Turkiye Klinikleri Journal of Dental Sciences

.: ORIGINAL RESEARCH
Primary Closure Versus Open Membrane Technique in Augmentation of Extraction Sockets
Çekim Soketlerinin Ogmentasyonunda Primer Kapamaya Karşı Açık Membran Tekniği
Nur ALTIPARMAKa, Sıdıka Sinem AKDENİZa
aBaşkent University Faculty of Dentistry, Department of Oral and Maxillofacial Surgery, Ankara TURKEY
Turkiye Klinikleri J Dental Sci. 2020;26(2):247-54
doi: 10.5336/dentalsci.2019-71964
Article Language: EN
Full Text
ABSTRACT
 Objectives: Funakoshi is the first one who reported 'Open Barrier Membrane' technique by using non-expanded, highdensity polytetrafluoroethylene(d-PTFE) membrane in 2005. d-PTFE membranes are impenetrable for bacteria invasion because of its surface characteristics and surgeon can leave the d-PTFE membrane intentionally exposed. The objective of this study was to investigate the clinical results of 'Open Barrier Membrane' technique in Guided Bone Regeneration (GBR) of the extraction sockets by using xenogenic bone graft and d-PTFE membranes. In this clinical study, open barrier membrane technique was compared to GBR technique. The comparison was made between the cases where the primary coverage of extraction site was obtained and the cases who completed the 6-month recovery period without exposure in terms of total bone gain. Material and Methods: Fifteen patients who were reported to have exposure in incision line during 6-month recovery period were included in open membrane group as study group (Group A). Fifteen patients who completed the 6-month recovery period without exposure were analyzed in primary coverage group as control group (Group B). The main groups were also divided into subgroups as horizontal and vertical augmentation. The amount of total bone gain was statistically compared between the groups based on the cone beam computerized tomography measurements. Results: Vertical and horizontal bone gain amounts (the main outcome variable) were statistically compared between Group A and B. There was no statistically significant difference between these groups in terms of bone gain (p=0.237 for comparison of vertical augmentation; p=0.482 for comparison of horizontal augmentation). Conclusion: Open barrier membrane technique can be considered as an alternative minimal invasive technique for both horizontal and vertical alveolar augmentation procedures.

Keywords: Bone transplantation, dental implantation
ÖZET
 Amaç: Funakoshi ilk kez 2005 yılında d-PTFE membran kullanarak 'Açık Bariyer Membran' tekniğini tanıtmıştır. d-PTFE membranları, yüzey karakteristiğinden dolayı bakteri tutulumu için olanaksızdır ve cerrah bu membranı primer kapama sağlamaksızın ağız boşluğuna açık bırakabilir. Bu çalışmanın amacı çekim soketlerinin ksenojenik kemik grefti ve d-PTFE membran kullanılarak gerçekleştirilen yönlendirilmiş kemik rejenerasyonu prosedürlerinin klinik sonuçlarının araştırılmasıdır. Bu çalışmada d-PTFE membranın üzerinin açıldığı vakalar (açık membran tekniği) ile 6 aylık süreç boyunca hiçbir açıklık gerçekleşmeyen vakalar arasında, kemik kazanımı bakımından karşılaştırma yapılmıştır. Gereç ve Yöntemler: İnsizyon hattında açıklık meydana gelen 15 hasta çalışma grubu olarak açık membran grubuna dahil edilmiştir (A Grubu) ve 6 aylık iyileşme sürecini hiç açıklık meydana gelmeden tamamlayan 15 hasta kontrol grubu olarak primer kapama grubunda analiz edilmiştir (B Grubu). Ana gruplar ayrıca horizontal ve vertikal ogmentasyonlar olarak alt gruplara ayrılmıştır. Toplam kemik kazancı miktarı gruplar arasında, konik ışınlı bilgisayarlı tomografi üzerinde yapılan ölçümler üzerinden istatistiksel olarak karşılaştırılmıştır. Bulgular: Yeni kemik kazanım oranı göz önünde bulundurulduğunda açık bariyer membran tekniği ve primer kapamanın sağlandığı konvasiyonel yönlendirilmiş kemik rejenerasyonu prosedürü arasında klinik olarak anlamlı bir farklılık görülmemiştir (p=0,234 vertikal ogmentasyon karşılaştırılması; p=0,481 horizontal ogmentasyon karşılaştırılması). Sonuç: Açık bariyer membran tekniği horizontal ve vertikal alveoler ogmentasyon prosedürleri için alternatif bir minimal invaziv teknik olarak düşünülebilir.

Anahtar Kelimeler: Kemik transplantasyonu, diş implantasyonu
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