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KMID : 0602720180220040242
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Implantology
2018 Volume.22 No. 4 p.242 ~ p.254
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Clinical Evaluation of Guided Bone Regeneration Using 3D-titanium Membrane and Advanced Platelet-Rich Fibrin on the Maxillary Anterior Area
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Lee Na-Yeon
Goh Mi-Seon
Jung Yang-Hun
Lee Jung-Jin
Seo Jae-Min
Yun Jeong-Ho
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Abstract
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The aim of the current study was to evaluate the results of horizontal guided bone regeneration (GBR) with xenograf t (deproteinized bovine bone mineral, DBBM), allograf t (irradiated allogenic cancellous bone and marrow), titanium membrane, resorbable collagen membrane, and advanced platelet-rich fibrin (A-PRF) in the anterior maxilla. The titanium membrane was used in this study has a three-dimensional (3D) shape that can cover ridge defects. Case 1. A 32-yearold female patient presented with discomfort due to mobility and pus discharge on tooth #11. Three months af ter extracting tooth #11, diagnostic sof tware (R2 GATE diagnostic sof tware, Megagen, Daegu, Korea) was used to establish the treatment plan for implant placement. At the first stage of implant surgery, GBR for horizontal augmentation was performed with DBBM (Bio-Oss®, Geistlich, Wolhusen, Switzerland), irradiated allogenic cancellous bone and marrow (ICB cancellous®, Rocky Mountain Tissue Bank, Denver, USA), 3D-titanium membrane (i-Gen®, Megagen, Daegu, Korea), resorbable collagen membrane (Collagen membrane®, Genoss, Suwon, Korea), and A-PRF because there was approximately 4 mm labial dehiscence after implant placement. Five months after placing the implant, the second stage of implant surgery was performed, and healing abutment was connected after removal of the 3D-titanium membrane. Five months after the second stage of implant surgery was done, the final prosthesis was then delivered. Case 2. A 35-year-old female patient presented with discomfort due to pain and mobility of implant #21. Removal of implant #21 fixture was planned simultaneously with placement of the new implant fixture. At the first stage of implant surgery, GBR for horizontal augmentation was performed with DBBM (Bio-Oss®), irradiated allogenic cancellous bone and marrow (ICB cancellous®), 3D-titanium membrane (i-Gen®), resorbable collagen membrane (Ossix plus®, Datum, Telrad, Israel), and A-PRF because there was approximately 7 mm labial dehiscence after implant placement. At the second stage of implant surgery six months after implant placement, healing abutment was connected after removing the 3D-titanium membrane. Nine months after the second stage of implant surgery was done, the final prosthesis was then delivered. In these two clinical cases, wound healing of the operation sites was uneventful. All implants were clinically stable without inflammation or additional bone loss, and there was no discomfort to the patient. With the non-resorbable titanium membrane, the ability of bone formation in the space was stably maintained in three dimensions, and A-PRF might influence soft tissue healing. This limited study suggests that aesthetic results can be achieved with GBR using 3D-titanium membrane and A-PRF in the anterior maxilla. However, long-term followup evaluation should be performed.
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KEYWORD
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Guided bone regeneration, Anterior teeth, Dental implant, Titanium membrane, Platelet rich fibrin
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