Ridge preservation after ridge expansion with simultaneous guided bone regeneration: a preclinical study

Abstract

Objective: To evaluate ridge preservation after ridge splitting with simultaneous implant placement and guided bone regeneration (GBR) in a miniature pig model.

Material and methods: In miniature pigs, the mandibular premolars and first molars were extracted together with removal of the interdental and buccal bone. Three months later, ridge splitting and expansion of the buccal plate were performed with simultaneous placement of two titanium implants per quadrant. On the test side, access by a mucoperiosteal flap followed by GBR with a biphasic calcium phosphate and a collagen membrane was performed. On the contralateral control side, a mucosal flap (MF), leaving the periosteum attached to the buccal bone, was elevated. After healing periods of 6 and 12 weeks, eight and four animals, respectively, were sacrificed for histological and histometric evaluation.

Results: In the MF group, all 16 implants were osseointegrated, while in the GBR group, one bone fracture occurred, and six of 16 implants were lost. After 6 weeks, significantly higher bone crest levels were found for the GBR group than for the MF group both buccally and lingually (P < 0.001), and buccal bone thickness was greater in the GBR group than in the MF group (P < 0.001 at the implant shoulder [IS]). After 12 weeks, bone was significantly higher in the GBR group compared to the MF group. Furthermore, buccal bone thickness in the GBR group was 0.93, 4.5, and 5.94 mm at, and 2 and 4 mm apical to the IS, respectively. The corresponding values in the MF group were greatly reduced (0, 0.21, and 2.56 mm). Bone loss on the buccal side compared to the lingual side was significantly greater only in the MF group.

Conclusions: In this ridge expansion model in miniature pigs, the buccal bone volume was significantly better preserved with GBR when compared to a mucosal access flap, provided that soft tissue healing occurred complication free.

Keywords: bone splitting/ridge expansion; guided bone regeneration; miniature pig; osseointegration; ridge preservation.