Alveolar crest contour changes after guided bone regeneration using different biomaterials: an experimental in vivo investigation
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To evaluate the changes in alveolar contour after guided bone regeneration (GBR) with two different combinations of biomaterials in dehiscence defects around implants.
Material and methods
Chronic alveolar ridge defects were created bilaterally in the mandible of eight Beagle dogs. Once implants were placed, three treatment groups were randomly allocated to each peri-implant dehiscence defect: (i) test group received a bone substitute composed of hydroxyapatite (HA) and β-tricalcium phosphate (β-TCP) covered by a cross-linked collagen membrane, (ii) positive control group with placement of deproteinized bovine bone mineral (DBBM) plus a porcine natural collagen membrane, and (iii) a negative control with no treatment. Two healing periods (8 and 16 weeks) were evaluated. Dental casts were optically scanned, the obtained files were uploaded into an image analysis software and superimposed to evaluate the linear changes.
In both healing periods, the gains in linear contours were higher in the test group and at the intermediate level (3 mm below the gingival margin). While at 8 weeks, no significant differences were found between the groups; at 16 weeks, the test and positive control groups demonstrated significant gains in contour compared with negative control.
GBR using different biomaterials significantly increased the buccal contours of the alveolar crest when used at dehiscence defects around dental implants.
Particulate highly porous synthetic bone substitute and a cross-linked collagen membrane demonstrated similar outcomes in terms of contour augmentation when compared to bovine xenograft (DBBM) and a collagen membrane.
KeywordsGuided bone regeneration Synthetic bone graft Collagen membrane Dental implant Animal model Prophilometric changes
MeSH TermsBone Regeneration Calcium Phosphates Membranes Biocompatible Materials Dental Implants Animal Model Alveolar Bone Loss
The authors acknowledge professor Ui-Won Jung for the active involvement in the surgical procedure. We also thank the veterinary doctors, Maria Carmen Calles-Vázquez and Elena Abellán, as well as the staff from the Minimally Invasive Surgery Centre, Cáceres, Spain, who so effectively took care of the experimental animals used in this investigation.
This work was partially supported through a research contract between the University Complutense of Madrid and Dentium Implants, Suwon (Korea). Support was also obtained from the ETEP (Etiology and therapeutics in Periodontal Diseases) Research Group at the Faculty of Odontology, University Complutense of Madrid (Spain).
Compliance with ethical standards
Conflict of interest
The authors declare that they have no conflict of interest.
This article contains data from an experimental study with animals performed at the Experimental Surgical Department of the Minimally Invasive Surgery Centre in Cáceres (Spain) after receiving approval from the Regional Ethics Committee for Animal Research (CCMIJU Reference 011/15). All applicable international, national, and/or institutional guidelines for the care and use of animals were followed.
For this type of study, formal consent is not required.
- 1.Schropp L, Kostopoulos L, Wenzel A, Isidor F (2005) Clinical and radiographic performance of delayed-immediate single-tooth implant placement associated with peri-implant bone defects. A 2-year prospective, controlled, randomized follow-up report. J Clin Periodontol 32(Suppl. 5):480–487PubMedCrossRefPubMedCentralGoogle Scholar
- 6.Von Arx T, Cochran DL, Hermann JS, Schenk RK, Higginbottom FL, Buser D (2001) Lateral ridge augmentation and implant placement: an experimental study evaluating implant osseointegration in different augmentation materials in the canine mandible. Int J Oral Maxillofac Implants 16:3Google Scholar
- 8.Sanz M, Vignoletti F (2016) Key aspects on the use of bone substitutes for bone regeneration of edentulous ridges. Dent Mater 31(Suppl 6):640–647Google Scholar
- 18.Schwarz F, Rothamel D, Herten M, Wustefeld M, Sager M, Ferrari D (2008) Immunohistochemical characterization of guided bone regeneration at a dehiscence-type defect using different barrier membranes: an experimental study in dogs. Clin Oral Implants Res 19(Suppl 4):402–415PubMedCrossRefGoogle Scholar
- 20.Hammerle CHF, Cordaro L, Van Assche N, Benic GI, Bornstein M, Gamper F, Gotfredsen K, Harris D, Hurzeler M, Jacobs R, Kapos T, Kohal RJ, Patzelt SBM, Sailer I, Tahmaseb A, Vercruyssen M, Wismeijer D (2015) Digital technologies to support planning, treatment, and fabrication processes and outcome assessments in implant dentistry. Summary and consensus statements. The 4th EAO consensus conference 2015. Clin Oral Implant Res 26(Suppl 11):97–101CrossRefGoogle Scholar
- 22.Sanz Martin I, Vignoletti F, Nuñez J, Permuy M, Muñoz F, Sanz-Esporrin J, Fierravanti L, Shapira L, Sanz M (2017) Hard and soft tissue integration of immediate and delayed implants with a modified coronal macro design: Histological, micro CT and volumetric soft tissue changes from a pre-clinical in vivo study. J Clin Periodontol 44(8):842–853PubMedCrossRefPubMedCentralGoogle Scholar
- 23.Sanz Martin I, Ferrantino L, Vignoletti F, Nuñez J, Baldini N, Duvina M, Alcaraz J, Sanz M (2018) Contour changes after guided bone regeneration of large non-contained mandibular buccal bone defects using deproteinized bovine bone mineral and a porcine-derived collagen membrane: an experimental in vivo investigation. Clin Oral Invest 22(3):1273–1283CrossRefGoogle Scholar
- 24.Gonzalez-Martin O, Veltri M, Moraguez O, Belser UC (2014) Quantitative three-dimensional methodology to assess volumetric and profilometric outcome of subepithelial connective tissue grafting at pontic sites: a prospective pilot study. Int J Periodontics Restorative Dent 34(Suppl 5):673–679PubMedCrossRefPubMedCentralGoogle Scholar
- 27.Schwarz F, Herten M, Ferrari D, Wieland M, Schmitz L, Engelhardt E (2007) Guided bone regeneration at dehiscence-type defects using biphasic hydroxyapatite + beta tricalcium phosphate (Bone Ceramic) or a collagen-coated natural bone mineral (BioOss Collagen): an immunohistochemical study in dogs. Int J Oral Maxillofac Surg 36(Suppl 12):1198–1206PubMedCrossRefPubMedCentralGoogle Scholar
- 29.Artzi Z, Weinreb M, Givol N, Rohrer MD, Nemcovsky CE, Prasad HS, Tal H (2004) Biomaterial Resorption Rate and Healing Site Morphology of Inorganic Bovine Bone and β-Tricalcium Phosphate in the Canine: A 24-month Longitudinal Histologic Study and Morphometric Analysis. Int J Oral Maxillofac Implants 19(Suppl 3):357–368PubMedPubMedCentralGoogle Scholar
- 30.Mordenfeld A, Hallman M, Johansson CB, Albrektsson T (2010) Histological and histomorphometrical analyses of biopsies harvested 11 years after maxillary sinus floor augmentation with deproteinized bovine and autogenous bone. Clin Oral Implants Res 21(Suppl 9):961–970PubMedPubMedCentralGoogle Scholar
- 31.Jensen SS, Broggini N, Hjørting-Hansen E, Schenk R, Buser D (2006) Bone healing and graft resorption of autograft, anorganic bovine bone and β-tricalcium phosphate. A histologic and histomorphometric study in the mandibles of minipigs. Clin Oral Implants Res 17(Suppl 3):237–243PubMedCrossRefGoogle Scholar
- 32.Sanz M, Ferrantino L, Vignoletti F, De Sanctis M, Berglundh T (2017) Guided bone regeneration of non-contained mandibular buccal bone defects using deproteinized bovine bone mineral and a collagen membrane: an experimental in vivo investigation. Clin Oral Implant Res 28(11):1466–1476CrossRefGoogle Scholar
- 37.Becker J, Al-Nawas B, Klein MO, Schliephake H, Terheyden H, Schwarz F (2009) Use of a new cross-linked collagen membrane for the treatment of dehiscence-type defects at titanium implants: a prospective, randomized-controlled double-blinded clinical multicenter study. Clin Oral Implants Res 20(Suppl 7):742–749PubMedCrossRefGoogle Scholar