임플란트 주위 골외 결손부의 골유도재생술에서 3차원적으로 미리 제작된 티타늄 막의 효과에 대한 분석

Abstract

I. Introduction Many studies have shown predictable results for guided bone regeneration(GBR) in intrabony defects. However, the GBR performed on extrabony defects still lacks predictability. The use of three-dimensional, preformed titanium membranes(3D preformed Ti membrane, 3D-PFTM) can achieve GBR by ensuring graft stability and space maintenance so as to ensure optimal neovascularization. This study aimed to clinically and radiographically evaluate the results of GBR using 3D-PFTM on extrabony defects. Also, we tried to find out the effect of the absorbable collagen membrane used with 3D-PFTM.

II. Subjects and Methods This study was conducted on 100 patients (129 implants) with extrabony defects which existed around dental implants after implantation. 100 patients were divided into 3 groups; group using only 3D-PFTM (Group 1), group using additional cross-linked collagen membranes (Group 2), and group using additional non-cross-linked collagen membranes (Group 3). Patients were evaluated clinically and radiographically by using cone beam computed tomography(CBCT) at baseline, Implant 1st surgery, after 6 months each. At first, the exposure of 3D-PFTM isevaluated between first surgery and second surgery in each group. Secondly, Horizontal bone gain and bone formation rate were evaluated at implant’s platform level on 129 implants by the radiographic analysis.

III. Results Membrane exposure occurred in 7 (5.4%) of the total of 129 implants. The mean number and rate of membrane exposure were 2 (11.8%) in group 1, 3 (4.2%) in group 2, 2 (5.0%) in group 3. The mean horizontal bone gain in each group was 3.2 ± 1.7 mm(group 1), 3.1 ± 1.2 mm(group 2) and 3.0 ± 1.2 mm(group 3) at 6 months postoperatively. And the mean bone formation rate of each groups was 71.0 ± 23.0%(group 1), 84.2 ± 21.5%(group 2), 84.0 ± 22.9%(group 3). There is a statistically significant difference between Group 1 and Group 2, as are Groups 1 and 3 (P < 0.05). There was no statistically significant difference between groups 2 and 3 (P > 0.05).

IV. Conclusion 3D-PFTM should be considered as a valuable option for GBR on extrabony defects. And regardless of cross-linking, the use of an additional absorbable collagen membrane would provides additional advantages.