Dental News - Open-healing approach to avoid flap mobilization and subsequent morbidity

Dr. Georg Taffet

Tue. 10. January 2017

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This retrospective analysis evaluated the outcome of bone regeneration using membranes in an open-healing approach.

Materials and methods
In 119 patients with 160 surgical areas, ridge preservation or bone augmentation was performed. Bone defects were filed and covered with a membrane that was left exposed during healing. Outcome parameters were the need to perform an unplanned augmentation and complication rates during wound healing.

Results
Bone augmentation was performed in 33.1%, ridge preservation in 41.9% and ridge preservation combined with bone augmentation in 13.1% of the surgical areas. In 78.8% of the surgical areas, a native bilayer collagen membrane was used. Healing was uneventful in 90.6% of the surgical areas. Complications occurred in 9.4% of the surgical areas and included premature membrane resorption, hematoma, membrane loosened by tongue, pain, wound dehiscence and fractured bone plate during augmentation surgery. One patient developed an abscess, one lost an implant. The graft was partially lost in 1.9% of the surgical areas.

Implants could be inserted as planned in a two-stage procedure in all but the one surgical area in which the abscess had occurred. In this area, an unplanned re-augmentation was required. In 86.9% of the surgical areas, no re-augmentation was necessary. Secondary augmentation was performed in 12.5% according to the treatment plan.

Conclusion
Using suitable membranes, open healing may allow uneventful wound healing and sufficient bone formation. This approach may help to avoid soft-tissue problems associated with extensive flap mobilization and tension.

Editorial note: The full article was published in the 4/2016 issue of the Journal of Oral Science and Rehabilitation. It can be access free of charge at www.dtscience.com.

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