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Impact of Collagen Membrane in Vertical Ridge Augmentation Using Ti-Reinforced PTFE Mesh: A Randomised Controlled

Istvan A Urban1,2,3,4,5, Matteo Serroni2,6, Debora R Dias2,7

  • 1Graduate Implant Dentistry, Loma Linda University, Loma Linda, California, USA.

Journal of Clinical Periodontology
|February 15, 2025
PubMed
Summary

Vertical ridge augmentation using perforated PTFE mesh alone or with a collagen membrane showed comparable bone gain and complication rates. Adding a collagen membrane may reduce soft tissue ingrowth.

Keywords:
alveolar bone lossalveolar ridge augmentationbone regenerationcone‐beam computed tomographydental implants

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Area of Science:

  • Oral and Maxillofacial Surgery
  • Regenerative Dentistry
  • Biomaterials Science

Background:

  • Vertical ridge augmentation (VRA) is crucial for dental implant placement in atrophic jaws.
  • Titanium-reinforced dense-polytetrafluoroethylene (PTFE) mesh is a common material for VRA.
  • The role of additional collagen membranes (CM) in VRA with PTFE mesh requires further investigation.

Purpose of the Study:

  • To compare vertical bone gain (VBG) and complication incidence after VRA using PTFE mesh with or without a collagen membrane.
  • To evaluate volumetric bone changes and bone density in augmented sites.
  • To assess the non-inferiority of PTFE mesh alone versus PTFE mesh plus CM.

Main Methods:

  • A non-inferiority randomized clinical trial involving 30 patients with vertical bone defects.
  • Patients received VRA with either PTFE mesh + CM or PTFE mesh alone.
  • CBCT scans were used to evaluate VBG, regeneration rates, and bone density; meshes were removed after 9 months.

Main Results:

  • Non-inferiority for absolute VBG was not demonstrated for PTFE alone compared to PTFE + CM.
  • Both groups showed comparable VBG (4.5 ± 2.1 mm vs. 4.1 ± 2.7 mm), effective regeneration rates (69.3% ± 17.9% vs. 72.3% ± 16.4%), and complication rates (6.7% in both).
  • A higher incidence of type 1 pseudo-periosteum was noted in the PTFE + CM group, suggesting potential soft tissue ingrowth prevention.

Conclusions:

  • While non-inferiority of PTFE alone was not statistically established for absolute VBG, both techniques yielded similar clinical outcomes.
  • Comparable VBG, complication rates, and bone density were observed between the two groups.
  • The addition of a collagen membrane may be beneficial in preventing soft tissue ingrowth during VRA with PTFE mesh.