Horizontal Ridge Augmentation Using Native Collagen Membrane vs Titanium Mesh in Atrophic Maxillary Ridges: Randomized Clinical Trial

Atef M, Tarek A, Shaheen M, Alarawi R M, Askar N. 2020. Clin Implant Dent Relat Res.;1–11.

Evaluation of the quantity and the quality of the new gained bone using collagen membrane (Jason® membrane) with 1:1 mixture of autogenous and anorganic bovine bone mineral (cerabone®) compared to titanium mesh (Ti-mesh) with the same mixture of bone for GBR of horizontally deficient maxillary ridges.
10 patients receiving GBR using Jason® membrane using 1:1 autogenous and cerabone® mixture, and 10 patients receiving GBR using Ti-mesh with same mixture of bone graft material. Immediate postoperative CBCT scans were ordered for all patients and at 6 months interval, to assess the amount of horizontal bone gain which is the primary outcome. Bone volume was measured for each specimen and the mean volume for native bone and newly formed bone was calculated for statistics. Quantitative histomorphometric analysis was also performed.
Statistical analysis showed a significant increase in alveolar bone width in both techniques with a mean bone gain of 4.0 mm for the Jason® membrane group and 3.7 mm for Ti-mesh group, respectively. Bone area percent was almost 28% for both groups. In four cases, mesh exposure was detectable. The first three patients showed the exposure three weeks postoperatively while the fourth patient showed exposure four months postoperatively. The mean graft resorption in the Jason® membrane group and Ti-mesh group 6 months postoperative was considered nonsignificant.
GBR with both collagen membrane and Ti-mesh using a 1:1 mixture of autogenous and cerabone® is a viable technique for horizontal augmentation of deficient maxillary alveolar ridges but Ti-mesh is more technique sensitive compared to collagen membrane. Soft tissue dehiscence and difficulty during second stage removal should limit its use in augmentation of horizontally deficient maxillary ridges.

Dr. Mohammed Atef

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