Alveolar bone formation at dental implant dehiscence defects following guided bone regeneration and xenogeneic freeze‐dried demineralized bone matrix

Abstract

The present study evaluated rate and extent of alveolar bone formation in dental implant dehiscence defects following guided bone regeneration(GBR) and implantation of xenogeneic freeze‐dried demineralized bone matrix (xDBM). A total of 16 titanium plasma‐sprayed (TPS) and 16 hydroxyapatite‐coated (HA) titanium cylinder implants were inserted in 4 mongrel dogs following extraction of the mandibular premolar teeth. Four implant sites per jaw quadrant (2 TPS and 2 HA implant sites) were prepared into extraction sockets in each dog. Buccal alveolar bone was removed to create 3 x 5 mm dehiscence defects. Two jaw quadrants in separate animals received GBR, GBR+xDBM, xDBM (control), or gingival flap surgery alone (GFS; control). Thus, four conditions were available for each implant type (TPS or HA): GBR, GBR+xDBM; xDBM and GFS. The animals received fluorescent bone labels to allow observations of rate and extent of bone formation. Animals were sacrificed at 12 weeks postsurgery and block sections were harvested for histologic analysis. There were no apparent histologic differences between TPS and HA implant defects. GBR and GBR+xDBM resulted in almost complete bone closure of the dental implant dehiscence defect. Rate of bone formation appeared higher following GBR alone. Extent of bone formation appeared somewhat greater following GBR+xDBM; however, delayed. xDBM alone did not adequately resolve the bony defect. In conclusion, GBR results in rapid, clinically relevant bone closure of dental implant dehiscence defects. Adjunctive implantation of xDBM does not appear to significantly improve the healing response in the model used.

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

“…The present results corroborate, to a certain extent, previous studies investigating a bovine-derived HA (BioOss 1 , Geistlich) (BDX) or AB for GBR in dehiscence-type defects 6,17,19 . CHO et al 6 reported a nearly complete defect fill after 12 weeks of healing following the application of either ePTFE (81%; BIC: 49%) or ePTFE + BDX (84%; BIC: 67%) at both HA-and titanium plasma-sprayed implants.…”

“…The present results corroborate, to a certain extent, previous studies investigating a bovine-derived HA (BioOss 1 , Geistlich) (BDX) or AB for GBR in dehiscence-type defects 6,17,19 . CHO et al 6 reported a nearly complete defect fill after 12 weeks of healing following the application of either ePTFE (81%; BIC: 49%) or ePTFE + BDX (84%; BIC: 67%) at both HA-and titanium plasma-sprayed implants. HOCKERS et al 17 observed a mean BIC of 17-20% for either AB + BG, BDX + BG or BG alone at machined titanium implants, even though the vertical bone growth amounted to 45% of the defect height in the BG group, to 78% in the BDX + BG group, and to 69% in the AB + BG group.…”

“…For many years, the technique of guided bone regeneration (GBR) has been successfully used for bone augmentation at dehisced dental implants 2,6,17,19 . The basic concept originally described for GBR involves the placement of a barrier membrane to protect the blood clot and create a secluded space around the bone defect, thus enabling access for bone-forming cells without competition from other tissues 8 .…”

Lateral ridge augmentation using particulated or block bone substitutes biocoated with rhGDF-5 and rhBMP-2: an immunohistochemical study in dogs

“…To the best of our knowledge, these are the first histological data evaluating BOG for lateral ridge augmentation in dogs. However, the osteoconductive properties noted for BOG corroborate, to a certain extent, previous animal studies reporting on sinus floor augmentation, healing of self-contained BDs, or bone regeneration at dehiscence-type defects (Wetzel et al 1995;Cho et al 1998;Carmagnola et al 2002). When interpreting the present results, it was also observed that all grafted areas exhibited a certain amount of bone resorption between 3 and 8 weeks of healing.…”

Immunohistochemical characterization of wound healing at two different bone graft substitutes

“…Surgical creation of standardized buccal dehiscence-type defects in dogs is a commonly used model to evaluate bone regeneration at titanium implants 9,28,36,38,43 . Acute-type defects have a tendency to heal spontaneously and thus may have supported bone regeneration in all groups investigated.…”