Resorbable magnesium metal membrane for sinus lift procedures: a case series.

BACKGROUND: The purpose of this case series was to demonstrate the use of a magnesium membrane for repairing the perforated membrane in both direct and indirect approaches, as well as its application in instances where there has been a tear of the Schneiderian membrane. CASE PRESENTATION: The case series included four individual cases, each demonstrating the application of a magnesium membrane followed by bone augmentation using a mixture of xenograft and allograft material in the sinus cavity. In the first three cases, rupture of Schneiderian membrane occurred as a result of tooth extraction, positioning of the dental implant, or as a complication during the procedure. In the fourth case, Schneiderian membrane was perforated as a result of the need to aspirate a polyp in the maxillary sinus. In case one, 10 mm of newly formed bone is visible four months after graft placement. Other cases showed between 15 and 20 mm of newly formed alveolar bone. No residual magnesium membrane was seen on clinical inspection. The vertical and horizontal augmentations proved stable and the dental implants were placed in the previously grafted sites. CONCLUSION: Within the limitations of this case series, postoperative clinical examination, and panoramic and CBCT images demonstrated that resorbable magnesium membrane is a viable material for sinus lift and Schneiderian membrane repair. The case series showed successful healing and formation of new alveolar bone with separation of the oral cavity and maxillary sinus in four patients.

Longitudinal implant stability measurements based on resonance frequency analysis after placement in healed or regenerated bone.

Primary stability is an indicator of subsequent osseointegration of dental implants. However, few studies have compared the implant stability among anatomical regions and bone types; thus, not enough data exist regarding the stability of implants placed in regenerated bone (RB). The present study evaluated primary and long-term stability of implants placed in RB and non-regenerated healed bone (HB). A total of 216 screw cylinder implants were placed in 216 patients (98 in HB and 118 in RB, 6 [RB6, N = 68] or 12 [RB12, N = 50] months after tooth extraction). Implant stability was evaluated using resonance frequency analysis (RFA) measured at the time of implant placement (E1), at the time of loading (4 months after placement, E2), and 4 months after loading (E3). Various clinically relevant measurements were obtained, such as implant diameter, length, and location, as well as bone quality. At E1, implant location, bone quality, and experimental group significantly affected implant stability (all at P < .05). At E2, implant location, diameter, length, and experimental group significantly affected implant stability (all at P < .05). At E3, bone quality, implant diameter, length, and experimental group significantly affected implant stability (all at P < .01). Stability for the RB12 group was significantly higher than all other corresponding values; further, the values did not change significantly over time. For the HB and RB6 groups, stability was significantly higher at E2 than at E1 (P < .001) and was no different between E2 and E3. Implant location, length, and experimental group were associated with these differences (all at P < .05). Compared with HB and RB6, higher implant stability may be achieved in regenerated bone 12 months post-extraction (RB12). This stability was achieved at E1 and maintained for at least 8 months. Variables such as implant length, diameter, and bone quality affected the stability differently over time. Implant stability varied in different anatomic regions and with regard to different healing processes in the bone.

Application of Biodegradable Magnesium Membrane Shield Technique for Immediate Dentoalveolar Bone Regeneration.

For the first time, the clinical application of the first CE registered magnesium membrane is reported. Due to the material characteristics of magnesium metal, new treatment methodologies become possible. This has led to the development of a new technique: the magnesium membrane shield technique, used to rebuild the buccal or palatal walls of compromised extraction sockets. Four clinical cases are reported, demonstrating the handling options of this new technique for providing a successful regenerative outcome. Using the technique, immediate implant placement is possible with a provisional implant in the aesthetic zone. It can also be used for rebuilding both the buccal and palatal walls simultaneously. For instances where additional mechanical support is required, the membrane can be bent into a double layer, which additionally provides a rounder edge for interfacing with the soft tissue. In all reported clinical cases, there was a good bone tissue regeneration and soft tissue healing. In some instances, the new bone had formed a thick cortical bone visible in cone beam computed tomography (CBCT) radiographs of the regenerated sites, which is known to be remodeled in the post treatment period. Overall, the magnesium membrane shield technique is presented as an alternative treatment option for compromised extraction sockets.

Biodegradable magnesium barrier membrane used for guided bone regeneration in dental surgery.

Barrier membranes are commonly used as part of the dental surgical technique guided bone regeneration (GBR) and are often made of resorbable collagen or non-resorbable materials such as PTFE. While collagen membranes do not provide sufficient mechanical protection of the covered bone defect, titanium reinforced membranes and non-resorbable membranes need to be removed in a second surgery. Thus, biodegradable GBR membranes made of pure magnesium might be an alternative. In this study a biodegradable pure magnesium (99.95%) membrane has been proven to have all of the necessary requirements for an optimal regenerative outcome from both a mechanical and biological perspective. After implantation, the magnesium membrane separates the regenerating bone from the overlying, faster proliferating soft tissue. During the initial healing period, the membrane maintained a barrier function and space provision, whilst retaining the positioning of the bone graft material within the defect space. As the magnesium metal corroded, it formed a salty corrosion layer and local gas cavities, both of which extended the functional lifespan of the membrane barrier capabilities. During the resorption of the magnesium metal and magnesium salts, it was observed that the membrane became surrounded and then replaced by new bone. After the membrane had completely resorbed, only healthy tissue remained. The in vivo performance study demonstrated that the magnesium membrane has a comparable healing response and tissue regeneration to that of a resorbable collagen membrane. Overall, the magnesium membrane demonstrated all of the ideal qualities for a barrier membrane used in GBR treatment.

Biodegradable magnesium fixation screw for barrier membranes used in guided bone regeneration.

An ideal fixation system for guided bone (GBR) regeneration in oral surgery must fulfil several criteria that includes the provision of adequate mechanical fixation, complete resorption when no longer needed, complete replacement by bone, as well as be biocompatible and have a good clinical manageability. For the first time, a biodegradable magnesium fixation screw made of the magnesium alloy WZM211 with a MgF2 coating has been designed and tested to fulfill these criteria. Adequate mechanical fixation was shown for the magnesium fixation screw in several benchtop tests that directly compared the magnesium fixation screw with an equivalent polymeric resorbable device. Results demonstrated slightly superior mechanical properties of the magnesium device in comparison to the polymeric device even after 4 weeks of degradation. Biocompatibility of the magnesium fixation screw was demonstrated in several in vitro and in vivo tests. Degradation of the magnesium screw was investigated in in vitro and in vivo tests, where it was found that the screw is resorbed slowly and completely after 52 weeks, providing adequate fixation in the early critical healing phase. Overall, the magnesium fixation screw demonstrates all of the key properties required for an ideal fixation screw of membranes used in guided bone regeneration (GBR) surgeries.

Custom base preaging in indirect bonding.

This in vitro evaluation analyzed the influence of custom base composite age on bond strength in indirect bonding. One hundred fifty permanent bovine mandibular incisors were randomly divided into 10 groups of 15 specimens each. Stainless steel brackets were bonded to the teeth using the Thomas indirect bonding technique using two different custom base composite-sealant combinations: (1) chemically cured Phase II composite and chemically cured Custom I.Q. sealant, and (2) light-cured Transbond XT composite and chemically cured Sondhi Rapid Set sealant. The composite custom bases were preaged for 24 hours and for seven, 15, 30, and 100 days. Shear bond strength tests for the two composite-sealant combinations showed no significant differences. Preaging of the custom base composite up to 30 days did not affect shear bond strength, and mean bond strength values exceeded 15 MPa in these groups. However, bond strength measurements for groups with a custom composite base aged for a longer interval (100 days) before sealant polymerization were significantly lower. On the basis of the results of this study, clinicians can safely use custom base composites aged up to 30 days when using the Thomas indirect bonding technique.