Effect of membrane exposure on guided bone regeneration: A systematic review and meta‐analysis

Aims This review aimed at investigating the effect of membrane exposure on guided bone regeneration (GBR) outcomes at peri‐implant sites and edentulous ridges. Material and Methods Electronic and manual literature searches were conducted by two independent reviewers using four databases, including M...

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Published in:	Clinical oral implants research Vol. 29; no. 3; pp. 328 - 338
Main Authors:	Garcia, Jeffrey, Dodge, Austin, Luepke, Paul, Wang, Hom‐Lay, Kapila, Yvonne, Lin, Guo‐Hao
Format:	Journal Article
Language:	English
Published:	Denmark Wiley Subscription Services, Inc 01.03.2018
Subjects:	Alveolar Ridge Augmentation Augmentation Bone growth Bone Regeneration Bone Transplantation Clinical trials Confidence intervals Databases, Factual Dehiscence Dental Implantation, Endosseous evidence‐based dentistry Exposure Guided Tissue Regeneration, Periodontal - methods Humans Literature reviews Medical research Membranes, Artificial Meta-analysis Mouth, Edentulous Quantitative analysis Regeneration Regeneration (physiology) review surgical wound dehiscence Treatment Outcome Wound Healing meta-analysis bone regeneration surgical wound dehiscence alveolar ridge augmentation evidence-based dentistry review
ISSN:	0905-7161, 1600-0501, 1600-0501
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Abstract	Aims This review aimed at investigating the effect of membrane exposure on guided bone regeneration (GBR) outcomes at peri‐implant sites and edentulous ridges. Material and Methods Electronic and manual literature searches were conducted by two independent reviewers using four databases, including MEDLINE, EMBASE, Web of Science, and Cochrane Central Register of Controlled Trials, for articles up to February 2017. Articles were included if they were human clinical trials or case series reporting outcomes of GBR procedures with and without membrane exposure. A random‐effects meta‐analysis was conducted, and the weighted mean difference (WMD) between the two groups and 95% confidence interval (CI) were reported. Results Overall, eight articles were included in the quantitative analysis. The WMD of the horizontal bone gain at edentulous ridges was −76.24% (95% CI = −137.52% to −14.97%, p = .01) between sites with membrane exposure and without exposure. In addition, the WMD of the dehiscence reduction at peri‐implant sites was −27.27% (95% CI of −45.87% to −8.68%, p = .004). Both analyses showed significantly favorable outcomes at the sites without membrane exposure. Conclusion Based on the findings of this study, membrane exposure after GBR procedures has a significant detrimental influence on the outcome of bone augmentation. For the edentulous ridges, the sites without membrane exposure achieved 74% more horizontal bone gain than the sites with exposure. For peri‐implant dehiscence defects, the sites without membrane exposure had 27% more defect reduction than the sites with exposure.
AbstractList	Aims This review aimed at investigating the effect of membrane exposure on guided bone regeneration (GBR) outcomes at peri‐implant sites and edentulous ridges. Material and Methods Electronic and manual literature searches were conducted by two independent reviewers using four databases, including MEDLINE, EMBASE, Web of Science, and Cochrane Central Register of Controlled Trials, for articles up to February 2017. Articles were included if they were human clinical trials or case series reporting outcomes of GBR procedures with and without membrane exposure. A random‐effects meta‐analysis was conducted, and the weighted mean difference (WMD) between the two groups and 95% confidence interval (CI) were reported. Results Overall, eight articles were included in the quantitative analysis. The WMD of the horizontal bone gain at edentulous ridges was −76.24% (95% CI = −137.52% to −14.97%, p = .01) between sites with membrane exposure and without exposure. In addition, the WMD of the dehiscence reduction at peri‐implant sites was −27.27% (95% CI of −45.87% to −8.68%, p = .004). Both analyses showed significantly favorable outcomes at the sites without membrane exposure. Conclusion Based on the findings of this study, membrane exposure after GBR procedures has a significant detrimental influence on the outcome of bone augmentation. For the edentulous ridges, the sites without membrane exposure achieved 74% more horizontal bone gain than the sites with exposure. For peri‐implant dehiscence defects, the sites without membrane exposure had 27% more defect reduction than the sites with exposure. This review aimed at investigating the effect of membrane exposure on guided bone regeneration (GBR) outcomes at peri-implant sites and edentulous ridges.AIMSThis review aimed at investigating the effect of membrane exposure on guided bone regeneration (GBR) outcomes at peri-implant sites and edentulous ridges.Electronic and manual literature searches were conducted by two independent reviewers using four databases, including MEDLINE, EMBASE, Web of Science, and Cochrane Central Register of Controlled Trials, for articles up to February 2017. Articles were included if they were human clinical trials or case series reporting outcomes of GBR procedures with and without membrane exposure. A random-effects meta-analysis was conducted, and the weighted mean difference (WMD) between the two groups and 95% confidence interval (CI) were reported.MATERIAL AND METHODSElectronic and manual literature searches were conducted by two independent reviewers using four databases, including MEDLINE, EMBASE, Web of Science, and Cochrane Central Register of Controlled Trials, for articles up to February 2017. Articles were included if they were human clinical trials or case series reporting outcomes of GBR procedures with and without membrane exposure. A random-effects meta-analysis was conducted, and the weighted mean difference (WMD) between the two groups and 95% confidence interval (CI) were reported.Overall, eight articles were included in the quantitative analysis. The WMD of the horizontal bone gain at edentulous ridges was -76.24% (95% CI = -137.52% to -14.97%, p = .01) between sites with membrane exposure and without exposure. In addition, the WMD of the dehiscence reduction at peri-implant sites was -27.27% (95% CI of -45.87% to -8.68%, p = .004). Both analyses showed significantly favorable outcomes at the sites without membrane exposure.RESULTSOverall, eight articles were included in the quantitative analysis. The WMD of the horizontal bone gain at edentulous ridges was -76.24% (95% CI = -137.52% to -14.97%, p = .01) between sites with membrane exposure and without exposure. In addition, the WMD of the dehiscence reduction at peri-implant sites was -27.27% (95% CI of -45.87% to -8.68%, p = .004). Both analyses showed significantly favorable outcomes at the sites without membrane exposure.Based on the findings of this study, membrane exposure after GBR procedures has a significant detrimental influence on the outcome of bone augmentation. For the edentulous ridges, the sites without membrane exposure achieved 74% more horizontal bone gain than the sites with exposure. For peri-implant dehiscence defects, the sites without membrane exposure had 27% more defect reduction than the sites with exposure.CONCLUSIONBased on the findings of this study, membrane exposure after GBR procedures has a significant detrimental influence on the outcome of bone augmentation. For the edentulous ridges, the sites without membrane exposure achieved 74% more horizontal bone gain than the sites with exposure. For peri-implant dehiscence defects, the sites without membrane exposure had 27% more defect reduction than the sites with exposure. AimsThis review aimed at investigating the effect of membrane exposure on guided bone regeneration (GBR) outcomes at peri‐implant sites and edentulous ridges.Material and MethodsElectronic and manual literature searches were conducted by two independent reviewers using four databases, including MEDLINE, EMBASE, Web of Science, and Cochrane Central Register of Controlled Trials, for articles up to February 2017. Articles were included if they were human clinical trials or case series reporting outcomes of GBR procedures with and without membrane exposure. A random‐effects meta‐analysis was conducted, and the weighted mean difference (WMD) between the two groups and 95% confidence interval (CI) were reported.ResultsOverall, eight articles were included in the quantitative analysis. The WMD of the horizontal bone gain at edentulous ridges was −76.24% (95% CI = −137.52% to −14.97%, p = .01) between sites with membrane exposure and without exposure. In addition, the WMD of the dehiscence reduction at peri‐implant sites was −27.27% (95% CI of −45.87% to −8.68%, p = .004). Both analyses showed significantly favorable outcomes at the sites without membrane exposure.ConclusionBased on the findings of this study, membrane exposure after GBR procedures has a significant detrimental influence on the outcome of bone augmentation. For the edentulous ridges, the sites without membrane exposure achieved 74% more horizontal bone gain than the sites with exposure. For peri‐implant dehiscence defects, the sites without membrane exposure had 27% more defect reduction than the sites with exposure. This review aimed at investigating the effect of membrane exposure on guided bone regeneration (GBR) outcomes at peri-implant sites and edentulous ridges. Electronic and manual literature searches were conducted by two independent reviewers using four databases, including MEDLINE, EMBASE, Web of Science, and Cochrane Central Register of Controlled Trials, for articles up to February 2017. Articles were included if they were human clinical trials or case series reporting outcomes of GBR procedures with and without membrane exposure. A random-effects meta-analysis was conducted, and the weighted mean difference (WMD) between the two groups and 95% confidence interval (CI) were reported. Overall, eight articles were included in the quantitative analysis. The WMD of the horizontal bone gain at edentulous ridges was -76.24% (95% CI = -137.52% to -14.97%, p = .01) between sites with membrane exposure and without exposure. In addition, the WMD of the dehiscence reduction at peri-implant sites was -27.27% (95% CI of -45.87% to -8.68%, p = .004). Both analyses showed significantly favorable outcomes at the sites without membrane exposure. Based on the findings of this study, membrane exposure after GBR procedures has a significant detrimental influence on the outcome of bone augmentation. For the edentulous ridges, the sites without membrane exposure achieved 74% more horizontal bone gain than the sites with exposure. For peri-implant dehiscence defects, the sites without membrane exposure had 27% more defect reduction than the sites with exposure.
Author	Lin, Guo‐Hao Garcia, Jeffrey Luepke, Paul Wang, Hom‐Lay Dodge, Austin Kapila, Yvonne
Author_xml	– sequence: 1 givenname: Jeffrey surname: Garcia fullname: Garcia, Jeffrey organization: Marquette University School of Dentistry – sequence: 2 givenname: Austin surname: Dodge fullname: Dodge, Austin organization: Marquette University School of Dentistry – sequence: 3 givenname: Paul surname: Luepke fullname: Luepke, Paul organization: Marquette University School of Dentistry – sequence: 4 givenname: Hom‐Lay orcidid: 0000-0003-4238-1799 surname: Wang fullname: Wang, Hom‐Lay organization: University of Michigan School of Dentistry – sequence: 5 givenname: Yvonne surname: Kapila fullname: Kapila, Yvonne organization: University of California San Francisco – sequence: 6 givenname: Guo‐Hao orcidid: 0000-0003-1290-9994 surname: Lin fullname: Lin, Guo‐Hao email: ghlin@umich.edu, guo-hao.lin@ucsf.edu organization: University of California San Francisco
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Snippet	Aims This review aimed at investigating the effect of membrane exposure on guided bone regeneration (GBR) outcomes at peri‐implant sites and edentulous ridges.... This review aimed at investigating the effect of membrane exposure on guided bone regeneration (GBR) outcomes at peri-implant sites and edentulous ridges.... AimsThis review aimed at investigating the effect of membrane exposure on guided bone regeneration (GBR) outcomes at peri‐implant sites and edentulous... This review aimed at investigating the effect of membrane exposure on guided bone regeneration (GBR) outcomes at peri-implant sites and edentulous...
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SubjectTerms	Alveolar Ridge Augmentation Augmentation Bone growth Bone Regeneration Bone Transplantation Clinical trials Confidence intervals Databases, Factual Dehiscence Dental Implantation, Endosseous evidence‐based dentistry Exposure Guided Tissue Regeneration, Periodontal - methods Humans Literature reviews Medical research Membranes, Artificial Meta-analysis Mouth, Edentulous Quantitative analysis Regeneration Regeneration (physiology) review surgical wound dehiscence Treatment Outcome Wound Healing
Title	Effect of membrane exposure on guided bone regeneration: A systematic review and meta‐analysis
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