One-stage horizontal guided bone regeneration with autologous bone, anorganic bovine bone and collagen membranes: Follow-up of a prospective study 30 months after loading

Purpose: To present the medium-term results of one-stage guided bone regeneration (GBR) using autologous bone and anorganic bovine bone, placed in layers, in association with resorbable collagen membranes, for the reconstruction of horizontal bony defects.Materials and methods: This study was designed as an uncontrolled prospective study. Partially edentulous patients, having less than 6.0 mm and more than 4.0 mm of residual horizontal bone width were selected and consecutively treated with simultaneously implant installation and bone regeneration by using 2.0 mm of autologous bone and 2.0 mm of anorganic bovine bone that was placed in layers and then covered with a resorbable collagen membrane. Outcome measures were: implant and prosthesis failures, any complications, peri-implant marginal bone level changes, probing pocket depth (PPD) and bleeding on probing (BOP).Results: In total, 45 consecutive patients (20 male, 25 female) with a mean age of 52.1 years each received at least one GBR procedure, with contemporary placement of 63 implants. At the 3-year follow-up examination, no patient had dropped out and no deviation from the original protocol had occurred. No implant or prosthesis failed. In six patients (13.3%) the collagen membrane was slightly exposed 1 to 2 weeks after bone reconstruction. Four of these patients were moderate smokers. Post-hoc analysis using Fisher's exact test found significant association (P = 0.0139) between a smoking habit and early membrane exposure. Mean marginal bone loss experienced between initial loading and 30 months afterwards was 0.60 +/- 0.20 mm (95% CI 0.54 - 0.66). The mean BOP values measured at the definitive restoration delivery were 1.23 +/- 0.93, while 2 years later they were 1.17 +/- 0.78. The difference was not statistically significant (-0.06 +/- 0.76; P = 0.569). The mean PPD values measured at the definitive restoration delivery were 2.62 +/- 0.59 mm, while 2 years later they were 2.60 +/- 0.54 mm. The difference was not statistically significant (-0.03 +/- 0.62; P = 0.765).Conclusions: Within the limitations of the present study, the use of a 2.0 mm layer of particulated autologous bone on the implant threads, and a 2.0 mm layer of anorganic bovine to cover the resorbed ridge, in combination with the resorbable collagen membrane, seems to be a viable treatment option for the reconstruction of horizontal bony defects.