Guided tissue regeneration in jawbone defects prior to implant placement

Abstract

The principle of guided tissue regeneration has been successfully applied for the regeneration of bone in various jaw defects in human. The purpose of this study was to assess the bone volume regenerated using nonresorbable membrane barriers. Nineteen patients with jaw bone defects of various sizes and configurations were included in the study. Combined split‐thickness/full‐thickness mucosal flaps were elevated in the area of missing bone. The size of the defects was assessed by measuring the distance from a reference line between 2 adjacent teeth (cementoenamel junctions) to the alveolar crest (a) every 2 or 3 mm. In addition, the crestal width was measured. Consequently, the surface of the triangle formed by a and the width of the crest as well as the volume between all triangles were calculated geometrically. Following the placement of Gore‐Tex® augmentation material as a barrier, the distance (b) to the top of the membrane from the reference line was assessed, and the maximum possible volume for bone regeneration based on (a‐b) and the width of the crest was calculated. At the time of membrane removal (3–8 months later). the same measurements were performed and the percentages of regenerated bone in relation to the possible volume for regeneration determined. In 6 patients in whom the membranes had to be removed early due to an increased risk for infection between 3 and 5 months, bone regeneration varied between 0 and 60%. In 13 patients in whom membranes were left for 6–8 months, regenerated bone filled 90–100% of the possible volume. It was concluded that successful bone regeneration consistently occurred with an undisturbed healing period of at least 6 months.