Minimal invasiveness in lateral bone augmentation with simultaneous implant placement: A systematic review

Abstract

AbstractThe presence of a peri‐implant bone dehiscence (BD) or fenestration (BF) is a common finding after implant placement in a crest with a reduced bucco‐lingual bone dimension. The presence of a residual BD is associated with a relevant incidence of peri‐implant biological complications over time. Guided bone regeneration (GBR), performed at implant placement, is the most validated treatment to correct a BD. In the present systematic review, the evidence evaluating factors which could reduce the invasiveness of a GBR procedure with respect to patient‐reported outcomes, intra‐ and post‐ surgical complications, was summarized. Factors included were: technical aspects, regenerative materials for GBR, and peri‐ and post‐operative pharmacological regimens. The available evidence seems to indicate that the use of membrane fixation and flap passivation by means of a double flap incision technique may reduce the incidence of post‐surgical complications. When feasible, the coronal advancement of the lingual flap is suggested. The use of a non‐cross linked resorbable membrane positively impacts on patient discomfort. The adjunctive use of autogenous bone to a xenograft seems not to improve BD correction, but could increase patient discomfort. Systemic antibiotic administration after a GBR procedure does not seem to be justified in systemically healthy patients.