Evaluation of Guided Bone Regeneration Using Xenograft/APRF Mixture in Atrophic Posterior Mandible (Clinical and Radiographic study)
Keywords:
Guided bone regeneration, A-PRF, Xenograft, Posterior mandible, implant stability
Abstract
Introduction: The rehabilitation of posterior mandible with dental implants represents today a hard challenge for clinicians due to the lack of supporting bone. Different surgical techniques are currently being used to augment the posterior mandible where GBR is considered most commonly used. Materials and Methods: Fifteen patients were selected to treat mandibular alveolar ridge resorption with guided bone regeneration using titanium reinforced membrane and a filling mixture of xenograft bovine bone/PRF. The membrane was fixed using meisinger pin control kit and profix 3mm microscrews. A PRF membrane was used to cover the Ti d-ptfe. Results: Using the mixture of PRF/xenograft as well as PRF membranes showed promising results in term of primary wound healing, whereas a significant bone quantity with a mean bone volume of 5.78 ± 0.81 was reported. The primary implant stability recorded high values and significantly increased at a period of 6 months post insertion p=0.037 Conclusion: It could be concluded that PFR/ xenograft mixture can be promising when used with the titanium reinforced d-ptfe membrane in 3D ridge reconstruction of atrophic posterior mandible, moreover using PRF membrane to cover the TI- d-ptfe membrane could enhance soft tissue healing as well as it can prevent soft tissue dehiscence due to the concentration of the growth factors that can be released during primary wound healing. Xenograft/PRf mixture can be consistent to be utilized for creation of new bone in severely atrophic ridges if used in GBR. The high ISQ at primary implant placement and at a period of 6 months post insertion according to Osstell can explain the successful application of this mixture in 3D bone augmentation of atrophic posterior mandible.
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References
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13. Maridati, P., Cremonesi, S., Fontana, F., & Cicciù, M. a.-P.-2. (2016). Management of d-PTFE membrane exposure for having final clinical success. . Journal of Oral Implantology, 42(3), 289-291.
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17. Meshram, V., Meshram, V., & Lambade, P. (2013). Assessment of Nerve Injuries after Surgical Removal of Mandibular Third Molar: A Prospective Study. Asian Journal of Neuroscience, 1-6.
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21. Pacifici, A., Carbone, D., Soda, G., & Polimeni, A. a. (2015). Guided bone regeneration procedure with platelet rich fibrin (PRF) membranes in the resolution of a severe maxillary bone defect: report of a case. Senses and Sciences, 2(1), 64-70.
22. Rakhmatia, Y., Ayukawa, Y., Furuhashi, A., & Koyano, K. (2013). Current barrier membranes: Titanium mesh and other membranes for guided bone regeneration in dental applications. J. Prosthodont. Res., 57, 3-14.
23. Rocchietta, I., Fontana, F., & Simion, M. (2008). Clinical outcomes of vertical bone augmentation to enable dental implant placement: A systematic review. J. Clin. Periodontol., 35, 203-215.
24. Romanos, G. (2010). Periosteal releasing incision for successful coverage of augmented sites. A technical note. Journal of Oral Implantology, 36(1), 25-30.
25. Ronda, M., Rebaudi, A., Torelli, L., & Stacchi, C. (2014). Expanded vs. dense polytetrafluoroethylene membranes in vertical ridge augmentation around dental implants: a prospective randomized controlled clinical trial. Clin. Oral Impl. Res., 25, 859-866.
26. Sharma, A., & Pradeep, A. (2011). Autologous platelet rich fibrin in the treatment of mandibular degree II furcation defects: a randomized clinical trial. Journal of Periodontol, 82, 1396-1403.
27. Simonpieri, A., Choukroun, J., Corso, M., Sammartino, G., & Ehrenfest, D. (2011). Simultaneous sinuslift and implantation using microthreaded implants and leukocyte and platelet-rich fibrin as sole grafting material: a six-year experience. Implant Dentistry, 20, 2-12.
28. Szolnoky, G., Szendi-Horváth, K., Seres, L., Boda, K., & Kemény, L. (2007). Manual lymph drainage efficiently reduces postoperative facial swelling and discomfort after removal of impacted third molars. . Lypmhology. , 40, 138-142.
29. Toscano, N., Shumaker, N., & Holtzclaw, D. (2010). The art of block grafting: A review of the surgical protocol for reconstruction of alveolar ridge deficiency. Journal of Implant and Advanced Clinical Dentistry., 2(2), 45-47.
30. Tunkel, J., de Stavola, L., & and Kloss‐Brandstätter, A. (2021). A. Alveolar ridge aug- mentation using the shell technique with allogeneic and autoge- nous bone plates in a split-mouth design-a retrospective case report from five patients. Clin Case Rep., 9(2), 947-959.
31. Urban, I., & Monje, A. (2019). Guided bone regeneration in alveolar bone reconstruction. Oral and Maxillofacial Surgery Clinics, 31(2), 331-338.
32. Urban, I., Lozada, J., Jovanovic, S., Nagursky, H., & Nagy, K. (2014). Vertical ridge augmentation with titanium-reinforced, dense-PTFE membranes and a combination of particulated autogenous bone and anorganic bovine bone-derived mineral: A prospective case A prospective case series in 19 patients. Int. J. Oral Maxillofac. Implant., 29, 185-193.
33. Urban, I., Montero, E., & Monje, A. a.‐S. (2019). Effectiveness of vertical ridge augmentation interventions: A systematic review and meta‐analysis. . Journal of Clinical Periodontology, 46, 319-339.
34. Urban, I., Montero, E., Amerio, E., & Palombo, D. a. (2023). Techniques on vertical ridge augmentation: Indications and effectiveness. Periodontology 2000.
35. Urban, I., Tattan, M., Ravida, A., Saleh, M., & Tavelli, L. a.-O. (2022). Simultaneous Alveolar Ridge Augmentation and Periodontal Regenerative Therapy Leveraging Recombinant Human Platelet-Derived Growth Factor-BB (rhPDGF-BB): A Case Report. . International Journal of Periodontics & Restorative Dentistry, 42(5), 42(5).
36. Van der Weijden, F., & Dell'Acqua, F. (2009). Alveolar bone dimensional changes of post-extraction sockets in humans: a systematic review. Journal of Clinical Periodontology., 36(12), 1048-1058.
37. Windisch, P. O. (2021). Vertical-guided bone regeneration with a titanium-reinforced d-PTFE membrane utilizing a novel split-thickness flap design: a prospective case series. Clinical oral investigations, 25, 2969-2980.
2. Amaral Valladão, C., Freitas Monteiro, M., & and Joly, J. (2020). Guided bone regeneration in staged vertical and horizontal bone augmentation using platelet-rich fibrin associated with bone grafts: a retrospective clinical study. . International journal of implant dentistry, 6, 1-10.
3. Blair, P., & Flaumenhaft, R. (2009). Platelet alpha - granules: basic biology and clinical correlates. Blood Reviews, 23, 177-189.
4. Choukroun, J., Diss, A., & Simonpieri, A. (2006). Platelet-rich fibrin (PRF): a second-generation platelet concentrate. Part V: histologic evaluations of PRF effects on bone allograft maturation in sinus lift. Oral Surgery Oral Medicine Oral Pathology Oral Rad Endod., 101, 299-303.
5. Coulthard, P., Patel, N., Bailey, E., & Coulthard, M. (2014). Measuring pain after oral surgery . Oral Surgery., 203-208.
6. Datla, M., Chellathurai, B., & Thiagarajan, R. a. (2018). Platelet-rich Fibrin Application in Guided Bone Regeneration Using Autogenous Block Graft in Staged Dental Implant Placement: A Case Report. Int J Oral Implantol Clin Res,, 9, 1-3.
7. Drăgan, E. a. (2022). Review of the Long-Term Outcomes of Guided Bone Regeneration and Autologous Bone Block Augmentation for Vertical Dental Restoration of Dental Implants. Medical Science Monitor: International Medical Journal of Experimental and Clinical Research, , 28(1), 937433-1.
8. Ehrenfest, D., Corso, M., Diss, A., Mouhyi, J., & Charrier, J. (2010). Three-dimensional architecture and cell composition of a Choukroun’s platelet-rich fibrin clot and membrane. Journal of Periodontology, 81, 546-555.
9. Garaicoa‐Pazmiño, C., Suárez‐López del Amo, F., Monje, A., Catena, A., Ortega‐Oller, I., & Galindo‐Moreno, P. a. (2014). Influence of crown/implant ratio on marginal bone loss: a systematic review. . Journal of periodontology, 85(9), 1214-1221.
10. Huang, H., Wu, G., & and Hunziker, E. (2020). The clinical significance of implant stability quotient (ISQ) measurements: A literature review. Journal of oral biology and craniofacial research, 10(4), 10(4), pp.629-638.
11. Kang, Y., Jeon, S., & Park, J. (2011). Platelet-rich fibrin (PRF) is a bioscaffold and reservoir of growth factors for tissue regeneration. Tissue Engineering, 17, 349-359.
12. Kingsmill, V. (1999). Post-extraction remodeling of the adult mandible. Critical Reviews in Oral Biology & Medicine, 10(3), pp.384-404., 10(3), 384-404.
13. Maridati, P., Cremonesi, S., Fontana, F., & Cicciù, M. a.-P.-2. (2016). Management of d-PTFE membrane exposure for having final clinical success. . Journal of Oral Implantology, 42(3), 289-291.
14. Mazor, Z., Horowitz, R., Corso, M., Prasad, H., Rohrer, M., & Ehrenfest, D. (2009). Sinus floor augmentation with simultaneous implant placement using Choukroun’s platelet-rich fibrin as the sole grafting material: a radiologic and histologic study at 6 months. Journal of Periodontol, 80, 2056-2064.
15. Mendoza‐Azpur, G., de la Fuente, A., Chavez, E., & Valdivia, E. a. (2019). Horizontal ridge augmentation with guided bone regeneration using particulate xenogenic bone substitutes with or without autogenous block grafts: A randomized controlled trial. Clinical implant dentistry and related research. . A randomized controlled trial. Clinical implant dentistry and related research., 21(4), 521-530.
16. Merli, M., Moscatelli, M., Mariotti, G., Rotundo, R., & Bernardelli, F. a. (2014). Bone level variation after vertical ridge augmentation: resorbable barriers versus titanium-reinforced barriers. A 6-year double-blind randomized clinical trial. Int J Oral Maxillofac Implants, 29, 905-913.
17. Meshram, V., Meshram, V., & Lambade, P. (2013). Assessment of Nerve Injuries after Surgical Removal of Mandibular Third Molar: A Prospective Study. Asian Journal of Neuroscience, 1-6.
18. Miron, R., Fujioka-Kobayashi, M., Bishara, M., Zhang, Y., & Hernandez, M. a. (2017). Platelet-rich fibrin and soft tissue wound healing: a systematic review. . Tissue Engineering Part B: Reviews, 23(1), 83-99.
19. Mourão, A., Valiense, H., ER., M., NBMF., M., & MD-C., M. (2015). Obtention of injectable platelets rich-fibrin (i-PRF) and its polymerization with bone graft: technical note. Rev Col Bras Cir [Internet]., 42(6), 21–3.
20. Ogata, Y., Griffin, T., Ko, A., & Y, H. (2013). Comparison of double- flap incision to periosteal releasing incision for flap advancement: a prospective clinical trial. . Int J Oral Maxillofac Implants , 26(2), 597– 604.
21. Pacifici, A., Carbone, D., Soda, G., & Polimeni, A. a. (2015). Guided bone regeneration procedure with platelet rich fibrin (PRF) membranes in the resolution of a severe maxillary bone defect: report of a case. Senses and Sciences, 2(1), 64-70.
22. Rakhmatia, Y., Ayukawa, Y., Furuhashi, A., & Koyano, K. (2013). Current barrier membranes: Titanium mesh and other membranes for guided bone regeneration in dental applications. J. Prosthodont. Res., 57, 3-14.
23. Rocchietta, I., Fontana, F., & Simion, M. (2008). Clinical outcomes of vertical bone augmentation to enable dental implant placement: A systematic review. J. Clin. Periodontol., 35, 203-215.
24. Romanos, G. (2010). Periosteal releasing incision for successful coverage of augmented sites. A technical note. Journal of Oral Implantology, 36(1), 25-30.
25. Ronda, M., Rebaudi, A., Torelli, L., & Stacchi, C. (2014). Expanded vs. dense polytetrafluoroethylene membranes in vertical ridge augmentation around dental implants: a prospective randomized controlled clinical trial. Clin. Oral Impl. Res., 25, 859-866.
26. Sharma, A., & Pradeep, A. (2011). Autologous platelet rich fibrin in the treatment of mandibular degree II furcation defects: a randomized clinical trial. Journal of Periodontol, 82, 1396-1403.
27. Simonpieri, A., Choukroun, J., Corso, M., Sammartino, G., & Ehrenfest, D. (2011). Simultaneous sinuslift and implantation using microthreaded implants and leukocyte and platelet-rich fibrin as sole grafting material: a six-year experience. Implant Dentistry, 20, 2-12.
28. Szolnoky, G., Szendi-Horváth, K., Seres, L., Boda, K., & Kemény, L. (2007). Manual lymph drainage efficiently reduces postoperative facial swelling and discomfort after removal of impacted third molars. . Lypmhology. , 40, 138-142.
29. Toscano, N., Shumaker, N., & Holtzclaw, D. (2010). The art of block grafting: A review of the surgical protocol for reconstruction of alveolar ridge deficiency. Journal of Implant and Advanced Clinical Dentistry., 2(2), 45-47.
30. Tunkel, J., de Stavola, L., & and Kloss‐Brandstätter, A. (2021). A. Alveolar ridge aug- mentation using the shell technique with allogeneic and autoge- nous bone plates in a split-mouth design-a retrospective case report from five patients. Clin Case Rep., 9(2), 947-959.
31. Urban, I., & Monje, A. (2019). Guided bone regeneration in alveolar bone reconstruction. Oral and Maxillofacial Surgery Clinics, 31(2), 331-338.
32. Urban, I., Lozada, J., Jovanovic, S., Nagursky, H., & Nagy, K. (2014). Vertical ridge augmentation with titanium-reinforced, dense-PTFE membranes and a combination of particulated autogenous bone and anorganic bovine bone-derived mineral: A prospective case A prospective case series in 19 patients. Int. J. Oral Maxillofac. Implant., 29, 185-193.
33. Urban, I., Montero, E., & Monje, A. a.‐S. (2019). Effectiveness of vertical ridge augmentation interventions: A systematic review and meta‐analysis. . Journal of Clinical Periodontology, 46, 319-339.
34. Urban, I., Montero, E., Amerio, E., & Palombo, D. a. (2023). Techniques on vertical ridge augmentation: Indications and effectiveness. Periodontology 2000.
35. Urban, I., Tattan, M., Ravida, A., Saleh, M., & Tavelli, L. a.-O. (2022). Simultaneous Alveolar Ridge Augmentation and Periodontal Regenerative Therapy Leveraging Recombinant Human Platelet-Derived Growth Factor-BB (rhPDGF-BB): A Case Report. . International Journal of Periodontics & Restorative Dentistry, 42(5), 42(5).
36. Van der Weijden, F., & Dell'Acqua, F. (2009). Alveolar bone dimensional changes of post-extraction sockets in humans: a systematic review. Journal of Clinical Periodontology., 36(12), 1048-1058.
37. Windisch, P. O. (2021). Vertical-guided bone regeneration with a titanium-reinforced d-PTFE membrane utilizing a novel split-thickness flap design: a prospective case series. Clinical oral investigations, 25, 2969-2980.
Published
2023-11-06
How to Cite
Richa, R., Osman, E., Attia, N., Arakji, H., & Shokry, M. (2023). Evaluation of Guided Bone Regeneration Using Xenograft/APRF Mixture in Atrophic Posterior Mandible (Clinical and Radiographic study). European Scientific Journal, ESJ, 23, 208. Retrieved from https://eujournal.org/index.php/esj/article/view/17411
Section
ESI Preprints
Copyright (c) 2023 Ramy Richa, Essam Osman, Nahed Attia, Hani Arakji, Mohamed Shokry
This work is licensed under a Creative Commons Attribution 4.0 International License.
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