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[Risks and complications of membrane-guided bone regeneration. Retrospective analysis]
1Abteilung für Oralchirurgie und Zahnärztliche Röntgenologie, Zentrum für Zahnmedizin, Universitätsklinikum Charité, Medizinische Fakultät, Humboldt-Universität Berlin. frank.strietzel@charite.de
Aim Of The Study:
The aim of this retrospective study was to determine the number of premature membrane exposures and to evaluate possible predisposing factors.
Patients And Methods:
A total of 72 patients were treated with ePTFE membranes (GoreTex Augmentation Material) for membrane-guided bone regeneration (GBR) of periimplant bone defects (median age 38.5 years, minimum 18 years, maximum 68 years; 39% male and 61% female patients, data collection between 03/1993 and 02/2000). Sixty-one percent of the membranes were applied in the upper jaw and 39% in the lower jaw; 61% of all GBR procedures were performed in conjunction with single tooth replacements.
Results:
Premature membrane exposure (PME) was found at 44% of the sites. Of these PMEs 72% occurred after a primary, uneventful healing period subsequent to membrane implantation. Statistical analysis revealed a significant correlation between the parameters "premature membrane exposure", "membrane covering the alveolar ridge" (P = 0.0004) and "membrane located beneath the incision line" (P = 0.0004). Additionally a tendency for correlation was calculated for the parameters "defect configuration" (P = 0.08) and "smoking" (P = 0.04).
Conclusions:
The defect morphology, the flap and incision design and the smoking habits of the patients have to be carefully considered if guided bone regeneration is planned. Non-space-maintaining defect configurations, smoking habits and crestal incisions crossing the planned membrane location seem to be contraindications for the use of ePTFE membranes. In such cases, alternative treatment methods should be considered.