Original title: Application of Biodegradable Magnesium Membrane Shield Technique for Immediate Dentoalveolar Bone Regeneration

Elad A, Rider P, Rogge S, Witte F, Tadić D, Kačarević ZP and Steigmann L. Biomedicines 2023, Mar; 11(3): 744

https://doi.org/10.3390/biomedicines11030744

The Magnesium Membrane Shield Technique uses the NOVAMag® membrane as a buccal or palatal/ lingual wall and demonstrates for the first time the simple and successful use of the new material.
The purpose of the investigation was to introduce an alternative method to treat compromised walls in extraction sockets instead of Immediate Dentoalveolar Restoration (IDR) or the Socket Shield Technique (SST) that use either autologous bone or partial root retention to rebuild the socket walls. The advantage of this technique is that due to its technical simplicity, it can be performed by anyone who performs socket extractions.

For the first time, the clinical application of the first CE registered magnesium membrane is reported. Due to the material characteristics of magnesium metal, new treatment methodologies become possible. This has led to the development of a new technique: the magnesium membrane shield technique, used to rebuild the buccal or palatal walls of compromised extraction sockets.

Four clinical cases are reported, demonstrating the handling options of this new technique for providing a successful regenerative outcome. Using the technique, immediate implant placement is possible with a provisional implant in the aesthetic zone. It can also be used for rebuilding both the buccal and palatal walls simultaneously. For instances where additional mechanical support is required, the membrane can be bent into a double layer, which additionally provides a rounder edge for interfacing with the soft tissue.

In all reported clinical cases, there was a good bone tissue regeneration and soft tissue healing after four months. In some instances, the new bone had formed a thick cortical bone visible in cone beam computed tomography (CBCT) radiographs of the regenerated sites, which is known to be remodeled in the post treatment period.

Overall, the magnesium membrane shield technique is presented as an alternative treatment option for compromised extraction sockets.

SURGICAL TECHNIQUE

For the magnesium shield technique, the magnesium membrane is first cut to shape using the NOVAMag® scissors (A).

The rim of the membrane is then flattened using the NOVAMag® sculptor (B) and bent into shape (C).

In a compromised extraction socket (D), the membrane is either place as a single layer or bent into a double layer, before being positioned to rebuild either the buccal or palatal wall.

The membrane is held in position by the periosteum and the defect space is filled with the graft material. A collagen membrane is placed on the top of the ridge (E).

Using the technique, it is also possible to immediately place implants with a provisional restoration (F).

Once implanted, the magnesium membrane will begin to degrade, transforming into magnesium salts that maintain the soft tissue barrier, and hydrogen gas will be released that provides a tenting of the soft tissue, which also extends the barrier effect, since cells cannot cross the gas cavity (G).

After the magnesium metal has transformed into magnesium salts, no more gas is released, and the soft tissue returns into position over the newly formed bone and magnesium salts (H).

After the critical healing period, the magnesium membrane is completely resorbed (I).

Beneficial properties of NOVAMag® membrane for the method:

Being mechanically strong but malleable, yet completely resorbable, the magnesium membrane was easily adapted to the contours of the defect during surgery and did not have to be removed in a second stage.

NOVAMag®, the world’s first product line of bioresorbable magnesium for oral regeneration, and how its unique mechanical and biological properties enable minimally invasive approaches for complex treatments. More information at https://botiss.com/product/novamag-membrane/