Bilayer Technique for Alveolar Ridge Augmentation in Pre-Prosthetic Implant Surgery: Indications and Problems
DOI:
https://doi.org/10.2478/amb-2024-0008Keywords:
guided bone regeneration, bone substitute materials, dental implants, bilayer techniqueAbstract
Background:
Prosthetic rehabilitation of missing teeth with dental implant-supported restorations has recently become a predictable treatment option in contemporary dentistry with a highly successful rate. Due to different factors, vertical and horizontal bone loss could present, and the available alveolar bone may not be sufficient for optimum implant position. Ridge augmentation procedures could be applied to increase the volume of the deficient sites for accurate prosthetic implant placement, which assures functional and esthetic stability of tissues around the implants, essential for long-term success.
Our study aims to evaluate the efficiency of the bilayer technique of guided bone regeneration for alveolar ridge augmentation procedure in cases of bone deficiency for optimum implant placement and long-term success.
Materials and methods:
We present several cases of alveolar bone deficiency treated with the bilayer technique – the combination of allo- and xenograft, covered by collagen membrane, with long-term follow-up. The defects were filled with allograft, and a layer of xenograft and barrier membrane was placed above it. This technique combines the benefits of all xenografts and barrier membranes.
Results:
The bilayer technique with allo- and xenograft and collagen membranes is predictable, with a high success rate and lower morbidity. We have a 100% survival rate of the implants placed in a grafted area with long-term follow-up with excellent aesthetic and functional results.
Conclusions:
The bilayer technique uses the benefits of two bone graft materials, is associated with less morbidity for the patients, and has excellent long-term results if performed accurately according to indications and technique.
References
Kim YK, Ku JK. Guided bone regeneration. J Korean Assoc Oral Maxillofac Surg. 2020 Oct 31; 46(5):361-366. doi: 10.5125/jkaoms.2020.46.5.361. PMID: 33122463; PMCID: PMC7609932
Urban IA, Nagursky H, Lozada JL, et al. Horizontal ridge augmentation with a collagen membrane and a combination of particulated autogenous bone and anorganic bovine bone-derived mineral: a prospective case series in 25 patients. Int J Periodontics Restorative Dent. 2013; 33:299-307. doi: 10.11607/prd.1407.
Urban IA, Monje A, Lozada JL, et al. Long-term Evaluation of peri-implant bone level after reconstruction of severely atrophic edentulous maxilla via vertical and horizontal guided bone regeneration in combination with sinus augmentation: a case series with 1 to 15 years of loading. Clin Implant Dent Relat Res. 2017; 19:46-55. doi: 10.1111/cid.12431.
Liu J, Kerns DG. Mechanisms of guided bone regeneration: a review. Open Dent J. 2014; 16:56-65. 10.2174/1874210601408010056.
Kim YK, Ku JK. Ridge augmentation in implant dentistry. J Korean Assoc Oral Maxillofac Surg. 2020; 46:211-7.
Miron RJ. Understanding Platelet-Rich Fibrin, Kindle ed.; Quintessence Publishing Co, Inc.: Batavia, IL, USA, 2021.
El Bagdadi K, Kubesch A, Yu X, et al. Reduction of relative centrifugal forces increases growth factor release within solid platelet-rich-fibrin (PRF)-based matrices: a proof of concept of LSCC (low-speed centrifugation concept). Eur J Trauma Emerg Surg. 2019 Jun; 45(3):467-479.
Benic GI, Hämmerle CH. Horizontal bone augmentation by means of guided bone regeneration. Periodontol 2000. 2014; 66:13-40. doi: 10.1111/prd.12039.
Aghaloo TL, Moy PK. Which hard tissue augmentation techniques are the most successful in furnishing bony support for implant placement? Int J Oral Maxillofac Implants. 2007; 22:49-70.
Tolstunov L, Hamrick JFE, Broumand V, et al. Bone Augmentation Techniques for Horizontal and Vertical Alveolar Ridge Deficiency in Oral Implantology. Oral and Maxillofacial Surgery Clinics of North America. 2019; 31(2): 163-191. doi:10.1016/j.coms.2019.01.005
Le BT, Borzabadi-Farahani A. Simultaneous implant placement and bone grafting with particulate mineralized allograft in sites with buccal wall defects, a three-year follow-up, and review of literature. J Craniomaxillofac Surg. 2014; 42:552-9. doi: 10.1016/j.jcms.2013.07.026.
Chiapasco M, Casentini P, Zaniboni M. Bone augmentation procedures in implant dentistry. Int J Oral Maxillofac Implants. 2009;24:237-259.
Jensen T, Schou S, Gundersen HJ, et al. Bone-to-implant contact after maxillary sinus floor augmentation with Bio-Oss and autogenous bone in different ratios in mini pigs. Clin Oral Implants Res. 2013;24:635-644. doi: 10.1111/j.1600-0501.2012.02438.
Cinar IC, Gultekin BA, Saglanmak A, et al. Comparison of Allogeneic Bone Plate and Guided Bone Regeneration Efficiency in Horizontally Deficient Maxillary Alveolar Ridges. Applied Sciences. 2022; 12(20):10518. https://doi.org/10.3390/app122010518
Avila G, Neiva R, Misch CE, et al. Clinical and histologic outcomes after the use of a novel allograft for maxillary sinus augmentation: a case series. Implant Dent. 2010; 19:330-341. doi: 10.1097/ID. 0b013e3181e59b32.
Chasioti E, Chiang TF, Drew HJ. Maintaining space in localized ridge augmentation using guided bone regeneration with tenting screw technology. Quintessence Int. 2013; 44: 763-771.
Owens KW, Yukna RA. Collagen membrane resorption in dogs: a comparative study. Implant Dent. 2001;10:49-58.
Soldatos NK, Stylianou P, Koidou VP, et al. Limitations and options using resorbable versus non-resorbable membranes for successful guided bone regeneration. Quintessence Int.2017;48:131-147.
Allan B, Ruan R, Landao-Bassonga E, et al. Collagen Membrane for Guided Bone Regeneration in Dental and Orthopedic Applications. Tissue engineering. Part A vol. 2021;27,5-6: 372-381. doi:10.1089/ten.TEA.2020.0140
Riedmann A, Strietzel FP, Maretzki B, et al. Observations on a new collagen barrier membrane in 16 consecutively treated patients. Clinical and histological findings. J Periodontol. 2001; 72:1616-1623.
Friedmann A, Gissel K, Soudan M, et al. Randomized controlled trial on lateral augmentation using two collagen membranes: morphometric results on mineralized tissue compound. J Clin Periodontol. 2011;38:677-685.
Gultekin BA, Erol Cansiz E, Serdar Yalcin S. Ridge Augmentation Techniques in preprosthetic Implant Surgery, A Text-book of Advanced Oral and Maxillofacial Surgery Volume 3, Mohammad Hosein Kalantar Motamedi, IntechOpen, 2016. DOI: 10.5772/63003.
Lundgren AK, Lundgren D, Hämmerle CH, et al. Influence of decortication of the donor bone on guided bone augmentation. An experimental study in the rabbit skull bone. Clin Oral Implants Res. 2000; 11:99-106.
Liu R, Yang Z, Tan J, et al. Immediate implant placement for a single anterior maxillary tooth with a facial bone wall defect: a prospective clinical study with a one-year followup period. Clin Implant Dent Relat Res. 2019; 21:1164-74. doi: 10.1111/cid.12854.
Dimova-Gabrovska M, Maksimovskaya L, Dimitrova D. Changes in the oral mucosa in patients with bruxism. Stomatologiia. 2021; 100(6.Vyp.2):48-52. doi: 10.17116/stomat202110006248.
Dimova-Gabrovska M. Thermographic assessment of structural analysis in patients with temporomandibular disorders. Comptes Rendus de L‘Academie Bulgare des Sciences., 2018, 71(5): 712-716. doi: 10.7546/CRABS.2018.05.17.
Rangelov S, Dimova-Gabrovska M, Kirilova E, et al. Strength qualities of test specimens of materials for preliminary nonremovable prosthetic constructions – Part 2. Principal component analysis
Bulgarian Chemical Communications. 2023, 55(3):328-334. doi:10.34049/bcc.55.3.SIMNS02
Dimova-Gabrovska M, Rangelov S, Kirilova E, et al. Physicо-mechanical characteristics of materials and methods for provisional non-removable prosthetic constructions – Part 1. Contemporary literature review. Bulgarian Chemical Communications, 2023, 55(3): 321-327. doi:10.34049/bcc.55.3.SIMNS01
Downloads
Published
Issue
Section
License
Copyright (c) 2024 E. Deliverska, B. Yordanov, J. Kirilova (Author)
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
You are free to share, copy and redistribute the material in any medium or format under these terms.
Journal Acta Medica Bulgarica 
