Amnion-Chorion Membrane in Open-Wound Approach for Localized Horizontal Ridge Augmentation: A Case Series Report

Introduction to Amniotic Membranes in Maxillofacial Surgery-A Scoping Review

Background: Amniotic membrane (AM) holds significant promise in various medical fields due to its unique properties and minimal ethical concerns. This study aims to explore the diverse applications of the human amniotic membrane (HAM) in maxillofacial surgery. Methodology: A comprehensive search was conducted on databases, namely Google Scholar, PubMed, and Scopus, from January 1985 to March 2024. Articles in English, Polish, and Spanish were included, focusing on keywords related to amniotic membrane and oral surgery. Results: Various preservation methods for HAM were identified, namely fresh, decellularized, cryopreserved, lyophilized, and air-dried formats. Clinical studies demonstrated the efficacy of HAM in repairing oral mucosal defects, vestibuloplasty, oronasal fistula closure, cleft palate treatment, bone defect repair, and medication-related osteonecrosis of the jaw (MRONJ). Surgeon evaluations highlighted the ease of handling but noted challenges in suturing and stability during application. Conclusions: Amniotic membranes offer a versatile and effective option in maxillofacial surgery, promoting wound healing, reducing inflammation, and providing a scaffold for tissue regeneration. Further research, including randomized trials and comparative studies, is warranted to validate the efficacy and optimize the utilization of HAM in clinical practice.

Simultaneous or staged lateral ridge augmentation: A clinical guideline on the decision-making process

Lateral ridge augmentation is a standard surgical procedure that can be performed prior to (staged) or simultaneously with implant placement. The decision between a simultaneous or staged approach involves considering multiple variables. This paper proposed a decision-making process that serves as a guideline for choosing the best treatment choice based on the available evidence and the author's clinical experience.

Membrane barriers for guided bone regeneration: An overview of available biomaterials

Dental implants revolutionized the treatment options for restoring form, function, and esthetics when one or more teeth are missing. At sites of insufficient bone, guided bone regeneration (GBR) is performed either prior to or in conjunction with implant placement to achieve a three-dimensional prosthetic-driven implant position. To date, GBR is well documented, widely used, and constitutes a predictable and successful approach for lateral and vertical bone augmentation of atrophic ridges. Evidence suggests that the use of barrier membranes maintains the major biological principles of GBR. Since the material used to construct barrier membranes ultimately dictates its characteristics and its ability to maintain the biological principles of GBR, several materials have been used over time. This review, summarizes the evolution of barrier membranes, focusing on the characteristics, advantages, and disadvantages of available occlusive barrier membranes and presents results of updated meta-analyses focusing on the effects of these membranes on the overall outcome.

Operating microscope-assisted reconstructive strategy for peri-implantitis: A case series report

BACKGROUND

Treating peri-implantitis with reconstructive means has been largely unpredictable due to access limitations for surface decontamination, unfavorable bony topography, difficulty in achieving wound stability, and inferior soft tissue qualities. A microsurgical approach with the use of the operating microscope (OM) that provides adjustable higher magnification (∼5-30 times) and coaxial illumination, coupled with the use of microsurgical instruments, may overcome, or alleviate some of the abovementioned obstacles, resulting in more predictable outcomes.

METHODS

Three patients received reconstructive therapy for correcting peri-implant defects under OM in private practice settings. After precise incisions to preserve soft tissue volume, the flaps were dissected prudently from underlying granulomatous tissues, which were subsequently removed, followed by controlled flap releasing under ∼10-15x magnification. Surface decontamination was performed using a piezoelectric ultrasonic device, air polishing, and hand instruments at ∼30x magnification. The biomaterial selections were dehydrated human de-epithelialized amnion-chorion membrane with mineralized allograft particulates in two cases and xenografts in one case, based on the surgeons' preference. Wound closure followed the non-submerged approach.

RESULTS

These cases demonstrated uneventful soft tissue healing, favorable radiographic bone fill, and disease resolution with follow-ups ranging from 2 to 4 years.

CONCLUSIONS

Preliminary data suggest encouraging outcomes after the microsurgical approach following biological as well as biomechanical principles for peri-implant defect reconstruction.

Clinical protocol selection for alveolar ridge augmentation at sites exhibiting slight, moderate, and severe horizontal ridge deficiencies

FOCUSED CLINICAL QUESTION

What factors identify the optimal bone augmentation techniques for managing slight, moderate, and severe horizontal alveolar ridge deficiency (ARD) at dental implant sites?

SUMMARY

Horizontal ARD is a concern at a high proportion of sites receiving dental implants, and clinicians have developed a variety of surgical procedures to address such defects. In a particular case, selection of the optimal treatment may depend predominantly on defect severity, location (anterior versus posterior), and configuration (contained versus noncontained). This report provides a framework for selecting an augmentation method when presented with a slight, moderate, or severe horizontal ARD at a site requiring dental implant placement.

CONCLUSION

Multiple treatment options are available for planned implant sites exhibiting horizontal ARD; severe posterior and slight anterior defects intuitively call for different approaches. Although rigid guidelines for selecting the optimal augmentation method do not exist, some techniques are poorly suited for esthetically demanding sites. A framework considering defect severity, location, and configuration may help guide clinical decisions on this topic.