Journal of Periodontal and Implant Science

Korean Academy of Periodontology (대한치주과학회)
권호 표지
DOI QR코드

DOI QR Code

Secondary closure of an extraction socket using the double-membrane guided bone regeneration technique with immediate implant placement

  • Yun, Jeong-Ho (Department of Dentistry, Inha University School of Medicine) ;
  • Jun, Choong-Man (Department of Dentistry, Inha University School of Medicine) ;
  • Oh, Nam-Sik (Department of Dentistry, Inha University School of Medicine)
  • Received : 2011.08.11
  • Accepted : 2011.09.26
  • Published : 2011.10.31
Download PDF
⟨ Previous Next ⟩

Abstract

Purpose: Immediate implantation presents challenges regarding site healing, osseointegration, and obtaining complete soft-tissue coverage of the extraction socket, especially in the posterior area. This last issue is addressed herein using the double-membrane (collagen membrane+high-density polytetrafluoroethylene [dPTFE] membrane) technique in two clinical cases of posterior immediate implant placement. Methods: An implant was placed immediately after atraumatically extracting the maxillary posterior tooth. The gap between the coronal portion of the fixture and the adjacent bony walls was filled with allograft material. In addition, a collagen membrane (lower) and dPTFE membrane (upper) were placed in a layer-by-layer manner to enable the closure of the extraction socket without a primary flap closure, thus facilitating the preservation of keratinized mucosa. The upper dPTFE membrane was left exposed for 4 weeks, after which the membrane was gently removed using forceps without flap elevation. Results: There was considerable plaque deposition on the outer surface of the dPTFE membrane but not on the inner surface. Moreover, scanning electron microscopy of the removed membrane revealed only a small amount of bacteria on the inner surface of the membrane. The peri-implant tissue was favorable both clinically and radiographically after a conventional dental-implant healing period. Conclusions: Secondary closure of the extraction socket and immediate guided bone regeneration using the double-membrane technique may produce a good clinical outcome after immediate placement of a dental implant in the posterior area.

Keywords

References

  1. Covani U, Cornelini R, Barone A. Bucco-lingual bone remodeling around implants placed into immediate extraction sockets: a case series. J Periodontol 2003;74:268-73. https://doi.org/10.1902/jop.2003.74.2.268
  2. Paolantonio M, Dolci M, Scarano A, d'Archivio D, di Placido G, Tumini V, et al. Immediate implantation in fresh extraction sockets. A controlled clinical and histological study in man. J Periodontol 2001;72:1560-71. https://doi.org/10.1902/jop.2001.72.11.1560
  3. Wilson TG Jr, Schenk R, Buser D, Cochran D. Implants placed in immediate extraction sites: a report of histologic and histometric analyses of human biopsies. Int J Oral Maxillofac Implants 1998;13:333-41.
  4. Bartee BK. The use of high-density polytetrafluoroethylene membrane to treat osseous defects: clinical reports. Implant Dent 1995;4:21-6. https://doi.org/10.1097/00008505-199504000-00004
  5. Bartee BK, Carr JA. Evaluation of a high-density polytetrafluoroethylene (n-PTFE) membrane as a barrier material to facilitate guided bone regeneration in the rat mandible. J Oral Implantol 1995;21:88-95.
  6. Crump TB, Rivera-Hidalgo F, Harrison JW, Williams FE, Guo IY. Influence of three membrane types on healing of bone defects. Oral Surg Oral Med Oral Pathol Oral RadiolEndod 1996;82:365-74. https://doi.org/10.1016/S1079-2104(96)80299-X
  7. Walters SP, Greenwell H, Hill M, Drisko C, Pickman K, Scheetz JP. Comparison of porous and non-porous teflon membranes plus a xenograft in the treatment of vertical osseous defects: a clinical reentry study. J Periodontol 2003;74:1161-8. https://doi.org/10.1902/jop.2003.74.8.1161
  8. Hoffmann O, Bartee BK, Beaumont C, Kasaj A, Deli G, Zafiropoulos GG. Alveolar bone preservation in extraction sockets using non-resorbabledPTFE membranes: a retrospective non-randomized study. J Periodontol 2008;79: 1355-69. https://doi.org/10.1902/jop.2008.070502
  9. Irinakis T. Rationale for socket preservation after extraction of a single-rooted tooth when planning for future implant placement. J Can Dent Assoc 2006;72:917-22.
  10. Juodzbalys G, Wang HL. Soft and hard tissue assessment of immediate implant placement: a case series. Clin Oral Implants Res 2007;18:237-43. https://doi.org/10.1111/j.1600-0501.2006.01312.x
  11. Oh TJ, Meraw SJ, Lee EJ, Giannobile WV, Wang HL. Comparative analysis of collagen membranes for the treatment of implant dehiscence defects. Clin Oral Implants Res 2003;14:80-90. https://doi.org/10.1034/j.1600-0501.2003.140111.x
  12. Moses O, Pitaru S, Artzi Z, Nemcovsky CE. Healing of dehiscence-type defects in implants placed together with different barrier membranes: a comparative clinical study. Clin Oral Implants Res 2005;16:210-9. https://doi.org/10.1111/j.1600-0501.2004.01100.x
  13. Caffesse RG, Nasjleti CE, Morrison EC, Sanchez R. Guided tissue regeneration: comparison of bioabsorbable and non-bioabsorbable membranes. Histologic and histometricstudy in dogs. J Periodontol 1994;65:583-91. https://doi.org/10.1902/jop.1994.65.6.583
  14. Barber HD, Lignelli J, Smith BM, Bartee BK. Using a dense PTFE membrane without primary closure to achieve bone and tissue regeneration. J Oral MaxillofacSurg 2007;65:748-52. https://doi.org/10.1016/j.joms.2006.10.042
  15. Bragger U, Hämmerle CH, Lang NP. Immediate transmucosal implants using the principle of guided tissue regeneration (II). A cross-sectional study comparing the clinical outcome 1 year after immediate to standard implant placement. Clin Oral Implants Res 1996;7:268-76. https://doi.org/10.1034/j.1600-0501.1996.070309.x
  16. Lang NP, Brägger U, Hämmerle CH, Sutter F. Immediate transmucosal implants using the principle of guided tissue regeneration. I. Rationale, clinical procedures and 30-month results. Clin Oral Implants Res 1994;5:154-63. https://doi.org/10.1034/j.1600-0501.1994.050306.x
  17. Lekovic V, Camargo PM, Klokkevold PR, Weinlaender M, Kenney EB, Dimitrijevic B, et al. Preservation of alveolar bone in extraction sockets using bioabsorbable membranes. J Periodontol 1998;69:1044-9. https://doi.org/10.1902/jop.1998.69.9.1044
  18. Lekovic V, Kenney EB, Weinlaender M, Han T, Klokkevold P, Nedic M, et al. A bone regenerative approach to alveolar ridge maintenance following tooth extraction. Report of 10 cases. J Periodontol 1997;68:563-70. https://doi.org/10.1902/jop.1997.68.6.563
  19. Iasella JM, Greenwell H, Miller RL, Hill M, Drisko C, Bohra AA, et al. Ridge preservation with freeze-dried bone allograft and a collagen membrane compared to extraction alone for implant site development: a clinical and histologic study in humans. J Periodontol 2003;74:990-9. https://doi.org/10.1902/jop.2003.74.7.990
  20. Wang HL, Boyapati L. "PASS" principles for predictable bone regeneration. Implant Dent 2006;15:8-17. https://doi.org/10.1097/01.id.0000204762.39826.0f
  21. Trombelli L, Farina R, Marzola A, Bozzi L, Liljenberg B, Lindhe J. Modeling and remodeling of human extraction sockets. J ClinPeriodontol 2008;35:630-9.

Cited by

  1. Efficacy of using a dual layer of membrane (dPTFE placed over collagen) for ridge preservation in fresh extraction sites: a micro‐computed tomographic study in dogs vol.24, pp.10, 2011, https://doi.org/10.1111/j.1600-0501.2012.02526.x
  2. Microcomputed Tomographic Analysis of the Alveolar Ridge Alteration around Extraction Sites with and without Immediate Implants Placement: In Vivo Study vol.16, pp.2, 2011, https://doi.org/10.1111/j.1708-8208.2012.00471.x
  3. Histomorphometric Analysis of Bone Regeneration Using a Dual Layer of Membranes (dPTFE Placed Over Collagen) in Fresh Extraction Sites: A Canine Model vol.41, pp.2, 2011, https://doi.org/10.1563/aaid-joi-d-13-00027
  4. An update on the utilization of high-density polytetrafluoroethylene (d-PTFE) membranes for guided bone regeneration vol.8, pp.4, 2011, https://doi.org/10.4103/injo.injo_51_20