SUBSEQUENT THERAPEUTIC TREATMENT OF MEMBRANE EXPOSURE AFTER GBR IN THE ANTERIOR MAXILLAE: A CASE REPORT

Nota Katsiki, Despoina Gkouzoula, Konstantinos Marinis, Ioannis Fourmouzis
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Abstract

Guided bone regeneration (GBR) aims to augment the areas with osseous defects in compromised dentition. Bone grafting materials, barrier membranes and growth factor therapies have been utilized to minimize the dimensional changes in the bone morphology and architecture occurring postextraction. GBR procedures are performed using materials such as autografts, allografts, xenografts, or synthetic bone grafts or combination. Barrier membranes are used to maintain the space and prevent the infiltration of fibrous tissue. Such membranes are: non-resorbable PTFE membranes, collagen-based absorbable membranes, synthetic absorbable membranes, titanium mesh membranes and PRF. In this case report, a 67 years-old lady was referred for implant rehabilitation in the right anterior maxilla. The reason of tooth loss was vertical root fracture. GBR was performed at the area of #12 and #13, due to severe bone defect. A combination of 50:50 allograft and xenograft bone grafting material, non-resorbable titanium membrane and PRF membranes was used. One-month post-op exposure of the membrane was noticed. At this point, it is important to be mentioned that on the day of the surgery primary closure was not achieved at the area #13, due to lack of soft tissue thickness. Replacement of the first membrane by a collagen based absorbable one and tension free suturing was performed. One month after the second intervention, soft and hard tissue healing was completed unhindered.
前上颌GBR术后膜暴露的后续治疗1例
引导骨再生(GBR)的目的是增加受损牙列骨缺损的区域。植骨材料、屏障膜和生长因子疗法已被用于减少拔牙后骨形态和结构的尺寸变化。GBR手术采用自体移植物、同种异体移植物、异种移植物或合成骨移植物或组合等材料进行。屏障膜用于维持空间并防止纤维组织的浸润。这些膜有:不可吸收聚四氟乙烯膜,胶原基可吸收膜,合成可吸收膜,钛网膜和PRF。在这个病例报告中,一位67岁的女士在右前上颌接受种植体康复治疗。牙齿脱落的原因为牙根垂直断裂。由于严重的骨缺损,在#12和#13区域进行了GBR。采用50:50同种异种骨移植材料、不可吸收钛膜和PRF膜的组合。术后1个月观察到膜暴露。在这一点上,重要的是要提到,在手术当天,由于缺乏软组织厚度,未能在13区完成初步闭合。用胶原基可吸收膜代替第一层膜,并进行无张力缝合。第二次干预1个月后,软硬组织均顺利愈合。
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