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
The objective of this study was to evaluate soft tissue contour changes after three different regenerative therapies in chronic ridge defects.
Material and methods
Buccal bone defects were created in the mandible of nine beagle dogs. Augmentation procedures were performed 3 months later using a bone replacement graft (BRG), resorbable collagen membrane (MBG), or a combination of both procedures (CBG). Silicone impressions were taken before tooth extraction (T1), before the augmentation procedure (T2), and 3 months after the regenerative surgeries (T3). Casts were optically scanned and stereolithography files were superimposed to analyze the horizontal changes in ridge contours.
After defect creation, most part of the horizontal changes occurred 4 and 6 mm below the gingival margin. In the mesial defect (D1) at T3, the mean horizontal gain in MBG amounted to 0.47 ± 0.34 mm, 0.79 ± 0.67 mm in the BRG, and 0.87 ± 0.69 mm for the CBG. In the middle defect (D2), the mean changes for the MBG were 0.11 ± 0.31, 1.01 ± 0.91 for the BRG, and 0.98 ± 0.49 for the CBG. The mean changes in the distal defect (D3) amounted to 0.24 ± 0.72 for the MBG, 1.04 ± 0.92 for the BRG, and 0.86 ± 0.56 for the CBG. The differences reached significance in all defects for the comparison MBG-BRG and MBG-CBG, while similar parameters were observed for the comparison BRG-CBG.
BRG and CBG were equally effective and superior to MBG in increasing the horizontal tissue contours. The augmentation seldom reached the values before extraction.
Scaffolding materials are needed for contour augmentation when using resorbable collagen membranes.
KeywordsBovine bone mineral Collagen membrane Bone regeneration Experimental study Wound healing
The authors would like to express their sincere gratitude to Dr. Nicola Discepoli, Dr. Fernando Luengo who participated in the experimental surgeries, and the staff from the veterinary hospital of Rof Codina in Lugo in particular Prof. Fernando Muñoz. A high appreciation is also expressed to Prof. Massimo De Sanctis and Prof. Raul Caffesse for their contribution to the study.
This investigation was partially supported with a research contract between Geistlich Pharma AG and the Universities of Goteborg, Complutense of Madrid, and University of Siena.
Compliance with ethical standards
This investigation was conducted according to Spanish and European Union regulations (European Communities Council Directive 86/609/EEC) on experimental in vivo experimentation.
Conflict of interest
Dr. Sanz-Martín, Dr. Ferrantino, Dr. Vignolettu, Dr. Nuñez, Dr. Baldini, and Dr. Duvina report no conflict of interest. Dr. Sanz reports to have received research grants through the University Complutense of Madrid and lecture fees from Geistlich Pharma.
The study protocol was approved by the Ethical Committee of the Rof Codina Foundation (Lugo, Spain) (Ref AE-LU-001/12/INVMED (02)/Outros/04).
No informed consent was obtained since the present was an animal study.
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