Periosteal-secured suture and fixation device in horizontal guided bone regeneration: a retrospective study

The aim of this study was to compare volumetric and linear hard tissue changes, as well as the efficacy of augmentation using periosteal secured suture (PSS) and fixation devices (FD) for resorbable membrane stabilization in horizontal guided bone regeneration (GBR).

A retrospective matched cohort study was conducted on 14 patients undergoing horizontal GBR, with 7 in each of the PSS and FD (screws/tacks) groups. Inclusion criteria included the availability of high-quality pre- and post-GBR cone beam computed tomography (CBCT) scans and complete documentation of patient- and GBR-related characteristics. Patient-related variables (medical history and demographics) and GBR-related variables (location, type of bone substitute and membrane, and complications) were extracted from dental records. Postoperative CBCT scans were obtained at least 5 months after GBR procedure. CBCT subtraction analysis was performed using spatial registration and semi-automatic segmentation. Outcome variables included volumetric hard tissue gain (primary outcome), volumetric hard tissue loss, efficacy of augmentation (i.e. volumetric gain relative to defect extent), and changes in linear vertical and horizontal hard tissue dimensions between pre- and post-operative scans, measured at the mesial, middle, and distal planes.

Both PSS and FD groups demonstrated significant increases in the linear horizontal dimension from preoperative to postoperative (p < 0.05). The mean horizontal hard tissue gains at 3 mm from the crestal bone in the middle plane were 2.8 ± 1.6 mm for the PSS group and 3.8 ± 1.2 mm for the FD group. The mean volumetric gain and efficacy of augmentation were 0.8 ± 0.9 cm³ and 0.025 ± 0.018 cm³/mm for the PSS group, and 0.6 ± 0.3 cm³ and 0.024 ± 0.010 cm³/mm for the FD group, respectively. No significant differences were observed between groups in linear dimensions, volumetric changes, or efficacy (p > 0.05).

Stabilizing resorbable membranes using periosteal secured sutures or fixation devices in horizontal guided bone regeneration procedures results in comparable linear and volumetric hard tissue gains, demonstrating similar efficacy in hard tissue augmentation.

Periosteal secured sutures and fixation devices are both reliable methods for stabilizing resorbable membranes in horizontal guided bone regeneration, yielding comparable efficacy in hard tissue augmentation.