الفهرس 
Review of Literature
Surgical ProcedureOnly 14 pages are availabe for public view
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Abstract
Reconstruction of alveolar bone defect can be achieved by many regenerative surgical procedures, including ridge splitting, onlay grafting, interpositional inlay grafting, distraction osteogenesis, and guided bone regeneration (GBR). In restoring horizontal bone deficiency, GBR was successfully developed. However, there is still a debate about the optimal barrier for GBR.
The aim of the present study was evaluation of dimensional changes following horizontal alveolar ridge augmentation in the esthetic zone using pericardial membrane versus titanium mesh histologically, radiographically, and clinically.
This study included twenty patients suffering from maxillary partial edentulism with inadequate bone width to allow implant placement within an adequate bone volume that allows long term stability of the installed dental implant. Patients were each assigned to a number starting from (1) to (20) and were randomly and equally allocated to group I (PM) and group II (TM) following a simple randomization procedure.
A baseline CBCT was performed while the patient was wearing the vacuum stent to evaluate the dimension of defected site. A standardized sagittal cross-section view of the CBCT was detected by reference mark and radiopaque gutta-percha point. The labio-palatal dimension was measured on three levels: first on the crest, second at apical line and one midway between the crest and apical line. The mean of these measurements was calculated to represent the preoperative width for each case. Then, the same measurements were repeated at 4-months postoperatively.
Bone block was harvested from donor site symphysis area for both groups using trephine bur, then an auto max trephine bur was used to harvest autogenous cancellous particulate bone from the same site of the harvested block. The harvested cancellous particulate autogenous bone graft was mixed with an equal volume of particulate anorganic bovine bone matrix (ABBM) to create a 1:1 composite graft. The augmentation technique was the same in both groups, except the membrane material. Bone block was fixed using titanium screw. In 1st group, bovine pericardium membrane (BP) was placed to cover the graft. while in 2nd group fixation of ti-mesh membrane over the graft material, periosteal releasing incision was performed to achieve tension-free closure.
Augmented area for both groups was assessed clinically by measuring the amount of horizontal bone gain. Trephine bur with an inner diameter of 1.7 mm was used initially to obtain a core biopsy of the harvested bone for histological analysis then a suitable implant was placed in right position.
Regarding histomorphometric analysis, in (PM) group, no difference was seen when compared to (TM) group. The (PM) group had lower area fraction of newly formed bone (AF) mean value than that of (TM) group, yet the difference was not significant. The (PM) group had a higher osteocyte count mean value than that of (TM) group, again the difference was not significant.
Radiographically there was statistically significant difference in LP dimension between base line and after 4 months in both groups. On the other hand, there was no statistically significant difference in mean LP dimension and LP dimensional change between both groups at baseline and after 4 months.
Clinically, there was statistically significant difference in LP dimension between base line and after 4 months in both groups. On the other hand, there was no statistically significant difference in mean LP dimension and LP dimensional change between both groups at baseline and after 4 months.