Preserving the Bone Profile in Anterior Maxilla using an Equine Cortical Bone Membrane and an Equine Enzyme-treated Bone Graft: A Case Report with 5-year Follow-up

Abstract

Aim: This study aimed to report a well-succeeded use of equine enzyme-deantigenic cortical membrane and bone granules for guided bone regeneration (GBR) in the esthetic zone concomitant with implant placement. Background:In the anterior maxilla, where patients typically have the highest expectations for implant-supported restorations, bone resorption in the wake of tooth loss often leads to a lack of soft tissue support and ultimately to unsatisfactory esthetic results. Buccal bone augmentation at the time of implant placement has thus become common. This is usually accomplished following GBR principles and employing membranes made from various materials to serve as a barrier between the soft tissue and graft material. One of the more recently introduced membrane materials is made from thin, flexible equine cortical bone, i.e., rendered nonantigenic in an enzymatic process that preserves native bone collagen.Case report: This report describes the treatment of a patient who received an equine enzyme-deantigenic graft and membrane in conjunction with placement of an implant in the right maxillary lateral incisor site. Conclusion:After 5 years of follow-up, the patient was very satisfied with her appearance. A cone-beam computed tomography scan showed that the peri-implant bone levels and ridge thickness had been maintained, and the cortical layer in the pristine ridge had also undergone remodeling. Clinical significance: Guided bone regeneration with the concomitant use of enzyme-deantigenic membrane and graft is a valuable and suitable option for effective implant-supported prosthetic rehabilitation in the esthetic zone. Preserving the Bone Profile in Anterior Maxilla

A Preshaped Titanium Mesh for Guided Bone Regeneration with an Equine-Derived Bone Graft in a Posterior Mandibular Bone Defect: A Case Report

“…This seems to confer to the graft remodeling kinetics comparable to that of natural bone; indeed, very few residual biomaterial particles could be identified by histological examination, implying that this equine-derived xenograft can be expected to be nearly completed resorbed 6.5 years after grafting. This result is consistent with the present clinical evidence on this bone substitute [41,42,43,44,45,46,47,48,49,50].…”

A comparison between anorganic bone and collagen-preserving bone xenografts for alveolar ridge preservation: systematic review and future perspectives

“…The preservation of type I collagen in bone substitutes can improve socket healing in ARP procedures by a series of processes, including (1) enhanced stimulation by endogenous growth factors; (2) longer duration of regenerative stimuli; (3) physiological modulation of bone metabolism and remodeling; and (4) increased osteoblast adhesion, proliferation, and differentiation [95][96][97][98]. Indeed, this might have contributed to the successful clinical outcomes with CBXs use reported for different oral surgery procedures including sinus lift bone grafting [42,[99][100][101][102], ridge augmentation [103][104][105], and peri-implant-guided bone regeneration [106][107][108]. However, direct clinical comparisons between anorganic and CBXs for socket preservation were only reported in three clinical trials [31,38,82], so the superiority of one biomaterial over another has not been established yet.…”

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“…After follow-up through computed tomography images, they demonstrated that bone growth in the peri-implant regions and rim thickness were maintained, with alveolar crest remodeling and this indicates that the use of equine membrane and graft is a very viable option for implant-supported prosthetic rehabilitation in the aesthetic region. 23…”