Top

International Journal of Implant Dentistry

Published in:

Open Access 01-12-2020 | Bone Defect | Research

Guided bone regeneration in staged vertical and horizontal bone augmentation using platelet-rich fibrin associated with bone grafts: a retrospective clinical study

Authors: Carlos Alberto Amaral Valladão Jr, Mabelle Freitas Monteiro, Julio Cesar Joly

Published in: International Journal of Implant Dentistry | Issue 1/2020

Abstract

Background

The use of guided bone regeneration (GBR) for vertical and horizontal bone gain is a predictable approach to correct the bone defects before implant installation; however, the use of different protocols is associated with different clinical results. It is suggested that platelet-rich fibrin (PRF) could improve the outcomes of regenerative procedures. Thus, this study aimed to describe the bone gain associated with GBR procedures combining membranes, bone grafts, and PRF for vertical and horizontal bone augmentation.

Materials and methods

Eighteen patients who needed vertical or horizontal bone regeneration before installing dental implants were included in the study. The horizontal bone defects were treated with a GBR protocol that includes the use of a mixture of particulate autogenous and xenogenous grafts in the proportion of 1:1, injectable form of PRF (i-PRF) to agglutinate the graft, an absorbable collagen membrane covering the regenerated region, and leukocyte PRF (L-PRF) membrane covering the GBR membrane. The vertical bone defects were treated with the same grafted mixture protected by a titanium-reinforced non-resorbable high-density polytetrafluoroethylene (d-PTFE-Ti) membrane and covered by L-PRF. The bone gain was measured using a cone-beam computed tomography at baseline and after a period of 7.5 (± 1.0) months.

Results

All patients underwent surgery to install implants after this regenerative protocol. The GBR produces an increase in bone thickness (p < 0.001) and height (p < 0.005) after treatment, with a bone gain of 5.9 ± 2.4 for horizontal defects and 5.6 ± 2.6 for vertical defects. In horizontal defects, the gain was higher in the maxilla than in mandible (p = 0.014) and in anterior than the posterior region (p = 0.033). No differences related to GBR location were observed in vertical defects (p > 0.05).

Conclusion

GBR associated with a mixture of particulate autogenous and xenogenous grafts and i-PRF is effective for vertical and horizontal bone augmentation in maxillary and mandibular regions, permitting sufficient bone gain to future implant placement.

Trial registration

REBEC, RBR-3CSG3J. Date of registration—19 July 2019, retrospectively registered. http://www.ensaiosclinicos.gov.br/rg/RBR-3csg3j/

Chiapasco M, Casentini P, Zaniboni M. Bone augmentation procedures in implant dentistry. Int J Oral Maxillofac Implant. 2009;24(Suppl):237–59.

Tan WL, Wong TLT, Wong MCM, Lang NP. A systematic review of post-extractional alveolar hard and soft tissue dimensional changes in humans. Clin Oral Implants Res [Internet]. 2012;23:1–21 Available from: http://doi.wiley.com/10.1111/j.1600-0501.2011.02375.x.PubMedCrossRef

Milinkovic I, Cordaro L. Are there specific indications for the different alveolar bone augmentation procedures for implant placement? A systematic review. Int J Oral Maxillofac Surg [Internet]. 2014;43(5):606–25.PubMedCrossRef

Saletta JM, Garcia JJ, Caramês JMM, Schliephake H, da Silva Marques DN. Quality assessment of systematic reviews on vertical bone regeneration. Int J Oral Maxillofac Surg [Internet]. 2019 Mar;48(3):364–72.PubMedCrossRef

Nisand D, Picard N, Rocchietta I. Short implants compared to implants in vertically augmented bone: a systematic review. Clin Oral Implants Res [Internet]. 2015 Sep;26(Suppl 1):170–9.PubMedCrossRef

Raghoebar G, Meijndert L, Kalk W, Vissink A. Morbidity of mandibular bone harvesting: a comparative study. Int J Oral Maxillofac Implant. 2007;22(3):359–65.

Pereira RS, Pavelski MD, Griza GL, Boos FBJD, Hochuli-Vieira E. Prospective evaluation of morbidity in patients who underwent autogenous bone-graft harvesting from the mandibular symphysis and retromolar regions. Clin Implant Dent Relat Res. 2019;cid:12789.CrossRef

Plonka A, Urban I, Wang H-L. Decision tree for vertical ridge augmentation. Int J Periodontics Restorative Dent [Internet]. 2018 Mar;38(2):269–75.PubMedCrossRef

Vetromilla BM, Moura LB, Sonego CL, Torriani MA, Chagas OL. Complications associated with inferior alveolar nerve repositioning for dental implant placement: a systematic review. Int J Oral Maxillofac Surg [Internet]. 2014 Nov;43(11):1360–6.PubMedCrossRef

10.

Martin V, Bettencourt A. Bone regeneration: biomaterials as local delivery systems with improved osteoinductive properties. Mater Sci Eng C. 2018;82:363–71.CrossRef

11.

Aghaloo T, Moy P. Which hard tissue augmentation techniques are the most successful in furnishing bony support for implant placement? Int J Oral Maxillofac Implant. 2007;22(Suppl):49–70.

12.

Liu J, Kerns DG. Mechanisms of guided bone regeneration: a review. Open Dent J [Internet]. 2014 May 16;8(1):56–65.PubMedPubMedCentralCrossRef

13.

Wang H-L, Boyapati L. “PASS” principles for predictable bone regeneration. Implant Dent [Internet]. 2006;15(1):8–17.PubMedCrossRef

14.

Turri A, Elgali I, Vazirisani F, Johansson A, Emanuelsson L, Dahlin C, et al. Guided bone regeneration is promoted by the molecular events in the membrane compartment. Biomaterials. 2016;84:167–83.PubMedCrossRef

15.

Rakhmatia YD, Ayukawa Y, Furuhashi A, Koyano K. Current barrier membranes: titanium mesh and other membranes for guided bone regeneration in dental applications. J Prosthodont Res [Internet]. 2013 Jan;57(1):3–14.PubMedCrossRef

16.

Bunyaratavej P, Wang H-L. Collagen membranes: a review. J Periodontol [Internet]. 2001;72(2):215–29 Available from: http://doi.wiley.com/10.1902/jop.2001.72.2.215.PubMedCrossRef

17.

Miron RJ, Fujioka-Kobayashi M, Bishara M, Zhang Y, Hernandez M, Choukroun J. Platelet-rich fibrin and soft tissue wound healing: a systematic review. Tissue Eng Part B Rev [Internet]. 2017 Feb;23(1):83–99.PubMedCrossRef

18.

Al-Hamed FS, Mahri M, Al-Waeli H, Torres J, Badran Z, Tamimi F. Regenerative effect of platelet concentrates in oral and craniofacial regeneration. Front Cardiovasc Med [Internet]. 2019;3:6.

19.

Cawood JI, Howell RA. A classification of the edentulous jaws. Int J Oral Maxillofac Surg [Internet]. 1988 Aug;17(4):232–6.PubMedCrossRef

20.

Monje A, Monje F, Hernández-Alfaro F, Gonzalez-García R, Suárez-López del Amo F, Galindo-Moreno P, et al. Horizontal bone augmentation using autogenous block grafts and particulate xenograft in the severe atrophic maxillary anterior ridges: a cone-beam computerized tomography case series. J Oral Implantol [Internet]. 2015;41(S1):366–71.CrossRef

21.

Simion M, Fontana F, Rasperini G, Maiorana C. Vertical ridge augmentation by expanded-polytetrafluoroethylene membrane and a combination of intraoral autogenous bone graft and deproteinized anorganic bovine bone (Bio Oss). Clin Oral Implants Res [Internet]. 2007 Oct;18(5):620–9.PubMedCrossRef

22.

Danesh-Sani SA, Tarnow D, Yip JK, Mojaver R. The influence of cortical bone perforation on guided bone regeneration in humans. Int J Oral Maxillofac Surg [Internet]. 2017 Feb;46(2):261–6.PubMedCrossRef

23.

Mourão ABCF, Valiense H, Melo ER, Mourão NBMF, Maia MD-C. Obtention of injectable platelets rich-fibrin (i-PRF) and its polymerization with bone graft: technical note. Rev Col Bras Cir [Internet]. 2015;42(6):421–3.

24.

Scarano A, Inchingolo F, Murmura G, Traini T, Piattelli A, Lorusso F. Three-dimensional architecture and mechanical properties of bovine bone mixed with autologous platelet liquid, blood, or physiological water: an in vitro study. Int J Mol Sci [Internet]. 2018;19(4):1230.CrossRef

25.

Urban IA, Nagursky H, Lozada JL, Nagy K. Horizontal ridge augmentation with a collagen membrane and a combination of particulated autogenous bone and anorganic bovine bone–derived mineral: a prospective case series in 25 patients. Int J Periodontics Restor Dent [Internet]. 2013;33(3):299–307.CrossRef

26.

Rothamel D, Schwarz F, Sager M, Herten M, Sculean A, Becker J. Biodegradation of differently cross-linked collagen membranes: an experimental study in the rat. Clin Oral Implants Res [Internet]. 2005;16(3):369–78 Available from: http://doi.wiley.com/10.1111/j.1600-0501.2005.01108.x.PubMedCrossRef

27.

Monje A, Urban I, Miron R, Caballe-Serrano J, Buser D, Wang H-L. Morphologic patterns of the atrophic posterior maxilla and clinical implications for bone regenerative therapy. Int J Periodontics Restorative Dent [Internet]. 2017 Sep;37(5):e279–89.PubMedCrossRef

28.

Chackartchi T, Iezzi G, Goldstein M, Klinger A, Soskolne A, Piattelli A, et al. Sinus floor augmentation using large (1-2 mm) or small (0.25-1 mm) bovine bone mineral particles: a prospective, intra-individual controlled clinical, micro-computerized tomography and histomorphometric study. Clin Oral Implants Res [Internet]. 2011;22(5):473–80 Available from: http://doi.wiley.com/10.1111/j.1600-0501.2010.02032.x.CrossRef

29.

Urban IA, Lozada JL, Jovanovic SA, Nagursky H, Nagy K. 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 series in 19 patients. Int J Oral Maxillofac Implants [Internet]. 2014;29(1):185–93.PubMedCrossRef

30.

Galindo-Moreno P, Hernández-Cortés P, Mesa F, Carranza N, Juodzbalys G, Aguilar M, et al. Slow resorption of anorganic bovine bone by osteoclasts in maxillary sinus augmentation. Clin Implant Dent Relat Res [Internet]. 2013 Dec;15(6):858–66.PubMedCrossRef

31.

Dahlin C, Gottlow J, Linde A, Nyman S. Healing of maxillary and mandibular bone defects using a membrane technique: an experimental study in monkeys. Scand J Plast Reconstr Surg Hand Surg [Internet]. 1990 Jan 8;24(1):13–9.PubMedCrossRef

32.

Khojasteh A, Soheilifar S, Mohajerani H, Nowzari H. The effectiveness of barrier membranes on bone regeneration in localized bony defects: a systematic review. Int J Oral Maxillofac Implants [Internet]. 2013;28(4):1076–89.PubMedCrossRef

33.

Wessing B, Lettner S, Zechner W. Guided bone regeneration with collagen membranes and particulate graft materials: a systematic review and meta-analysis. Int J Oral Maxillofac Implants [Internet]. 2018;33(1):87–100.PubMedCrossRef

34.

Hartmann A, Seiler M. Minimizing risk of customized titanium mesh exposures – a retrospective analysis. BMC Oral Health [Internet]. 2020;20(1):36.CrossRef

35.

Chenchev IL, Ivanova VV, Neychev DZ, Cholakova RB. Application of platelet-rich fibrin and injectable platelet-rich fibrin in combination of bone substitute material for alveolar ridge augmentation - a case report. Folia Med (Plovdiv) [Internet]. 2017;59(3):362–6.CrossRef

36.

Andrea P, Carbone D, Soda G, Polimeni A, Pacifici L. Guided bone regeneration procedure with platelet-rich fi brin (PRF) membranes in resolution of a severe maxillary bone defect: report of case. Senses Sci. 2015;2(1):64–70.

37.

Lim G, Lin G-H, Monje A, Chan H-L, Wang H-L. Wound healing complications following guided bone regeneration for ridge augmentation: a systematic review and meta-analysis. Int J Oral Maxillofac Implants [Internet]. 2018;33(1):51–0.CrossRef

38.

Garcia J, Dodge A, Luepke P, Wang H-L, Kapila Y, Lin G-H. Effect of membrane exposure on guided bone regeneration: a systematic review and meta-analysis. Clin Oral Implants Res [Internet]. 2018;29(3):328–38 Available from: http://doi.wiley.com/10.1111/clr.13121.PubMedCrossRef

39.

Elnayef B, Monje A, Albiol G, Galindo-Moreno P, Wang H-L, Hernández-Alfaro F. Vertical ridge augmentation in the atrophic mandible: a systematic review and meta-analysis. Int J Oral Maxillofac Implants [Internet]. 2017;32(2):291–312.PubMedCrossRef

40.

Naenni N, Lim H-C, Papageorgiou SN, Hämmerle CHF. Efficacy of lateral bone augmentation prior to implant placement: a systematic review and meta-analysis. J Clin Periodontol [Internet]. 2019;46:287–306 Available from: http://doi.wiley.com/10.1111/jcpe.13052.PubMedCrossRef

41.

Urban IA, Montero E, Monje A, Sanz-Sánchez I. Effectiveness of vertical ridge augmentation interventions: a systematic review and meta-analysis. J Clin Periodontol [Internet]. 2019;46:319–39 Available from: http://doi.wiley.com/10.1111/jcpe.13061.PubMedCrossRef

42.

Misch C, Jensen O, Pikos M, Malmquist J. Vertical bone augmentation using recombinant bone morphogenetic protein, mineralized bone allograft, and titanium mesh: a retrospective cone beam computed tomography study. Int J Oral Maxillofac Implants [Internet]. 2015;30(1):202–7.PubMedCrossRef

43.

Garaicoa C, Suarez F, Fu J-H, Chan H-L, Monje A, Galindo-Moreno P, et al. Using cone beam computed tomography angle for predicting the outcome of horizontal bone augmentation. Clin Implant Dent Relat Res [Internet]. 2015;17(4):717–23.PubMedCrossRef

Title: Guided bone regeneration in staged vertical and horizontal bone augmentation using platelet-rich fibrin associated with bone grafts: a retrospective clinical study
Authors: Carlos Alberto Amaral Valladão Jr
Mabelle Freitas Monteiro
Julio Cesar Joly
Publication date: 01-12-2020
Publisher: Springer Berlin Heidelberg
Keyword: Bone Defect
Published in: International Journal of Implant Dentistry / Issue 1/2020
Electronic ISSN: 2198-4034
DOI: https://doi.org/10.1186/s40729-020-00266-y

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Guided bone regeneration in staged vertical and horizontal bone augmentation using platelet-rich fibrin associated with bone grafts: a retrospective clinical study

Abstract

Background

Materials and methods

Results

Conclusion

Trial registration

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Materials and methods

Results

Conclusion

Trial registration

Please log in to get access to this content

Other articles of this Issue 1/2020

Accuracy of static computer-assisted implant placement in anterior and posterior sites by clinicians new to implant dentistry: in vitro comparison of fully guided, pilot-guided, and freehand protocols

Influence of the use of autogenous bone particles to close the access window after maxillary sinus floor augmentation: an experimental study in rabbits

Is maxillary diastema an appropriate site for implantation in rats?

Investigation of different electrochemical cleaning methods on contaminated healing abutments in vitro: an approach for metal surface decontamination

Relationship between risk markers for cardiovascular disease and peri-implant diseases

Calcium channel blocker induced gingival enlargement following implant placement in a fibula free flap reconstruction of the mandible: a case report