconium material (Ti-Zr), with superior mechanical resistance, compared with pure titanium alloys has been introduced into the market. The purpose of this systematic review was to determine the available data on clinical performance of Ti-Zr NDI. MATERIALS AND METHODS: A literature search of all available clinical articles dealing with Ti-Zr NDI has been carried out. After including only prospective clinical trials, 14 papers were retrieved for thorough reviewing. CONCLUSION: Short-term results from preliminary clinical reports are quite promising, although the number of published studies and the follow-up periods are still insufficient to determine the real benefit of this hybrid material compared with titanium, especially when using NDI.
