Barrier Membrane and Bone Graft Treatments of Dehiscence-Type Defect at Existing Implant: A Case Report

Barrier Membrane and Bone Graft Treatments of Dehiscence-Type Defect at Existing Implant: A Case Report
June 2003
Dogan, Necdet DDS, PhD*; Murat Okcu, Kemal DDS, PhD*; Ortakoglu, Kerim DDS, PhD*; Dalkiz, Mehmet DDS, PhD**; Gunaydin, Yilmaz DDS, PhD***
Implant Dentistry: Volume 12(2) June 2003 pp 145-150
Lippincott Williams & Wilkins
*Assistant Professor, Department of Oral and Maxillofacial Surgery, Dental Sciences Center, G??lhane Military Medical Academy, Etlik, Ankara, Turkey.
**Associate Professor, Department of Prosthetic Dentistry, Dental Sciences Center, G??lhane Military Medical Academy, Ankara, Turkey.
***Professor and Chairman, Department of Oral and Maxillofacial Surgery, Dental Sciences Center, G??lhane Military Medical Academy, Ankara, Turkey.
Reprint requests and correspondence to:
Necdet Dogan
G??lhane Askeri Tip Akademisi
Dishekimligi Bilimleri Merkezi
Ag??z, Dis, Cene Hastaliklari ve Cerrahisi AD
06018 Etlik/Ankara/Turkey
Phone: (0312) 3046049
E-mail: mdalkiz@gata.edu.tr
Abstract
Dehiscence-type bony defects may occur after implant application because of microbial action as well as of biomechanical and occlusal overload. The aim of the treatment of a periimplant defect is to arrest the progression of the bone loss and to achieve a maintainable site for the implant. In these situations, barrier membranes and bone graft materials can be used to achieve complete bone healing around dental implants. Bone regeneration is possible in a periimplant bony defect of a functioning implant if the proper surgical technique is utilized and the etiologic cause is eradicated. This study presents the surgical coverage of a periimplant bony defect around an implant that was inserted 7 years ago. The surgical correction was made using a barrier membrane in conjunction with bone graft materials. A follow-up of 6 months seemed to reveal radiographic bone regeneration.
Successful dental implant rehabilitation depends not only on the long-term biologic integration of titanium fixtures to surrounding tissue, but also on the establishment of an ideal implant position within a proper inter- and intra-arch relationship. Thus, aesthetic goals and proper function can be achieved. 1-4 Sometimes complications can also occur. Pathological changes of the periimplant tissues can be placed in the general category of periimplant disease. Progressive periimplant bone loss in conjunction with a soft tissue inflammatory lesion can be defined as periimplantitis. 3,5,6
It has been reported that two major etiologic factors associated with resorption of crestal periimplant bone tissue are bacterial infection and biomechanical factors associated with an overloaded site. It is important to note that the cause of periimplant crestal bone loss can be multifactorial, and that bacterial infection and biomechanical factors can both be contributing factors. 2,3,5 There is also some experimental and clinical evidence to support the concept that excessive biomechanical forces may lead to high stress and microfractures in the coronal bone-to-implant contact. This can lead to the loss of osseointegration around the neck of the implant. Thus, a dehiscence-type defect or fenestration can occur around a dental implant following the insertion and use of a dental implant. 3,5,7 In these situations, barrier membranes and bone graft materials can be used to achieve complete bone healing around dental implants. 1,6-11
In this case, bone graft material and a barrier membrane were used to cover a dehiscence-type defect in vestibular alveolar bone. This was observed in a patient who had been functional with an implant for 7 years. The defect was subsequently covered with a bone graft material and barrier membrane.
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