Categories (Cases/Videos)
Implant Therapy
- Anterior/Esthetic (164/4)
- Implants (229/8)
- Full Arch & Dentures (19/0)
- Failures (34/0)
- CBCT & CAD/CAM (9/0)
Surgical (Regenerative)
Restorative
Comprehensive Dentistry
- Periodontics (52/0)
- Endodontics (29/5)
- Orthodontics (36/0)
- Practice Management (21/0)
- Other (24/2)
Other
non resorbable membrane exposure
Posted on 08.01.2012 08:36 AM
By Alireza Firouzeh
In Implants
Hi DR salama
This is a 30 years old male patient that I did horizontal bone augmentation with particulated autogenous bone and xenograft 50/50 utilizing screws 1.6mm as a tent and titanium reinforced membranes with tack fixation and simultaneously 2 open sinus grafting in both side.I closed the flap tension free with PTFE sutures but after 2 weeks an exposured area created in anterior area and I put my effort to close the wound 3 times.Unfortunately,I could not succeed in closing the flap and the flap began to open widely as it is illustrated so I decided to remove the membranes.My question is about what decision should I make to manage my graft material after removing the membranes???If the graft material was sufficient yet,should I place another membrane such as low resorbing collagen membrane which remain in the region for upcoming 6 months or not???
3 Comments
Maurice Salama says on 08.01.2012 02:10 PM
Let the flap close and heal completely. Re-evaluate via CBCT at 4-6 months. Then make decision about 2nd surgery to correct as needed. Do nothing now other than remove the membranes and monitor soft tissue healing.
Dr. Salama
ali momen says on 08.01.2012 03:27 PM
hi dr firoozeh.there is an classification for PTFE membrane exposure and treatment in dr forum book 2010( GBR complication chapter) that you can see it.in larger than 3 mm exposure if you dont have abcess formation And if passed minimum 3-4 weeks from surgery you must remove membrane but bone graft can be remain. for your better soft tissue healing, Ct graft can be useful,but your soft tissue recession is very big and CT graft should be use with caution.please put outcome photo.
thank you
Ali
Arash Aflatooni says on 08.13.2012 06:55 PM
Just out of curiosity, would a titanium mesh have worked better than the non-resorbable membrane? Additionally, I think continuous mattress sutures accross the incision lines may have been more prudent as the exposure was along that region. For now, all you can do is let healing complete and re-eval in 4-6 months.