Abstract:
Introduction. Guided bone regeneration (GBR) is a surgical method that allows the formation of new bone in areas of
atrophy of the maxillary bone. The integration of the graft or the augmented bone under the mucosal flap and the primary
healing of the soft tissues are essential conditions for preventing the exposure of the regeneration site and infectious complications
that inevitably lead to the failure of the GBR procedure.
Materials and methods. This study presents the results of a cohort study that includes 70 patients who underwent
GBR. The research involved techniques for forming muco-periosteal flaps: the Modified Periosteal Releasing Incision
(MPRI) according to the principle of the double flap technique (DF) and the coronal advanced lingual flap (CALF).
The study group included patients who underwent GBR using perforated titanium membrane, while the second group
underwent GBR using bioresorbable poly-4 hydroxybutyrate (P4HB) synthetic mesh. The patients were evaluated
periodically to monitor postoperative progress, the cases of dehiscence of the area related to augmentation site were
recorded, measured and classified according to Fontana. Statistical results were generated and processed by the R
Studio program.
Results. In the study groups, a total of 8 cases of gingival dehiscence were registered, 4 cases in each group. In two cases,
partial removal of the titanium membrane was performed by milling it, and the remaining 6 cases of dehiscence were
remedied with rinses with oral antiseptic solution and scheduled visits for local care until the appearance of granulation
tissue and epithelization.
Conclusions. Protective membrane, flap formation, thread tension and suture relaxation all play crucial roles in guided
bone augmentation without dehiscence. In our study, the small number of dehiscence cases recorded as complications did
not provide significant statistical results, namely due to the technique of performing the flap according to contemporary
methods, a fact also described by the specialized literature.
