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The influence of wound closure on graft stability- a comparison of different bone grafting techniques for the treatment of one-wall horizontal bone defects
EAO Online Library. Mertens C. 10/09/18; 232511; P-BR-11
Christian Mertens
Christian Mertens
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After bone grafting procedures, resorption can cause a decrease of bone volume. Furthermore, wound closure can induce an additional negative influence on the final bone volume. Augmentation procedures with particulate grafting materials can be particularly affected.The aim of this study was to analyze and compare different grafting techniques with respect to volume stability after wound closure. In this in-vitro study ten mandibles of ten pigs were treated. Four different grafting techniques were evaluated for volume stability. All of the grafted horizontal bone defects were outside the ridge contour of the mandible. Group 1- guided bone regeneration (GBR) with collagen membrane and particulated xenograft+ group 2- GBR with collagen membrane, particulated xenograft, and titanium pins+ group 3- GBR with non-resorbable, titanium reinforced membrane, particulated xenograft, and titanium pins+ and group 4- autogenous block graft, particulated xenograft, and collagen membrane. Cone beam computed tomography scans were performed before and after wound closure and the horizontal bone dimensions were analyzed for stability at 0–5 mm apical to the implant shoulder (H0–H5).Wound closure led to a horizontal volume reduction at level H0 of 63.5% ± 40.5% (group 1), 32% ± 20.1% (group 2), 3.7% ± 5.6% (group 3) and 8.9% ± 12.9% (group 4). At level H1 the values were- 45.9% ± 30.9%, 13.0% ± 15.7, -0.4% ± 4.3% and 4.9% ± 9.6%, respectively, and at level H2 the values were- 41.6% ± 25.3%, 9.5% ± 10.7%, 3.5% ± 6.1% and 6.1% ± 9.0%, respectively.**At H0–H2, wound closure induced a statistically significant change in bone dimensions in groups 1 and 2, while for group 3, only the change in H0 was significant and for group 4, only the change in H2 was significant.**Wound closure has a significant impact on graft stability in a one-wall horizontal defect configuration. Titanium-reinforced membranes and autogenous bone blocks showed significantly greater volume stability compared to GBR with a collagen membrane, especially in the coronal portion. GBR with additional membrane fixation showed better results than GBR without fixation.
After bone grafting procedures, resorption can cause a decrease of bone volume. Furthermore, wound closure can induce an additional negative influence on the final bone volume. Augmentation procedures with particulate grafting materials can be particularly affected.The aim of this study was to analyze and compare different grafting techniques with respect to volume stability after wound closure. In this in-vitro study ten mandibles of ten pigs were treated. Four different grafting techniques were evaluated for volume stability. All of the grafted horizontal bone defects were outside the ridge contour of the mandible. Group 1- guided bone regeneration (GBR) with collagen membrane and particulated xenograft+ group 2- GBR with collagen membrane, particulated xenograft, and titanium pins+ group 3- GBR with non-resorbable, titanium reinforced membrane, particulated xenograft, and titanium pins+ and group 4- autogenous block graft, particulated xenograft, and collagen membrane. Cone beam computed tomography scans were performed before and after wound closure and the horizontal bone dimensions were analyzed for stability at 0–5 mm apical to the implant shoulder (H0–H5).Wound closure led to a horizontal volume reduction at level H0 of 63.5% ± 40.5% (group 1), 32% ± 20.1% (group 2), 3.7% ± 5.6% (group 3) and 8.9% ± 12.9% (group 4). At level H1 the values were- 45.9% ± 30.9%, 13.0% ± 15.7, -0.4% ± 4.3% and 4.9% ± 9.6%, respectively, and at level H2 the values were- 41.6% ± 25.3%, 9.5% ± 10.7%, 3.5% ± 6.1% and 6.1% ± 9.0%, respectively.**At H0–H2, wound closure induced a statistically significant change in bone dimensions in groups 1 and 2, while for group 3, only the change in H0 was significant and for group 4, only the change in H2 was significant.**Wound closure has a significant impact on graft stability in a one-wall horizontal defect configuration. Titanium-reinforced membranes and autogenous bone blocks showed significantly greater volume stability compared to GBR with a collagen membrane, especially in the coronal portion. GBR with additional membrane fixation showed better results than GBR without fixation.
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