Search Results (4)

Objectives: This study aimed to compare vertical bone gain (VBG) and horizontal bone gain (HBG) after guided bone regeneration using titanium-reinforced dense PTFE (TiR-dPTFE) versus reinforced PTFE mesh (RPM) at 9 and 12 months on three-dimensional tomographic imaging, and to perform histological assessment in selected cases. Materials and Methods: This prospective comparative case series included 14 patients (46 vertical ridge defect sites) treated with guided bone regeneration using either Ti-reinforced dPTFE membranes (TiR-dPTFE; n = 23) or resorbable porcine collagen membranes (RPM; n = 23). All sites received a 60:40 mixture of autogenous bone chips and anorganic bovine bone mineral (ABBM). After 9 months, during implant placement, a protective secondary augmentation using a 70:30 ABBM/autogenous mixture was performed and covered with a collagen membrane. Vertical and horizontal bone gain (VBG, HBG) were assessed on standardized matched CBCT cross-sections obtained at 9 and 12 months. Core biopsies were harvested at implant placement (9 months) for histological evaluation. Surgical and healing complications were recorded. Results: Both membranes produced significant VBG. TiR-dPTFE achieved greater VBG than RPM at 9 months (p = 0.045) and 12 months (p = 0.012) and remained stable from 9 to 12 months, whereas RPM showed a significant decline over time (MDa −0.48 mm; 95% CI −0.64 to −0.31; p < 0.001). HBG was similar between groups at both time points (p = 0.918 and p = 0.922). No major clinical complications occurred. Histology at 9 months confirmed vital bone formation and graft integration in both groups. Conclusions: Both TiR-dPTFE and RPM are reliable options for vertical ridge augmentation; TiR-dPTFE yielded superior and more stable vertical gains over 12 months, with comparable horizontal outcomes. Clinical Relevance: TiR-dPTFE may offer enhanced vertical augmentation, while both membranes remain suitable for implant site development. Full article

Background/Objectives: Vertical ridge augmentation (VRA) is often necessary in severe bone atrophy, yet the most predictable approach remains unclear. This systematic review compared Guided Bone Regeneration (GBR) and the Shell Technique (ST) for vertical bone gain (VBG), bone quality, complications, patient-reported outcomes (PROMs), and implant survival. Methods: Following PRISMA 2020 and PROSPERO registration (CRD420251128502), PubMed and Scopus databases were searched. Adults requiring VRA before implants were included. Interventions were GBR using titanium-reinforced dense PTFE (Polytetrafluoroethylene) or collagen membranes and ST using autogenous or allogeneic cortical plates. Results: Both techniques achieved clinically meaningful vertical augmentation. Median VBG was 4.24 mm for GBR (range 2.20–8.78 mm) and 5.16 mm for ST (range 3.10–7.60 mm) at re-entry (typically 4–9 months). Long-term series showed maintained gains for ST up to 10 years and multi-year stability after GBR in selected cohorts. Major early-healing complications were uncommon with both methods. Minor soft-tissue events varied; several GBR cohorts reported more exposures/dehiscence and occasional infections. Implant survival was uniformly high; validated PROMs were seldom reported. Conclusions: GBR and ST both enable vertical reconstruction sufficient for implant placement. ST tended toward higher median VBG but requires greater technical expertise and, when autogenous, adds donor-site morbidity; allogeneic shells reduce harvesting needs. GBR remains a versatile, donor-site-sparing alternative. Standardized outcome (including validated PROMs) reporting and head-to-head randomized trials are needed to refine case selection and confirm comparative effectiveness. Full article

Background: Vertical ridge augmentations (VRAs), including guided bone regeneration (GBR) techniques, have been utilized in the reconstruction of deficient alveolar ridges for quite some time. GBR-based VRA procedures are technique-sensitive, operator-dependent, and often lead to complications detected during or after the treatment. The main objective of this systematic review was to include randomized and non-randomized human studies that investigated the regenerative outcome differences, as well as the incidence rates of healing and surgical complications of titanium meshes and/or titanium-reinforced membranes with and without collagen membranes utilized in GBR-based VRA. Methods: This systematic review has been prepared and organized according to the preferred reporting items for systematic reviews and meta-analyses (PRISMA) 2020 guidelines and is registered at PROSPERO (Registration ID: CRD420251002615). Medline via PubMed, Scopus, Web of Science, Embase, and the Cochrane Library were searched for eligible studies up to 5 June 2025. Randomized and non-randomized human clinical studies, except for case reports, focused on applying titanium meshes or titanium-reinforced membranes with or without collagen membranes in GBR-based VRA, were eligible. Results: A total of 119 patients from three human randomized clinical trials (RCTs) and one case series reported across nine articles were included. The addition of collagen membranes causes no significant differences in vertical bone gain or surgical/healing complication rates. Conclusions: The addition of collagen membranes on top of titanium meshes and titanium-reinforced membranes might not be necessary in GBR-based VRA. Further human RCTs are required to reach a reliable conclusion. Full article

Background/Objectives: Guided bone regeneration (GBR) is a regenerative technique used to treat maxillary osseous defects to enable implant placement for prosthetic rehabilitation. It is generally performed with the use of barrier membranes and bone substitute materials of human or animal origin. Here, we report the clinical and histological outcomes of a horizontal GBR, treated using only synthetic biomaterials. Methods: A graft of nanocrystalline hydroxyapatite (NH) embedded in a silica gel matrix was used to fill a horizontal bone defect. The graft was covered with a titanium-reinforced dense polytetrafluoroethylene (TR-dPTFE) membrane, and primary closure was completed and maintained for 10 months. Then, the site was re-opened for membrane removal and implant insertion. During implant bed preparation, a bone biopsy was obtained for histological evaluation. A metal–ceramic crown was fitted, and the 5-year follow-up after prosthetic loading showed clinical and radiographically healthy tissues. Results: Histological examination revealed good integration of the biomaterial into the surrounding tissues, which were composed of lamellar bone trabeculae and connective tissue. New bone formation occurred not only around the NH granules but even inside the porous amorphous particles. Conclusions: The combination of NH and the TR-dPTFE membrane produced good clinical and histological results, which remained stable for 5 years. Full article