Evaluation of efficacy of non-resorbable membranes compared to resorbable membranes in patients undergoing guided bone regeneration

Shankargouda Patil; Shilpa Bhandi; Mohammed Mousa H Bakri; Dhalia H Albar; Khalid J Alzahrani; Mohammad S Al-Ghamdi; Mrim M Alnfiai; Marcos Roberto Tovani-Palone

doi:10.1016/j.heliyon.2023.e13488

Evaluation of efficacy of non-resorbable membranes compared to resorbable membranes in patients undergoing guided bone regeneration

Heliyon. 2023 Feb 4;9(3):e13488. doi: 10.1016/j.heliyon.2023.e13488. eCollection 2023 Mar.

Authors

Shankargouda Patil¹, Shilpa Bhandi¹, Mohammed Mousa H Bakri², Dhalia H Albar³, Khalid J Alzahrani⁴, Mohammad S Al-Ghamdi⁴, Mrim M Alnfiai⁴, Marcos Roberto Tovani-Palone⁵

Affiliations

¹ College of Dental Medicine, Roseman University of Health Sciences, South Jordan, Utah 84095, USA.
² Department of Oral and Maxillofacial Surgery and Diagnostic Sciences, College of Dentistry, Jazan University, Jazan 45142, Saudi Arabia.
³ Department of Preventive Dental Sciences, College of Dentistry, Jazan University, Jazan 45142, Saudi Arabia.
⁴ Department of Clinical Laboratories Sciences, College of Applied Medical Sciences, Taif University, Taif 21944, Saudi Arabia.
⁵ Department of Research Analytics, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences (SIMATS), Chennai 600077, India.

Abstract

Background: Replacement of missing teeth in patients with prolonged edentulism poses a challenge for clinicians. An extended period of edentulism results in severe atrophy of alveolar ridges rendering them unsatisfactory for rehabilitation using an implant-supported prosthesis. To overcome this difficulty, Guided Bone Regeneration (GBR) was introduced and constructed upon the principles of Guided Tissue Regeneration (GTR) procedures. Evidence suggests that GBR has proven to be a predictable treatment modality for treating vertical and horizontal ridge deficiencies.

Objective: The present systematic review aimed to evaluate the efficacy of non-resorbable (N-RES) membranes compared to resorbable (RES) membranes in patients undergoing GBR.

Methods: An electronic search of three databases, including PubMed, Web of Science, and Scopus, was conducted for articles published until March 2022. A supplementary manual search of references from these articles was performed to include any articles that may have been overlooked in the electronic search. Articles that evaluated the efficacy of RES membranes and N-RES membranes in GBR were included. Case reports, case series, commentaries, letters to the editor, narrative or systematic reviews were excluded. Articles in languages other than English were also excluded. The articles were assessed against risk of bias 2 tool for Randomized Control Trials (RCTs) and ROBINS-I tool for Non-Randomized Clinical Trials (N-RCTs). The Grading of Recommendations Assessment, Development and Evaluation (GRADE) assessment was followed based on the Cochrane Handbook for quality assessment. A summary of findings table was used to present the results.

Results: One hundred and fifty one articles were identified in an electronic search. Eight articles met the inclusion criteria and were included in the present systematic review. The studies were conducted on partially or completely edentulous patients with alveolar ridge deficiencies undergoing vertical or horizontal bone for subsequent implant placement. The majority of the studies reported similar results for bone gain in both RES and N-RES membrane groups.

Conclusion: The available evidence suggests that RES and N-RES membranes are equally effective in GBR. However, the evidence must be interpreted with caution due to its 'low quality' GRADE assessment.

Clinical implications: Further research focusing on human clinical trials with well-matched subjects with homogeneity in the type and method of GBR and method of assessment of new bone formation will derive conclusive results on the efficacy of RES and N-RES membranes in achieving new bone formation.

Keywords: Alveolar bone atrophy; Alveolar bone loss; Bone regeneration; Bone resorption; Dental implants; Mouth rehabilitation; Oral health; Systematic review as topic.

Publication types

Review