Clinical outcomes of GBR procedures to correct peri‐implant dehiscences and fenestrations: a systematic review

Abstract

Despite the favorable results obtained, it was difficult to draw a significant conclusion as far as the more reliable grafting material and membrane barrier for the correction of dehiscence/fenestration defects are concerned, due to the limited sample of patients and the wide variety of grafting materials and membranes, used alone or in combination. Moreover, due to the lack of randomized clinical trials, it was impossible to demonstrate that such augmentation procedures are actually needed to allow the long-term survival of implants.

Comparative Efficacies of a 3D-Printed PCL/PLGA/β-TCP Membrane and a Titanium Membrane for Guided Bone Regeneration in Beagle Dogs

“…Nevertheless, in cases of periodontal diseases, trauma, or atrophy, ideal implant placement is restricted due to insufficient alveolar bone [3,4]. In clinical cases of limited alveolar bone defect treatment, guided bone regeneration (GBR) has been most frequently documented and is reportedly the most commonly used [5][6][7].…”

“…Dental implants for replacing missing teeth in partially or completely edentulous patients have been widely recognized in the last decade as a routine treatment modality that provides reliable long-term results [1][2][3]. For long-term prognoses and for acceptable aesthetic and functional outcomes for implant-supported restorations, sufficient bone must be provided to recipient sites [4][5][6].…”

Connective tissue graft to improve aesthetic peri-implant area: modified clinical technique.

“…Bone resorption following maxillary anterior tooth extraction is common and often promotes dehiscence defects, which compromises gingival tissue level for the implant restoration [5,6,10]. When dehiscence defect was caused by tooth extraction in an anterior area, the presurgical planning should include bone augmentation before implant therapy [6,20]. If the affected area is not recovered the fixture may be placed inadequately and the crown restoration will have an undesirable appearance, and the adjacent teeth may present functional abnormalities as gingival recession and dental hypersensitivity [5,7].…”

Prosthetic restoration of the canine

“…Unfortunately the buccal anatomy of the maxilla in the canine area when the tooth has been missing for any length of time is concave, often excessively above the area where the canine bulge ought to be. Because the quantity of bone palatally is always sufficient and they fear they will risk fenestration, if they place the implant too close to cortical buccal bone, oral surgeons are tempted to position their implants with the apex too far palatally, which often makes the pivot emerge too far buccally 6,7,9,14,26,47 (fig. 7).…”

“…The surgeon will then use the surgical guide to reproduce the planned placement in the mouth operatively 4,26 . More than the angulation itself, which, if not precisely what it ought to be, can be corrected with an angulated post, is the precise spot of the implant's emergence, which will determine the success or failure of the implant/prosthetic replacement of a missing canine 6,7 . (fig.…”