Management of 80 Complications in Vertical and Horizontal Ridge Augmentation with Nonresorbable Membrane (d-PTFE): A Cross-Sectional Study

Purpose: Vertical and horizontal guided bone regeneration with nonresorbable membranes is a regenerative alternative for treating bone defects in edentulous zones. Its indication and good outcomes have been confirmed by different authors; however, this procedure remains highly technique sensitive and might lead to complications. The purpose of this study was to describe the management of complications such as exposures and infections following vertical and horizontal guided bone regeneration with titaniumreinforced high-density polytetrafluoroethylene (d-PTFE) nonresorbable membranes carried out using a new management protocol for complications related to this type of membrane. Materials and Methods: Complications in vertical and horizontal guided bone regeneration were evaluated by the same surgeon in a private practice between 2010 and 2017. They were classified and managed according to whether they were exposures and/or infections, and also according to their size, sagittal location, and coronal position of the alveolar ridge of the exposures. Descriptive analyses were conducted to evaluate the influence of age, sex, clinical characteristics of the complication, time of appearance, location, membrane size, anatomical and sagittal location, pink ceramic use, and definitive restoration, both before and after management protocol application. Results: Eighty complications were evaluated. The sextant with the highest number of complications was the anterior maxilla (35/80, 43.75%), followed by the mandibular left side area (16/80, 20.00%). The majority (56/80, 70.00%) of all complications appeared before 2 months. In relation to the sagittal location of exposures, 43.64% (24/55) were located coronal to the alveolar ridge. Statistically significant differences were found between exposures with or without purulent exudate, related to the coronal location of the exposure (P .05). Conclusion: A new protocol for managing complications with titanium-reinforced high-density PTFE nonresorbable membranes is proposed based on the follow-up of 80 complications. These steps can help prevent total graft loss, allowing patients to reach final rehabilitation without multiple additional surgeries. Infections continue to be the most common cause of bone loss in guided bone regeneration. Long-term results and follow-up studies are necessary to assess the stability of soft and hard tissues in patients rehabilitated using this complication management protocol. Keywords: complications, d-PTFE membrane, nonresorbable membrane, vertical ridge augmentation