Collagen Membrane Fixation Technique Affects Its Space Maintenance Capacity After Flap Closure: An Ex Vivo Analysis

doi:10.1111/clr.70146

AutoresMuhammad H. A. Saleh, Javier Calatrava, Nataly Rabelo Mina Zambrana, Lucrezia Parma‐Benfenati, Hamoun Sabri, István Urbán, Hom‐Lay Wang

Por qué importa

Este estudio ex vivo investigó cómo diferentes técnicas de fijación de membranas de colágeno afectan la estabilidad del injerto óseo en defectos alveolares no contenidos tras el cierre del colgajo. Se compararon la ausencia de fijación, suturas periósticas y pines de titanio. Los resultados indican que la fijación, especialmente con pines de titanio, ofrece una resistencia significativamente mayor al desplazamiento del injerto comparada con la no fijación o las suturas periósticas. La falta de fijación resultó en una pérdida considerable del volumen del injerto. Esta evidencia subraya la importancia crítica de una fijación adecuada de la membrana para el éxito de la regeneración ósea guiada en defectos de difícil manejo, impactando directamente en la planificación y ejecución de procedimientos de aumento alveolar previos a la implantología.

Abstract original

AIMS: To quantify immediate graft displacement following tension-free flap closure in non-contained alveolar ridge defects regenerated using three membrane fixation strategies in an ex vivo human model. METHODS: Eighteen sites from six fresh cadaveric heads with non-contained defects underwent horizontal guided bone regeneration using deproteinized bovine bone mineral and a collagen membrane stabilized by no fixation (NF), periosteal sutures (PS), or titanium fixation pins (FP). Techniques were applied sequentially. Cone-beam CT scans were obtained at baseline, post-grafting, and after passive closure. Linear ridge width was measured at 12 standardized positions, and graft volumes were segmented from STL reconstructions. Mixed-effects multilevel linear regression assessed width changes, while Friedman and paired Wilcoxon tests evaluated volumetric outcomes, with Tukey-adjusted contrasts for intergroup comparisons. RESULTS: ; 44.4% ± 17.9%) (loss p = 0.030; stability p = 0.002). Ridge collapse was greatest with no fixation (-1.37 ± 0.85 mm) compared with PS (-0.40 ± 0.62 mm) and FP (-0.28 ± 0.61 mm). After adjustment, PS and FP reduced collapse by 0.96 mm (p = 0.012) and 1.11 mm (p = 0.004), respectively. CONCLUSION: Even after passive flap release and tension-free closure, membrane fixation, particularly with titanium pins, provides superior resistance to graft displacement in non-contained defects, while unfixed membranes allow substantial graft loss and are therefore not recommended in non-contained defects.

Leer texto completo ↗DOI · 10.1111/clr.70146

Autor Doctor&Cols

Javier Calatrava Serrano de Haro
Cirugía Oral e Implantología

Cómo citar

Saleh MHA, Calatrava J, Zambrana NRM, Parma‐Benfenati L, Sabri H, Urbán I, et al. Collagen Membrane Fixation Technique Affects Its Space Maintenance Capacity After Flap Closure: An Ex Vivo Analysis. Clinical Oral Implants Research. 2026. doi:10.1111/clr.70146