Implant Tribune Middle East & Africa Edition No. 3, 2017

PUBLISHED IN DUBAI www.dental-tribune.me May-June 2017 | No. 3, Vol. 7 Guided Bone Regeneration using NeoGen Ti-Reinforced Membranes: Case Reports By Neoss Ltd, Cases by Dr. Norbert Hassfurther, Germany Membranes are used in Guided Bone Regeneration (GBR) to aid in the re- generative healing of bone defects. The membrane is surgically placed under the oral mucosa. It stops the soft tissue from growing into the de- fect and creates space for complete fill of the defect with regenerated bone. In many cases where substantial bone regeneration is required, such as vertical bone augmentation, a titanium-reinforced non-resorbable membrane is required to achieve predictable results. NeoGen Ti-reinforced Membrane is a new generation of non-resorbable titanium-reinforced membrane combining the handling and tissue interactions of expanded PTFE with the enhanced barrier function of- fered by dense PTFE. The membrane has a three-layer design. The outer, soft tissue friendly, PTFE layer has a tight texture that is impermeable to bacteria; the middle layer is a strong and highly shapeable titanium mesh that retains its shape throughout the healing period; and the inner PTFE layer has an expanded texture that enables predictable hard tissue inte- gration. This combination results in a membrane that is easy to handle and protects the augmentation site in a predictable manner. This article describes three cases of GBR using a Ti-reinforced PTFE membrane and simultaneously placed dental implants without the use of bone substitutes. Case 1 Vertical ridge augmentation of severely resorbed mandible A 52 year old male was referred to the clinic with a severely resorbed ante- rior mandible due to a failed bone graft after removal of a large cyst (Figure 1). Pre-treatment radiograph- ic assessment (Figure 2) showed that the bone height was inadequate to properly house implants. It was decided to perform a vertical ridge augmentation using NeoGen™ Ti- Reinforced Membrane and simulta- neous placement of Neoss ProActive Straight Implants. A full thickness flap with releas- ing incisions was opened and four Neoss ProActive Straight implants were placed; two anterior and two posterior. The vertical defect be- tween the two anterior implants was 5-6 mm (Figure 3). Autogenous bone cylinders (3.4 x 4-5 mm) were harvested from the oblique line of the mandible in the molar region and placed between the two ante- rior implants to accelerate regen- eration and to act as space fillers. A NeoGen™ Ti-Reinforced Membrane Large was trimmed, shaped, and fit- ted at the surgical site and secured buccally with two tacks (Figure 4). A stable membrane configuration was achieved using the implants as tent posts (Figure 5). Stress free flap clo- sure was achieved by releasing the periosteum on the buccal side. The soft tissue healing was uneventful (Figure 6). After 4-5 months, second stage sur- gery was performed. A mid-crestal incision was used to lift a flap and ex- ÿPage D2 Fig 1 Fig 2 Fig 3 Fig 4 Fig 5 Fig 6 Fig 7 Fig 8 Fig 9 Fig 10 Fig 11 Fig 12 Fig 13 Fig 14 Fig 15 Fig 16

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