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Alveolar crest contour changes after guided bone regeneration using different biomaterials: an experimental in vivo investigation

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Abstract

Objective

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.

Results

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.

Conclusions

GBR using different biomaterials significantly increased the buccal contours of the alveolar crest when used at dehiscence defects around dental implants.

Clinical relevance

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.

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References

  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):480–487

    PubMed  Google Scholar 

  2. Fickl S, Zuhr O, Wachtel H, Stappert CF, Stein JM, Hurzeler MB (2008) Dimensional changes of the alveolar ridge contour after different socket preservation techniques. J Clin Periodontol 35(Suppl. 10):906–913

    PubMed  Google Scholar 

  3. Van der Weijden F, Dell’Acqua F, Slot DE (2009) Alveolar bone dimensional changes of post-extraction sockets in humans: a systematic review. J Clin Periodontol 36(Suppl. 12):1048–1058

    PubMed  Google Scholar 

  4. Benic GI, Hammerle CH (2014) Horizontal bone augmentation by means of guided bone regeneration. Periodontol 2000 66(Suppl 1):13–40

    PubMed  Google Scholar 

  5. Hammerle CH, Jung RE (2003) Bone augmentation by means of barrier membranes. Periodontol 2000(33):36–53

    Google 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 16:3

    Google Scholar 

  7. Van Assche N, Michels S, Naert I, Quirynen M (2013) Randomized controlled trial to compare two bone substitutes in the treatment of bony dehiscences. Clin Implant Dent Relat Res 15(Suppl 4):558–568

    PubMed  Google 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):640–647

    Google Scholar 

  9. Araujo M, Linder E, Lindhe J (2009) Effect of a xenograft on early bone formation in extraction sockets: an experimental study in dog. Clin Oral Implants Res 20(1):1–6

    PubMed  Google Scholar 

  10. Sanz-Sanchez I, Ortiz-Vigon A, Sanz-Martin I, Figuero E, Sanz M (2015) Effectiveness of Lateral Bone Augmentation on the Alveolar Crest Dimension: A Systematic Review and Meta-analysis. J Dent Res 94(Suppl 9):128S–142S

    PubMed  Google Scholar 

  11. Tanuma Y, Matsui K, Kawai T, Matsui A, Suzuki O, Kamakura S (2013) Comparison of bone regeneration between octacalcium phosphate/collagen composite and beta-tricalcium phosphate in canine calvarial defect. Oral Surg Oral Med Oral Pathol Oral Radiol 115(Suppl 1):9–17

    PubMed  Google Scholar 

  12. Trisi P, Rao W, Rebaudi A, Fiore P (2003) Histologic effect of pure-phase beta-tricalcium phosphate on bone regeneration in human artificial jawbone defects. Int J Periodontics Restorative Dent 23(Suppl 1):69–77

    PubMed  Google Scholar 

  13. Jung UW, Cha JK, Vignoletti F, Nuñez J, Sanz-Esporrin J, Sanz M (2017) Simultaneous lateral bone augmentation and implant placement using a particular synthetic bone substitute around chronic peri-implant dehiscence defects in dogs. J Clin Periodontol 44(11):1172–1180

    PubMed  Google Scholar 

  14. Dahlin C, Linde A, Gottlow J, Nyman S (1988) Healing of bone defects by guided tissue regeneration. Plast Reconstr Surg 81:672–676

    PubMed  Google Scholar 

  15. Zhao S, Pinholt EM, Madsen JE, Donath K (2000) Histological evaluation of different biode- gradable and nonbiodegradable membranes im- planted sub-cutaneously in rats. J Craniomaxillofac Surg 28:116–122

    PubMed  Google Scholar 

  16. Owens KW, Yukna RA (2001) Collagen membrane resorption in dogs: a comparative study. Implant Dent 10:49–56

    PubMed  Google Scholar 

  17. Paul BF, Mellonig JT, Towle HJ III, Gray JL (1992) Use of a collagen barrier to enhance healing in human periodontal furcation defects. Int J Periodontics Restorative Dent 12:123–131

    PubMed  Google 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):402–415

    PubMed  Google Scholar 

  19. Chen LC, Lundgren T, Hallstrom H, Cherel F (2008) Comparison of different methods of assessing alveolar ridge dimensions prior to dental implant placement. J Periodontol 79(Suppl 3):401–405

    PubMed  Google 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):97–101

    Google Scholar 

  21. Fickl S, Schneider D, Zuhr O, Hinze M, Ender A, Jung RE (2009) Dimensional changes of the ridge contour after socket preservation and buccal overbuilding: an animal study. J Clin Periodontol 36(Suppl 5):442–448

    PubMed  Google 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):842–853

    PubMed  Google 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):1273–1283

    Google 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):673–679

    PubMed  Google Scholar 

  25. Sanz Martin I, Benic GI, Hammerle CH, Thoma DS (2016) Prospective randomized controlled clinical study comparing two dental implant types: volumetric soft tissue changes at 1 year of loading. Clin Oral Implants Res 27(4):406–411

    PubMed  Google Scholar 

  26. Vignoletti F, Abrahamsson I (2012) Quality of reporting of experimental research in implant dentistry. Critical aspects in design, outcome assessment and model validation. J Clin Periodontol 39(Suppl. 12):6–27

    PubMed  Google 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):1198–1206

    PubMed  Google Scholar 

  28. Lee IK, Lim HC, Lee JS, Hong JY, Choi SH, Jung UW (2016) Layered approach with autogenous bone and bone substitute for ridge augmentation on implant dehiscence defects in dogs. Clin Oral Implants Res 27(Suppl 5):622–628

    PubMed  Google 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):357–368

    PubMed  Google 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):961–970

    PubMed  Google 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):237–243

    PubMed  Google 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):1466–1476

    Google Scholar 

  33. Cha JK, Joo MJ, Yoon S, Lee JS, Choi SH, Jung UW (2017) Sequential healing of only bone grafts using combining biomaterials with cross-linked collagen in dogs. Clin Oral Implants Res 28:76–85

    PubMed  Google Scholar 

  34. Schwarz F, Rothamel D, Herten M, Sager M, Becker J (2006) Angiogenesis pattern of native and cross-linked collagen membranes: an immunohistochemical study in the rat. Clin Oral Implants Res 17(Suppl 4):403–409

    PubMed  Google Scholar 

  35. Friedman A, Gissel K, Soudan M, Kleber BM, Pitaru S, Dietrich T (2011) Randomized controlled trial on lateral augmentation using two collagen membranes: morphometric results on mineralized tissue compound. J Clin Periodontol 38(7):677–685

    Google Scholar 

  36. Bornstein MM, Bosshardt D, Buser D (2007) Effect of two different bioabsorbable collagen membranes on guided bone regeneration: a comparative histomorphometric study in the dog mandible. J Periodontol 78(Suppl 10):1943–1953

    PubMed  Google 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):742–749

    PubMed  Google Scholar 

  38. Jemt T, Lekholm U (2003) Measurements of buccal tissue volumes at single-implant restorations after local bone grafting in maxillas: a 3-year clinical prospective study case series. Clin Implant Dent Relat Res 5(Suppl 2):63–70

    PubMed  Google Scholar 

  39. Jemt T, Lekholm U (2005) Single implants and buccal bone grafts in the anterior maxilla: measurements of buccal csrystal contours in a 6 year prospective clinical study. Clin Implant Dent Relat Res 7(3):127–135

    PubMed  Google Scholar 

  40. Henriksson K, Jemt T (2004) Measurements of soft tissue volume in association with single implant restoration: a 1 year comparative study after abutment connection surgery. Clin Implant Dent Relat Res 6(4):181–189

    PubMed  Google Scholar 

  41. Schneider D, Gründer U, Ender A, Hammerle CH, Jung RE (2011) Volume gain and stability of peri-implant tissue following bone and soft tissue augmentation: 1 year results from a prospective cohort study. Clin Oral Implant Res 22(1):28–37

    Google Scholar 

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Acknowledgments

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.

Funding

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).

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Authors and Affiliations

  1. Section of Graduate Periodontology, University Complutense, Madrid, Spain

    R. Di Raimondo, R. Plá, I. Sanz-Martín, F. Luengo, J. Nuñez & Mariano Sanz

  2. ETEP (Etiology and Therapy of Periodontal Diseases) Research Group, University Complutense, Madrid, Spain

    J. Sanz-Esporrín, F. Vignoletti & Mariano Sanz

  3. Facultad de Odontología, Plaza Ramón y Cajal s/n (Ciudad Universitaria), 28040, Madrid, Spain

    Mariano Sanz

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  1. R. Di Raimondo
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  2. J. Sanz-Esporrín
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  4. I. Sanz-Martín
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  5. F. Luengo
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  6. F. Vignoletti
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  7. J. Nuñez
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  8. Mariano Sanz
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Correspondence to Mariano Sanz.

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The authors declare that they have no conflict of interest.

Ethical approval

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.

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Di Raimondo, R., Sanz-Esporrín, J., Plá, R. et al. Alveolar crest contour changes after guided bone regeneration using different biomaterials: an experimental in vivo investigation. Clin Oral Invest 24, 2351–2361 (2020). https://doi.org/10.1007/s00784-019-03092-8

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  • DOI: https://doi.org/10.1007/s00784-019-03092-8

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