IADR Abstract Archives
Retrospective Analysis of Guided Bone Regeneration Failures
Objectives: Guided Bone Regeneration (GBR) is not as predictable when applied to large combination type defects. We previously completed a large retrospective study screening GBR procedures performed within single training center and reported that 13% of documented cases required additional grafting at implant placement. The purpose of this follow-up study was to determine possible common predisposing factors negatively affecting GBR outcomes by retrospectively examining procedural details of the failed cases at first GBR attempt.
Methods: Patients who received GBR prior to dental implant placement and any possible corrective procedure at the same anatomical area were screened by using the scheduling/billing software. Selective cases with a secondary corrective surgery at the same anatomical site were chosen. The charts of the subjects who had more than one GBR procedure documented at the same location were manually screened to determine complications.
Results: 15 of 143 cases (11%) had secondary corrective surgeries to create sufficient bone to place dental implants (mean age 48±4 yrs; 9 female) in 25 sites. Most sites with complication were localized in the maxillary anterior sextant (11 sites=44%). Major complications requiring secondary corrective surgery were lack of sufficient bone augmentation/graft integration from previous GBR (9 sites= 36%), occurrence of dehiscence (6 sites= 24%) at time of implant placement, and premature wound opening following initial GBR (7 cases=28%). At 5 sites (20%), implant placement was not accomplished despite the repeated procedure.
Conclusions: Within the limits of this study, it appears that the prevalence of GBR failure is low and it is mostly associated with insufficient ridge width and significant dehiscence development at time of implant placement.
Methods: Patients who received GBR prior to dental implant placement and any possible corrective procedure at the same anatomical area were screened by using the scheduling/billing software. Selective cases with a secondary corrective surgery at the same anatomical site were chosen. The charts of the subjects who had more than one GBR procedure documented at the same location were manually screened to determine complications.
Results: 15 of 143 cases (11%) had secondary corrective surgeries to create sufficient bone to place dental implants (mean age 48±4 yrs; 9 female) in 25 sites. Most sites with complication were localized in the maxillary anterior sextant (11 sites=44%). Major complications requiring secondary corrective surgery were lack of sufficient bone augmentation/graft integration from previous GBR (9 sites= 36%), occurrence of dehiscence (6 sites= 24%) at time of implant placement, and premature wound opening following initial GBR (7 cases=28%). At 5 sites (20%), implant placement was not accomplished despite the repeated procedure.
Conclusions: Within the limits of this study, it appears that the prevalence of GBR failure is low and it is mostly associated with insufficient ridge width and significant dehiscence development at time of implant placement.