J Periodontal Implant Sci.  2015 Aug;45(4):128-135. 10.5051/jpis.2015.45.4.128.

The effect of overlaying titanium mesh with collagen membrane for ridge preservation

• Lim HC
• Lee JS
• Choi SH
• Jung UW

• KMID: 2164341
• DOI: http://doi.org/10.5051/jpis.2015.45.4.128

Abstract

PURPOSE
The aim of this study was to determine the effect of overlaying titanium mesh (TM) with an adjunctive collagen membrane (CM) for preserving the buccal bone when used in association with immediate implant placement in dogs.
METHODS
Immediate implant placements were performed in the mesial sockets of the third premolars of five dogs. At one site the TM was attached to the fixture with the aid of its own stabilizers and then covered by a CM (CM group), while the contralateral site received only TM (TM group). Biopsy specimens were retrieved for histologic and histomorphometric analyses after 16 weeks.
RESULTS
All samples exhibited pronounced buccal bone resorption, and a high rate of TM exposure was noted (in three and four cases of the five samples in each of the TM and CM groups, respectively). A dense fibrous tissue with little vascularity or cellularity had infiltrated through the pores of the TM irrespective of the presence of a CM. The distances between the fixture platform and the first bone-implant contact and the bone crest did not differ significantly between the TM and CM groups.
CONCLUSIONS
Our study suggests that the additional use of a CM over TM does not offer added benefit for mucosal healing and buccal bone preservation.

Keyword

Bone regeneration; Bone resorption; Dental implants; Postoperative complications; Tooth extraction

MeSH Terms

Animals
Bicuspid
Biopsy
Bone Regeneration
Bone Resorption
Collagen*
Dental Implants
Dogs
Membranes*
Postoperative Complications
Titanium*
Tooth Extraction
Collagen
Dental Implants
Titanium

Figure

• 

  Figure 1 Clinical photographs of the surgery. (A) The implant was installed after extraction. (B) A ready-made titanium mesh (TM) and its stabilizer were affixed to the fixture (TM group). (C) The collagen membrane (CM) fully covered the TM (CM group). B, buccal; L, lingual.

• 

  Figure 2 Illustration of the measurements, indicating the vertical distances between the fixture platform (P) and the most-coronal level of bone-implant contact (B), and between P and the level of the alveolar bone crest (C), and the width of the horizontal defect at the level of C (GAP).

• 

  Figure 3 Clinical photographs taken after 16 weeks of recovery. (A) A nonexposed site. (B) An exposed site. Gingival tissues around the exposed TM exhibited mucosal deformity with slight redness. In the nonexposed sites, the gingiva above the stabilizer became thin. B, buccal; C, Lingual.

• 

  Figure 4 Photomicrographs of exposed sites in the TM group (A) and CM group (B), and of nonexposed sites in the TM group (C) and the CM group (D). The buccal walls were significantly resorbed in all samples, irrespective of the presence or absence of TM exposure. Hematoxylin-eosin stain; scale bars = 2 mm.

• 

  Figure 5 Photomicrographs of a nonexposed site in the TM group. (A, B) Polarizing photomicrographs. (B, C) Higher magnification views of the boxed area in A. The tissue fibers appeared to infiltrate through pores and wrap around them. Hematoxylin-eosin stain; scale bar (A) = 2 mm, (B,C) =500 µm, respectively. G, gingival tissue; P, pore; V, void; PS, pseudoperiosteum; arrow, the most-coronal level of bone-implant contact.

• 

  Figure 6 Photomicrographs of a nonexposed site in the CM group. (A, B) Polarizing photomicrographs. (B, C) Higher magnification views of the boxed area in A. Collagen membrane did not prevent the infiltration of tissue fiber through the pores. Hematoxylin-eosin stain; scale bar (A) = 2 mm, (B,C) = 500 µm, respectively. G, gingival tissue; P, pore; PS, pseudoperiosteum.

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