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대한구강악안면임프란트학회지 2018 ; 22 (4) : p.54~66

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상악 전치부 3D-티타늄 차폐막과 혈소판농축섬유소를 적용한 골유도재생술의 임상적 평가, Clinical Evaluation of Guided Bone Regeneration Using 3D-titanium Membrane and Advanced Platelet-Rich Fibrin on the Maxillary Anterior Area

저자 이나연1†, 고미선1,2†, 정양훈1,2, 이정진4,5, 서재민4,5, 윤정호1,2,3*
논문 종류 증례보고 전문 보기 22-4_5.pdf 22-4_5.pdf
The aim of the current study was to evaluate the results of horizontal guided bone regeneration
(GBR) with xenograf t (deproteinized bovine bone mineral, DBBM), allograf t (irradiated
allogenic cancellous bone and marrow), titanium membrane, resorbable collagen membrane, and
advanced platelet-rich fibrin (A-PRF) in the anterior maxilla. The titanium membrane was used
in this study has a three-dimensional (3D) shape that can cover ridge defects. Case 1. A 32-yearold
female patient presented with discomfort due to mobility and pus discharge on tooth #11.
Three months af ter extracting tooth #11, diagnostic sof tware (R2 GATE diagnostic sof tware,
Megagen, Daegu, Korea) was used to establish the treatment plan for implant placement. At
the first stage of implant surgery, GBR for horizontal augmentation was performed with
DBBM (Bio-Oss®, Geistlich, Wolhusen, Switzerland), irradiated allogenic cancellous bone and
marrow (ICB cancellous®, Rocky Mountain Tissue Bank, Denver, USA), 3D-titanium membrane
(i-Gen®, Megagen, Daegu, Korea), resorbable collagen membrane (Collagen membrane®,
Genoss, Suwon, Korea), and A-PRF because there was approximately 4 mm labial dehiscence after implant placeme
nt. Five months after placing the implant, the second stage of implant surgery was performed,
and healing abutment was connected after removal of the 3D-titanium membrane. Five months after the second
stage of implant surgery was done, the final prosthesis was then delivered. Case 2. A 35-year-old female patient
presented with discomfort due to pain and mobility of implant #21. Removal of implant #21 fixture was planned
simultaneously with placement of the new implant fixture. At the first stage of implant surgery, GBR for horizontal
augmentation was performed with DBBM (Bio-Oss®), irradiated allogenic cancellous bone and marrow (ICB
cancellous®), 3D-titanium membrane (i-Gen®), resorbable collagen membrane (Ossix plus®, Datum, Telrad, Israel),
and A-PRF because there was approximately 7 mm labial dehiscence after implant placement. At the second stage
of implant surgery six months after implant placement, healing abutment was connected after removing the
3D-titanium membrane. Nine months after the second stage of implant surgery was done, the final prosthesis was
then delivered. In these two clinical cases, wound healing of the operation sites was uneventful. All implants were
clinically stable without inflammation or additional bone loss, and there was no discomfort to the patient. With
the non-resorbable titanium membrane, the ability of bone formation in the space was stably maintained in three
dimensions, and A-PRF might influence soft tissue healing. This limited study suggests that aesthetic results can be
achieved with GBR using 3D-titanium membrane and A-PRF in the anterior maxilla. However, long-term followup
evaluation should be performed.
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