Implantology (대한구강악안면임플란트학회지)

The Korean Academy of Oral & Maxillofacial Implantology (대한구강악안면임플란트학회)
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Clinical Evaluation of Guided Bone Regeneration Using 3D-titanium Membrane and Advanced Platelet-Rich Fibrin on the Maxillary Anterior Area

상악 전치부 3D-티타늄 차폐막과 혈소판농축섬유소를 적용한 골유도재생술의 임상적 평가

  • Lee, Na-Yeon (Department of Periodontics, Chonbuk National University Dental Hospital) ;
  • Goh, Mi-Seon (Department of Periodontics, Chonbuk National University Dental Hospital) ;
  • Jung, Yang-Hun (Department of Periodontics, Chonbuk National University Dental Hospital) ;
  • Lee, Jung-Jin (Department of Prosthodontics, Chonbuk National University Dental Hospital) ;
  • Seo, Jae-Min (Department of Prosthodontics, Chonbuk National University Dental Hospital) ;
  • Yun, Jeong-Ho (Department of Periodontics, Chonbuk National University Dental Hospital)
  • 이나연 (전북대학교 치과병원 치주과) ;
  • 고미선 (전북대학교 치과병원 치주과) ;
  • 정양훈 (전북대학교 치과병원 치주과) ;
  • 이정진 (전북대학교 치과병원 보철과) ;
  • 서재민 (전북대학교 치과병원 보철과) ;
  • 윤정호 (전북대학교 치과병원 치주과)
  • Received : 2018.11.09
  • Accepted : 2018.12.21
  • Published : 2018.12.31
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Abstract

The aim of the current study was to evaluate the results of horizontal guided bone regeneration (GBR) with xenograf t (deproteinized bovine bone mineral, DBBM), allograf t (irradiated allogenic cancellous bone and marrow), titanium membrane, resorbable collagen membrane, and advanced platelet-rich fibrin (A-PRF) in the anterior maxilla. The titanium membrane was used in this study has a three-dimensional (3D) shape that can cover ridge defects. Case 1. A 32-year-old female patient presented with discomfort due to mobility and pus discharge on tooth #11. Three months after extracting tooth #11, diagnostic software (R2 GATE diagnostic software, Megagen, Daegu, Korea) was used to establish the treatment plan for implant placement. At the first stage of implant surgery, GBR for horizontal augmentation was performed with DBBM ($Bio-Oss^{(R)}$, Geistlich, Wolhusen, Switzerland), irradiated allogenic cancellous bone and marrow (ICB $cancellous^{(R)}$, Rocky Mountain Tissue Bank, Denver, USA), 3D-titanium membrane ($i-Gen^{(R)}$, Megagen, Daegu, Korea), resorbable collagen membrane (Collagen $membrane^{(R)}$, Genoss, Suwon, Korea), and A-PRF because there was approximately 4 mm labial dehiscence after implant placement. Five months after placing the implant, the second stage of implant surgery was performed, and healing abutment was connected after removal of the 3D-titanium membrane. Five months after the second stage of implant surgery was done, the final prosthesis was then delivered. Case 2. A 35-year-old female patient presented with discomfort due to pain and mobility of implant #21. Removal of implant #21 fixture was planned simultaneously with placement of the new implant fixture. At the first stage of implant surgery, GBR for horizontal augmentation was performed with DBBM ($Bio-Oss^{(R)}$), irradiated allogenic cancellous bone and marrow (ICB $cancellous^{(R)}$), 3D-titanium membrane ($i-Gen^{(R)}$), resorbable collagen membrane (Ossix $plus^{(R)}$, Datum, Telrad, Israel), and A-PRF because there was approximately 7 mm labial dehiscence after implant placement. At the second stage of implant surgery six months after implant placement, healing abutment was connected after removing the 3D-titanium membrane. Nine months after the second stage of implant surgery was done, the final prosthesis was then delivered. In these two clinical cases, wound healing of the operation sites was uneventful. All implants were clinically stable without inflammation or additional bone loss, and there was no discomfort to the patient. With the non-resorbable titanium membrane, the ability of bone formation in the space was stably maintained in three dimensions, and A-PRF might influence soft tissue healing. This limited study suggests that aesthetic results can be achieved with GBR using 3D-titanium membrane and A-PRF in the anterior maxilla. However, long-term follow-up evaluation should be performed.

Keywords

Acknowledgement

Supported by : 전북대학교병원

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