引导骨再生术(GBR)相关膜暴露的风险防控策略
The Prevention and Treatment Strategies of Membrane Exposure in Guided Bone Regeneration (GBR)
DOI: 10.12677/ACM.2021.114268, PDF,   
作者: 徐建刚, 谢怡文, 何福明*：浙江大学医学院附属口腔医院，浙江 杭州；浙江省口腔生物医学研究重点实验室，浙江 杭州
关键词: 引导骨再生；并发症；膜暴露；Guided Bone Regeneration； Complications； Membrane Exposure
摘要: 膜暴露是引导骨再生(Guided Bone Regeneration, GBR)术后最常见的并发症，若不及时处理，会影响骨再生过程甚至导致手术失败。因此，本文就口腔种植手术中GBR相关膜暴露进行分级和分类，探究不同屏障膜暴露的发生率及其对种植成功率和骨再生的影响，并提出适当的预防和处理方法，旨在为临床医生提供诊疗思路和防控策略。
Abstract: Membrane exposure is the most common complication after Guided Bone Regeneration (GBR). If not treated in time, it will affect the process of bone regeneration and even lead to failure. This review grades and classifies GBR-related membrane exposure in oral implant surgery, explores the incidence of membrane exposure of different types and their impacts on implant success rate and bone regeneration, and proposes appropriate prevention and treatment measures, aiming to provide clinicians with diagnosis and treatment ideas as well as prevention and control strategies.
文章引用：徐建刚, 谢怡文, 何福明. 引导骨再生术(GBR)相关膜暴露的风险防控策略[J]. 临床医学进展, 2021, 11(4): 1864-1869. https://doi.org/10.12677/ACM.2021.114268

参考文献

[1] Dahlin, C., Linde, A., Gottlow, J. and Nyman, S. (1988) Healing of Bone Defects by Guided Tissue Regeneration. Plastic and Reconstructive Surgery, 81, 672-676. [Google Scholar] [CrossRef] [PubMed]
[2] Wang, H.L. and Boyapati, L. (2006) “PASS” Principles for Predictable Bone Regeneration. Implant Dentistry, 15, 8-17. [Google Scholar] [CrossRef] [PubMed]
[3] Rakhmatia, Y.D., Ayukawa, Y., Furuhashi, A. and Koyano, K. (2013) Current Barrier Membranes: Titanium Mesh and Other Membranes for Guided Bone Regeneration in Dental Applications. Journal of Prosthodontic Research, 57, 3-14. [Google Scholar] [CrossRef] [PubMed]
[4] Calciolari, E., Ravanetti, F., Strange, A., Mardas, N., Bozec, L., Cacchioli, A., et al. (2018) Degradation Pattern of a Porcine Collagen Membrane in an in Vivo Model of Guided Bone Regeneration. Journal of Periodontal Research, 53, 430-439. [Google Scholar] [CrossRef] [PubMed]
[5] Sbricoli, L., Guazzo, R., Annunziata, M., Gobbato, L., Bressan, E. and Nastri, L. (2020) Selection of Collagen Membranes for Bone Regeneration: A Literature Review. Materials, 13, Article No. 786. [Google Scholar] [CrossRef] [PubMed]
[6] Benic, G.I. and Hammerle, C.H. (2014) Horizontal Bone Augmentation by Means of Guided Bone Regeneration. Periodontology 2000, 66, 13-40. [Google Scholar] [CrossRef] [PubMed]
[7] Jung, R.E., Fenner, N., Hammerle, C.H. and Zitzmann, N.U. (2013) Long-Term Outcome of Implants Placed with Guided Bone Regeneration (GBR) Using Resorbable and Non-Resorbable Membranes after 12-14 Years. Clinical Oral Implants Research, 24, 1065-1073. [Google Scholar] [CrossRef] [PubMed]
[8] Hammerle, C.H. and Jung, R.E. (2003) Bone Augmentation by Means of Barrier Membranes. Periodontology 2000, 33, 36-53. [Google Scholar] [CrossRef] [PubMed]
[9] de Azambuja Carvalho, P.H., Dos Santos Trento, G., Moura, L.B., Cunha, G., Aparecida Cabrini Gabrielli, M. and Pereira-Filho, V.A. (2019) Horizontal Ridge Augmentation Using Xenogenous Bone Graft-Systematic Review. Oral and Maxillofacial Surgery, 23, 271-279. [Google Scholar] [CrossRef] [PubMed]
[10] Merli, M., Migani, M. and Esposito, M. (2007) Vertical Ridge Augmentation with Autogenous Bone Grafts: Resorbable Barriers Supported by Ostheosynthesis Plates versus Titanium-Reinforced Barriers. A Preliminary Report of a Blinded, Randomized Controlled Clinical Trial. International Journal of Oral & Maxillofacial Surgery, 22, 373-382.
[11] Tay, J.R.H., Lu, X.J., Lai, W.M.C. and Fu, J.-H. (2020) Clinical and Histological Sequelae of Surgical Complications in Horizontal Guided Bone Regeneration: A Systematic Review and Proposal for Management. International Journal of Implant Dentistry, 6, Article No. 76. [Google Scholar] [CrossRef] [PubMed]
[12] Fontana, F., Maschera, E., Rocchietta, I. and Simion, M. (2011) Clinical Classification of Complications in Guided Bone Regeneration Procedures by Means of a Nonresorbable Membrane. The International Journal of Periodontics & Restorative Dentistry, 31, 265-273.
[13] Sakkas, A., Schramm, A., Karsten, W., Gellrich, N.-C. and Wilde, F. (2016) A Clinical Study of the Outcomes and Complications Associated with Zygomatic Buttress Block Bone Graft for Limited Preimplant Augmentation Procedures. Journal of Cranio-Maxillofacial Surgery, 44, 249-256. [Google Scholar] [CrossRef] [PubMed]
[14] Cucchi, A., Vignudelli, E., Napolitano, A., Marchetti, C. and Corinaldesi, G. (2017) Evaluation of Complication Rates and Vertical Bone Gain after Guided Bone Regeneration with Non-Resorbable Membranes versus Titanium Meshes and Resorbable Membranes. A Randomized Clinical Trial. Clinical Implant Dentistry and Related Research, 19, 821-832. [Google Scholar] [CrossRef] [PubMed]
[15] Meloni, S.M., Jovanovic, S.A., Pisano, M., De Riu, G., Baldoni, E. and Tallarico, M. (2018) One-Stage Horizontal Guided Bone Regeneration with Autologous Bone, Anorganic Bovine Bone and Collagen Membranes: Follow-up of a Prospective Study 30 Months after Loading. European Journal of Oral Implantology, 11, 89-95.
[16] Meloni, S.M., Jovanovic, S.A., Urban, I., Canullo, L., Pisano, M. and Tallarico, M. (2017) Horizontal Ridge Augmentation Using GBR with a Native Collagen Membrane and 1:1 Ratio of Particulated Xenograft and Autologous Bone: A 1-Year Prospective Clinical Study. Clinical Implant Dentistry and Related Research, 19, 38-45. [Google Scholar] [CrossRef] [PubMed]
[17] Lim, G., Lin, G.H., Monje, A., Chan, H.-L. and Wang, H.-L. (2018) Wound Healing Complications Following Guided Bone Regeneration for Ridge Augmentation: A Systematic Review and Meta-Analysis. International Journal of Oral & Maxillofacial Implants, 33, 41-50. [Google Scholar] [CrossRef] [PubMed]
[18] Roca-Millan, E., Jane-Salas, E., Estrugo-Devesa, A. and López-López, J. (2020) Evaluation of Bone Gain and Complication Rates after Guided Bone Regeneration with Titanium Foils: A Systematic Review. Materials, 13, Article No. 5346. [Google Scholar] [CrossRef] [PubMed]
[19] Wessing, B., Lettner, S. and Zechner, W. (2018) Guided Bone Regeneration with Collagen Membranes and Particulate Graft Materials: A Systematic Review and Meta-Analysis. International Journal of Oral & Maxillofacial Implants, 33, 87-100. [Google Scholar] [CrossRef] [PubMed]
[20] Jung, R.E., Mihatovic, I., Cordaro L, Windisch, P., Friedmann, A., Carrion, J.B., et al. (2020) Comparison of a Polyethylene Glycol Membrane and a Collagen Membrane for the Treatment of Bone Dehiscence Defects at Bone Level Implants—A Prospective, Randomized, Controlled, Multicenter Clinical Trial. Clinical Oral Implants Research, 31, 1105-1115. [Google Scholar] [CrossRef] [PubMed]
[21] Levin, P.A. and Angert, E.R. (2015) Small but Mighty: Cell Size and Bacteria. Cold Spring Harbor Perspectives in Biology, 7, Article ID: a019216. [Google Scholar] [CrossRef] [PubMed]
[22] Bartee, B.K. and Carr, J.A. (1995) Evaluation of a High-Density Polytetrafluoroethylene (n-PTFE) Membrane as a Barrier Material to Facilitate Guided Bone Regeneration in the Rat Mandible. Journal of Oral Implantology, 21, 88-95.
[23] Simion, M., Trisi, P., Maglione, M. and Piattelli, A. (1994) A Preliminary Report on a Method for Studying the Permeability of Expanded Polytetrafluoroethylene Membrane to Bacteria in Vitro: A Scanning Electron Microscopic and Histological Study. Journal of Periodontology, 65, 755-761. [Google Scholar] [CrossRef] [PubMed]
[24] Tal, H., Kozlovsky, A., Artzi, Z., Nemcovsky, C.E. and Moses, O. (2008) Cross-Linked and Non-Cross-Linked Collagen Barrier Membranes Disintegrate Following Surgical Exposure to the Oral Environment: A Histological Study in the Cat. Clinical Oral Implants Research, 19, 760-766. [Google Scholar] [CrossRef] [PubMed]
[25] Tal, H., Kozlovsky, A., Artzi, Z., Nemcovsky, C.E. and Moses, O. (2008) Long-Term Bio-Degradation of Cross-Linked and Non-Cross-Linked Collagen Barriers in Human Guided Bone Regeneration. Clinical Oral Implants Research, 19, 295-302. [Google Scholar] [CrossRef] [PubMed]
[26] Zucchelli, G., Pollini, F., Clauser, C. and De Sanctis, M. (2000) The Effect of Chlorhexidine Mouthrinses on Early Bacterial Colonization of Guided Tissue Regeneration Membranes. An in Vivo Study. Journal of Periodontology, 71, 263-271. [Google Scholar] [CrossRef] [PubMed]
[27] Garcia, J., Dodge, A., Luepke, P., Wang, H.-L., Kapila, Y. and Lin, G.-H. (2018) Effect of Membrane Exposure on Guided Bone Regeneration: A Systematic Review and Meta-Analysis. Clinical Oral Implants Research, 29, 328-338. [Google Scholar] [CrossRef] [PubMed]
[28] Machtei, E.E. (2001) The Effect of Membrane Exposure on the Outcome of Regenerative Procedures in Humans: A Meta-Analysis. Journal of Periodontology, 72, 512-516. [Google Scholar] [CrossRef] [PubMed]
[29] Annibali, S., Bignozzi, I., Sammartino, G. and La Monaca, G. (2012) Horizontal and Vertical Ridge Augmentation in Localized Alveolar Deficient Sites: A Retrospective Case Series. Implant Dentistry, 21, 175-185. [Google Scholar] [CrossRef] 
[30] Moses, O., Pitaru, S., Artzi, Z. and Nemcovsky, C.E. (2005) Healing of Dehiscence-Type Defects in Implants Placed Together with Different Barrier Membranes: A Comparative Clinical Study. Clinical Oral Implants Research, 16, 210-219. [Google Scholar] [CrossRef] [PubMed]
[31] Eskan, M.A., Girouard, M.E., Morton, D. and Greenwell, H. (2017) The Effect of Membrane Exposure on Lateral Ridge Augmentation: A Case-Controlled Study. International Journal of Implant Dentistry, 3, Article No. 26. [Google Scholar] [CrossRef] [PubMed]
[32] Milinkovic, I. and Cordaro, L. (2014) Are There Specific Indications for the Different Alveolar Bone Augmentation Procedures for Implant Placement? A Systematic Review. International Journal of Oral & Maxillofacial Surgery, 43, 606-625. [Google Scholar] [CrossRef] [PubMed]
[33] Merli, M., Merli, I., Raffaelli, E., Umberto, P., Nastri, L. and Nieri, M. (2016) Bone Augmentation at Implant Dehiscences and Fenestrations. A Systematic Review of Randomised Controlled Trials. European Journal of Oral Implantology, 9, 11-32.
[34] Makowiecki, A., Hadzik, J., Blaszczyszyn, A., Gedrange, T. and Dominiak, M. (2019) An Evaluation of Superhydrophilic Surfaces of Dental Implants—A Systematic Review and Meta-Analysis. BMC Oral Health, 19, Article No. 79. [Google Scholar] [CrossRef] [PubMed]
[35] Ghensi, P., Stablum, W., Bettio, E., Soldini, M.C., Tripi, T.R. and Soldini, C. (2017) Management of the Exposure of a Dense PTFE (d-PTFE) Membrane in Guided Bone Regeneration (GBR): A Case Report. Journal of Oral Implantology, 10, 335-342.
[36] Jung, R.E., Halg, G.A., Thoma, D.S. and Hämmerle, C.H.F. (2009) A Randomized, Controlled Clinical Trial to Evaluate a New Membrane for Guided Bone Regeneration around Dental Implants. Clinical Oral Implants Research, 20, 162-168. [Google Scholar] [CrossRef] [PubMed]
[37] Ronda, M., Rebaudi, A., Torelli, L. and Stacchi, C. (2014) Expanded vs. Dense Polytetrafluoroethylene Membranes in Vertical Ridge Augmentation around Dental Implants: A Prospective Randomized Controlled Clinical Trial. Clinical Oral Implants Research, 25, 859-866. [Google Scholar] [CrossRef] [PubMed]
[38] Park, S.H. and Wang, H.L. (2007) Clinical Significance of Incision Location on Guided Bone Regeneration: Human Study. Journal of Periodontology, 78, 47-51. [Google Scholar] [CrossRef] [PubMed]
[39] Chao, Y.C., Chang, P.C., Fu, J.H., Wang, H.-L. and Chan, H.-L. (2015) Surgical Site Assessment for Soft Tissue Management in Ridge Augmentation Procedures. International Journal of Periodontics & Restorative Dentistry, 35, e75-e83. [Google Scholar] [CrossRef] [PubMed]
[40] Ronda, M. and Stacchi, C. (2011) Management of a Coronally Advanced Lingual Flap in Regenerative Osseous Surgery: A Case Series Introducing a Novel Technique. International Journal of Periodontics & Restorative Dentistry, 31, 505-513.

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