Case Study On The Use Of Bio-gide Combined With Titanium Mesh For Alveolar Ridge Reconstruction

PURPOSE: Research on ossification stability and titanium mesh explosion condition of using bio-gide combined with titanium mesh for guided bone regeneration and alveolar ridge reconstruction.METHODS:Thirteen patients were extracted who seriously suffered bone defects in maxillaryanterior and were used guided bone regeneration for alveolar ridge reconstruction inplanting divisionin the School and Hospital of Stomatology,Fujian Medical University Fujian Stomatological Hospitalfrom May.2015 to Apr.2017,including male 4 and female 9.Age ranged from 20 to 69,average 43.84.There were 25 implants in total.According to patients’ preoperative CBCT report,oral and economical condition and after communication with patients,surgical contraindications were excluded and implanting procedure,implanting points and numbers were determined.All 13 patients could not be generally implanted because of bone insufficiency in maxillary anterior and needed twice implantations.In primary operation,bio-gide combined with titanium mesh were used to guide bone regeneration for alveolar ridge reconstruction and bone mass improvements in implanting zone.Implanting was conducted six months after alveolar ridge reconstruction.After guided bone regeneration,patients’ postoperative clinic condition(titanium mesh explosion)were observed.For titanium mesh explosion patient,hydrogen peroxide and saline would be used to irrigate alternately.Minocycline hydrochloride was locally used for treatment for two weeks.Healing condition of soft tissue was observed and CBCT DICOM data of pre-GBR,immediate post-GBR,six-month after operation and immediate post-implantation were imported to Mimics 19.0 software.Based on CBCT image of immediate post-implantation,implanting points were determined and reference points were confirmed.According to matching results of reference points,lip side bone tissue and bone replacement materials of implanting points pre-GBR,immediate post-GBR,six-month after operation were reconstructed and bone meal absorption and absorption rate six months after GBR operation was calculated.RESULTS: In 25 implanting points,6 points were discovered with titanium mesh explosion,explosion rate was 24%.After local anti-inflection treatment on six explosion points,two soft tissue splits of them were widened continuously.Titanium mesh were taken out and bone meal were found powder-like and failed to ossify.Expert for two failed points,other23 points’ average bone meal absorption was(54.81±24.30)mm3,average absorption rate was(29.59±12.42)%.Among 23 points,4 of them were classified as explosion group,other 19 were classified into no-explosion group based on good tissue healing and no titanium mesh explosion.Average bone meal absorption of explosion group was(92.82±7.57)mm3,and no-explosion group was(46.80±17.99)mm3.Difference of these two was statistical significant(P<0.05).Average bone meal absorption rate of explosion group was(45.98±13.70)%,and no-explosion group was(26.14±9.21)%.Difference of these two was statistical significant(p<0.05).Conclusion: The use of bio-gide combined with titanium mesh for guided bone regeneration are effective on maxillary anterior teeth defects with alveolar bone insufficiency.It extends implanting indications and deserves promotion.