Vertical ridge augmentation using a membrane technique associated with osseointegrated implants

The purpose of this study was to evaluate: (1) the surgical protocol, effectiveness, and reliability for vertical ridge augmentation using a new titanium-reinforced membrane and osseointegrated implants; and (2) the histologic characteristics of the interface between a pure titanium implant and newly regenerated human bone. Five patients received 15 conical Brånemark-type implants in six different surgical sites requiring vertical augmentation. The implants protruded 4 to 7 mm from the bone crest. Pure titanium miniscrews (1.3 x 10 mm) were positioned distally to the implants, protruding 3 to 4 mm from the bone level. The implants and the miniscrews were covered with a titanium-reinforced membrane, and the flaps were sutured. Membranes were removed at the stage 2 surgery after 9 months of healing. Measurements of biopsy specimens showed a gain in bone height from 3 to 4 mm. Histologic examination showed that all retrieved miniscrews were in direct contact with bone. Histomorphometric analysis of bone contact gave a mean value of 42.5 ± 3.6% for five of the six examined miniscrews. The results suggest that the placement of implants protruding 3 to 4 mm from the top of resorbed bone surfaces may result in vertical bone regeneration to the top of the implant cylinder and that the regenerated bone is able to osseointegrate pure titanium implants.