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ePaper created 2017-01-11, 10:22:38 | version 1.38.0
Journal of Oral Science & Rehabilitation Volume 2 | Issue 4/2016 23 O p e n h e a l i n g : A r e t r o s p e c t i v e a n a l y s i s brane degradation and a shortened barrier fun- ction.19 Various studies have shown controversial results regarding the effect of se- condary wound dehiscence occurring during healing. Moses et al. evaluated bone healing of buccalperiimplant bone dehiscence defectswith or without membrane exposure.21 Using NBCM, they found a mean defect reduction of 95% in the case of uneventful healing, while defect re- solution was significantly reduced to 53% when the membrane was exposed. In a dog study, a significant negative effect ofmembrane exposu- reondefectfillwasfoundtoo.22 Incontrast,other studies demonstrated only a slight, nonsignifi- cant reduction in defectfillifexposed membrane sites were compared to nonexposed ones.16, 19 In ridge preservation, positive results using the membrane in an open-healing approach have been described before. Filipek et al. compared open and closed healing in extraction sites in 40 patients.23 Whenanalyzingthedimensionsofthe alveolar ridge six months after tooth extraction, they did not find any significant difference be- tween open and closed healing. In anotherstudy, Cardaropoli et al. achieved good results using open healing with regard to ridge dimension.8 However,thecontroltreatmentwasspontaneous extraction socket healing and there was no con- trol treatment with closed healing. Owingtoitsretrospectivenatureandthelack of a control group, the current analysis does not allow drawing of clear conclusions on whether open healing may have a certain negative effect on the outcome of the regenerative procedure. The positive result regarding the low necessity of re-augmentation indicates that open healing may be a suitable clinical procedure. However, prospectivestudiesshouldcomparetheoutcome of open and closed healing under standardized clinical conditions. In this study, the second outcome parameter was the incidence of complications during heal- ing. Healingwas uneventful in 90.6% ofthe sur- gical areas. In 2.5% of the surgical areas, the complications were associated with the surgical intervention (hematoma and one broken bone plate). In 6.9% of the areas, the complications may have been related to the open-healing approach. These complications were premature resorption, membrane loosening by tongue, ex- posed titanium mesh and wound dehiscence. A certain rate of healing complications has been Table 5 Table 6 Defect morphology (number of bone walls present) No complication (%) Complication (%) Membrane type used per surgical area in which complication developed 1–4 1 (100.0) 0 (0.0) – 2 12 (85.7) 2 (14.3) NBCM (n = 2) 2–3 8 (80.0) 2 (20.0) NBCM (n = 2) 3 62 (92.5) 5 (7.5) JM (n = 2) NBCM (n = 3) 3–4 8 (88.9) 1 (11.0) NBCM (n = 1) 4 54 (91.5) 5 (8.5) DM (n = 1) NBCM (n = 4) Table 5 Number of complications per defect morphology and types of membranes used per surgical area with complications. Table 6 Number of secondary augmentations performed after healing. Secondary augmentations Number of surgical areas (%) Not necessary 139 (86.88) Planned 20 (12.50) Unplanned† 1 (0.63) † Re-augmentation. Volume 2 | Issue 4/201623 1–41 (100.0) 0 (0.0) – 212 (85.7) 2 (14.3) NBCM (n = 2) 2–38 (80.0) 2 (20.0) NBCM (n = 2) 362 (92.5) 5 (7.5) 3–48 (88.9) 1 (11.0) NBCM (n = 1) 454 (91.5) 5 (8.5)